Shock is a frequent, lethally dangerous complication of infectious diseases in children. The main reason for high mortality among children population is late diagnostics and irrational therapy. The variability of clinical picture urges to develop a clear algorithm for searching shock markers and therapeutic approaches depending on the severity.

The purpose of research is to designate the significance of histamine and symbiotic microbiota in the development of allergopathology  in the first months of baby’s life.

As a result of the study of 80 «mother-child» pairs with a burdened genetic history of allergopathology, it has been found that the intensity of histamine production by intestinal strains in women with intestinal microbiota disorders was significantly higher than that in women without it (2 = 4,6; p = 0,032). It has been revealed that the intensity of the histamine release depends on the severity of intestinal symbiotic microbiota disorders.

The correlation between the severity of the gut microbiota disorders and the intensity of histamine release of intestinal strains of mothers with these indicators of their newborns  (rs = 0,761; p < 0,05) has been revealed.

The degree of severity of intestinal symbiotic microbiota disorders and the intensity of histamine release the baby’s risk of allergic disease development significantly affect the frequency of gastrointestinal and skin manifestations of allergies (2 > 3,8; p = 0,05).

The purpose of the study is to characterize the clinical and epidemiological indicators of the acute period of tick-borne encephalitis (TBE) in children who became ill in 1990—2017 and living in the region of Siberia and the Far East.

We presented clinical and epidemiological data on TBE. The diagnosis  of TBE was confirmed by Hemagglutination inhibition reaction, ELISA test and PCR. Other tick-borne diseases and diseases with similar symptoms were excluded. It was mathematically proved that incidence rate depends on the increase in tick populations and duration of epidemic season but not on their virus activity.

A significant reduction in the incidence rate and a change in the ratio of clinical forms were recorded after 2003. The frequency of a febrile form increased, while the frequency of meningeal and focal forms decreased without change in frequency and severity of TBE symptoms. The threat of a fatal outcome persists, which can only be prevented by early diagnosis, adequate therapy and vaccination.

In most cases, HIV infection in children is accompanied by the development of anemia with a decrease in hemoglobin  levels.

We studied the structure of anemia in 114 children  with HIV infection aged from 1 year to 18 years. Depending on the clinical stage of HIV infection, the patients were divided into 3 groups: 1st group — 20 children with the second clinical stage of HIV infection;  2nd group — 74 children with the third clinical stage; 3rd group — 20 children with a fourth clinical stage. Serum iron and ferritin were determined.

In the majority of patients (95.2%) of the studied groups iron deficiency anemia (IDA) was detected, in 4.8% of cases anemia of chronic diseases (ACD) was detected.

The importance of differentiation of the identified anemia determines the therapeutic tactics and the need for the appointment of iron-containing drugs.

It has been shown that various infectious diseases can be a factor in the formation and development of pathology of the digestive system organs in children.

The literature describes, mainly, the clinical aspect of changes in the organs of the digestive system in infectious diseases, studies of the functional activity of the organs of the digestive system are extremely rare.

The digestive organs are also the immune organ in children, studying the interrelationships of the infectious process and the developing changes in the digestive system organs allows predicting the course and outcomes of infectious diseases, increasing the effectiveness of their therapy, and also identifying children at risk of forming a chronic pathology of the digestive system.

A review of trichinosis literature is presented.

In the Russian Federation, from a few dozen to several hundred cases of trichinosis are registered annually, caused by 4 types of trichinae: T. spiralis, T. pseudospiralis, T. nativa and T. britovi.

Adults and larvae develop in the same host, which is both final and intermediate.  Adults live in the small intestine, and the larvae develop inside the skeletal muscle fibers. Infection occurs when eating meat containing live larvae.

Clinical symptoms of trichinosis include nausea, vomiting, diarrhea, fever lasting from several days to a month, then myalgia, facial swelling, eyelids, maculo-papular, urticarial exanthema join. Complications of trichinosis: myocarditis (the most common cause of death), pneumonia, meningoencephalitis. Albendazole and mebendazole are most effective as antihelminthic therapy.

98 patients from 2 to 12 years old were observed with infectious mononucleosis (IM). Diagnosis was confirmed by the detection of M- and G-antibodies to EBV, CMV, HHV6, PCR DNA these viruses, bacteriological and blood-tests investigations. 58 patients in the complex therapy was given probiotic bifidumbacterin forte 45—90 doses a day (1-st group). The comparison group consisted of 40 patients with IM receiving symptomatic complex therapy and antibiotics (2-nd group). The observations shoved significant decreasing of length of clinical symptoms IM in the 1-st group with comparison of the 2-nd group. The investigation of concentration DNA these viruses (1-st group) demonstrated its rapid decreasing in blood to the second week of mononucleosis. The obtained results allow to recommend bifidumbacterin forte in the complex therapy in children with these infections.

Two clinical observations of measles in sisters old 1 year 10 months and 3 years and 8 months have been described. Measles was severe with the development of an early complication in the form of severe bilateral community-acquired pneumonia with pulmonary edema and severe respiratory failure 2 degrees, which required treatment in the intensive care unit. At the sisters measles proceeded on the background of persistent herpetic (cytomegalovirus and HHV-6) infections, and at older sister measles was on the background of pyoderma. Measles was confirmed by detection of specific IgM by ELISA. The sisters were not vaccinated against measles and had home contact with a younger sister who had an infection with a clinical of measles.

