Archives of Pediatric Infectious Diseases
Volume:4 Issue: 4, Oct 2016

Context: A postnasal drip (PND) or catarrh refers to the drainage of secretions from the paranasal sinuses or nose into the posterior nasal space and the oropharynx. A history of pharyngeal or postnasal mucus build-up may be at odds with the lack of other physical findings and the absence of systematic clinical data. The physiological basis and suitable treatments for PND have been insufficiently recorded in the medical literature. However, Iranian traditional medicine (ITM), which has a history of thousands of years, has discussed in detail the causes, origins, complications, and treatment of catarrh. Communication and cooperation between conventional and traditional medicine can lead to positive steps in solving the ambiguities related to catarrh. The present paper examines the origin of catarrh according to Avicenna and compares it with that described in conventional medicine..
Evidence Acquisition: In this study, we examined a major resource of ITM, the Qanoon fi al-teb (The Canon of medicine), by Avicenna and the writings of prominent ancient scholars and physicians on the origins of catarrh. PubMed and Google scholar were also searched for information on PND and catarrh, and they were compared with the catarrh in ITM..
Physicians of ITM believe that the main substance in catarrh is discharged from the brain and that it is a connection between the brain and nasopharyngeal space. New scientific findings also confirm the relationship between cerebrospinal fluid (CSF) and catarrh, in common with that described by Avicenna thousands of years ago..
Catarrh is a serious condition and requires more investigation. It is hoped that a joint study of conventional and traditional medicine can elucidate different aspects of catarrh.

Congenital pulmonary lesions may be diagnosed through ultrasonographic screenings or be revealed as causes of respiratory distress in the neonatal period and infancy. Less commonly, they are detected as incidental features..
Our study represents the diversity of congenital pulmonary lesions and their characteristics during an 11-year period in a referral teaching children’s hospital in Tehran, the capital city of Iran..
Data from an 11-year period of patients with the final diagnosis of congenital pulmonary lesions in Mofid Children’s hospital were reviewed. The data included the prenatal ultrasonographic, postnatal radiographic, and pathologic diagnoses, along with the patient’s age, way of presentation, length of hospitalization, and accompanying features and morbidities..
Of 37 cases of congenital pulmonary lesions, 28 cases (75%) were boys. Thirty-six cases (97.2%) presented with pure pulmonary signs and symptoms. Of these cases, 16 (43.2%) were neonates, 17 (46%) were infants, and 4 (10.8%) were children. Twenty-seven (73%) patients missed the opportunity for early diagnosis. In order of frequency, cases were diagnosed as congenital lobar emphysema (43.5%), congenital cystic adenomatoid malformation (32.5%), pulmonary sequestration (19%), hybrid lesion (2.5%), or bronchogenic cyst (2.5%)..
In an analysis of retrospective data of 37 congenital pulmonary lesions, male predominance was obvious, as has been found in previous studies..

Procalcitonin (PCT) levels are increased in sepsis. In most previously conducted research, PCT levels were found to increase during septic shock..
The purpose of this study was to compare PCT levels with CRP and ESR levels in children with systemic inflammatory response syndrome (SIRS), sepsis, and septic shock..
This cross-sectional study was conducted between December 2011 and December 2012 on 84 children between 3 months and 13 years old admitted in pediatric and PICU wards. The required venous samplings were taken during their hospitalization prior to antibiotic therapy. Urine and CSF fluid cultures were analyzed in specific cases. Patients treated with intravenous antibiotics during the week prior to admission were not included in the study..
Due to incomplete information, a total of 81 children were examined; of them, 31 were suffering from SIRS (36.9%), 27 had sepsis (32.1%), 10 had undergone septic shock (11.9%), and 13 had positive cultures (15.5%). PCT levels were higher than 0.5 ng/mL in 57.1% of the patients, CRP levels were higher than 10 mg/L in 71.4% of the patients, and ESR levels were higher than 20 mm/h in 69% of the patients. In our study, a moderate correlation was found between PCT and CRP levels. However, there was a poor correlation between PCT and ESR levels..
PCT levels are a faster and more reliable marker of inflammation than ESR or CRP levels. However, since PCT tests are expensive, CRP levels are preferable to study in differentiating the three stages of infection..

