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Acute tonsillopharyngitis is one of the most common infectious diseases in children. Viral etiology is the most common. Among bacterial causes, the main causative agent is Streptococcus pyogenes or group A beta-hemolytic Streptococcus, which causes about 30 % of episodes. Diphtheria and necroba­cillosis are infrequent but they are associated with severe course of disease. In the process of diagnosis, clinical evaluation scales can help clinicians better predict suspected bacterial etiology by selecting patients. The use of management algorithms may be useful for identifying and screening cases that do not require antibiotic therapy. Beta-lactam antibiotics or macrolides are recommended for the treatment of streptococcal tonsillopharyngitis. Proper diagnosis of bacterial tonsillopharyngitis and correct use of antibiotics based on available scientific evidence are crucial.

The article reviews the international practical recommendations and clinical experience of monitoring children born by mothers suffering from measles in different terms of pregnancy. The paper considers the international criteria for the diagnosis of congenital measles. The authors describe the experience of a clinical case of congenital measles during the outbreak in 2017–2018 in the Regional Pediatric Clinical Hospital.

Introduction. Recently, there are accumulated more data on the role of infection as a risk factor for wheezing syndrome, bronchial asthma (BA) and its exacerbations, which often calls for differential diagnosis with such complications, as pneumonia of bacterial or viral etiology. Objective of the study: in order to improve the diagnosis of bacterial inflammations of the airways in children of all ages to explore some results of the patients’ survey. Materials and methods. Comprehensively, we have examined 279 sick children, from infancy to the preschool age. The first (I) clinical group consisted of 100 infants, who were admitted to the hospital for community-acquired bacterial pneumonia (BP). The second (II) group included 56 children with asthma, in whom we have confirmed the bacterial nature of febrile asthma attacks. The third (III) group consisted of 46 BA patients with confirmed viral nature of febrile asthma exacerbations. The fourth (IV) group included 77 infants with acute respiratory viral infection (ARVI) in the form of acute bronchitis (45 children), bronchiolitis (15 cases) and viral pneumonia (17 patients). Results and their discussion. The white blood cell count of the peripheral blood revealed in patients with BP the presence of bacterial and inflammatory process in contrast to peers with ARVI. The study of C-reactive protein concentrations in the blood serum allowed us to obtain the following results: the average content of this protein and in I clinical group was 67.26 ± 4.90 mg/l, in IV group — 22.39 ± 4.40 mg/l, in II group — 56.2 ± 2.6 mg/l and in III comparison group— 28.8 ± 2.4 mg/l (PI : II, III, IV; II : III, IV < 0.05). Conclusions. Consequently, none of the studied clinical and paraclinical markers have an independent diagnostic value in confirming bacterial inflammation.

Introduction. Significant polymorphism of clinical manifestations of infectious mononucleosis, multisystemic lesions, frequent lack of clear clinical and paraclinical criteria and delayed results of available laboratory tests, and sometimes impossibility of their execution complicate the diagnosis of the disease in prehospital stage and on admission to hospital. Objective of the study: to optimize the diagnosis and treatment of infectious mononucleosis in children by examining current features of the course and analyzing the diagnostic value of clinical and instrumental parameters in the verification of the disease. Materials and methods. On the basis of infectious boxed unit of respiratory infections of Municipal Healthcare Institution «Regional Children’s Hospital» (Chernivtsi), there were examined 65 children with infectious mononucleosis, who were hospitalized in the period of 2014–2015. The first clinical group (I) consisted of 42 children, the final clinical diagnosis of the disease in them was verified on the basis of comprehensive clinical and hematological criteria, the second (II) clinical group included 23 patients with serologically confirmed infectious mononucleosis. In terms of the main clinical signs, the observation groups were not significantly different. Results. It was found that for children with infectious mononucleosis, such clinical features are typical: sudden onset of the disease (in 93.8 %) with fever higher than 37.5 °C (80 %), the presence of exudative tonsillitis (81.6 %), submandibular and cervical lymphadenopathy (in 90.7 %), difficulty in nasal breathing (in 78.4 %), and nasal voice (in 73.8 %). In confirmation of Epstein-Barr virus infectious mononucleosis, phenomena of exudative tonsillitis and lymphadenopathy were highly sensitive (90 and 95 %, respectively), but with a high proportion of false positive results. Conclusion. Thus, given the lack of diagnostic value of clinical-anamnestic and sonographic parameters in identifying Epstein-Barr virus infectious mononucleosis in children, as evidenced by low values of the likelihood ratio and risk indicators, their use is expedient only in the combination.

