Clinical Review : Acute Renal Failure in Children: Principles of Management

Abstract

Acute renal failure is a complicated disturbance, which taxes the clinical skills of the physician. This paper reviews the metabolic derangements, the principles of treatment, the consequences, and the advances recently made in our understanding of the pathophysiology and management of acute renal failure.

Invasive Streptococcus pneumoniae Infection Causing Hemolytic Uremic Syndrome in Children: Two Recent Cases

“…Sixty-five per cent (47 of 72 cases) were associated with pneumonia and/or empyema (1)(2)(3)(4)(5)(6)10,11,(15)(16)(17)(18)(19)(26)(27)(28)31), and 31% were associated with meningitis (3,6,7,11,16,20,23,25,29,31). Sepsis was documented in 22% (1,2,18,(21)(22)(23)(24)(28)(29)(30)32) and otitis media in 7% of cases (3,19); one case was associated with mastoiditis (3). One study suggested that HUS typically followed pneumonia by approximately one week (18); however, our patients demonstrated both concurrently.…”

“…One study suggested that HUS typically followed pneumonia by approximately one week (18); however, our patients demonstrated both concurrently. Among the described cases, S pneumoniae was isolated from several different sites, including blood (61%) (2)(3)(4)(5)(6)11,16,18,(20)(21)(22)24,25,(27)(28)(29)(30)32), cerebrospinal fluid (27% ) (3,7,11,16,20,25,29) and pleural fluid (13%) (10,16,19,26).…”

“…In addition, the reference lists of articles found with this search were examined to identify more articles. We identified 27 articles that reported on 70 cases of HUS associated with S pneumoniae (1)(2)(3)(4)(5)(6)(7)10,11,(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”