Search

In the period 2020-2022 as a result of epidemiological measures specific to the COVID-19 pandemic (protective mask, online teaching activity, social distancing) we witnessed a considerable decrease in the number of cases of respiratory viroids in children. With the lifting of prophylactic measures that coincided with the start of physical teaching activities and the onset of the cold season, we have been confronted in pediatric wards with an increase in the incidence of virological infections in the pediatric population. In this article we aim to analyze the particularities of respiratory virological diseases in children in the season 2022 - 2023 both from the etiological and epidemiological point of view and the characteristic clinical forms of the disease. We conducted a retrospective clinical study of cases admitted to the Clinical Departments of Infectious DiseasesPediatrics of the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” in the period October 2022 - March 2023. During this period, we recorded 3.012 cases of respiratory virology in children, which represents the majority of pediatric pathology admitted (72,9 %). The peak incidence of respiratory virology occurred in December (688 cases). From the etiological point of view, most cases were SARS-CoV-2 infections, followed by influenza (predominantly type A), then a smaller number of infections with respiratory syncytial virus (RSV), rhinovirus, adenovirus, metapneumovirus. The most common clinical form of the disease was moderate (66.9%), with severe forms accounting for 10.5%. All pediatric cases of respiratory virology admitted to our wards have evolved favorably, with no deaths. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 infection is usually a self-limiting viral infection in healthy children. Still, it’s effects on the neonatal population remain largely unknown. There has been evidence of adverse events on neonates, mostly consisting in case reports of patients with severe forms of COVID-19 and also recent cohort studied of the pediatric population including the neonatal subgroup. The clinical presentation appears different in the neonatal patients in contrast with older children, and may manifest also as a life-threatening respiratory infection with systemic complications. In this paper we present a clinical case of a premature boy with a corrected age of 40 weeks at admission to the Pediatric Infectious Diseases Clinical Department IX of the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” with the diagnosis of SARS-CoV-2 infection. The positive diagnosis was established on suggestive clinical picture (fever, dry couch, rhinorrhea, loose stools and inappetence) and confirmed by SARS-CoV-2 rapid antigen test. Laboratory investigations at admission showed only moderate to severe anemia, mild inflammatory syndrome and a mild neonatal hyperbilirubinemia, with normal leukocyte count, normal glycaemia, ionograme and blood gases. Chest x-ray showed moderate interstitial pneumonia. In the second day of admission, after 24h of favorable evolution, with no fever and present appetite, he suddenly presented during defecation a presumptive vasovagal syndrome, with general hypotonia and a short period of desaturation. Laboratory investigations made during the episode showed normal glycaemia, normal ionograme, normal blood gases, moderate-severe anemia and important metabolic acidosis. A new chest x-ray showed evolution of the interstitial pneumonia. We did a blood transfusion and continued antiviral treatment, antibiotic treatment and perfusions. He maintained normal pulmonary and cardiac function for another 6 hours, after which he presented a tonic-clonic seizure and after administration of intrarectal benzodiazepines he presented cardio-pulmonary arrest. He was resuscitated, intubated and sedated and transfer to a children ICU. 2 weeks later after admission in the ICU he was discharged with favorable outcome. The case presented shows that although SARS-CoV-2 infection is often a mild condition in children, COVID-19 in neonates can have an unpredicted course. Rapid evolution to sever forms can be a possible disease outcome. Preterm birth with associated complications like bronchodysplasia or anemia, can predispose to sever evolution of the disease, and this child must be kept safe. There is also a neurotropic potential of the SARS-CoV-2 virus that has to be followed. [ABSTRACT FROM AUTHOR]

