Abstract:
:Three infants with infant botulism are presented to illustrate how atypical, early, and severe features may obscure or delay diagnosis. Two boys aged 6 weeks and 20 days, respectively, presented with rapid deterioration after brief periods of poor feeding, one with an apparent life-threatening event at home and the other with a full cardiopulmonary arrest. Initial abnormal laboratory findings of coagulopathy suggested sepsis in the first infant. In the second infant, severe acidosis and hypoglycemia suggested an underlying metabolic disorder. A third infant, aged 1 month, was hospitalized originally with an admitting diagnosis of "pharyngitis" resulting from his inability to take adequate feedings. He received intravenous fluids and antibiotics. One week later he suffered a respiratory arrest. Laboratory findings of severe hyponatremia and acidosis at the time of his arrest suggested a metabolic etiology. Even retrospectively, none of these infants had the typical initial complaint of constipation, and none were noted to have ptosis or facial weakness before catastrophic collapse. However, in each case, the parent had initially brought the child to the physician for "poor feeding" or "poor suck," which was not recognized by medical personnel as a result of bulbar weakness. Ultimately, all 3 infants were found to have infant botulism. All 3 had received antibiotics before catastrophic collapse, possibly contributing to the rapidity of the deterioration. Each recovered, although the delay in diagnosis made them ineligible for treatment with botulism immunoglobulin.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Mitchell WG,Tseng-Ong Ldoi
10.1542/peds.2005-0297subject
Has Abstractpub_date
2005-09-01 00:00:00pages
e436-8issue
3eissn
0031-4005issn
1098-4275pii
116/3/e436journal_volume
116pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract::To improve child health at a community level, pediatricians require knowledge and skills that have not been traditionally included in residency training. Recent policy statements from the American Academy of Pediatrics and requirements from Accreditation Council for Graduate Medical Education Residency Review committe...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-2825J
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:As newborn screening (NBS) programs expand to include conditions that challenge traditional public health criteria, little is known about what influences physicians' attitudes toward screening. We examined the effect of state policy and perceived state policy on pediatricians' attitudes toward screening. MET...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-1990
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:Our goal was to determine the prevalence of intestinal parasites in internationally adopted children, to examine factors associated with infection, and to determine if evaluating multiple stool specimens increases the yield of parasite identification. METHODS:We evaluated internationally adopted children wit...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-3032
更新日期:2011-09-01 00:00:00
abstract::To determine what conditions are most likely to cause persistent or recurrent pneumonia (PRP) in children, the records of 81 children referred to James Whitcomb Riley Hospital for Children for evaluation of PRP were reviewed. Twenty patients had an apparent underlying cause that predisposed them to PRP. Of the 61 rema...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract::Advertising to children and teenagers is a multibillion-dollar industry. This policy statement reviews the forms of advertising that children and teenagers encounter, including newer forms of digital marketing, such as sponsored content, influencers, data collection, persuasive design, and personalized behavioral mark...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2020-1681
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:In connection with the possible relationship between Mycoplasma infection and the onset of asthma, several studies have shown not only a high level of serum total immunoglobulin E (IgE) but also the production of IgE specific to Mycoplasma or common allergens during the course of Mycoplasma infection. It has ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.107.3.e39
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Despite high per capita health care expenditure, the United States has crude infant survival rates that are lower than similarly developed nations. Although differences in vital recording and socioeconomic risk have been studied, a systematic, cross-national comparison of perinatal health care systems is lac...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.109.6.1036
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:The goal was to investigate the efficacy of orally administered probiotics in preventing necrotizing enterocolitis for very low birth weight preterm infants. METHODS:A prospective, blinded, randomized, multicenter controlled trial was conducted at 7 NICUs in Taiwan, to evaluate the beneficial effects of prob...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2007-3007
更新日期:2008-10-01 00:00:00
abstract::The movement of young adults with special health care needs from pediatric-oriented care to adult-oriented care has been a growing concern in the health care literature over the past 20 years. This article reviews the development and evaluation of health care transition policy over that period of time. These health ca...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:2002-12-01 00:00:00
abstract::Children who become overweight by age 2 years have significantly greater risks of long-term health problems, and children in low-income communities, where rates of low adult literacy are highest, are at increased risk of developing obesity. The objective of the Greenlight Intervention Study is to assess the effectiven...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2013-3867
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:Bedside delivery of discharge medications improves caregiver understanding and experience. Less is known about its impact on medication adherence. We aimed to improve antimicrobial adherence by increasing on-time first home doses for patients discharged from the pediatric hospital medicine service from 33% t...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2019-2413
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of domestic violence against mothers in a pediatric emergency department and the relationship of their children to the abusers. DESIGN:Cross-sectional survey of a convenience sample of mothers seeking treatment for their children. SETTING:An urban pediatric emergency department. ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.103.5.1007
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:To follow up a previous retrospective analysis in which we found the use of a pacifier to be a risk factor for recurrent acute otitis media (AOM). METHOD:In the present prospective study, the occurrence of AOM and the use of a pacifier were recorded in 845 children attending day care centers during a 15-mont...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1995-11-01 00:00:00
