[Show abstract][Hide abstract] ABSTRACT: Intervertebral disc calcification in childhood is rare. Calcifications are discovered by occasion during routine examinations of healthy children or evoke symptoms like neck and shoulder pain or discrete neurological symptoms. The prognosis of nearly all patients is excellent. We report on a 11-year-old girl, who suffered from acute pain in the neck and the left shoulder with increasing paresthesias of her left extremities which led to hospitalisation. Intervertebral disc calcifications were found between several cervical and thoracic vertebra. The only paraclinical finding was an elevated erythrocyte sedimentation rate. After 12 days of conservative and analgetic treatment the clinical condition deteriorated with acute worsening of the neck pain. The MRI revealed a posterior herniation of a calcified disc between the lower cervical spine with spinal cord compression. Immediate neurosurgical intervention led to decompression and disappearance of the symptoms. After 14 months the clinically healthy child only showed the persistence of one intervertebral disc calcification and a complete resolution of the former findings.
No preview · Article · Jan 2000 · Klinische Pädiatrie
[Show abstract][Hide abstract] ABSTRACT: In the blast cells of children with acute lymphoblastic leukemia (ALL) more than 50 chromosomes can be observed in a quarter of cases. As a rule these children have a good prognosis. However, some of these patients develop a relapse of their basic disease. There is only poor information about the significance of distinct additional chromosomes for the prognosis. The white blood cell count (WBC) at the time of diagnosis is a further very important prognostic factor in childhood ALL. Therefore we compared the relation between trisomy of distinct chromosomes and the initial white blood cell count of 41 children with common ALL and hyperdiploid karyotype. The modal chromosome number ranged from 50 to 60 chromosomes. Most frequently, the chromosomes X, 4, 6, 8, 10, 17, 18 and 21 were multiplied. Additionally, in 25 of the 41 cases structural chromosome aberrations were observed. The average WBC was estimated as 9.6 Gpt/l with a range from 1.8 to 41.5 Gpt/l. The initial WBC was slightly increased in patients with the additional chromosome X, 6, 11, 12 or 19 and distinctly decreased in children with the additional chromosome 8 or 9 in their hyperdiploid blast cells. No patient with an additional Chromosome 9 showed a WBC higher than 10 Gpt/l and only 2 out of the 12 children with an additional chromosome 8 revealed an initial WBC higher than 10 Gpt/l. Additional structural chromosome aberrations were without influence on the WBC.
No preview · Article · Nov 1998 · Klinische Pädiatrie
[Show abstract][Hide abstract] ABSTRACT: Invasive aspergillosis is a feared complication in the management of patients with malignancies. We report a 13-year-old boy with acute myelogenous leukaemia and chronic sinusitis who developed a sinuorbital fungal infection during cytostatic and prolonged antibiotic treatment. The clinical findings, diagnostic measures and treatment and its adverse effects are described and discussed. Special emphasis is given to our experience of the use of colloidal dispersed amphotericin B (Amphocil®).
Zusammenfassung. Aspergillus-Infektionen sind gefürchtete Komplikationen bei der Behandlung von Tumorerkrankungen. Wir berichten über einen 13jährigen Jungen mit akuter myeloischer Leukämie und chronischer Pansinusitis, bei dem sich im Verlauf der zytostatischen und langdauernden antibiotischen Therapie eine sinuorbitale Schimmelpilzinfektion entwickelte. Es werden klinische Befunde, diagnostische Maßnahmen, die Therapie und deren Nebenwirkungen beschrieben und diskutiert. Insbesondere wird über Erfahrungen bei der Anwendung des kolloidal-dispergierten Amphotericin B (Amphocil®) berichtet.
[Show abstract][Hide abstract] ABSTRACT: Enteritis and pseudoappendicitis are typical manifestations of Yersinia infections in children. This is a report on a child with localised tumourous mesenteric lymphadenitis due to Yersinia enterocolitica persistent for a long time. We found specific antibodies against Yersinia outer membrane proteins repeat-edly in the patients’ serum. Only after a ciprofloxacin therapy for 16 weeks we observed a recovery of our patient.
Yersinia enterocolitica can be the cause of mesenteric lymphadenitis.
No preview · Article · Aug 1998 · Monatsschrift Kinderheilkunde
[Show abstract][Hide abstract] ABSTRACT: Between July and October 1996 hepatitis C virus infection was diagnosed in 21 children who underwent immunosuppressive therapy mainly for malignant diseases. We report on the clinical signs and symptoms, diagnostic procedures and the clinical course of the disease in these patients. Epidemiological, diagnostic and clinical aspects of the outbreak are discussed. Analysis of all available data led to the conclusion that these infections were of nosocomial origin. This requires consequences in the hygienic regimen. In addition to the routinely used antibody-test the HCV-PCR should be the diagnostic method of first choice concerning the HCV-diagnostics in immunocompromised patients.
