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Neonates who develop fever have a high risk for serious infection, and while the standard of care involves performing a full sepsis evaluation, current guidelines do not include viral polymerase chain reaction (PCR) testing of the cerebrospinal fluid as a standard of care, which means that cases of viral meningitis can be missed. This case presentation discusses a neonate who had a fever at four days of life who then underwent a full sepsis evaluation. A respiratory viral panel demonstrated rhino/enterovirus positivity. A lumbar puncture was consistent with aseptic meningitis and newborn was prophylactically covered with acyclovir until the cerebrospinal fluid PCR confirmed enterovirus positivity and was negative for herpes simplex virus. The neonate experienced thrombocytosis and elevated transaminase levels, which resolved before discharge. Acyclovir was discontinued following a pediatric infectious disease consultation. The patient steadily improved, passed all screenings, and was discharged on day 16 with follow-up appointments arranged, including developmental pediatrics and repeat hearing screenings. Despite the viral panel indicating a respiratory virus, the presence of a respiratory virus in a neonate does not necessarily reduce the risk of a serious bacterial illness, especially in infants younger than 29 days. Viral meningitis can be associated with substantial complications and, so viral PCR testing of the cerebrospinal fluid allows clinicians to monitor for the development of severe disease and set up outpatient follow-ups for potential long-term sequelae of viral meningitis, such as neurodevelopmental delays., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Levy et al.)

Cystic fibrosis (CF) is a genetic disorder that profoundly affects the respiratory and digestive systems, particularly in pediatric patients. This comprehensive review aims to conduct a comparative analysis of various treatment modalities employed in the management of CF in children. We systematically evaluated current literature focusing on pharmacological interventions, airway clearance techniques, nutritional management, and emerging therapies, including gene therapy and personalized medicine. Our analysis highlights the efficacy, safety, and accessibility of these treatments through a comparative lens, examining performance across diverse patient populations. Key comparisons include standard therapies, such as CF transmembrane conductance regulator (CFTR) modulators, versus traditional treatments and the effectiveness of airway clearance techniques in relation to lung function outcomes. We explore variations in treatment adherence and outcomes based on socioeconomic factors and healthcare systems. The review underscores the importance of individualized care plans tailored to the unique needs of pediatric patients. By synthesizing findings from clinical studies, meta-analyses, and expert guidelines, this review serves as a valuable resource for healthcare providers and researchers. Our goal is to optimize therapeutic strategies for pediatric patients with CF and ultimately improve their clinical outcomes., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Lakhani et al.)

Polydactyly, which is the presence of an extra appendage on the hand or the foot, is a common congenital anomaly encountered in children. It may be an isolated finding or found in conjunction with other congenital anomalies and syndromes. Polydactyly can occur in the hands or the feet. In the hand, it may occur as radial polydactyly (pre-axial polydactyly) or ulnar polydactyly (post-axial polydactyly (PAP)). Depending upon the side of occurrence, it may be medial, that is, toward the little finger (called ulnar polydactyly) or lateral, that is, toward the thumb (called radial polydactyly). On the feet, the extra digit can either be present on the side of the great toe (called tibial polydactyly) or on the side of the little toe (called fibular polydactyly). In both the upper and the lower limbs, affection of the central three digits is called central polydactyly. Central tetrapolydactyly, which is the presence of an extra appendage on all four limbs, is much more rarely encountered. This case report describes a 15-month-old female child who presented with findings of six digits on all four limbs and deviation of the left angle of mouth since birth. Her echocardiography showed a large atrial septal defect measuring 7 mm, with a left-to-right shunt. This is the first such case reported from all over the world from a tertiary care hospital with the aforementioned findings. Polydactyly, a very common congenital anomaly, should not be ignored in pediatric settings. It is important to diagnose associated features such as congenital heart diseases (CHDs), genitourinary abnormalities, and orofacial abnormalities to facilitate timely surgical correction and help improve the quality of life of those affected., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Thorat et al.)

Objectives This study examines the practice patterns with respect to the technique of non-oral hydration of infants admitted with bronchiolitis at one Canadian tertiary care institution. Additionally, the authors assess the infants' parents' attitudes regarding hydration through a nasogastric (NG) tube instead of an intravenous (IV) line. Methods A retrospective chart review was conducted for all infants admitted with bronchiolitis from May 1, 2016, to April 30, 2018, with a focus on the method of hydration, investigation with chest radiography, and use of IV antibiotics. Parents of infants who received IV fluids during the admission were surveyed by mail to assess their perceptions surrounding their child's experience with IV fluid therapy as well as their attitudes toward NG hydration, particularly in cases of difficult IV access. Results Of the 101 hospitalized infants, 54 received IV fluids and four received NG fluids. Of the 54 eligible for the survey, 17 completed surveys were returned. Parents were likely to consider NG hydration if suggested by their pediatrician. The proportion was extremely or very likely to consider this intervention increased from 29% in a generic situation to 53% in a scenario where there was more than one unsuccessful IV attempt (p=0.03). Conclusions In the institution studied, NG hydration was rarely used. Parents seemed receptive to the idea of NG hydration as an alternative, particularly when IV access is difficult., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Saqib et al.)