Recurrent parotitis had a biphasic age distribution. The major clinical features that distinguish it from other causes of parotid swelling are the lack of pus and recurrent episodes. A clinical diagnosis can often be confirmed by ultrasound. Antibiotics do not have a role in treatment. Affected children should be screened for Sjogren's syndrome and immune deficiency.
Among preterm infants, delayed cord clamping did not result in a lower incidence of the combined outcome of death or major morbidity at 36 weeks of gestation than immediate cord clamping. (Funded by the Australian National Health and Medical Research Council [NHMRC] and the NHMRC Clinical Trials Centre; APTS Australian and New Zealand Clinical Trials Registry number, ACTRN12610000633088 .).
Of 31 children with retropharyngeal abscess treated at this hospital between 1954 and 1990, 17 (55%) were 12 months old or less and 10 (32%) less than 6 months. Three of these 10 children were neonates, only one of whom had a predisposing congenital lesion. Fourteen children (45%) had a preceding upper respiratory illness and four (13%) had a prior history of pharyngeal trauma or ingestion of a foreign body.In children less than 1 year old the clinical presentation was usually classical with fever, neck swelling, stridor, and pharyngeal swelling. Significantly fewer children over 1 year had neck swelling and no child over 3 years old had stridor. A lateral radiograph of the neck, when performed, had a sensitivity of 88% in diagnosis.Bacteria isolated included pure growths of Staphylococcus aureus (25%), klebsiella species (13%), group A streptococcus (8%), and a mixture of Gram negative and anaerobic organisms (38%). There were two deaths. In six cases (24%) the abscess recurred necessitating further surgical drainage. A preceding illness including upper respiratory infection, tonsillitis, isolated cervical lymphadenitis, and herpetic gingivostomatitis in one case, was recorded in eight of 17 (47%) children under 1 year and six of 14 (43%) children over 1 year. One child had been bitten in the neck by a dog. Four children (13%) had a history of trauma to the pharynx or ingestion of a foreign body. These four cases included: (i) swallowing a safety pin which was removed two weeks before the retropharyngeal abscess developed, (ii) falling over with a pencil in the mouth and traumatising the posterior pharynx, (iii) swallowing two drawing pins, one of which was removed at drainage of the abscess, and (iv) swallowing a piece of plastic three days
Various pathogenic bacteria have coats of polysaccharide, many with repeating epitopes. Though polysaccharide vaccines have been available for some time, they induce mainly IgM production, and are only moderately protective in adults and ineffective in young children. It was originally shown in 1931 that the immunogenicity of polysaccharides could be enhanced by conjugating to a protein. The last two decades have witnessed the production and clinical testing of polysaccharide-protein conjugates specific for at least four different bacteria which normally cause considerable mortality and morbidity, especially in young children. In some cases, immunizing children from 4 months of age, with a booster early in the second year, has resulted in remarkably high success rates in protecting them from disease. For one pathogen, Haemophilus influenza type b, the success rate has been sufficiently high (> 95%) to suggest that this disease might, in time, be globally controlled in this way. The results of immunization with conjugate vaccines to Streptococcus pneumoniae, Neisseria meningiditis and Salmonella typhi are also very encouraging. More conjugate preparations are under development.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.