Numerous literature data show the role of mycoplasma infection in the development of non-respiratory lesions of various organs and systems, including the skin. Herpesvirus and mycoplasma infections can trigger the development of immune-mediated inflammatory reactions of the skin and mucous membranes — erythema multiforme exudative, Stevens-Johnson syndrome, vesicular pustular dermatosis — Sneddon-Wilkinson syndrome, etc.

In order to study the frequency and nature of skin lesions with mycoplasmosis combined with herpesvirus infection, 45 patients aged 3 to 15 years of life were observed. A comprehensive clinical and laboratory study revealed skin lesions in 27 patients associated with current mycoplasma and herpesvirus infections. Thus, multiforme exudative erythema in the small form variant was diagnosed in 13 patients, skin vasculitis in 4, hemorrhagic purpura in 3, urticaria rash in 3, erythema nodosum in 2, mucositis in 2 children. In 18 children, a combined mycoplasma and herpesvirus infection was established. In 9 children, a mono infection was detected (in 5 — herpes virus and in 4 — mycoplasma).

All observed patients showed antibodies to smooth muscle antigens in titers from 1:80 to 1:160 (normal 1:40) and in the vast majority (in 24 patients) — antibodies to vascular endothelial antigens in titers from 1:80 to 1:320 (with the norm of 1:40). Compaction of the intima-media complex was detected in 6 patients with monoinfection and in 16 patients with co-infection, according to ultrasound duplex scanning of the vessels of the brachiocephalic department.

Thus, for various immuno-inflammatory, allergic skin diseases, screening for infections, in particular, mycoplasma and herpesvirus, is necessary to optimize treatment.

The aim of the study was to study the features of cytokine balance and their effect on clinical and laboratory parameters in infectious hemorrhagic colitis in children. Materials and methods. In the Department of intestinal infections in 2018 observed 28 children with infectious haemorrhagic colitis. The diagnosis was established taking into account clinical recommendations; the severity of the disease was determined by the Clark index; the etiology was verified according to bacteriological and molecular studies of feces, serological methods. In the acute period of the disease, the concentration of cytokines in the blood serum — TNF-a, IL-4, IL-6, IL-10 was studied by enzyme immunoassay. Mann-Whitney method, Kruskal-Wallis dispersion analysis, Pearson correlation method we used to estimate the obtained data.

Results. The age structure of patients was dominated by young children (53.6%). Mild form of the disease was diagnosed in 32.1% of patients, moderate — in 67.9%. A high level of IL-4 was observed against a relatively low level of TNF-a, IL-6 and IL-10. Significantly higher concentrations of TNF-a and IL-6 were found in children with moderate form of the disease. The maximum values of IL-6 were observed in young children, IL-10 — in infants. In the moderate form of the disease, negative correlations of IL-4 with the number of leukocytes (r = –0.46; p = 0.05) and platelets (r = –0.48; p < 0.05) in the hemogram noted. Early age patients were found to have correlations of TNF-a with the relative number of rod neutrophils (r = 0.62; p < 0.01). There was a significant correlation of IL-4 with the relative number of segmental neutrophils (r = 0.49; p < 0.05). The relationship of TNF-a with the severity of the disease (r = 0.42; p < 0.05) revealed. The data on the possible suppressive effect of TNF-a and IL-10 on the synthesis of urea and the relationship of IL-6 with reactive changes in the liver obtained.

Conclusion. Studies of cytokine balance in infectious hemorrhagic colitis in children showed the severity of systemic inflammatory response with the activation of Th-2 immune response. The correlation of TNF-a with the severity of the disease was established, which may have diagnostic and prognostic value.

The study showed a high prevalence of markers of herpesvirus infections among mothers — from 71% to 98% of HSV, EBV and CMV infections and from 29% to 58% of HHV-6 infection. HSV remains the most common etiological agent of intrauterine infections among herpesviruses — markers of active infection caused by this virus were found in 28.3% samples. The difficulty of determining the source of infection in the absence of data in the early stages of pregnancy is presented on 4 out of 10 cases of active HHV-6 infection. Markers of active pneumocystic infection were detected only in mothers: in the group with children under the age of 21 days — in 21—27% of cases, with children aged 22 to 28 days — in 15—21%. In addition to non-specific multiple organ failure during intrauterine infections (26.3%), only one organ system was observed: hypoxic-hemorrhagic lesions of the central nervous system were diagnosed more often — 17%, as well as meningitis/encephalitis, or hepatitis, or pneumonia, or disorders of hematopoiesis, or rash. In 17.5% of children from the comparison group, i.e. without any clinical manifestations of intrauterine infections, markers of active herpes virus infections were detected.

