BackgroundThe purpose of this study was to determine the incidence and seasonal distribution of viral etiological agents and to compare their clinical manifestations and disease severity, including single and co infections.MethodsMultiplex reverse-transcription PCR was performed for the detection of viruses in nasopharyngeal aspirat. Disease severity was grouped using a categorization index as very mild/mild, and moderate/severe. Clinical and laboratory characteristics of hospitalized children with viral respiratory tract infection were analyzed.ResultsViral pathogens were detected in 103/155 (66.5%) of patients. In order of frequency, identified pathogens were respiratory syncytial virus (32.0%), adenovirus (26.2%), parainfluenza viruses type 1–4 (19.4%), rhinovirus (18.4%), influenza A and B (12.6%), human metapneumovirus (12.6%), coronavirus (2.9%), and bocavirus (0.9%). Coinfections were present in 21 samples. Most of the children had very mild (38.8%) and mild disease (37.9%). Severity of illness was not worse with coinfections. The most common discharge diagnoses were "URTI" with or without LRTI/asthma (n=58). Most viruses exhibited strong seasonal patterns. Leukocytosis (22.2%) and neutrophilia (36.6%) were most commonly detected in patients with adenovirus and rhinovirus (p<0.05). Monocytosis was the most remarkable finding in the patients (n=48, 53.3%), especially in patients with adenovirus (p<0.05).ConclusionsRSV and RhV were associated with higher severity of illness in hospitalized children. RSV found to account for half of LRTI hospitalizations. In AdV and FluA and B infections, fever lasted longer than in other viruses. Coinfections were detected in 21 of the patients. The presence of coinfections was not associated with increased disease severity.

Although etiology of Kawasaki disease has not been precisely determined, it has been speculated that there was an association with a variety of bacterial and viral agents because of the seasonality of this disease. Some viruses including human adenovirus have been isolated from patients with Kawasaki Disease. Adenoviral infection may mimic Kawasaki disease clinically but it may also be detected in patients with Kawasaki disease. We have presented two patients with Kawasaki disease who infected with human adenovirus in this case report.

Background:Acute gastroenteritis is responsible observed in all age groups, especially infants and children. The etiology and clinical course of acute gastroenteritis may vary with age and etiological agents. In developing countries, the morbidity and mortality associated with infectious diarrhea is higher in children younger than five-years-of-age.Objectives:The aim of this study was to determine the prevalence and seasonal distribution of the major agents of acute gastroenteritis in children who were admitted to a Turkish university hospital pediatric emergency unit during 2009.Patients and Methods:Seasonal distribution within a one year period and quantitative distribution were analyzed with demographic data and laboratory findings. A total of 644 subjects were enrolled in the study, with a mean age of 4.14 years. Pathogens were detected in 183 (28.4%) stool samples in children less than 16 years, admitted with acute gastroenteritis.Results:Pathogens were detected in 184 (28.4%) stool samples. The age distributions of the cases were 0 - 24 months (n = 59), 2 - 5 years (n = 100), and > 5 years (n = 25). The detection rate of rotavirus, norovirus and adenovirus were; 12.7% (75/588), 9.8% (51/520) and 4.9% (28/575), respectively. Bacterial agents were detected in 36 cases. The main agent was norovirus in the 0 - 24 months group (n = 25, 42.4%), and rotavirus for ages 2 - 5 years (n = 43, 43%) and > 5 years. On the monthly distribution, cases of rotavirus were found to be more frequent in the first four months of the year.Discussion:Viruses were the major pathogens in all age groups. Norovirus was the leading pathogen in the first two years. For the age groups 2 - 5 years and 6 - 16 years, rotavirus was the major pathogen.

The low sensitivity of the RADT may be related to streptococcal carriage in some patients. The throat culture should be repeated after treatment to detect streptococcal carriage.

