The article describes some topical problems of neuroinfections in children and the ways of their solutions on the basis of the experience of a leading institution — Pediatric Research and Clinical Center for Infectious Diseases. There are introduced some innovation approaches of diagnostics and therapy of bacterial purulent meningitis tested at the institution. There are described diagnostic markers of meningitis in children, method of ultrasound evaluation monitoring of the condition of kidneys, renal blood flow, adrenal glands in the patients with a fulminant course of generalized form of meningococcal infection, and innovation therapeutic approach by recombinant interleukin-2 — roncoleukin introduction to the complex therapy. There is reflected an innovation method of differential diagnostics by the determination of acute-phase protein haptoglobin in cerebrospinal fluid. There are presented the tested methods to diagnose sensorineural deafness in children with bacterial purulent meningitis, critical condition polyneuropathy, and inflammatory polyneuropathy by the technique of rehabilitation potential evaluation.

The article is devoted to study the etiological role of herpes viruses in infectious and somatic pathology of children (n = 770) using the complex of methods of laboratory diagnostics. Determined the leading etiological role of HSV in children with neuroinfections (12,7%) during primary infection and in children with intrauterine infection (29,0%) during its reactivation. It is shown that in 50,9% of cases, the diagnosis of «infectious mononucleosis» confirmed by the detection of markers of acute EBV-infection, and 20,0%, it was replaced by mononucleotides syndrome was discovered markers of acute CMV-infection, and 18,1% — markers of acute HHV-6-infection. The role of HHV-6 as the primary etiologic agent of the disease is established at 36,3% of children admitted with convulsive syndrome on the background of febrile, at 29,1% — a sudden exanthema and 25,5% — with fever of unknown origin.

A comparative analysis of the development of acute stenosing laryngotracheitis (LSLT) in respiratory viral monoinfections in 1050 children, hospitalized in St. Petersburg hospitals. It was established that the clinical manifestations, severity and outcome of OSLT in viral monoinfections depend highly on the etiologic factor, the patient's age and his premorbid background. More often, stenoses of the larynx are provoked by parainfluenza viruses (26,7%), the next most important are the PC virus (22,3%) and adenoviruses (18,8%), but during epidemics the number of lesions of the larynx sharply increases, with influenza viruses as the main pathogen, reaching up to 31,1%. Boys (71,2%) suffer from LSLT more often than girls (28,8%). Burdened premorbid background were 88,1% of children.

A total of 75 children with chronic hepatitis B (ChHB) with a refractory variant of anemia of inflammation (AV) course were examined, the pathogenetic manifestation of which was the development of iron overload syndrome (IOS). It was revealed that against the background of an increase in the severity of the IOS, the incidence of progressive forms of the disease with persistent prevalence of asthenovegetative, hemorrhagic syndromes and severe hepatosplenomegaly increased. At the same time, the leading biochemical syndromes were the presence of cytolysis with prolonged hyperfermentemia, endotoxemia and mesenchymal inflammatory syndrome. A directly proportional dependence of the hepcidin-25 peptide level on the degree of expression of the IOS, the higher the presentation of the IOS, the higher the level of suppression of peptide expression in hepatocytes. Diagnostically significant tests of severe forms of IOS in ChHB in children are the presence of hemosiderin in the urine and an increase in the level of sIL-6R in the serum.

The aim of the study was to determine the clinical and epidemiological features of Epidemic parotitis in children in the Astrakhan Region under conditions of vaccine prophylaxis. 260 cases of laboratory-confirmed Epidemic parotitis in children under 17 years of age have been analyzed.Contact with diseased Epidemic parotitis was found in 180 (69,2%) of affected children. In the age structure of the patients, children aged 3 to 9 years (73,8%) prevailed, of which 87,5% of children in this age group had vaccination and revaccination against Epidemic parotitis. Patients aged 9 to 17 years accounted for 26,2% of cases with an immune stratum of 76,5%. Severe forms of the disease were noted when a combination of Epidemic parotitis with orchitis, pancreatitis, meningitis. The epidemiological process of Epidemic parotitis infection in children, under conditions of vaccine prevention, is characterized by an increase in the number of patients among older children and adolescents up to 26,2%. The decrease in the immune stratum, among infected children, compared with the recommended level of coverage with vaccination and revaccination against Epidemic parotitis 95% of children, may be the cause of the increase in the incidence of this pathology in the region. In the structure of clinical forms, medium-severe forms of the disease predominate (63,9%). Displacement of morbidity by Epidemic parotitis in the direction of older and adolescent years may indicate a decrease in the intensity of postvaccinal immunity after revaccination at the age of 6 years, which calls for discussion of the need for a second planned revaccination against Epidemic parotitis at the age of 15—17.