A prospective cohort study was conducted to assess the effect of a recombinant interferon alpha-2b prophylactic course on cyto-immunological parameters of induced sputum in children with mild asthma, the main trigger of exacerbation of which was respiratory viral infections.

We examined 40 children aged 1 to 7 years with (mean age — 4.8 ± 0.2 years), half of whom received a course of recombinant interferon alpha-2b. The authors detected respiratory viruses in scrapings from throat and nose (PCR method) and evaluated the different cell counts, also the levels of interleukin-10, tumor necrosis factor alpha, interferon alpha and immunoglobulin E on the 1st and 30th day of the study (ELISA method) were determined in sputum.

The number of asthma exacerbations, triggered by respiratory viral infection, decreased in 4.5 times against. In children who received recombinant interferon alpha-2b the count of sputum eosinophils and the number of children with sputum eosinophilia (≥3 %) reduced. After two months the level of nasal eosinophils was 30% lower than the start level. The level of IgE in induced sputum decreased by 35%, but the level of IL-10 was increased by 1.5 times. 75% of parents whose children received recombinant interferon alpha-2b, note positive effect of this drug.

There were no adverse events to receive the drug in any case. Thus, the use of recombinant interferon alpha-2b in children with virus-induced asthma to reduce episodes of exacerbations associated with acute respiratory diseases can be recommended.

According to the Rospotrebnadzor of the Russian Federation for the first quarter of 2019 were registered 872 cases of measles, which indicates a tense epidemic situation for this pathology.

Objective: to establish clinical and epidemiological features of measles in children depending on age in the Astrakhan region for the period from January 2013 to June 2019.

Research methods: the analysis of 370 cases of measles in children aged 3 months to 17 years, confirmed by enzyme immunoassay (ELISA).

The results of the study: in the age structure of the incidence of measles in the Astrakhan region prevail unvaccinated children aged 2—3 years, and less than 1 year, not subject to vaccination against measles. The main reasons for the lack of vaccinations in children with measles are: medical taps. The incidence of vaccinated children against measles can be a consequence of violations in the organization of vaccination work. The causes of the presence of measles foci with the spread of infection are nosocomial outbreaks, measles drifts in organized groups, as a result of late detection and isolation of patients. Measles in children of different age groups, both vaccinated and unvaccinated proceeded typically with a predominance of moderate forms. The symptom of Filatov-Koplik remains the main sign of the diagnosis of measles in the catarrhal period of the disease, the gradual appearance of a spotty-papular rash in combination with catarrhal syndrome — in the period of rash, and pigmentation is a retrospective sign of the survive infection.

Objective: to assess the effect of viruses of herpes family in pregnant women on the health of children in the first half of their lives.

A clinical and laboratory observation of 33 mother-child pairs was conducted. Of these, 25 women were from the risk group for intrauterine infection and 8 women were with a physiological course of pregnancy. The quantitative content of herpes virus markers was studied by their effect on cholesterol metabolism and symbiotic microbiota was studied by the quantitative content of long chain fatty acids and fatty aldehydes, phospholipids by gas chromatography-mass spectrometry in all women at 34-37 weeks of gestation and their infants.

It was revealed that pregnant women of “risk group” increased the quantitative content of herpes virus markers with the prevalence of herpes simplex virus (HSV) 1,2 types and its associations with cytomegalovirus (CMV) and Epstein-Barr virus (EBV).

A correlation was found between the degree of increase in markers of HSV, EBV, and CMV with that of the bacterial load of the intestine by conditionally pathogenic representatives and the deficiency of priority genera of the intestinal microbiota in mothers and the same indicators in their children.

An increase in the quantitative content of herpes viruses, exceeding the norm by more than 2 times, is interconnected with the pathological course of pregnancy and the violation of the microecological status of pregnant women, which predicts the realization of somatic and infectious pathology in children in the first half of life.

