Lung ultrasound (LUS) is as an easily accessible, radiation-free imaging technique that might be used as a diagnostic tool in community-acquired pneumonia (CAP). The aim of the study was to evaluate the usefulness and accuracy of LUS in the diagnosis and monitoring of childhood CAP. One hundred six consecutive children aged between 1 and 213 (median 52.5) months referred to the hospital with suspicion of CAP were enrolled. All patients underwent LUS on the day of admission, followed by chest radiograph (CXR). Lung ultrasound was also performed in 25 children between 5th-7th and 31 children between 10th-14th day after admission. Radiographic signs of pneumonia were demonstrated in 76 children, while lung ultrasound revealed pulmonary abnormalities consistent with pneumonia in 71 children. LUS gave false negative results in 5 patients with parahilar pulmonary infiltrates demonstrated by CXR. Almost perfect overall agreement between LUS and CXR was found in terms of pneumonia diagnosis (Cohen kappa coefficient of 0.89). The diagnostic performance of LUS in demonstration of lung involvement was as follows: sensitivity of 93.4%, specificity of 100%, positive predictive value of 100%, negative predictive value of 85.7% and accuracy of 95.3%. Our study showed that LUS is a sensitive and highly specific diagnostic method in children with CAP. Therefore, LUS may be considered as the first imaging test in children with suspicion of CAP. A diagnostic algorithm of CAP which includes LUS should be validated in prospective studies. Lung ultrasound can also be used to follow-up resolution of pneumonic lesions.

Some clinical and laboratory data including chest pain, longer duration of fever, higher acute phase reactants, and especially preadmission treatment with ibuprofen or acetaminophen were associated with local complications of CAP. The results of this study highlight the association between the dose of ibuprofen and local CAP complications.

Food allergy (FA) can be classified into IgE-and non-IgE-mediated depending on the involvement of IgE in its pathogenesis. In this review, we are focusing on IgE-mediated food allergy. FA affects about 8% of children in the Western countries and seems to be rising in other parts of the world such as in Vietnam and South Africa, and other parts of Asia and Africa, particularly in urban rather than rural areas. [1][2][3][4] The prevalence of FA has increased over the recent decades, as has the number of hospitalizations for food-induced anaphylaxis, following what seems to be the 'second wave of the allergy epidemic' after the rise in the prevalence of asthma and respiratory allergy in previous decades. [5][6][7] Pouessel et al 8 have shown that foods caused 37% of cases of ICU admissions for anaphylaxis and 79% of recurrent anaphylaxis. Self-reported FA is even more common with an often underappreciated impact. 1 Gupta et al 1 report that about 40% of food allergic children report multiple food allergies, often severe food allergies, and carry an adrenaline auto-injector. In Western countries, such as the USA and the UK, FA affects disproportionally children from ethnic minorities, such as children of Afro-Caribbean descent. 1,9,10 Whether this has to do with genetic predisposition in face of environmental factors related to the modern lifestyle

Necrotizing pneumonia (NP) is an emerging complication of community acquired pneumonia (CAP) in children. This study aimed at the evaluation of etiology, clinical features, treatment, and prognosis of NP. The institutional database of children with CAP treated between April 2008 and July 2013 was searched to identify children with NP. Then, data on the NP characteristics were retrospectively reviewed and analyzed. We found that NP constituted 32/882 (3.7%) of all CAPs. The median age of children with NP was 4 (range 1-10) years. The causative pathogens were identified in 12/32 children (37.5%) with Streptococcus pneumoniae being the most common (6/32). All but one patient developed complications: parapneumonic effusion (PPE), pleural empyema or bronchopleural fistula (BPF), which required prompt local treatment. The median duration of hospital stay and antibiotic treatment was 26 (IQR 21-30) and 28 (IQR 22.5-32.5) days, respectively. Despite severe course of the disease no deaths occurred. A follow-up visit after 6 months revealed that none of the patients presented with any signs and symptoms which could be related to earlier pneumonia. Chest radiographs showed complete or almost complete resolution of pulmonary and pleural lesions in all patients. We conclude that necrotizing pneumonia is a relatively rare but severe form of CAP that is almost always complicated by PPE/empyema and/or BPF. It can be successfully treated with antibiotics and pleural drainage without major surgical intervention.

BackgroundSalmonella species are widespread in the environment, and occur in cattle, pigs, and birds, including poultry and free-living birds. In this study, we determined the occurrence of Salmonella in different wild bird species in Poland, focusing on five Salmonella serovars monitored in poultry by the European Union: Salmonella serovars Enteritidis, Typhimurium, Infantis, Virchow, and Hadar. We characterized their phenotypic and genetic variations.Isolates were classified into species and subspecies of the genus Salmonella with a polymerase chain reaction (PCR) assay. The prevalence of selected virulence genes (spvB, spiA, pagC, cdtB, msgA, invA, sipB, prgA, spaN, orgA, tolC, ironN, sitC, ipfC, sifA, sopB, and pefA) among the isolated strains was determined. We categorized all the Salmonella ser. Typhimurium strains with enterobacterial repetitive intergenic consensus (ERIC)-PCR.ResultsSixty-four Salmonella isolates were collected from 235 cloacal swabs, 699 fecal samples, and 66 tissue samples (6.4% of 1000 samples) taken from 40 different species of wild birds in Poland between September 2011 and August 2013. The largest numbers of isolates were collected from Eurasian siskin and greenfinch: 33.3% positive samples for both. The collected strains belonged to one of three Salmonella subspecies: enterica (81.25%), salamae (17.19%), or houtenae (1.56%). Eighteen strains belonged to Salmonella ser. Typhimurium (28.13%), one to ser. Infantis (1.56%), one to ser. Virchow (1.56%), and one to ser. Hadar (1.56%). All isolates contained spiA, msgA, invA, lpfC, and sifA genes; 94.45% of isolates also contained sitC and sopB genes. None of the Salmonella ser. Typhimurium strains contained the cdtB gene. The one Salmonella ser. Hadar strain contained all the tested genes, except spvB and pefA; the one Salmonella ser. Infantis strain contained all the tested genes, except tspvB, pefA, and cdtB; and the one Salmonella ser. Virchow strain contained all the tested genes, except spvB, pefA, cdtB, and tolC.The Salmonella ser. Typhimurium strains varied across the same host species, but similarity was observed among strains isolated from the same environment (e.g., the same bird feeder or the same lake).ConclusionsOur results confirm that some wild avian species are reservoirs for Salmonella serotypes, especially Salmonella ser. Typhimurium.