No preview · Article · Jan 1998 · Klinische Pädiatrie
[Show abstract][Hide abstract] ABSTRACT: This is a review of the symptoms and signs of children with malignant diseases and septicemia due to viridans streptococci, treated during a 6-year-period (1990-1995) in the Departments of Pediatrics or Pediatric Surgery, University of Leipzig. All 11 children suffered from leukemia. Streptococcus mitis was the most frequently isolated streptococcal species. All patients had fever and malaise, in most cases we could find inflammatory signs of the respiratory tract. In two children we saw a severe course of the disease, one child had symptoms and signs of ARDS, the other died on septicemic shock. All 11 patients had neutropenia and a central venous line, 10 of them were treated by cytarabine before the streptococcal infection was diagnosed. Like others we could note during the last years an increase of systemic infections due to viridans streptococci in neutropenic patients with malignant diseases. Possibly there is an association between streptococcal infection and cytarabine therapy. The empiric antibiotic therapy in neutropenic patients with malignant diseases should cover also streptococcal infections.
No preview · Article · Jan 1997 · Klinische Pädiatrie
[Show abstract][Hide abstract] ABSTRACT: Cardiomyopathy is a severe complication of the tomour therapy with anthracyclines. Since even minor disturbances of myocardial cell membranes could influence the dipole moment of the heart the noninvasive measurements of this parameter might be useful, particularly in the paediatric population. 17 children aged 2-15 years treated clinically for various malign blood diseases were examined repeatedly with a modified Nelson lead-system up to 3 years. The dipole moment was evaluated by visual comparison of the calculated horizontal and frontal VCGs, evaluation of 3 distinctive vectors, as well as of the magnitude curves and the velocity curves, all of them compared with the normal age dependent percentiles of each respective child. Conventional 12-lead ECGs were used to confirm rhythm disturbances and alterations of P-, PQ-, QRS-, and QT-durations. Our results show that damages of the heart are different during the time of the drug administration, then consisting of acute toxic reactions such as sudden dilatation and/or rhythm disturbances, and of long-term disturbances leading to growth retardation of the heart with the danger of chronic congestive heart failure months or years after the end of the anthracycline treatment. Morphological and biochemical damages of myofibrils caused by the toxicity of anthracyclines precede functional restraints of the heart. A noninvasive method for an early and reliable diagnosis of these damages is urgently needed, particularly for children. Measurements of the dipole moment with the Nelson-lead system seem to offer this diagnostic tool which aims possible changes of the drug administration protocol. (Fig. 3, Ref. 15.)
No preview · Article · Oct 1996 · Bratislavske lekarske listy
[Show abstract][Hide abstract] ABSTRACT: From January 1971 until the end of 1989, 94 infants suffering from meningitis caused by Haemophilus influenzae were treated in the Department of Pediatrics of the University of Leipzig. The anamnestic data, signs and symptoms, laboratory findings, the courses and final results of treatment are described. 88 children survived; in eight of them neurological or mental sequelae were found on discharge. Generally, a certain stagnation regarding treatment results is observed over the observation period. Therefore vaccination against Haemophilus influenzae type B should be encouraged.
No preview · Article · Feb 1993 · Pediatrics and Related Topics
[Show abstract][Hide abstract] ABSTRACT: Blood cultures are extremely useful in diagnosing various bacteremic diseases in childhood. The results obtained in this study are presented in relation to two periods of equal length (1972-1978, 1979-1985). At the present time there are about 22 relevant isolates from blood cultures per 1000 admitted children and year in the Department of Pediatrics, and about 3 isolates per 1000 admitted children and year in the Department of Pediatric Surgery, respectively. From newborns we isolated most frequently E. coli, Staph. aureus, B-Streptococci, Pseudomonas aeruginosa, Klebsiella pneumoniae, and yeasts. From children beyond the first month of life Haemophilus influenzae, Streptococcus pneumoniae, other streptococci, Neisseria meningitidis, and Staph. aureus were the most frequent identified etiologic agents. The main factors influencing the spectrum of agents causing bacteremia are: age of patients, status of hospitals, and applicated diagnostic and therapeutic procedures.
No preview · Article · Feb 1989 · Pediatrics and Related Topics
[Show abstract][Hide abstract] ABSTRACT: In a total of 223 children over one month old suffering from purulent meningitis, there was a predominance (n = 96) of meningococci over hemophilus influenzae (n = 68) and pneumococci (n = 59). Crucial to therapeutic strategy for purulent meningitis is early diagnosis, in our laboratory covering both liquor and blood cultures. Initial therapy has to take account of these three chief causal agents. We have not as yet observed any resistance to penicillin from meningococci or pneumococci, and none of the liquor-cultivated hemophilus influenzae stock has been resistant to ampicillin. In the first two years of life, initial therapy for bacterial meningitis should include ampicillin, a liberal (300-400 mg/kg KM/d) dosage continuing to be important after the onset of improvement. In view of the lack of resistance of the causal agents cultivated, we had hitherto no cell to deploy modern cephalosporins in cases of bacterial meningitis in children.
No preview · Article · Sep 1987 · Psychiatrie, Neurologie, und medizinische Psychologie
[Show abstract][Hide abstract] ABSTRACT: We saw 5 young infants with severe pneumonias due to RS virus (diagnosed serologically). Three of these infants were born as premature babies. Artificial ventilation was necessary in two cases. After the case reports follows a discussion of the most important problems of epidemiology, diagnostics and therapy of RS virus infections in young infants.
No preview · Article · Feb 1987 · Zeitschrift für Erkrankungen der Atmungsorgane