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Background: Echinococcosis is a uncommon condition in pediatric patients, and encompasses alveolar and cystic forms, predominantly affecting the lungs and liver. Transmission occurs primarily through zoonotic means, such as the contamination of water and food by infected dog and other canid feces. Diagnosis can be challenging due to nonspecific symptoms that often mimic pneumonia. The case: A 6-year-old female patient from a rural area in Ecuador who initially presented with nonspecific symptoms indicative of pneumonia. However, further investigation into socio-environmental factors led to a diagnosis of pulmonary and hepatic hydatid disease. Conclusion: The timely and accurate diagnosis of this infectious disease enabled the patient to receive appropriate treatment and surgical intervention, leading to her complete recovery.

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BACKGROUND: The incidence of respiratory diseases has dropped during the school closures at the COVID-19 pandemic including acute otitis media (AOM) among the pediatric population. METHODS: This study included 2090 patients under 12 years old, that were diagnosed with AOM between March 2019 and February 2021 at the otolaryngology and pediatrics emergency room at a public tertiary hospital in Sao Paulo, Brazil. RESULTS: There was a significant drop in number of AOM cases diagnosed during the quarantine. The group before the pandemic represents 87,2% of the total attendings and the first two months of quarantine had the major attendance discrepancy between the same period during pre-pandemic times. CONCLUSION: Quarantine isolation measures and school closures may have helped reduce not only the coronavirus spread but also other infectious diseases such as AOM among the pediatric population.

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Emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains in healthcare settings has changed the hospital epidemiology of MRSA in the last few years. Despite a global increase in MRSA frequency, infections caused by methicillin-susceptible S. aureus (MSSA) have persisted in healthcare settings and the community. Staphylococcus aureus isolates were collected between 2009 and 2017 at the Children's Hospital of a Caribbean city in South America. Methicillin-resistant isolates were subjected to SCCmec typing. Representative isolates were analyzed by multilocus sequence typing (MLST) and spa typing. Antibiotic susceptibility was assessed by agar dilution method. D-zone test was performed in erythromycin-resistant isolates to determine macrolide/lincosamide/streptogramin resistance. Spa typing revealed 10 different spa types. The main epidemic clones circulating during the study period were: ST8-MRSA-IVc, ST923-MRSA-IVa and ST8-MRSA-IVa. The study found high frequencies of PVL genes and resistance to erythromycin and clindamycin in the isolates. This study provides the first description of the population structure of MRSA and MSSA causing infections attended in the participating Children's Hospital. ST8-MRSA-IVc, ST923-MRSA-IVa and ST8-MRSA-IVa were the most prevalent in the isolate population.

This study was aimed to determine the distribution of sequence types, SCCmec types and antibiotic resistance profiles of MRSA and MSSA isolates recovered from pediatric patients with clinical infections attended in the Children's Hospital of a Caribbean city in South America in a period spanning 8 years. We found high frequencies of PVL genes and resistance to erythromycin and clindamycin in the isolates. The fact that MRSA and MSSA isolates in this study were frequently resistant to erythromycin and clindamycin is an indication of the selective pressure imposed by the extensive use of these two antibiotics in the treatment of skin and soft tissue infections in the geographical area of this study. This is the first study reporting the clonal distribution of Staphylococcus aureus causing infections in the pediatric population of Cartagena, a tropical city in the Caribbean coast of Colombia.

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BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an important therapeutic strategy for several hematologic diseases. In the absence of a matched related donor, allogeneic HSCT has been associated with increased risk of infectious complications. Here, we present the clinical and epidemiological characteristics of early infectious complications in children undergoing HSCT from Southern Brazil. METHODS: This is a retrospective unicentric cohort study of infections in all children receiving their first HSCT during the period between 2010 and 2017. RESULTS: Data from 292 patients were analyzed; bone marrow failures (52.7%) comprised most of the baseline diagnosis. Bone marrow (BM) was the stem cell source in 254 (87%), followed by cord blood (CB) in 34 (11.6%) children. The use of alternative donors (77.8%) and presence of acute graft-vs-host disease (GVHD) (23.6%) were associated with an increased risk of viral and fungal infection. Bacterial infection was observed in 79 patients (27%); 220 patients (75.3%) were diagnosed with viral infection, and 35 patients (12%) developed fungal infection. The presence of fungal disease together with the presence of multiple infections during follow-up was associated with an increased risk of death (P < .001). CONCLUSIONS: The clinical profile of HSCT-related infections in this cohort suggests that prognosis in allogeneic HSCT is influenced by the source of stem cells (CB having worse prognosis), presence of acute GVHD and complications arising from fungal infections. The appropriate management of these factors has the potential to improve the overall prognosis rates in pediatric allogeneic HSCT recipients.