Upper respiratory tract infections caused by adenoviruses present long lasting fever for five days and elevated acute phase reactant levels. They are generally misdiagnosed as bacterial infections and are mistreated with antibiotics. The diagnosis of adenovirus infections mainly depends on direct antigen tests, virus isolation and detection of viral DNA using polymerase chain reaction (PCR). The aim of this study was to evaluate the clinical and laboratory findings of the children diagnosed as adenoviral respiratory tract infection by multiplex PCR (mPCR). A total of 27 children (18 male, 9 female; age range: 1-7 years, mean age: 4.4 years) whose nasopharyngeal swab samples were found positive for adenovirus DNA with a commercial mPCR method (Seeplex® RV15 ACE Detection Kit, Seegene Inc, Korea) were included in the study. The throat cultures of the patients revealed no bacterial pathogens and EBV VCA-IgM antibodies were negative. The clinical and laboratory data of the children with long lasting high fever diagnosed as adenovirus infection were evaluated retrospectively in terms of their complaints on admission, symptoms detected in physical examination, laboratory findings and therapy protocols. The patients were categorized according to hospitalization period (< 3 days or ≥ 3 days) and also according to the symptoms compatible with upper or lower respiratory tract infections. The quantity of clinical symptoms (≤ 2 or > 2) and the presence of upper or lower respiratory tract findings were evaluated if there were a difference by means of hospitalization rate and period. The most common complaint of the patients with adenoviral respiratory diseases was fever (27/27; 100%), and the most common admittance season was april-may-june period (20/27; 74%). The mean temperature was 38.4°C (range: 38-39.8°C) and the fever continued for 1-5 days after hospitalization. The most common physical examination finding was tonsillary hyperemia and hypertrophy (63%), followed by lower respiratory tract disease symptoms (37%), otitis media (14.8%), conjunctivitis (7.4%), and rash (3.7%). Laboratory tests could be performed for 24 cases and 95.8% of them yielded high CRP level, 87.5% high sedimentation rate, 62.5% neutrophilia, 33.4% leukocytosis and 20.8% lymphocytosis. It was noticed that 85.2% (23/27) of the patients were under antibiotic treatment on admission. Twenty-three patients (85.2%) were hospitalized, and the duration of hospitalization was between 1-8 (mean: 3.78) days. When the hospitalization rate was evaluated in terms of different measures, it was found that the rate was 81.8% (18/22) in patients with ≤ 2 symptoms, 100% in patients with > 2 symptoms (5/5); 100% (10/10) in patients with lower respiratory tract disease symptoms; 100% (15/15) in patients with neutrophilia, 88.2% (15/17) in patients with CRP levels of ≥ 2.8 - < 100 mg/L, and 100% (6/6) in patients with CRP levels of ≥ 100 mg/L. Neutrophilia and high CRP levels were found to be the main factors related to the hospitalization rate (p< 0.05). In conclusion,...

