Doris Y. Sanders

Bacteroides infections in children

Four case reports of Bacteroides infections in children are presented. Two of thesepatients were brothers with agammaglobulinemia who developed pyogenic arthritis due to Bacteroides. The literature regarding Bacteroides infections in infants and children is reviewed.

Mixed connective tissue disease in a child

T h e episode of D I C could have resolved spontaneously; however, the rap id clearance of soluble circulat ing fibrin coincident with the inst i tut ion of hepar in therapy suggests that hepar in may have been ins t rumenta l in l imit ing the process. Fur thermore , all previously repor ted newborn infants with Listeria sepsis and petechiae not t reated with hepar in have died. T h e findings, therefore, suggest that a short course of hepar in should be given to infants with Lister ia sepsis in whom int ravascular coagulat ion is documented. R E F E R E N C E S

Chronic granulomatous disease of childhood with onset of symptoms at age 11 years

An l l-year-old boy with a febrile illness of one months duration was admitted to the North Carolina Baptist Hospital. The child had been well except for recurrent suppurative axillary and inguinal adenopathy in the preceding two years. There were no known familial diseases except diabetes. Physical examination revealed a boy who appeared chronically ill. He was normotensive. Temperature was 99.6 ~ F. Height was 56 inches and weight was 68~ pounds. An eczematoid-Iike dermatitis was present on the ears, around the nail of the left thumb, and at the base of the penis. There were healed areas of scarring in the right axillary and inguinal regions. There were several small freely movable

Antibody titers to polioviruses in patients ten years after immunization with sabin vaccine.

Summary Serum neutralizing antibody titers to poliovirus Types I, II, and III were performed on 45 young adults 10 years after immunization with trivalent oral poliovirus vaccine and compared to previous antibody titers. Eighty-four per cent of the participants had antibody titers to all three types of poliovirus in a dilution of 1:3 or greater 10 years after immunization.

Shigellosis associated with appendicitis

Abstract Shigellosis and acute appendicitis presented concomitantly in a 5-yr-old girl. The literature regarding the association of Shigella infections and acute appendicitis is reviewed briefly.

Thyroid abscess in a 14-month-old child

Abstract Suppurative thyroiditis occurring in childhood is rare. Progression to abscess formation is an even more uncommon occurrence. Only four thyroid abscesses occurring in children under 15 yr of age have been reported in the past 20 yr. 1–4 A 14-mo-old white girl developed an enlarging mass in the anterior neck. Two weeks previously she was treated for otitis media by her local physician and subsequently was observed to develop a mass in the area of the thyroid gland. Her febrile course was not altered by antibiotics. Physical examination was entirely within normal limits except for the thyroid which was firm and hard with a 4-cm movable mass in the region of the left lobe of the thyroid. There was no associated erythema or apparent tenderness. Laboratory studies included a hemoglogin of 11.6 g/100 ml, hematocrit of 33.5 vol %, white blood cell count of 16,700/ml 3 with a differential count of 65 neutrophils, 30 lymphocytes, and 5 monocytes. A urinalysis revealed no abnormalities. Stool culture grew normal enteric flora. A throat culture grew non-Group A beta hemolytic streptococci. A chest film revealed no abnormalities. Studies of thyroid function included a T-3 (30.4%) within normal limits and a T-4 (10.1 μg) in the high euthyroid range. The child received erythromycin 125 mg orally at 6-hr intervals without cessation of fever for 4 days. At this time, it was felt that the fever was related to the thyroid mass which appeared unchanged from the time of admission. At operation, an abscess cavity was noted in the superion of the left lobe of the thyroid gland. Approximately 10 cc of purulent material was removed from the cavity and a Penrose drain was placed in the abscess cavity. A biopsy specimen revealed inflammation and fibrosis consistent with the wall of the abscess. Bacterial, fungal, and acid-fast cultures of the pus were negative. The child became afebrile within 24 hr after operation. The postoperative course was uncomplicated except for the occurrence of a skin abscess at the site of the operative incision. Drainage of this abscess yielded 4 cc of purulent material from which staphylococcus epidermidis was grown. Subsequently the child has not experienced any further difficulty and remains euthyroid.

Chronic Salmonellosis in Infancy

a fi‘~e-day course of intramuscular Kanamycin in a dosage of 22.5 mg every 12 hours. He improved transiently but then persistent diarrhea recurred. At eight weeks of age, he was hospitalized for studies because he was lethargic and appeared severely malnourished. His weight was 2.9 kg, as compared with his birth weight of 3.9 kg. Pulse rate was 120 per minute; respirations, 25 per minute, and rectal temperature, 100.4 F. No other abnormalities were detected on physical , examination.