The analysis of the epidemiological situation of vaccine-preventable infections in the Republic of Dagestan. The introduction of mass vaccine prophylaxis had a positive effect on reducing the incidence of infections such as poliomyelitis, diphtheria, tetanus, rubella, and viral hepatitis B in the Republic of Dagestan. However, despite the ongoing routine immunization of the population for “controlled” infections, the incidence of measles and parotitis infection remains high in 2018, this is due to an increase in the number of people who refuse to receive preventive vaccinations, in most cases, for religious reasons.

Congenital cytomegalovirus infection (CMVI) ranks first among congenital infections, making contribution significantly to the variety of congenital defects formation. The review describes in details the pathogenic mechanisms of the virus effects on the fetus and newborn. Congenital CMVI develops as a result of infection of the mother with the virus or its reactivation, causing an active infection. CMV is pantropic. Infected cells acquire the characteristic appearance of an «owl’s eye» due to a 3—4-fold increase in size, and the cytoplasm is visualized only in the form of a thin strip due to the large diameter of the nucleus. With a congenital CMV infection, the virus itself, its DNA or antigens is detected in biological media up to 14—21 days of life. The manifest and asymptomatic form of infection is distinguished.

Attention is drawn to the various clinical findings and long-term outcomes of the infection. When the fetus is infected in the early stages of pregnancy, various malformations of the central nervous system, cardiovascular, kidneys, etc. are formed. When infected in the late stages of pregnancy, a variety of diseases and pathological conditions are revealed in newborns. In 40—90% of newborns with manifest CMVI, there are long-term neurological consequences and hearing loss, as well as damage to the organ of vision.

Group A beta-hemolytic streptococcus is one of the most important infectious agents leading to both direct damage to organs, and to various cross-reactions with body antigens. One of these forms, manifested by the defeat of subcortical ganglia, is PANDAS syndrome. This paper describes the international criteria and clarifies the differences between this disorder and other forms of brain damage. Paper also describes the clinical case of PANDAS syndrome in a 7-year-old child.

The aim is to study the relationship of Mycobacterium tuberculosis infection and the development of laryngeal stenosis (croup) in children. 250 children with croup aged from 6 months to 8 years were examined.

It was found that infection with Mycobacterium tuberculosis in children with laryngeal stenosis (croup) developed at the age of under 4 years. The first episode of croup coincided in 90% of cases with the early period of primary infection with Mycobacterium tuberculosis. A high proportion of close contact with adult tuberculosis patients reached 35% in patients with recurrent laryngeal stenosis (croup). The incidence of tuberculosis among children with repeated episodes of croup was 30%. Anti-TB therapy for latent tuberculosis infection or local forms of tuberculosis led to the cessation of repeated episodes of croup in 85% of cases. Infection with Mycobacterium tuberculosis and active tuberculosis infection is considered as one of the factors contributing to the recurrent course of laryngeal stenosis in children.

A clinical example shows the erroneous diagnosis of listeriosis in a 15-year-old child hospitalized in the infectious department. The child was admitted with severe symptoms of intoxication, febrile fever, difficulty in nasal breathing, hyperemia of the mucous membranes of the oropharynx, tonsillitis, cervical lymphadenitis, facial tissue pasteness with swelling of the eyelid and conjunctivitis of the left eye, hepatosplenomegaly. A laboratory examination revealed pronounced leukocytosis up to 24 thousand, lymphocytosis, atypical mononuclear cells up to 9%, IgM and IgG to EBV capsid protein, IgM to CMV, IgM and IgG to listeria. But with a repeated double study of IgM and IgG to Listeria were not detected. The initial positive result was possibly due to the presence of cross-reacting antibodies in EBV mononucleosis. The final diagnosis was made: Infectious mononucleosis of mixed (EBV, CMV) etiology. Chronic polypous rhinosinusitis, exacerbation. Reactive edema of the eyelids against the background of inflammation of the sinuses.

Given the variety of clinical forms of listeriosis and their similarity with the manifestations of other infections, for the full diagnosis of listeriosis infection, it is advisable to evaluate the epidemiological and medical history data, as well as use an extended spectrum of laboratory confirmation of the diagnosis.

The article provides a brief literature review on tularemia, shows the current epidemic situation of tularemia in Russia and analyzes the characteristic clinical picture of the ulceroglandular form of tularemia. A clinical example of an ulceroglandular form of tularemia in a child.