Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/transmissão , HIV-1 , Transmissão Vertical de Doenças Infecciosas , Estudos de Coortes , DNA Viral/análise , Reações Falso-Positivas , Seguimentos , Infecções por HIV/prevenção & controle , HIV-1/genética , Humanos , Lactente , Reação em Cadeia da Polimerase , Sensibilidade e EspecificidadeAssuntos
Doenças Desmielinizantes/etiologia , Infecções por HIV/complicações , Polineuropatias/etiologia , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/imunologia , Pré-Escolar , Doenças Desmielinizantes/sangue , Doenças Desmielinizantes/imunologia , Anticorpos Anti-HIV/análise , Anticorpos Anti-HIV/imunologia , Humanos , Masculino , Polineuropatias/sangue , Polineuropatias/imunologiaRESUMO
Although common in tropical regions, pyomyositis is rare in the continental United States. Fewer than 50 cases have been reported to date. It is characterized by suppuration of large muscle groups that can, if not quickly and appropriately treated, lead to sepsis and death. Diagnosis can be difficult secondary to the atypical appearance of the abscess process early on. Almost all cases have occurred in otherwise healthy people. The simultaneous occurrence of pyomyositis and immunodeficiency is rare. A recent report of a case in an adult with the acquired immunodeficiency syndrome (AIDS) is not, however, unexpected. We describe the first documented occurrence of pyomyositis in a child with AIDS. A brief review of the topic is included. Pyomyositis should be included in the list of unusual infections that can occur in children with AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Miosite/complicações , Infecções Estafilocócicas/complicações , Humanos , Lactente , Masculino , Miosite/patologia , Infecções Estafilocócicas/patologia , SupuraçãoRESUMO
The safety and efficacy of simultaneous administration of measles-mumps-rubella (MMR), diphtheria-tetanus-pertussis (DTP), and trivalent oral poliovirus (OPV) vaccines in a test group of 405 children were compared with the safety and efficacy of sequential administration of the same vaccines in a control group of 410 children given MMR followed by booster doses of DTP and OPV 2 months later. The study was double blind and placebo controlled with respect to DTP and OPV. Seroconversion rates to measles, mumps, and rubella exceeded 96% in both groups. Geometric mean titers to measles (P = .05) and rubella (P = .004) were higher in the test group, and titers of antibodies to the other seven antigens were similar in both groups. Clinical reaction data were analyzed in 248 of 405 test children and 249 of 410 control children. The rates of serious vaccine-associated reactions were low and similar in the two groups. Some minor side effects were reported more frequently in the test group, but these differences were judged to be related to study design rather than to differences in the safety of the two vaccine schedules. The results indicate that the safety and serologic efficacy of administering MMR simultaneously with reinforcing doses of DTP and OPV in the second year of life is equivalent to the safety and efficacy observed after administering these antigens separately.
Assuntos
Vacina contra Difteria, Tétano e Coqueluche , Esquemas de Imunização , Vacinas/administração & dosagem , Anticorpos/análise , Toxoide Diftérico/administração & dosagem , Método Duplo-Cego , Combinação de Medicamentos/administração & dosagem , Humanos , Imunização Secundária , Lactente , Vacina contra Sarampo/administração & dosagem , Vacina contra Sarampo-Caxumba-Rubéola , Vacina contra Caxumba/administração & dosagem , Vacina contra Coqueluche/administração & dosagem , Vacina Antipólio de Vírus Inativado/administração & dosagem , Distribuição Aleatória , Vacina contra Rubéola/administração & dosagem , Toxoide Tetânico/administração & dosagem , Vacinas/efeitos adversos , Vacinas CombinadasRESUMO
A 5-month-old Amish infant boy with chronic granulomatous disease underwent bone marrow transplantation from his 5-year-old, histocompatible brother after a preconditioning regimen of busulfan 2 mg/kg/day for 4 days, followed by cyclophosphamide 50 mg/kg/day for 4 days. At the time of bone marrow transplantation, he was free of infection, and remained so throughout the course of the transplant. He was engrafted promptly, with complete reversal of the neutrophil function defect and no sign of graft-versus-host disease. This was followed by loss of the erythroid graft and deterioration in neutrophil function over a period of 9 months. Sixteen months after transplantation, he is free of infection and growing normally, with essentially no evidence for neutrophil engraftment.