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Background: In contrast to adults, Trypanosoma cruzi-infected children have more broadly functional Trypanosoma cruzi-specific T cells, and the total T-cell compartment exhibits fewer signs of immune exhaustion. However, not much is known about the link between immunocompetence and the treatment efficacy for human Chagas disease. Methods: Using cytokine enzyme-linked immunosorbent spot (ELISPOT) polychromatic flow cytometry, cytometric bead assay, multiplex serological assays and quantitative PCR, we evaluated T. cruzi-specific T-cell and antibody immune responses, T-cell phenotypes and parasitemia in children in the early chronic phase of Chagas disease undergoing anti-Trypanosoma cruzi treatment. Results: Treatment with benznidazole or nifurtimox induced a decline in T. cruzi-specific IFN-γ- and IL-2-producing cells and proinflammatory cytokines and chemokines. T-cell responses became detectable after therapy in children bearing T-cell responses under background levels prior to treatment. The total frequencies of effector, activated and antigen-experienced T cells also decreased following anti-T. cruzi therapy, along with an increase in T cells expressing the receptor of the homeostatic cytokine IL-7. Posttreatment changes in several of these markers distinguished children with a declining serologic response suggestive of successful treatment from those with sustained serological responses in a 5-year follow-up study. A multivariate analysis demonstrated that lower frequency of CD4+CD45RA-CCR7-CD62L- T cells prior to drug therapy was an independent indicator of successful treatment. Conclusions: These findings further validate the usefulness of alternative metrics to monitor treatment outcomes. Distinct qualitative and quantitative characteristics of T cells prior to drug therapy may be linked to treatment efficacy.

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La Bronquiectasia es una enfermedad poco frecuente en pediatría y representa el estado final de una variedad de procesos patológicos. El objetivo de este trabajo es llamar la atención en hace el diagnóstico temprano y brindar un tratamiento temprano y adecuado de las enfermedades pulmonares agudas y crónicas en pediatría para tratar de evitar las complicaciones como las Bronquiectasias. Materiales y métodos: Se realizó este estudio prospectiva durante el periodo comprendido entre el 1 de enero 2006 y el 30 de abril de 2010 en el Hospital de Especialidades Pediátrica. Se incluyeron en este trabajo todos los pacientes mayores de 1 mes hasta los 15 años que durante el periodo de estudio se le realizó el diagnóstico de bronquiectasias de forma ambulatoria u hospitalaria. Se registraron y analizaron las siguientes informaciones como la edad y sexo, diagnóstico de la enfermedad de base, edad de presentación de las bronquiectasias, características de las imágenes radiográficas de las bronquiectasias, , análisis espirométricos, resolución de las bronquiectasias, características de las bronquiectasias, y la mortalidad. Resultados: Un total de 7 pacientes se le realizó el diagnóstico de bronquiectasias durante el periodo de estudio. En relación a la distribución de los pacientes por edad podemos observar que el 57.1% ( 4 pacientes) se presentaron a una edad de 10-15 años. Con respecto al sexo hubo predilección por el sexo femenino en el 57.1% ( 4 pacientes). El 86% ( 6 pacientes) cursaban con una enfermedad de base. La edad de presentación de las bronquiectasias observada más frecuentes fue a la edad de 5-15 años en el 57% de los casos. En relación a las imágenes de las bronquiectasias fueron más frecuentes las cilíndricas y focales en el 100% de los pacientes y además 2 de los cuales presentaron imágenes quística y varicosas. En 4 de nuestros casos se le pudo realizar una espirometría siendo informada como limitación ventilatoria restrictiva. Conclusiones: Aunque se considera que las bronquiectasias son poco frecuentes en la población pediátrica, en nuestro medio como en otros países en vías de desarrollo, las infecciones respiratorias agudas bajas son una de las principales causas de morbi-mortalidad en los niños, siendo un importante factor de riesgo para el desarrollo de las bronquiectasias.

The bronchiectasis is a slightly frequent disease in pediatrics and represents the final condition of a variety of pathological processes. The aim of this work is to call the attention in doing the early diagnosis and offering an early and suitable treatment of the pulmonary sharp and chronic diseases in pediatrics to try to avoid the complications as the bronchiectasis. Materials and methods: This market study was realized during the period understood between 1 January, 2006 and April 30, 2010 in the Hospital de Especialidades Pediátricas. There were included in this work all the major patients of 1 month up to 15 years that during the period of study, the diagnosis was realized of bronchiectasis of ambulatory or hospitable form. They registered and analyzed the following information like the age and sex, diagnosis of the base disease, age of presentation of the bronchiectasis, characteristics of the radiographic images of the bronchiectasis, and the mortality. Results : A total of 7 patients carried out the diagnosis of bronchiectasis during the period of study. In relation to the distribution of the patients for age we can observe that 57.1% ( 4 patients) appeared to an age of 10- 15 years. With regard to the sex there was predilection for the feminine sex in 57.1% (4 patients). 86%( 6 patients) was dealing with a base disease. Conclusions: Though it thinks that the bronchiectasis are slightly frequent in the pediatric population, in our way as in other developing countries, the respiratory sharp low infections are one of the principal reasons of morbid-mortality in the children, being an important factor of risk for the development of the bronchiectasis.