It has been more than 3 years since the novel coronavirus(SARS-CoV-2)pandemic raged globally.The coronavirus disease 2019(COVID-19)has greatly influenced human society.According to data from the World Health Organizat...It has been more than 3 years since the novel coronavirus(SARS-CoV-2)pandemic raged globally.The coronavirus disease 2019(COVID-19)has greatly influenced human society.According to data from the World Health Organization(WHO),there were over 656 million confirmed cases of COVID-19 in the world as of January 1,2023,including over 6.6 million deaths[1].展开更多
Background Chronic active Epstein-Barr virus infection (CAEBV) has been previously reported to be sometimes associated with an aggressive clinical course. The characteristics of CAEBV in Mainland Chinese pediatric p...Background Chronic active Epstein-Barr virus infection (CAEBV) has been previously reported to be sometimes associated with an aggressive clinical course. The characteristics of CAEBV in Mainland Chinese pediatric patients are largely unreported. The main aims of this survey were to recognize the clinical features of CAEBV in children and to explore its diagnostic criteria and risk factors. Methods A retrospective study was performed on 53 pediatric patients (36 boys and 17 girls) with CAEBV who were admitted to Beijing Children's Hospital between 2003 and 2007. All their medical records were reviewed and analyzed. For each patient, demographic, clinical, laboratory data and outcome were collected. Independent-samples t test was used for statistical analysis. Results The age at onset of CAEBV was from 2 months to 14.6 years (mean (5.3_+3.3) years). At the time of onset, 43.4% patients had an infectious mononucleosis-like symptom. Most patients exhibited intermittent fever (92.5%, 49/53), hepatomegaly (81.1%, 43/53) and splenomegaly (77.4%, 41/53). Life-threatening complications including hemophagocytic syndrome (24.5%,13/53), interstitial pneumonia (24.5%, 13/53), hepatic failure (15.1%, 8/53) and malignant lymphoma (11.3%, 6/53) were also observed. The serum EBV DNA level in 23 patients with CAEBV was in the range of 5.05×10^2-4.60×10^6 copies/ml with a mean value of 103.7 copies/ml. Many patients with CAEBV generally had continuous symptoms during the observational period. Eleven out of 42 patients (26.2%) died 7 months to 3 years after onset. Deceased patients were more likely to have had lower platelet counts and albumin levels than the living patients (P 〈0.05 for all comparisons). Conclusions The study reveals that CAEBV in Chinese pediatric patients has a severe clinical course and prognosis is poor. Thrombocytopenia and decreases in albumin might potentially be risk factors for a poor prognosis. EBV loads should be measured and tissue should be stained on hybridization probes for EBV-encoded small RNA (EBER) if a patient presents with the known symptoms of CAEBV.展开更多
Background Herpangina is a common infectious disease in childhood caused by an enterovirus.This consensus is aiming to standardize and improve herpangina prevention and clinical diagnosis.Methods The Subspecialty Grou...Background Herpangina is a common infectious disease in childhood caused by an enterovirus.This consensus is aiming to standardize and improve herpangina prevention and clinical diagnosis.Methods The Subspecialty Group of Infectious Diseases,the Society of Pediatric,Chinese Medical Association and Nation Medical Quality Control Center for Infectious Diseases gathered 20 experts to develop the consensus,who are specialized in diagnosis and treatment of herpangina.Results The main pathogenic serotypes of herpangina include Coxsackievirus-A,Enterovirus-A and Echovirus.Its diagnosis can be rendered on the basis of history of epidemiology,typical symptoms,characteristic pharyngeal damage and virological tests.The treatment is mainly symptomatic,and incorporates topical oral spray with antiviral drugs.The course of herpangina generally lasts 4-6 days with a good prognosis.Conclusion The consensus could provide advices and references for the diagnosis,treatment and management of herpangina in children.展开更多
Importance:Central nervous system infection is a severe illness in children.Little is known about the long-term outcome in children with central nervous system infection of various etiologies.Objective:The aims of thi...Importance:Central nervous system infection is a severe illness in children.Little is known about the long-term outcome in children with central nervous system infection of various etiologies.Objective:The aims of this study were to investigate the long-term outcomes of childhood acute central nervous system infection and to examine possible prognostic factors.Methods:Of 172 children who were treated for acute central nervous system infection from January 2009 through December 2009,139 were eligible for follow-up evaluations.A structured interview was conducted with the parents 3.8-4.7 years after hospital discharge.The global outcome was determined in all patients using the Pediatric Version of the Glasgow Outcome Scale-Extended.Clinical features of the acute episode were retrieved from medical records.Results:The outcome was favorable in 109 of 139 patients (78%),38 (27%) were mildly impaired,six (4%) were moderately impaired,14 (10%) were severely impaired and two (1%) were in a vegetative state.There were eight deaths.The most frequent symptoms were difficulty concentrating (16%),epilepsy (12%),limb paralysis (12%),memory impairment (10%),speech disorders (9%),irritability (9%).Significant risk factors for epilepsy included the presence of recurrent seizures or status epilepticus,the existence of pure spikes in the electroencephalogram,brain parenchyma abnormalities on neuroimaging and herpes simplex virus encephalitis (HSVE).A multivariate analysis identified three factors that were independently associated with poor outcome:coma,brain parenchyma abnormalities on neuroimaging and HSVE.Interpretation:Most children with acute central nervous system infection experienced a favorable outcome 3.8-4.7 years after discharge from the hospital.Minor to severe disability persists in a high proportion of cases.Coma,brain parenchymal abnormalities on neuroimaging and HSVE may predict poor long-term outcome.展开更多
