Patrick S. Pasquariello

Intrafamilial transmission of Epstein-Barr virus infections.

Intrafamilial transmission of Epstein-Barr virus infections was studied in 35 familial. After infectious mononucleosis was diagnosed in an index child, all siblings were tested for antibodies to EBV. Susceptible children were retested in four to eight weeks. In five families, a concurrent seroconversion was detected in an asymptomatic younger child. Two of 35 seronegative siblings developed clinical IM, confirmed serologically, during the study period. Overall, there evidence of spread in 7 (20%) of the 35 families. We conclude that there is significant intrafamilial transmission of IM. Our findings are compatible with an incubation period of four to six weeks.

H. influenzae pneumonia in infants and children.

Five patients were seen in a 15 month period in whom H. influenzae pneumonia was diagnosed. A review of the clinical characteristics of H. influenzae pneumonia is presented. This diagnosis should be suspected in any patient, regardless of age, in whom the pneumonitis appears refractory to antibiotics. The etiologic diagnosis of H. influenzae pneumonia may be proved more frequently with intensive investigational diligence, including bronchoscopy.

Comparison of Self-Referred And Physician-Referred Patients To a Pediatric Diagnostic Center:

Self-referral of children by parents without the knowledge of the childs regular physician can lead to redundant or unnecessary testing and difficulty in arranging follow-up care. This study was designed to investigate reasons for self-referral in a hospital-based pediatric diagnostic center. During the study period, 59 patients were referred by their regular physicians and 51 were self-referred. In multiple-choice questionnaires completed by 85% of the parents, nearly half (18/39; 46%) of those who were self-referred but only 2/51 (4%) of physician-referred parents said the childs regular physician was unconcerned about the medical problem. Further study on the causes for this perception is needed before recommendations can be made to physicians about demonstrating their concern to families.