Although Campylobacter strains are one cause of acute bacterial gastroenteritis, their clinical and laboratory findings have only been examined in a few studies..
This study was performed to evaluate the frequency level as well as the clinical and laboratory findings of patients with acute gastroenteritis caused by Campylobacter..
Patients and In this cross-sectional study, 419 Iranian children in Semnan city with acute gastroenteritis were assessed for their clinical and laboratory findings, including fever, abdominal pain, vomiting, dehydration, the presence of red blood cells and white blood cells (WBCs) in the stool, and leukocytosis. After being prepared for testing, a sample of the patient’s stool was also examined for the presence of Campylobacter strains through microscopic examination, culture, and chemical reactions..
There were 36 positive cultures (8.6%) for Campylobacter, with frequencies of 6.4% and 10.3% for boys and girls, respectively (P = 0.16). The highest frequency of positive culture belonged to the age group over six years (P = 0.02). The most common findings associated with Campylobacter diarrhea included abdominal pain (77.8% vs.1 8.8%, P This study showed that abdominal pain, fever, leukocytosis, and WBCs in the stool were associated with gastroenteritis infection caused by Campylobacter..

Langerhans cell histiocytosis (LCH) is a rare histiocytic proliferative disorder of unknown etiology that mainly affects young children. The histological feature is the granuloma-like proliferation of Langerhans-type dendritic cells. The possible role of viruses such as Epstein-Barr virus (EBV, HHV-4), human herpesvirus-6 (HHV-6), herpes simplex virus (HSV) types 1 and 2, and cytomegalovirus (CMV, HHV-5) in the pathogenesis of LCH has been suggested in some studies; however, this still remains under debate..
HHV-6 infections are reported to be associated with LCH, but no such reports could be found on Iranian children in the English-language medical literature. This study investigated the presence of HHV-6 in Iranian children with LCH..
In this retrospective study, we investigated the presence of HHV-6 DNA in 48 patients with LCH, using paraffin-embedded tissue samples, and in 48 controls (age- and tissue-matched) using the nested polymerase chain reaction (nested PCR) method. The patients had been treated at the Department of Pediatric Pathology from 2002 - 2013 and had undergone operations for reasons other than infectious disease. Only the pathology reports were retrospectively reviewed, and the patients were anonymous..
There was no significant difference in the prevalence of HHV-6 detection between the LCH patients and the control subjects. HHV-6 was found by nested PCR in one (2.1%) of the 48 LCH patients and in six (12.5%) of the 48 control cases. P = 0.11 was calculated using Fisher’s exact test (OR: 0.15; 95%CI: 0.02 - 1.29)..
Our study is the first to investigate patients with LCH and its possible association with HHV-6 in Iran. Considering the P level of 0.11, which is statistically insignificant, our findings fail to support the hypothesis of a possible role for HHV-6 in the pathogenesis of LCH. These results are in concordance with previous investigations showing negative results..

Methicillin-resistant Staphylococcus aureus (MRSA) is considered one of the most important pathogenic bacteria and most prevalent pathogens causing dangerous infections in humans..
The purpose of this study was to analyze the hypervariable region (HVR) diversity of clinical MRSA isolates in Tabriz, northwestern Iran..
In this retrospective and descriptive study, from Staphylococcus aureus strains isolated from clinical specimens of hospitalized patients from 2006 to 2013 at Tabriz health centers, 151 isolates were randomly selected. Methicillin-resistant isolates were identified by the agar disk diffusion method and mecA PCR assays. The genetic diversity of the isolates in the HVR were analyzed with the HVR typing method..
According to the antibiogram test results, from 151 samples, 52 isolates (34.4%) were resistant to cefoxitin. However, based on the polymerase chain reaction (PCR) assay, 54 isolates (35.8%) had the mecA gene and were identified as MRSA strains. According to PCR of the mec HVR, these MRSA strains were classified into seven different genotypes of HVR groups..
High HVR diversity among the studied MRSA isolates could be a result of insufficient or inadequate infection-control protocols in Tabriz hospitals. Moreover, the high number of HVR genotypes showed that HVR typing can be used along with other typing methods in epidemiological studies of MRSA as a useful tool for monitoring, tracking contaminations, and controlling infections in hospital settings..

It is estimated that survival of children with perinatally transmitted acquired immunodeficiency syndrome (AIDS) in Brazil is around 60 months, and an upward trend has been shown over recent years. The reduction in mortality rates in Brazilian children is mainly attributed to the effectiveness of antiretroviral therapy..

The aim of this study was to characterize the epidemiological profile and survival rates among children diagnosed with AIDS in the state of Santa Catarina, Brazil..