Akut apandisit (AA) acil ameliyatların en sık nedenlerindendir. 1,2 AA tanısı klasik olarak bulantının eşlik ettiği önce periumblikal sonrasında sağ fossa iliakaya lokalize karın ağrısı ve fizik muayenede peritonit bulgularının saptanması ile konulur. 3,4 Ancak bu bulgulara göre tanı doğruluğu %70-80 oranında değişmektedir. 3,4 Hastalığın klinik tanısı özellikle çocuklarda güç olup, AA ön tanısıyla opere edilen çocuklarda negatif Amaç: Bu çalışmada, akut apandisitli çocuklarda ortalama trombosit hacminin (OTH) akut apandisit tanısındaki değerinin ve akut apandisitteki komplikasyon varlığının OTH değeri üzerine olan etkisinin araştırılması amaçlandı. Yöntemler: Bu çalışma geriye dönük olarak planlandı. Klinik ve patolojik olarak akut apandisit tanısı alan 43 olgunun OTH değerleri sağlam çocuklar arasından seçilen kontrol grubunun (n=51) OTH değerleriyle karşılaştırıldı. Peritonit, nekroz, perforasyon ve apse saptanan olgular komplike apandisit, diğerleri komplike olmayan apandisit olarak sınıflandırıldı ve bu iki grup arasında OTH değerleri bakımından karşılaştırma yapıldı. İstatistiksel analizlerde t-test, Kruskal-Wallis, Mann-Whitney U testleri kullanıldı. Bulgular: Akut apandisitli çocukların (n=43, %68'i erkek) yaş ortalaması 8,7±4,0 yıl olup, yaş dağılımı ≤3 yıl (n=7), 4-9 yıl (n=13) ve 10-16 yıl (n=23) şeklinde idi. Komplike ve komplike olmayan apandisit sırasıyla 12 (%28) ve 31 (%72) çocukta saptandı. Komplike apandisit oranları ≤3 yaş, 4-9 yaş and 10-17 yaş alt gruplarında sırasıyla %71,4, %30 ve %21 olarak saptandı. Akut apandisiti olan (9,4±0,5 fL) ve olmayan (9,31±0,60 fL) çocukların OTH ortalamaları arasında anlamlı farklılık yoktu (p>0,05). Ortalama OTH değerleri komplike grupta 9,5±0,5 fL, komplike olmayan grupta ise 9,4±0,4 fL olup aralarında anlamlı farklılık yoktu (p>0,05). Sonuç: Çocuklarda OTH değerinin ilk dokuz yaş için akut apandisit tanısında uygun bir belirteç olmadığı görülmüştür. Akut apandisit saptanan 1-17 yaş arasındaki olgularda komplikasyon şüphesinde OTH değerinin tanısal bir değeri saptanamamıştır. Anahtar Kelimeler: Akut apandisit, çocuk, komplike apandisit, ortalama trombosit hacmi Introduction: The primary aim of this study was to investigate the diagnostic value of mean platelet volume (MPV) in the diagnosis of acute appendicitis and the effect of the presence of complication on MPV values in children with acute appendicitis. Methods: Mean MPV values were retrospectively compared between children who were diagnosed with acute appendicitis by clinical and pathological methods and healthy children (n=51). Children with peritonitis, necrosis, perforation and/or abscess were classified as complicated appendicitis. Mean MPV values were compared between children with and without complicated appendicitis. Statistical analyses were performed by student's t-test, the Kruskal-Wallis, and Mann-Whitney U tests. Results: The mean age of the children (n=43, 68% was male) was 8.7±4.0 years (range: 1-17). The children were divided into 3 age subgroups: ≤3 years (n=7), 4-9 years (n=13), and 10-...

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Background and Aims Acute gastroenteritis is responsible for dehydration in many children. The viruses are considered the main agents of gastroenteritis, and these are included by rotavirus, norovirus, adenovirus. Evaluation of the symptoms, clinical findings and hospitalization requirements were aimed in cases of dehydration. Methods The distribution of age, symptoms, clinical and laboratory findings and hospitalization requirements of viral gastroenteritis cases who have moderate to severe dehydration were evaluated retrospectively. A total of 156 patients with moderate to severe dehydration caused by acute viral gastroenteritis were evaluated. Patients were between 3 months to 16 years of age (mean: 38.7 months). Rotavirus, Norovirus and Adenovirus were detected by immunochromatographic method, as the causes of gastroenteritis. Results Dehydration were detected in 156 patients with acute gastroenteritis (156/278), which included patients with Rotavirus (48%), Norovirus (41%) and Adenovirus (13.5%), respectively. Norovirus was mostly detected (51.8%) in the first 24 months of age, however, Rotavirus was mostly detected in >24 months of age (61.3%). The common symptoms of all patients were vomiting, diarrhea, abdominal pain and malaise, although fever was seen mostly the cases with Rotavirus. A total of 59 patients were hospitalized, they were Rotavirus cases mostly (n=35, 59.3%). Conclusions The main agents of acute gastroenteritis which caused in dehydration were Norovirus and Rotavirus in our patients. Norovirus was the mostly detected agent in infants and young children who were < 24 months of age. Rotavirus was detected in the most of hospitalized patients, it had caused to most of the severe symptoms.