Tick-borne encephalitis has not been reported in infants younger than 12 months of age. We report a 3.5-month-old child with a serologically proven tick-borne encephalitis. The infant had a history of a tick bite 3.5 weeks before the first symptoms of encephalitis appeared. The family lives in an endemic area of the disease. There were no prodromal signs and the course of the disease was monophasic. In an endemic area, prophylactic treatment with hyperimmunoglobulin after a tick bite should be considered even in very young infants, but in most children active immunization is probably not necessary because of infrequent exposure. Active immunization is still recommended after the 1st year of life.

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A total of 33 patients with bacterial meningitis were treated with single daily doses of ceftriaxone (CTR 100 mg/kg/day i.v.) for a median duration of 13 days. Pathogens isolated by culture and/or determined by latex agglutination were 15 Haemophilus influenzaeh, 7 Neisseria meningitidis, 2 Streptococcus pneumoniae, 1 group B streptococcus, 2 Streptococcus viridans and 2 Staphylococcus epidermidis. In 4 cases a diagnosis of purulent meningitis could only be made by means of the inflammatory liquor parameters. All cerebrospinal fluid (CSF) drug levels even at the end of the dosing interval were at least 10-fold higher than the MICs of the respective bacterial isolates. The average penetration of CTR into the CSF was 6.6%. Within 12–46 h after the first dose, control spinal taps were performed. Cultures were sterile in all cases. Side effects encountered were diarrhea, exanthema, neutropenia and transient elevation of glutamic oxaloacetic transaminase, but none caused a change of therapy. One patient developed a biliary concrement. No patient died; 5 patients had prolonged fever ( > 5 days), and 2 were left with persistent hearing deficiencies. CTR can be recommended as a safe and effective antibiotic agent for once daily treatment of bacterial meningitis in children.

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The case of a 2 89 girl with the unusual combination of fibrous dysplasia of bone and vitamin D-resistant rickets is described. Metabolic studies showed the evidence of phosphate diabetes with hypophosphatemia, normoealcemia and elevated alkaline phosphatase in the blood and extremely low calcium levels and high phosphate clearance that did not yield to calcium infusions in the urine. The X-ray pictures before and during high vitamin D therapy, which only made the rickets disappear, are discussed; they still showed fibrous dysplasia.Key words." l~[cCune-Albright Syndrome --Fibrous dysplasia of bone --Hypophosphatemie rickets --Secondary hyperparathyroidism --Vitamin-D therapy.Zusammen/assung. Bei einem 26/12j~hrigen, familigr nieht belasteten M~dehen wird die Kombination eines MeCune-Albright-Syndroms mit einem Phosphatdiabetes beobaehtet. Eine derartige Kombination ist in der Weltliteratur erst zweimal mitgeteilt worden. Nach kurzer Besehreibung der klinisehen Symptomatik wird auf die ausgedehnten Skeletbefunde eingegangen. Pharmakologisch dosiertes Vitamin D a fiihrt zur Abheilung der raehitiseh bedingten Veriinderungen, wS~hrend die fibr6se Knoehendysplasie dadureh radiologiseh deutlieher hervortritt. Untersuchungen des Calcium-Phosphor-Stoffwechsels erbringen die einem Phosphatdiabetes entspreehenden Serum-und t-Iarnbefunde; lediglich die alkalische Serumphosphatase zeigt ein Ausnahmeverhalten, da sic aueh unter Vitamin D nicht zur Norm absinkt.Die familigre hypophosphatgmische Rachitis (Phosphatdiabetes) ist eine x-chromosomal gebundene Erbkrankheit, die kliniseh dureh eine mit physiologisehen Dosen Vitamin D nicht zu beeinflussende Rachitis