abstract::In Canada, 8% to 20% of infants are breast-fed by mothers who smoke. To determine whether breast-feeding increases infants' exposure to tobacco smoke products, urinary cotinine excretion was measured in 172 babies, 33 of whom were breast-fed. A milk sample was taken from the mothers who were breast-feeding, and cotini...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::The clinical course, laboratory data, outcome, and autopsy findings in 61 pediatric patients with suspected brain death were reviewed. In 58% of patients, the initial EEG was isoelectric, and cerebral blood flow was absent. In six of nine children, the initial EEG, which showed activity, became isoelectric by 72 hours...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1986-07-01 00:00:00
abstract::A newborn with graft-vs-host (GVH) disease following an exchange transfusion was treated by attempting to eradicate the incompatible graft and to reconstitute the child hematologically and immunologically with a bone marrow transplant. The patient was a female term infant (blood group B, Rh+ Coombs test positive) who ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1982-07-01 00:00:00
abstract::Death from cancer is often painful. Usually, the pain can be relieved in ways that allow patients to remain awake and alert until the end. Sometimes, however, the only way to relieve pain is to sedate patients until they are unconscious. This method has been called palliative sedation therapy. Palliative sedation ther...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2017-0487
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the effect of left-to-right shunting on the resting energy expenditure (REE), total energy expenditure (TEE), and energy intake in a group of 3- to 5-month-old infants with moderate to large unrepaired ventricular septal defects (VSDs) compared with age-matched, heal...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.102.5.1172
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVES:In recent years there has been increasing emphasis on the mental health aspects of primary health care for children and adolescents. The Health Resources and Services Administration's Maternal and Child Health Bureau has contributed to efforts aimed at strengthening primary care not only in early identificat...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.99.4.e5
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVES:The purpose of this work was to determine whether visual impairment caused by toxoplasmic chorioretinitis is associated with impaired performance of specific tasks on standardized tests of cognitive function. If so, then we worked to determine whether there are patterns in these difficulties that provide a l...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-1530
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVE:To determine if the incidence of empyema among children in the United States has changed since the introduction of the pneumococcal conjugate vaccine in 2000. METHODS:We used the nationally representative Kids' Inpatient Database to estimate the annual total number of hospitalizations of children < or = 18 y...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-0184
更新日期:2010-01-01 00:00:00
abstract::Tobacco use is the leading preventable cause of morbidity and death in the United States. Because 80% to 90% of adult smokers began during adolescence, and two thirds became regular, daily smokers before they reached 19 years of age, tobacco use may be viewed as a pediatric disease. Every year in the United States, ap...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-2121
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVES:CHARGE (coloboma, heart defect, atresia choanae, retarded growth and development, genital hypoplasia, ear anomalies/deafness) syndrome and chromosome 22q11.2 deletion syndrome are known to have significant clinical overlap including cardiac anomalies, ear abnormalities, hearing loss, developmental delay, ren...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2008-3400
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Growth-restricted preterm infants are at increased risk of developing necrotizing enterocolitis (NEC) and initiation of enteral feeding is frequently delayed. There is no evidence that this delay is beneficial and it might further compromise nutrition and growth. METHODS:Infants with gestation below 35 week...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2011-2379
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Medical care for very low birth weight (VLBW) infants and their mothers has changed dramatically during the 1990s, yet it is unclear how these changes have affected mortality and morbidity. OBJECTIVE:We used the Vermont Oxford Network Database to identify trends in clinical practice and patient outcomes for...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.110.1.143
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:The impact of secondhand marijuana smoke exposure on children is unknown. New methods allow for the detection of marijuana smoke exposure in children. METHODS:We studied children who were hospitalized in Colorado and had a parent participating in a smoking cessation study; all children had urine samples rem...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2018-0820
更新日期:2018-12-01 00:00:00
abstract::The place of causal inference in clinical practice is considered. One function relates to the validation of existing knowledge, as in the evaluation of the medical literature, and is exemplified by the process of editorial selection. A second function relates to the validation of potential knowledge, as in the testing...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract::Hyperphenylalaninemia due to dihydropteridine reductase deficiency results from the inability to maintain the aromatic amino acid hydroxylase cofactor, tetrahydrobiopterin, in its reduced or active form. Diagnosis of the disease is usually made by direct enzymatic assay on liver biopsies or in cultured skin fibroblast...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
abstract::Kawasaki disease is a childhood vasculitis of medium-sized vessels, affecting the coronary arteries in particular. We have treated a therapy-resistant child who met all diagnostic criteria for Kawasaki disease. After the boy was given intravenous immunoglobulins and salicylates, as well as several courses of pulsed me...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.112.4.986
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:The association of childhood sexual intercourse, excluding sexual abuse, with adolescent health and risk behaviors was examined using the urban component of a statewide study on adolescent health, risky behaviors, and resiliency factors. METHODOLOGY:A specialized cohort design was used to derive a two-group ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00