The paper deals with the problems of diagnosis, differentiated diagnosis, dispensary for disease, prevention and treatment of poliomyelitis in children. There are presented the WHO guidelines on poliomyelitis for Ukraine.

The article deals with the problem of poliomyelitis in children. The history of this disease and the current state of morbidity in Ukraine are considered. The features of the clinical pattern in children are described. Diagnostic criteria and treatment methods are presented.

In the infectious boxed department of intestinal infections in regional children’s clinical hospital (Chernivtsi), there were examined 109 children who suffered from acute intestinal infection, caused by obligate pathogenic flora, in particular, 76 patients with salmonellosis and 33 children who were diagnosed with shigellosis. The main etiological factors of salmonellosis were S.typhimurium and S.enteritidis in incidence ratio 3 : 2, shigellosis — Sh.sonnei and Sh.flexneri in the ratio 9 : 1. The average age of children with salmonellosis was 3.7 ± 0.5 years, of patients with shigellosis — 7.1 ± 0.7 years. In modern conditions, the course of salmonellosis in children is characterized by typical symptoms of bacterial lesions of the gastrointestinal tract with the development of local gastrointestinal form of the disease (gastroenterokolitis variant in 57.9 % of cases), mainly, moderate (86.9 %). In 89.2 % of patients, the onset of the disease was accompanied by the fever reaction (febrile values in 57.9 % of children) and manifestations of gastrointestinal dysfunction as the diarrhea (77.6 %) and emetic (57.9 %) syndromes. In the vast majority of children with shigellosis, a disease proceeds in colitis form (75.8 %) of moderate severity (90.9 %) with significant cytoscopic signs of distal colon inflammation. Laboratory hematology indices in both groups were characterized by insignificant leukocytosis with significant regenerative shift and the tendency to anemia in children with salmonellosis.

The study of clinical features and identification of inflammatory markers in the bronchi of 52 schoolchildren with overweight and bronchial asthma has been carried out. It was found that overweight children are characterized by long persistent nature of bronchial asthma, and, compared with patients with normal body weight, — by worse asthma control, especially due to more frequent use of β-agonists as needed and more exacerbations. It was noted that after 6 months of the basic anti-inflammatory therapy, patients with overweight still had worse indicators of asthma control in comparison with children with normal weight, and a significant improvement was only in terms of such indicator of the subjective assessment of their condition, as the incidence of daytime symptoms, and of objective criteria of the control — respiratory function. It should be noted that the effectiveness of a standard basic treatment in patients with overweight is insufficient, indicating the need for individualized treatment in this cohort of patients.

One of the aspects of inadequate control of severe bronchial asthma (BA) is its phenotypic heterogeneity. Although the relationship between obesity and BA is certain, the mechanism of this phenotype of the disease is poorly understood. The objective of the study was to improve the efficiency of basic treatment for severe BA in school-age children predisposed to overweight based on an analysis of indicators of control, inflammatometry and spirometric characteristics. In a pulmonary department of regional clinical hospital (Chernivtsi), there were examined 18 children predisposed to overweight, whose body mass index exceeded the limits of 95% confidence interval (21.7 kg/m2) (I clinical group). Control group consisted of 39 patients with severe BA, who are not predisposed to overweight. It is proved that a predisposition to overweight in children with severe persistent BA adversely affect the indicators of achieving disease control. The lower efficacy of basic treatment in children predisposed to overweight is established that is due to a significantly greater share of school-age children with neutrophilic nature of bronchia inflammation in this group and airway hypersensitivity to histamine.

The article deals with the pressing issues of timely diagnosis of acute tonsillopharyngitis in children. Particular attention is paid to early diagnosis of acute streptococcal tonsillopharyngitis. As additional paraclinical criteria to confirm the streptococcal nature of acute tonsillopharyngitis, there were selected indicators of cellular immunity (content in peripheral blood of CD3, CD4, CD8, CD22). Sufficient indicators of sensitivity (80 %) and specificity (81.3 %) enable to use integrated clinical and immunological parameters, which include the contents of CD8-lymphocytes > 10 %, CD-3 lymphocytes > 30 %, CD22-lymphocytes < 18 % in the peripheral blood with a total evaluation of the clinical status by McIsaac’s scale ≥ 4 points to confirm the streptococcal nature of acute tonsillopharyngitis in children.

