W. Lane M. Robson

Childhood cervical lymphadenopathy.

Abstract Cervical lymphadenopathy is a common problem in children. The condition most commonly represents a transient response to a benign local or generalized infection, but occasionally it might herald the presence of a more serious disorder. Acute bilateral cervical lymphadenopathy usually is caused by a viral upper respiratory tract infection or streptococcal pharyngitis. Acute unilateral cervical lymphadenitis is caused by streptococcal or staphylococcal infection in 40% to 80% of cases. The most common causes of subacute or chronic lymphadenitis are cat scratch disease, mycobacterial infection, and toxoplasmosis. Supraclavicular or posterior cervical lymphadenopathy carries a much higher risk for malignancies than does anterior cervical lymphadenopathy. Generalized lymphadenopathy is often caused by a viral infection, and less frequently by malignancies, collagen vascular diseases, and medications. Laboratory tests are not necessary in the majority of children with cervical lymphadenopathy. Most cases of lymphadenopathy are self-limited and require no treatment. The treatment of acute bacterial cervical lymphadenitis without a known primary source should provide adequate coverage for both Staphylococcus aureus and group A beta hemolytic streptococci.

Association of preauricular sinuses and renal anomalies

Renal ultrasonography was performed on 69 children who had a preauricular sinus. Three children (4.3%) were found to have a significant renal anomaly. Two children had hydronephrosis secondary to vesicoureteric reflux. One patient with branchio-oto-renal syndrome had an absent left kidney and a hypoplastic right kidney associated with two dysplastic arteries. Renal anomalies were significantly more common in patients with a preauricular sinus than the 1 percent incidence of renal anomalies reported in the general population. We recommend that renal ultrasonography be performed on all children with a preauricular sinus.

In Chinese Newborn Infants Comparison with Other Ethnic Groups

The palpebral fissure length was measured in 60 normal Chinese term infants in the first 48 hours of life. The measurement of the palpebral fissure length was performed with a vernier caliper by placing it across the greatest horizontal axis of the eye from the medial to the lateral canthus. The head circumference was measured by placing a tape anteriorly just above the eyebrows and posteriorly at the maximum point of the occiput. There was no difference according to sex or between the measurements in the right and the left eye. The palpebral fissure length was 1.94 ± 0.17 cm (mean ± standard deviation (SD)) and the head circumference was 34.0 ± 1.3 cm (mean ± SD). These data suggest that Chinese neonates have a shorter palpebral fissure length than do black American neonates and a longer palpebral fissure length than do white American and Turkish neonates.The palpebral fissure length was measured in 60 normal Chinese term infants in the first 48 hours of life. The measurement of the palpebral fissure length was performed with a vernier caliper by placing it across the greatest horizontal axis of the eye from the medial to the lateral canthus. The head circumference was measured by placing a tape anteriorly just above the eyebrows and posteriorly at the maximum point of the occiput. There was no difference according to sex or between the measurements in the right and the left eye. The palpebral fissure length was 1.94 +/- 0.17 cm (mean +/- standard deviation (SD)) and the head circumference was 34.0 +/- 1.3 cm (mean +/- SD). These data suggest that Chinese neonates have a shorter palpebral fissure length than do black American neonates and a longer palpebral fissure length than do white American and Turkish neonates.

Acute diarrhea in children. What to do and what not to do.

Acute diarrhea is a leading cause of childhood morbidity and mortality. Primary care physicians and pediatricians should be familiar with its clinical features and management. Rehydration and maintenance of proper fluid and electrolyte balance are the most important aspects of treatment. While intravenous rehydration is the best form of treatment for children who are in shock or unable to drink, oral rehydration is the treatment of choice for the majority of children who have mild to moderate dehydration. Oral rehydration therapy is simple, practical, inexpensive, effective, and safe for children in developing as well as developed countries. We recommend the use of commercially available rather than homemade solutions. Antibiotic and antidiarrheal agents are usually not indicated. Early reintroduction of milk, formula, or solid food is important, as is instruction of parents in measures to minimize transmission of infectious agents.

Dominantly-inherited lop ears.

We describe a four‐generation Chinese family that included five members who had an isolated bilateral lop ear anomaly. The presentation suggested a dominant mode of inheritance. The absence of male‐to‐male transmission does not exclude an X‐linked dominant mode of inheritance. Since the phenotypic anomaly of the male proband was no more severe than the affected female members, an autosomal dominant mode of inheritance is most likely.

Antibiotic Dosages in the Treatment of Group A Streptococcal Infections

tion of penicillin V 200,000 U (125 mg) in children less than 60 lb and 400,000 U (250 mg) in larger children. The Committee recommends that the penicillin be given orally, three or four times a day, for 10 days. Alternatively, benzathine penicillin G 600,000 U is recommended to be administered intramuscularly to children less than 60 lb and 1,200,000 U to larger children and adults. This suggests that a child weighing 59 lb should be given 200,000 U of penicillin V orally

A giant congenital nevus spilus in an 8-year-old girl.

Congenital nevus spilus is rare, and the lesion is usually small. This report describes an 8-year-old girl with a giant congenital nevus spilus that involved the left side of her abdomen, perineal area, and left upper thigh. The patient also had a Mongolian spot in the lumbosacral area.