Risk-adapted individualisation of treatment led to a reduction of chemotherapy in the low and standard risk group without compromising survival. The outcome of RME and RMA was similar in this cohort of patients. These preliminary results after a median observation time of 2.5 years confirm the CWS 96 strategy.

We report the case of a 14-year-old girl who presented with an 8-week history of unilateral pansinusitis. In the course of the disease a right-side frontal swelling was observed, which disappeared following antibiotic treatment. Four weeks later, however, the swelling reappeared and was now diagnosed as recurrent Pott's puffy tumor. Interestingly, C-reactive protein levels were in the normal range throughout. Following functional endoscopic frontal sinusotomy, antibiotic treatment with ceftriaxone was administered over 3 weeks and led to complete remission of the lesion. Pott's puffy tumor is a subperiostal abscess of the frontal bone, usually presenting as localized swelling of the soft tissue in the overlying region of the forehead, and is associated with localized osteomyelitis and occasionally with intracranial epidural abscess. The entity has been known since 1768, although recurrent cases with normal inflammation parameters have not been published previously.

Group A streptococcal (GAS) disease shows increasing incidence worldwide. We characterised children admitted with GAS infection to European hospitals and studied risk factors for severity and disability. This is a prospective, multicentre, cohort study (embedded in EUCLIDS and the Swiss Pediatric Sepsis Study) including 320 children, aged 1 month to 18 years, admitted with GAS infection to 41 hospitals in 6 European countries from 2012 to 2016. Demographic, clinical, microbiological and outcome data were collected. A total of 195 (61%) patients had sepsis. Two hundred thirty-six (74%) patients had GAS detected from a normally sterile site. The most common infection sites were the lower respiratory tract (LRTI) (22%), skin and soft tissue (SSTI) (23%) and bone and joint (19%). Compared to patients not admitted to PICU, patients admitted to PICU more commonly had LRTI (39 vs 8%), infection without a focus (22 vs 8%) and intracranial infection (9 vs 3%); less commonly had SSTI and bone and joint infections ( p < 0.001); and were younger (median 40 (IQR 21–83) vs 56 (IQR 36–85) months, p = 0.01). Six PICU patients (2%) died. Sequelae at discharge from hospital were largely limited to patients admitted to PICU (29 vs 3%, p < 0.001; 12% overall) and included neurodisability, amputation, skin grafts, hearing loss and need for surgery. More patients were recruited in winter and spring ( p < 0.001). Conclusion : In an era of observed marked reduction in vaccine-preventable infections, GAS infection requiring hospital admission is still associated with significant severe disease in younger children, and short- and long-term morbidity. Further advances are required in the prevention and early recognition of GAS disease. What is Known: • Despite temporal and geographical variability, there is an increase of incidence of infection with group A streptococci. However, data on the epidemiology of group A streptococcal infections in European children is limited. What is New: • In a large, prospective cohort of children with community-acquired bacterial infection requiring hospitalisation in Europe, GAS was the most frequent pathogen, with 12% disability at discharge, and 2% mortality in patients with GAS infection. • In children with GAS sepsis, IVIG was used in only 4.6% of patients and clindamycin in 29% of patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00431-022-04718-y.

Fragestellung: Ziel dieser Untersuchung war es, die Prävalenz depressiver Störungen am fünften Tag postpartum mit der Edinburgh Postnatal Depression Scale (EPDS) zu untersuchen und Zusammenhänge mit geburtshilflichen und psychosozialen Variablen darzustellen. Methoden: Die Erfassung soziodemographischer Daten, somatischer und psychiatrischer Anamnesen sowie geburtshilflicher und psychologischer Variablen erfolgte mittels Interview bzw. der Krankengeschichte. An der Untersuchung nahmen 1250 Wöchnerinnen 5 Tage nach der Geburt teil. Ergebnisse: Gemäss den Resultaten der deutschen Validierung der EPDS zeigte sich für 254 (20,3%) Wöchnerinnen eine zumindest leichte depressive Störung. Der Vergleich zwischen nichtdepressiven Frauen (EPDS ≤9, n = 996) und depressiven Frauen (EPDS ≥10, n = 254) erbrachte folgende Risikofaktoren für eine depressive Störung: subjektiv erhöhte Geburtsbelastung, höhere Angstneigung, ungünstige Partnerbeziehung, niederer Sozialstatus und geringere Berufszufriedenheit. Hinsichtlich geburtshilflicher Variablen erwiesen sich vermehrte Schwangerschaftsrisiken, Fehlgeburten in der Anamnese, niederes Geburtsgewicht und Kaiserschnittentbindungen als Risikofaktoren. Schlussfolgerungen: Depressive Störungen im frühen Wochenbett treten bei 20% der Wöchnerinnen auf. Entsprechend der Literatur stellt diese Gruppe von Frauen das Risikokollektiv für eine spätere postpartale Depression dar. Unter Beachtung der psychosozialen und geburtshilflichen Risikovariablen sind präventive psychotherapeutische Interventionen bereits an der Wochenstation sinnvoll.

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