The World Health Organization(WHO)announced COVID-19 as a global pandemic in March of 2020[1].The COVID-19 pandemic may persist for a long period of time.Global prevention and control becomes a complex and challenging...The World Health Organization(WHO)announced COVID-19 as a global pandemic in March of 2020[1].The COVID-19 pandemic may persist for a long period of time.Global prevention and control becomes a complex and challenging task,and such efforts should be sustained.Although general measures,such as social distancing,face masks,respiratory hygiene and hand sanitization,will bear fruits for decreasing spread of other respiratory illnesses including influenza,the specific prevention through vaccination is a key focus especially in the upcoming winter and spring seasons[2].展开更多
INTRODUCTION
Bacterial meningitis (BM) is a serious disease for children,and many patients have various complications and sequelae even after receiving antibacterial treatments.Moyamoya disease (MMD) is a cerebrovasc...INTRODUCTION
Bacterial meningitis (BM) is a serious disease for children,and many patients have various complications and sequelae even after receiving antibacterial treatments.Moyamoya disease (MMD) is a cerebrovascular disease characterized by bilateral stenosis/occlusion of the terminal portion of the internal carotid artery (ICA) and its main branches and by moyamoya vessels (abnormal vascular net) in the base of the brain.The etiology of MMD is unknown.Patients having similar cerebral vasculopathy with underlying diseases are described using the term moyamoya syndrome (MMS).1 Onset of MMS after BM is rare.Here,we report the case of a patient diagnosed with MMS 22 weeks after the onset of Streptococcus pneumoniae meningitis.This is the first reported pediatric case of MMS diagnosed after pneumococcal meningitis.展开更多
基金National Natural Science Foundation of China(72174138)High-level Public health Talents Training Program of Beijing Municipal Health Commission(2022-2-002).
文摘It has been more than 3 years since the novel coronavirus(SARS-CoV-2)pandemic raged globally.The coronavirus disease 2019(COVID-19)has greatly influenced human society.According to data from the World Health Organization(WHO),there were over 656 million confirmed cases of COVID-19 in the world as of January 1,2023,including over 6.6 million deaths[1].
基金This study was supported by the grants from Beijing Natural Science Foundation (No. 7072026) and the Scientific Research Program of Beijing Municipal Commission of Education (No. KM200710025023).Acknowledgments: We are grateful to Prof. ZHAORI Ge-tu for a critical reading of the manuscript. We are also grateful to the anonymous peer-reviewers whose constructive comments have significantly improved this paper.
文摘Background Chronic active Epstein-Barr virus infection (CAEBV) has been previously reported to be sometimes associated with an aggressive clinical course. The characteristics of CAEBV in Mainland Chinese pediatric patients are largely unreported. The main aims of this survey were to recognize the clinical features of CAEBV in children and to explore its diagnostic criteria and risk factors. Methods A retrospective study was performed on 53 pediatric patients (36 boys and 17 girls) with CAEBV who were admitted to Beijing Children's Hospital between 2003 and 2007. All their medical records were reviewed and analyzed. For each patient, demographic, clinical, laboratory data and outcome were collected. Independent-samples t test was used for statistical analysis. Results The age at onset of CAEBV was from 2 months to 14.6 years (mean (5.3_+3.3) years). At the time of onset, 43.4% patients had an infectious mononucleosis-like symptom. Most patients exhibited intermittent fever (92.5%, 49/53), hepatomegaly (81.1%, 43/53) and splenomegaly (77.4%, 41/53). Life-threatening complications including hemophagocytic syndrome (24.5%,13/53), interstitial pneumonia (24.5%, 13/53), hepatic failure (15.1%, 8/53) and malignant lymphoma (11.3%, 6/53) were also observed. The serum EBV DNA level in 23 patients with CAEBV was in the range of 5.05×10^2-4.60×10^6 copies/ml with a mean value of 103.7 copies/ml. Many patients with CAEBV generally had continuous symptoms during the observational period. Eleven out of 42 patients (26.2%) died 7 months to 3 years after onset. Deceased patients were more likely to have had lower platelet counts and albumin levels than the living patients (P 〈0.05 for all comparisons). Conclusions The study reveals that CAEBV in Chinese pediatric patients has a severe clinical course and prognosis is poor. Thrombocytopenia and decreases in albumin might potentially be risk factors for a poor prognosis. EBV loads should be measured and tissue should be stained on hybridization probes for EBV-encoded small RNA (EBER) if a patient presents with the known symptoms of CAEBV.