Purpose: assessment of the clinical and epidemiological situation of current invasions in children of the Astrakhan region. 315 outpatient cards of children were analyzed in 2016.

The diagnosis of Giardiasis was made to 151 children, the diagnosis of Enterobiasis — 164. The age of all observed children ranged from 9 months to 17 years. The largest part was made up of children aged 3 to 14 years of age — 80.3%, among them enterobiasis was identified — in 46.7%, giardiasis — in 33.6% of cases. Most of the children  — 90.5% were from organized groups (they attended preschool institutions or school). The reasons for the examination of all children were varied. Some children — 63.5% went to the doctor with complaints  or clinical symptoms. Another part of the children — 33% of the diagnosis was made as a result of preventive examinations.

In most cases — 78.7% various bad habits were identified. Thus, geophagy (the habit of eating the earth) was noted in 33.3% of children, and onigophagy (the habit of biting the nails) in 24.8%. In 21.3% of cases, bad habits were absent. Contact with pets was established in 22.9% of children. According to the ultrasound, most children with giardiasis (83.8%) had pathology (reactive changes of the pancreas, liver, gallbladder dyskinesia, etc.)

In case of giardiasis niferator, albendazole was administered. In case of enterobiasis albendazole, pyrantel, and mebendazole were administered in age dosages. After antiparasitic treatment, in 91.4% of cases, the clinical symptoms of the disease completely disappeared, with giardiasis — in 85.4%, with enterobiasis — in 97% of cases.

In 1.3% of children with giardiasis, after several courses of antiparasitic drugs, Giardia was found in feces in the absence of complaints and clinical symptoms, indicating a possible Giardia carrier parasite in children.

The aim of the study was to study the etiology and clinical manifestations of acute intestinal infections (AII) in children aged 1 month to 18 years old who were hospitalized in the infectious diseases ward of a Moscow city hospital  in 2016—2018.

A retrospective analysis of 9076 case histories was performed. Etiological interpretation was carried out using bacteriological examination of feces, latex agglutination reaction, immunochromatographic analysis, polymerase chain reaction (PCR), serological reactions (indirect hemagglutination test).

The majority of children hospitalized with AII (62.2%) were 1—6 years of age. The etiology of AII was deciphered in 32% of cases. Acute intestinal infections of viral etiology prevail (64%), among them — rotavirus (73%), less often — norovirus (21%). AII of bacterial etiology accounted for only 14%, among them salmonellosis remains significant (5.6%), and in young children — staphylococcal infection (1.7%). There were also mixed infections (22%), mainly of viral and bacterial etiology. Noteworthy is the increase in the frequency of occurrence of bacterial AII in the winter season. The leading topical diagnosis in the vast majority of patients (85.1%) was gastroenteritis with the development of exsiccosis (77.6%).

A case of bilateral polysegmental destructive legionella pneumonia with the formation of multiple lung abscesses in an immunocompetent boy aged 15 years is presented.

The child had symptoms of intoxication with febrile fever, myalgia, unproductive cough, respiratory failure, dull percussion sound and weakening of breathing on both sides in the lower sections. A computed tomography of the chest revealed multiple bilateral multifocal foci of pulmonary tissue with destruction. The diagnosis of legionella pneumonia was made on the basis of detection of IgM antibodies to L. pneumophila with an increase in titer in the dynamics and exclusion of other causes of lung damage. Levofloxacin turned out to be an effective antibacterial drug.

It is necessary to take into account the ability of microorganisms of the genus Legionella to cause multiple abscess formation of lung tissue.

Ascariasis is the most common infectious parasitic disease in childhood.  In the Omsk region, the situation on the disease of this helminthiasis can not be considered safe or even stable. Within 5 years, the rate of increase in the incidence of ascariasis in rural areas was 9.33%.

The authors' team presented a clinical case of severe ascariasis, complicated by toxic-allergic dermatitis in a child aged 10 years. Allergic manifestations of helminthiasis were also nasopharyngitis, acute bronchitis, and cheilitis. The accession of a bacterial infection in the form of bilateral conjunctivitis, balanoposthitis due to a decrease in the protective factors of immunity in parasitosis was noted. Anemia 1 degree developed on the background of damage to the intestinal wall and the absorption of vitamin B 12 by ascaris.

Identified defects in the management of the patient by the district service,  the timely conduct of the study of feces on helminths would lead to early diagnosis and rational treatment.

Among patients  with tularemia in Russia, children make up 15%. In the available literature, the description of tularemia in children is practically not found. The article provides two clinical examples of tularemia in children of different ages.

A child aged 2 years with an ulcero-glandular  form had a primary affect, febrile fever for a week, regional lymphadenitis, inflammatory changes in the general blood test. The second child at the age of 8 years with a glandular form had a painful increase in the inguinal lymph node to the right, up to 4 cm without primary affect, febrile fever during the week. The diagnosis of tularemia was confirmed in both cases serologically  in the agglutination  test on the 19th and 6th days of the disease, respectively.

The diagnosis of tularemia caused difficulties for doctors of different specialties (pediatrician, surgeon), which did not allow for the timely appointment of treatment. Etiotropic drug was amikacin.