Urgency of the problem of diagnosis and treatment for acute tonsillopharyngitis is due to their considerable prevalence among children population (12 to 17 %). Inadequate treated acute tonsillopharyngitis, especially caused by group A beta-hemolytic streptococcus, determine the development of life-threatening conditions and chronization of the process. Thus, the objective of the work was to study the diagnostic value of general clinical and paraclinical indicators in verification of acute streptococcal tonsillopharyngitis in children to optimize the initial etiotropic treatment and to prevent polypragmasy. Two clinical groups were formed: I group consisted of 10 children with a diagnosis of acute streptococcal tonsillopharyngitis, II clinical group included 16 patients with acute tonsillopharyngitis of non-streptococcal origin. The studies found that at the stage of early detection of acute streptococcal tonsillopharyngitis in children the following clinical-paraclinical complex can be used: total score by McIsaac’s scale above 4, level of segmental leukocytes in the blood more than 50.0 %, indices of stimulated test with nitroblue tetrazolium (NBT) of neutrophilic granulocytes in the blood by cytochemical coefficient below 0.5 c.u., reserve of NBT-test less than 0,15 c.u., which increases the risk of disease detection by four times.

The lecture describes the etiology, epidemiology, classification and clinical features of diphtheria in children, taking into account various sites, covers the issues of diagnosis. Treatment for diphtheria in children is carried as per the order of Ministry of Healthcare of Ukraine № 354 dated July 9, 2004 in accordance with the form and severity of the disease.

The article provides a literary analysis of the current state of the problem of early diagnosis of tonsillopharyngitis in childhood, namely timely etiological diagnosis of the disease. The questions of etiology, epidemiology, clinical picture, differential diagnosis, paraclinical diagnosis, directions of treatment for tonsillopharyngitis in children were considered. Emphasis was placed on the literature review of the problems and the modern limitations of rapid etiological diagnosis of tonsillitis in children, as well as the principles of efficient antibiotic therapy and disease prevention methods from the standpoint of evidence-based medicine. The paper noted that early detection of streptococcal etiology of tonsillopharyngitis is of particular importance, it allows at the very beginning of the disease to prescribe efficient antibiotic therapy. This will reduce the duration of disease, significantly reduce the risk of early complications and significant reduce the period of contagiousness of the patient, which in turn reduces the likelihood of spreading of streptococcal infection. Gold standard for detection of β-hemolytic streptococcus for the administration of antibiotic therapy is streptotest. Using of express test systems in the clinic of children’s infectious diseases should lead to improved early etiological diagnosis of tonsillopharyngitis in children and thereby contribute to the timely adequate administration of treatment, which ultimately should significantly reduce the risk of complications and contribute to a positive economic effect.

The lecture deals with the diagnosis and treatment of meningococcal disease. Attention is given to laboratory diagnosis, differential diagnosis. There are provided the algorithms of medical care for children with meningococcemia in the prehospital and hospital stages, as well as the issues of treatment of meningococcal meningitis, meningococcal carriage and nasopharyngitis, measures in relation to exposed person, the conditions of discharge of patients after treatment, and their admission into the team.

The article presents a clinical case of foodborne botulism in an adolescent. Against the background of classical clinical picture in the midst of disease with the development of ophthalmoplegic, pharyngoplegic, phonolaryngoplegiс syndromes, there were marked atypical features of epidemiological history, onset and the sequence of prodromal symptoms. It have been indicated the importance of timely and adequate specific therapy that, in addition to etiotropic, detoxification and metabolic treatment, helped to achieve regression of neurological symptoms with the restoration of the quality of life of the patient in early terms.

The aim of the research was to access clinical efficacy of oral rehydration therapy using III generation solutions in the treatment of secretory diarrhea in infants. To achieve this aim, on the basis of infectious box unit (enteric infections) of regional clinical hospital (Chernivtsi) we examined 116 infants, randomly selected, with acute gastroenteritis, who admitted to the hospital with signs of exycosis due to secretory diarrhea. Among examined patients, 73 (67.5 %) children with the purpose of oral rehydration therapy received rehydration solutions, and 35 (32.4 %) patients received other rehydration solutions. Monitoring of the dynamics of patients’ state enabled to state that, when we used III generation mixture as a main component of oral rehydration therapy, rate of positive dynamics in terms of clinical status of patients was significantly faster, in particular, body temperature, frequency and nature of bowel movements normalized significantly earlier, vomiting disappeared. In children treated with rehydration solutions, compared with patients receiving other rehydration solutions, odds ratio to confine only oral rehydration was 3.7 (95% CI 0.4–38.9) with an absolute risk to avoid the need for infusion therapy — 11 %.