文摘Background Herpangina is a common infectious disease in childhood caused by an enterovirus.This consensus is aiming to standardize and improve herpangina prevention and clinical diagnosis.Methods The Subspecialty Group of Infectious Diseases,the Society of Pediatric,Chinese Medical Association and Nation Medical Quality Control Center for Infectious Diseases gathered 20 experts to develop the consensus,who are specialized in diagnosis and treatment of herpangina.Results The main pathogenic serotypes of herpangina include Coxsackievirus-A,Enterovirus-A and Echovirus.Its diagnosis can be rendered on the basis of history of epidemiology,typical symptoms,characteristic pharyngeal damage and virological tests.The treatment is mainly symptomatic,and incorporates topical oral spray with antiviral drugs.The course of herpangina generally lasts 4-6 days with a good prognosis.Conclusion The consensus could provide advices and references for the diagnosis,treatment and management of herpangina in children.
文摘Importance:Central nervous system infection is a severe illness in children.Little is known about the long-term outcome in children with central nervous system infection of various etiologies.Objective:The aims of this study were to investigate the long-term outcomes of childhood acute central nervous system infection and to examine possible prognostic factors.Methods:Of 172 children who were treated for acute central nervous system infection from January 2009 through December 2009,139 were eligible for follow-up evaluations.A structured interview was conducted with the parents 3.8-4.7 years after hospital discharge.The global outcome was determined in all patients using the Pediatric Version of the Glasgow Outcome Scale-Extended.Clinical features of the acute episode were retrieved from medical records.Results:The outcome was favorable in 109 of 139 patients (78%),38 (27%) were mildly impaired,six (4%) were moderately impaired,14 (10%) were severely impaired and two (1%) were in a vegetative state.There were eight deaths.The most frequent symptoms were difficulty concentrating (16%),epilepsy (12%),limb paralysis (12%),memory impairment (10%),speech disorders (9%),irritability (9%).Significant risk factors for epilepsy included the presence of recurrent seizures or status epilepticus,the existence of pure spikes in the electroencephalogram,brain parenchyma abnormalities on neuroimaging and herpes simplex virus encephalitis (HSVE).A multivariate analysis identified three factors that were independently associated with poor outcome:coma,brain parenchyma abnormalities on neuroimaging and HSVE.Interpretation:Most children with acute central nervous system infection experienced a favorable outcome 3.8-4.7 years after discharge from the hospital.Minor to severe disability persists in a high proportion of cases.Coma,brain parenchymal abnormalities on neuroimaging and HSVE may predict poor long-term outcome.
文摘The World Health Organization(WHO)announced COVID-19 as a global pandemic in March of 2020[1].The COVID-19 pandemic may persist for a long period of time.Global prevention and control becomes a complex and challenging task,and such efforts should be sustained.Although general measures,such as social distancing,face masks,respiratory hygiene and hand sanitization,will bear fruits for decreasing spread of other respiratory illnesses including influenza,the specific prevention through vaccination is a key focus especially in the upcoming winter and spring seasons[2].
文摘INTRODUCTION
Bacterial meningitis (BM) is a serious disease for children,and many patients have various complications and sequelae even after receiving antibacterial treatments.Moyamoya disease (MMD) is a cerebrovascular disease characterized by bilateral stenosis/occlusion of the terminal portion of the internal carotid artery (ICA) and its main branches and by moyamoya vessels (abnormal vascular net) in the base of the brain.The etiology of MMD is unknown.Patients having similar cerebral vasculopathy with underlying diseases are described using the term moyamoya syndrome (MMS).1 Onset of MMS after BM is rare.Here,we report the case of a patient diagnosed with MMS 22 weeks after the onset of Streptococcus pneumoniae meningitis.This is the first reported pediatric case of MMS diagnosed after pneumococcal meningitis.