This was a retrospective cohort study of survival in children aged under 13 years who were reported to have human immunodeficiency virus (HIV) infection in the state of Santa Catarina between 1988 and 2013. The cases were selected from the records of HIV infection cases reported by the Information System for Notifiable and by the Mortality Information System of Santa Catarina, Brazil..

We studied 990 children whose median age at diagnosis was 26 months. Among those who died, the survival time after diagnosis was 39.7 months on average, with a median of 16 months. Children’s mean age at death attributed to AIDS was 73.8 months, with a median of 55 months. Of the 990 surveyed children, the median survival time was 263 months, and 14.7% died of AIDS. The chance of survival at 60 months was estimated to be 88.1%..

The studied indicators suggest that the AIDS epidemic in children showed a decreasing tendency in terms of the incidence and mortality rates with tendency, along with an unexpected growth trend in lethality rate in the last period..

The accurate diagnosis and management of febrile urinary tract infection (UTI) is a clinical challenge in the absence of specific clinical and laboratory findings in infants and young children..
The aim of this study was to identify and compare the diagnostic and therapeutic implications of recently introduced cytokines for the diagnosis of acute pyelonephritis (APN)..
This multicenter prospective study was performed on 37 (female/male = 6.5:1) children with symptomatic culture-proven APN and 37 (female/male = 1.6/1) age-matched febrile children without UTIs as the control group. Urine samples were obtained before antibiotic treatment in both groups and 3 - 4 days after treatment in the UTI group, and evaluated for interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor-α (TNFα), monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF) using an ELISA immunoassay kit..
Mean urinary IL-1α, IL-4, IL-6, and IL-8 concentrations significantly increased in the acute phase of APN compared to the control group, and decreased following antibiotic treatment..
We recommend routine urinalysis and urine culture for the diagnosis of children with APN. Urinary IL-4 was a relatively good cytokine for the prediction and treatment-monitoring of children with acute febrile UTI..

Kawasaki disease (KD) is the most important cause of ischemic heart disease in children. Its pathogenesis is not well understood, but geographic, ethnic and familial pattern of this syndrome is reported. Ischemic heart disease (IHD) in parents can be the result of KD in their children. This is a study on the prevalence of IHD in parents of children with severe and non-severe Kawasaki disease..
The current study aimed to estimate the prevalence of IHD in the families of children with KD..
Patients and Sixty-one children with Kawasaki disease were admitted from December 21, 2004 to January 21, 2008to Mofid Children Hospital (from one month to thirteen-year old) and 50 patients entered the study. Subjects were divided into the severe (24subjects) and non-severe (26 subjects) groups. All of the parents were called for investigation. Data were analyzed by SPSS ver. 21 software..
Thirty-two (64%) subjects were male and 18(36%) were female.(1.8/1), mean age of children was 43 ± 33.1 months, and mean age in the severe and non-severe groups were 53.48 ± 37.26 and 32.19 ± 25.76 month, respectively (CI = 2-38.2, P = 0.02). History of IHD was more common in fathers of children in the severe Kawasaki disease group (P = 0.001) with no mean age difference between them. History of cardiac drug usage and hypertension was more common in the severe Kawasaki group (P = 0.009 and P = 0.046)..
Results of the current study revealed higher incidence of IHD in fathers of the subjects with severe KD. More investigation of genetic predisposition to Kawasaki disease acquisition is recommended..

Kawasaki disease (KD) is an acute febrile illness of childhood that can lead to significant coronary artery abnormalities, particularly in untreated patients. Diagnosis of KD is made in the presence of its standard criteria, including bilateral conjunctivitis. Some patients do not fulfill the diagnostic criteria and are known as atypical KD..
In this report, we describe a 12-year-old boy presenting with prolonged fever, unilateral conjunctivitis, ipsilateral preauricular lymphadenopathy, skin rashes, and finger scaling. The initial evaluation for KD was negative, so he received gentamycin as a case of oculoglandular syndrome. The fever subsided, but he developed bilateral conjunctivitis later in course of the disease. A second echocardiograph revealed coronary artery dilation. He immediately received intravenous immunoglobulin (IVIG) and aspirin and was discharged from hospital with a recommendation of close follow-up..
To our knowledge, KD presenting with unilateral conjunctivitis and oculoglandular syndrome is not reported to date. G iven that delay in diagnosis and treatment of KD can cause serious cardiac complications, the diagnosis of Kawasaki disease should be considered in such cases..