Treatment of chronic viral hepatitis is not a fully resolved problem, especially in children. There are no convincing criteria for recovery. The paper presents various schemes used for etiotropic therapy of viral hepatitis at the present stage — interferons and antiviral drugs. For the treatment of hepatitis B, synthetic nucleoside and nucleotide analogues are used as an antiviral therapy, in the case of hepatitis C — ribavirin and protease and polymerase inhibitors. In children, interferon therapy remains important with the use of domestic drugs, including rectal forms of interferon administration (VIFERON®). At the same time, active research is underway to study non-interferon regimens for the treatment of chronic viral hepatitis in pediatric practice, but so far the choice of drugs for non-interferon therapy is limited to individual drugs. With hepatitis B, it is a lamivudine, prescribed from 3 years (the reception of which is accompanied by frequent development of resistance) and — tenofovir (appointed from 12 years). With hepatitis C, ribavirin can be administered from 3 years.

50 children aged from 3 to 67 months with acute intestinal infections receiving antibiotic therapy, were clinically and microbiologically examined using gas-liquid chromatographic test with the measurement of short-chain fatty acids (SCFAs) in coprofiltrates. The influence on the biocenosis is assessed upon treatment with an-tidiarrhoeal medication Gelatin tannat (Adiarin), which acts by forming a protective film on the surface of intestinal mucosa preventing loss of body fluids and microbial toxins. 20 children in the control group received antibiotics, sorbents, probiotics. The study has proved the clinical effect of Gelatin tannat, resulting in reduction of time to normalization of diarrhea and intoxication for 2 days, and data on the probiotic effect of the drug, similar to that of probiotics in the control group which expands the indications for the use of Gelatin tannat for prevention of antibiotic-associated diarrhea.

A new value was acquired by the drug Orvirem®, which is a combination of rimantadine and natrium alginate. In recent years, it has not been recommended for use due to the resistance to it strains of the influenza A(H1N1) virus pdm2009. Currently, this drug has acquired a new meaning, and this is due to the dominance of subtype A(H3N2). Two recent clinical studies have demonstrated that the drug Orvirem® has proven activity against viruses not only of influenza A but also B, coronavirus, and other common pathogens of respiratory viral infections (rhinoviruses, respiratory syncytial virus, adenovirus, etc.). High efficacy, safety and absence of adverse reactions make it possible to widely use Orvirem® in children from the first year of life, incl. with chronic diseases.

The data on the safety and effectiveness of the use of the domestic immunomodulating preparation Polyoxidonium® (azoximer bromide) in children are summarized in the following pages. Polyoxidonium has an immunomodulatory (including interferon-inducing), detoxication and anti-inflammatory effect that allows the clinical course of the disease to be quickly alleviated and the natural immune response modulated. The clinical effectiveness of the drug in acute respiratory infections (ARI) in children, including those with allergic anamnesis. Recent studies have proven the effectiveness of the 7-day course of the preparation Polyoxidonium® for the treatment and prevention of ARI and influenza in children, starting at the age of 3 years, as evidenced by a rapid positive dynamics of clinical symptoms and a 2-fold decrease in ARI frequency compared to placebo group at 6 months after the end of therapy.

The article presents the results of the study of the etiological structure and clinical features of acute intestinal infections of viral, bacterial and mixed etiology in children hospitalized in a specialized department of Children's Clinical Hospital №9 named G. N. Speransky, city of Moscow in 2008—2016. It was found that during 9 years of follow-up, the number of hospitalized patients with acute intestinal infections does not have an obvious tendency to decrease. More than half of hos-pitalized patients are children 1—7 years old. Among the reasons for acute intestinal infections of established etiology, viral agents (rotaviruses and noroviruses) prevail. Among bacterial intestinal infections, the most urgent are salmonellosis, campylobacteriosis and staphylococcal infection.

Purpose of the study: Analyze the epidemiological situation of echinococcosis in children in the Astrakhan region. In the Astrakhan region from 2001 to 2016. Registered 141 cases of echinococcosis in humans, incl. In children — 22 cases (15,6%). Among all the sick children, echinococcosis was more often reported in school-age persons — 90,9%. From the preschool age group, echinococcosis was recorded in two (9,1%) unorganized children aged 5 and 6 years. The main complaints in the majority of invasive children were pain and a feeling of heaviness in the right hypochondrium — 40,9%, periodically arising cramping pain in the area of localization of the parasite — 31,8%. In rare cases, complaints of weakness and a feeling of bursting at the site of echinococcal cyst localization were noted — 4,5% each. A part of patients — 18,2% of the complaints were absent. When diagnosing, both laboratory and instrumental diagnostic methods were used. In most cases — 90,9%, the diagnosis of echinococcosis was confirmed by the enzyme immunoassay (ELISA method). Thus, recently in the territory of the Astrakhan region there has been an increase in the number of cases of human infection with echinococcus, incl. аnd children of school age. The parasite is located, as a rule, in the liver and lung. The disease was susceptible to those who had a history of permanent contact with non-undelminthic dogs. In the diagnosis of echinococcosis, the main role is played by the complex methods of ELISA, CT, ultrasound, x-ray and histological methods.

Clinical cases of generalized Haemophilus influenzae (Hib) infection with the central nervous system lesions in children from the same family were presented. Methods of the prevention have been proposed in focus of Hib-infection.