Sepsis is one of the most severe pediatric infectious diseases that can progress to serious complications or even death without specialized treatment. It often evolves as a complication of a viral illness or against the background of a depressed host immune terrain. SARS-CoV-2 infection is a self-limiting viral infection in children, which is rarely complicated, especially in immunocompromised or co-morbid individuals. In this paper we present a clinical case of a 1 year and 2 months old child admitted to the Pediatric Infectious Diseases Clinical Department IX of the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” with the diagnosis of SARS-CoV-2 infection. The positive diagnosis was established on epidemiological data (parents with SARS-CoV-2 infection), suggestive clinical picture (fever, inappetence, vomiting) and confirmed by RT-PCR. 72 hours after admission, with favorable clinical evolution, the child presented again fever and chills. Laboratory investigations show leukocytosis with neutrophilia, inflammatory syndrome present and, in nasal exudate and blood culture, staphylococcus aureus MSSA is isolated. Also, immunogram shows low IgA level, the rest of the laboratory tests are within normal limits. Antibiotic treatment was instituted, symptomatic hydroelectrolytic and acid-base rebalancing infusions with favourable evolution. The case presented shows that although SARS-CoV-2 infection is often a mild condition in children, it can evolve severely, especially in immunosuppressed individuals with comorbidities. The presented child was not known to have selective IgA immunodeficiency, which probably in combination with COVID-19 induced immunosuppression, favored the development of sepsis. [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus (RSV) infection in children is a major public health problem, especially in the 0-1 year age group where clinical forms of the disease can evolve severely with life-threatening complications. In the period 2020 – 2022, as a result of epidemiological measures specific to the COVI-19 pandemic (protective mask, online teaching activity, social distancing) we have witnessed a considerable decrease in the number of cases of RSV infection in children. With the lifting of prophylactic measures and the onset of the cold season, we have seen an increase in the number of admissions with a diagnosis of respiratory virus in pediatric wards. In this article, we aim to analyze the clinical, evolutionary and epidemiological features of respiratory syncytial virus infection in children in the 2022 - 2023 season. We conducted a retrospective clinical study of RSV infection cases admitted to the Pediatric Infectious Diseases Clinical Departments of the National Institute of Infectious Diseases “Prof. Dr. Matei Bals” in the period October 2022 - March 2023. During this period, we registered 195 cases of RSV infection in children, which represents 6.47% of the total number of hospitalized virological illnesses in children (195/3012). All pediatric RSV infection cases admitted to our wards have progressed favorably; we have not recorded any deaths. From an epidemiological point of view, the peak incidence of RSV infection in children occurred in December (98 cases). The most frequent clinical form of the disease was the medium form, but severe forms represented 31.8%. Among the complications, the most common were respiratory (acute respiratory failure, pneumonia/bronchopneumonia), hematological (intrainfectious and deficiency anemia, leukopenia, thrombocytopenia), digestive (diarrhoeal disease, hepatic cytolysis syndrome) and acute dehydration syndrome associated with hydroelectrolytic and acid-base disturbances. Severe complications were more frequent than in previous seasons, being associated with a risk of an unfavorable outcome: acute respiratory failure and neurological complications (convulsions, encephalitis). We also observed that acute RSV infection in the 2022 - 2023 season is characterized by the association of co-infections (viral, bacterial and fungal) more frequent than in previous years (22.5%). The most frequent co-infections were bacterial (superinfections - pneumonia/bronchopneumonia) probably due to the immunosuppression of the hosts as a result of repeated recent episodes of viral infections. Of note, RSV infection associated with other coinfections evolved more severely, with prolonged hospitalization and more complications. In conclusion we can say that RSV infection in the 2022 - 2023 season evolved more severely in children compared to previous seasons because in the last 3 years during the COVID-19 pandemic there were very few cases of respiratory viroids, thus the population was not naturally immunized, especially the age group 0 - 4 years. In addition, the abandonment of specific protective measures for respiratory diseases has “exploded” the number of respiratory illnesses in the pediatric population, especially in children. [ABSTRACT FROM AUTHOR]

Norovirus represents the most frequent cause of pediatric gastroenteritis requiring medical care. We conducted a prospective study on 276 patients admitted to a tertiary hospital in Romania from January 2017 to December 2019 to estimate the clinic-epidemiological and evolutionary impact of Norovirus infection. Among the 276 patients, the median age was 2.34 years, and 57.61% were male. The frequency of hospitalizations in a year was higher in August, September, and October, and 72.1% of patients were from urban areas. Diarrhea (92.58%), vomiting (83.33%), anorexia (92.03%), and fever (57.61%) predominated, while abdominal pain (46.74%), nausea (30.8%), headache (18.84%), and myalgia (18.12%) were in lower percentages. Dehydration occurred in 99.28% of patients. Using the Pearson correlation coefficient, we formulated two hypotheses: in the 0-4 years category, the number of cases requiring hospitalization is inversely proportional to age (Pearson coefficient age-number of cases - 0.92), and the younger the age, the more it is associated with other infections and the longer the hospitalization duration. Conclusions. The clinic-epidemiological characteristics of patients with Norovirus infection are influenced by age – the younger the age, the longer the hospitalization duration and the higher the presence of associated infections; the average age is 2.34 years, with a predominance of males and children from urban areas. Hospitalization is high in August, September, and October, and diarrhea, vomiting, and anorexia predominate. [ABSTRACT FROM AUTHOR]

Congenital lung malformations or CLM have resulted in an apparent increase in their frequency with the advances in fetal ultrasound technology and more widely available investigations in prenatal and postnatal periods. The advantage of an early diagnosis came together with the difficulty of the treatment decision, in special in the postnatal management of asymptomatic CLM. In this article, we summarized findings from current literature, with a particular emphasis on the therapeutic strategies. Management of infants for thoracic surgery represents a challenge not only for pediatric surgeon but also for anesthesiologists because of the anatomic and physiologic variations particularities. There are two main important parts that must be obtained: one lung ventilation and specific techniques for optimal pain management, distinguishing pediatric thoracic anesthesia from other pediatric anesthetic disciplines. A comprehensive multimodal approach is necessarily followed by a long-term assessment of respiratory function of children who underwent surgery for lung resection. [ABSTRACT FROM AUTHOR]