Necrotizing fasciitis in children: report of two cases and review of the literature

Article Abstract:

Necrotizing fasciitis (NF) must be promptly diagnosed and aggressively treated to prevent death. Any skin injury, including minor cuts, insect bites, surgical incisions, or infected chicken pox may initiate NF as may systemic infections. The most common NF-causing bacteria is systemic group beta-hemolytic streptococci (GABHS), but many other bacteria have been implicated. GABHS-caused NF infections are reported to be increasing in adults, but not in children. Severe pain in what seems a minor infection is a common presenting symptom. Redness, heat, and swelling, and fever ensue as does rapid progression of tissue death. Treatment consists of intravenous antibiotics and surgical removal of the gangrenous tissues. Two cases are reported of a 5-year-old girl and a 15-year-old boy where prompt recognition, antibiotic therapy, and surgical removal of dead tissues resulted in complete recovery. The infection started in a chicken pock in the girl's arm. In the boy, GABHS was isolated from a blister on his foot.

Streptococcal infections, Necrotizing fasciitis

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Hospitalization of abused and neglected children

Article Abstract:

Hospitals may not be following the recommendation of the American Academy of Pediatrics to hospitalize abused and neglected children for comprehensive assessment of their mental and physical status. Researchers reviewed the medical records of two Arizona hospitals over a two-year period. Only 34 abused or neglected children were admitted to the hospital in over 11,000 pediatric admissions, representing 3 admissions per 1,000 pediatric admissions. Child protective services admitted 715 children to the crisis nursery. Few children admitted to the hospital had private health insurance and half were younger than one year.

Analysis, Abused children, Hospital utilization

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Recent Corticosteroid Use and the Risk of Complicated Varicella in Otherwise Immunocompetent Children

Article Abstract:

Corticosteroids do not appear to increase the risk of severe chickenpox. In a study of 167 children with severe chickenpox and 134 healthy children, only two children with chickenpoz and one healthy child had taken corticosteroids in the previous 30 days.

Complications and side effects, Risk factors, Corticosteroids, Adrenocortical hormones, Chickenpox

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