Introduction:The COVID-19 pandemic progresses. The clinical manifestation of the disease and the severity of its course vary significantly. There are considerable differences between symptoms of SARS-CoV-2 infection in the child and adult populations. The gastrointestinal (GI) symptoms are an essential element in understanding the pathophysiology of the disease and in drawing conclusions concerning the diagnostic, therapeutic, and epidemiological management of COVID-19. The aim of the study was to characterize the gastroenterological symptoms of COVID-19 in the paediatric population and to find differences in the course of the disease between paediatric patients with and without GI symptoms of COVID-19. Material and methods: We report the clinical characteristics of 321 children with COVID-19 (age 0-215 months) hospitalized between March 2020 and April 2021. The following division was used when processing the data: the first wave of cases in Poland lasted from the beginning of the pandemic to June 2020, the 2 nd wave September-November 2020, and the 3 rd wave February-May 2021. We specifically compared the differences between patients with and without GI symptoms. Results: Among all included patients, 95 (29.5%) had GI symptoms -the most common included abdominal pain (15.27%) and diarrhoea (14%). Approximately 3% of patients with GI symptoms required surgical intervention. As the pandemic progressed, GI symptoms were reported with increasing frequency -during the first wave 9%, the second wave 25%, and the third wave 38%. Patients with GI symptoms had more frequent and statistically significantly higher inflammatory parameters. During treatment, GI patients more often required the administration of antibiotics. The most common abdominal ultrasound abnormalities were liver enlargement, a slight amount of free fluid in the peritoneal cavity, and moderately enlarged individual lymph nodes. Conclusions: Gastrointestinal symptoms form an image of COVID-19, which is a possible prognostic risk factor for severe course of the disease. Gastrointestinal symptoms should be treated as a possible isolated image of COVID-19.
Celem pracy była analiza źródeł zakażenia z uwzględnieniem zachowań rodziców oraz ich wiedzy na temat dróg przenoszenia bakterii, przebiegu klinicznego oraz objawów zejściowych salmonellozy odzwierzęcej u dzieci z województwa wielkopolskiego w związku z wystąpieniem w regionie ogniska endemicznego choroby. Analizie retrospektywnej poddano dokumentację 35 pacjentów przebywających na dwóch oddziałach zakaźnych Wielkopolski w okresie od maja 2016 r. do kwietnia 2017 r. Zakażenie Salmonella enterica potwierdzono u dzieci w wieku od 3 miesięcy do 15 lat, w znaczącej większości (33 osoby) wcześniej zdrowych. U 30% pacjentów występował w wywiadzie bezpośredni kontakt (spożycie, zabawa) z surowymi produktami pochodzenia zwierzęcego, a rodzice nie mieli świadomości ryzyka zakażenia Salmonella. W 6 przypadkach choroba miała charakter rodzinny. Zespół uogólnionej reakcji zapalnej obserwowano u 11 pacjentów. U 1 dziecka rozpoznano salmonellozowe zapalenie opon mózgowo-rdzeniowych. Dominującymi objawami zakażenia były luźne stolce, które wystąpiły u wszystkich pacjentów i trwały od 1 do 13 dni przed hospitalizacją. Badania laboratoryjne wszystkich pacjentów wykazywały znaczny wzrost poziomu białka C-reaktywnego, natomiast istotna leukocytoza segmentarna obserwowana była w grupie dzieci do 5. roku życia. Wnioski: Zakażenie pałeczkami Salmonella stanowi nadal istotny problem pediatryczny ze względu na możliwość jego wystąpienia w każdej grupie wiekowej oraz ryzyko poważnych powikłań. Ważnym elementem profilaktyki jest edukacja rodziców na temat dróg przenoszenia choroby.
Varicella-zoster virus is an exclusively human α-herpesvirus, known as the aetiological factor of chickenpox which is usually linked with childhood. The disease occurs with a worldwide geographic distribution, and in temperate climates shows a seasonal pattern with epidemics occurring mostly during late winter and spring. The annual incidence is estimated at 80–90 million cases worldwide. Children usually acquire varicella during the first five to 10 years of life, and the highest risk of infection is related to household contacts without a history of vaccination. Although the disease is commonly considered benign, varicella-zoster virus bears the potential of causing a wide range of complications, including the most serious ones of central nervous system manifestations. The neuropathogenesis of varicella-zoster virus infections is not well understood. Based on a wide spectrum of clinical syndromes, multiple theories explaining the pathways of spread of the virus, and host immune response to the viral presence have been proposed, including direct retrograde trafficking of the virus and haematogenous spread as well as inflammatory response with vasculitis. Neurological complications related to varicella-zoster virus infection are the second most common indication for hospitalisation in immunocompetent children with varicella, following skin superinfections. In this paper, the neurological aspects of chickenpox in children are discussed. The characteristics of the clinical syndromes, pathogenesis, methods of diagnosis and treatment, as well as long-term consequences are presented.
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