It was found that the clinical picture of rotavirus infection in infants with an initially low number of immunocompetent cells expressing TLR-3 does not differ significantly from that of patients with an initially large number of cells expressing TLR-3. When analyzing the treatment, it turned out that antibacterial therapy due to the activation of bacterial microflora was used only in children with an initially low number of immunocompetent cells expressing TLR-3. In the same group of patients, the development of atopic dermatitis and food allergies was noted during catamnestic observation for 6—12 months after rotavirus infection.

Objective – to characterize the clinic and the immune status state in children with HIV infection, taking into account the presence of congenital CMVI.

Methods. A clinical and laboratory examination of 91 children with HIV infection with congenital CMVI (20; group I) and without it (71; group II) was carried out. Results. The anamnestic risk groups for congenital CMVI on the part of the mother included age over 30 years (55%), drug use (75%), chronic metroendometritis (85%), colpitis (55%), features of HIV status (secondary disease stage 4 — in 20%, CD4-lymphocyte count 0,5 х 109/l or less in 85%, HIV blood viral load 50 cop./ml or more in 80%), pregnancy pathology (threat of miscarriage — in 50%, developmental delay fetus — in 65%), lack of chemoprophylaxis for vertical transmission of HIV (55%). The clinical criteria for diagnosing of congenital CMVI in newborns included prematurity (40%), congenital malformations (45%), intrauterine growth retardation (65%), jaundice syndrome (50%), and perinatal CNS damage (80%). Children with congenital CMVI at the age of three months developed multiple organ pathology — lymphadenopathy (80%), hepatomegaly (65%), splenomegaly (40%), underweight (75%), pneumonia (60%), hepatitis (30%), pancreatitis (15%), enterocolitis (20%), nephritis (25%), carditis (20%), encephalitis (15%), chorioretinitis (20%), anemia (60%), thrombocytopenia (15%). A severe immunodeficiency state with a predominant violation of the T-cell link was revealed. A high titer of CMV was found in biological materials, IgG antibodies in the blood.

Conclusion. The use of clinical and laboratory criteria makes it possible to timely diagnose congenital CMVI in children with HIV infection and prescribe complex therapy.

Objective: to study the clinical and epidemiological features of the course of a new coronavirus infection in children of different ages undergoing outpatient treatment.

The study participants were 812 children with COVID-19 aged from 1 month to 17 years, who were on outpatient treatment in the children's polyclinic of the city of Kirov from July to December 2021. The average age of patients with COVID-19 was 5.9 ± 1.1 years. Among the sick young children there were 28%, adolescents — 16%. In 76% of cases, contact with patients with a new coronavirus infection was detected, mainly in the family, as well as in educational institutions. In 70% of cases, an early request for medical help was registered — in the first three days of illness. In most cases (89%), a mild severity of the disease was established with the development of subfebrile fever and pharyngitis. Rhinitis phenomena were recorded in 20% of cases. 7% of children complained of a dry cough. Lung tissue lesion (RG1) was detected in 5% of patients, gastrointestinal tract — 5%. In adolescents, the phenomena of rhinitis, pharyngitis, dry cough were less common than in other age groups. Recombinant interferon alpha-2b and umifenovir were used for etiotropic therapy. All children recovered within 7—10 days from the onset of the disease.

In the treatment of Lyme borreliosis (LB), early diagnosis is a key component. The epidemiological history of the patient plays one of the leading roles in suspected borreliosis and at the same time is an important criterion for clinical diagnosis.

Purpose. Analysis of epidemiological history data in outpatient cases of LB in Moscow.

Material and methods. We conducted a retrospective, non-randomized, single-center cohort study, based on the analysis of data from 660 outpatient records of patients, referred by local physician with tick bite or suspicion of LB, and consulted by an infectious disease specialist on the basis of the Infectious clinical hospital No.1 in Moscow. For further analysis, patients were divided by age and the presence or absence of LB. Confirmation of LB was based on clinical and/or laboratory criteria using methods of enzyme immunoassay and immune blot.

Results. We have updated the epidemiological features of the LB for Moscow, such as: the relative number of cases in the administrative districts of Moscow, places and seasonality of tick bites. Among children, compared with adults, cases of a tick bite without the development of LB was predominant, which must be taken into account in order to avoid overdiagnosis of LB. In patients with LB, an indication of the fact of tick bite in the anamnesis was much less common than going to its habitats.

Conclusion. Our data clarify the epidemiological features of LB for residents of Moscow. In the absence of a history of indications of tick bite, an informative sign for clinical diagnosis is a visit to its habitats, including not only trips to wooded areas, but also to suburban areas and parks.

Objective: based on the production of cytokines, to identify the immunological features of the chronic course of cytomegalovirus infection in children of the first year of life against the background of hypoxic-ischemic CNS damage.

Research methods:108 newborns with cytomegalovirus infection occurring against the background of perinatal hypoxic-ischemic lesions of the central unequal system were examined. All observed patients immediately after the diagnosis of cytomegalovirus infection underwent an immunological examination, including the determination of the levels of interferon-alpha (IFN-α) and interferon-gamma (IFN-γ), the level of interleukins — 2 and 4 (IL -2 and IL-4) necrosis factor human alpha tumors (TNF-α in blood serum was determined by enzyme immunoassay using a set of reagents ProCon IF2 plus, ProCon Ifgamma, ProCon TNFα (Protein contour LLC, Russia, St. Petersburg). At 1 and 6 months of life .

The observation groups consisted of 78 children (72.2%) with an acute course of the disease (Group 1) and 30 children (27.3%) with a chronic course (Group 2). The control group consisted of 15 newborns without herpes virus infection.

Results. Of the totality of the studied cytokines, statistically significant for the chronic course of cytomegalovirus infection in children of the first year of life against the background of hypoxic-ischemic CNS damage were found: IL-2, IFN-γ. It was found that in children with a persistent low level of IFN-γ and an increased level of IL-4 in the blood serum at the age of 6 months, there was a chronic course of cytomegalovirus infection against the background of perinatal hypoxic-ischemic CNS damage.

A decrease in IFN-γ production indicates a congenital or acquired deficiency of the interferon system and can be considered as an indication for long-term interferon replacement therapy.

A clinical and laboratory examination of 62 children aged 10—17 years vaccinated against hepatitis B according to the standard scheme (0—1—6 months) in the first year of life strictly according to the National Calendar of preventive vaccinations in a standard dose (10 micrograms of recombinant HBsAg) with a monocomponent vaccine was carried out.

The majority of children (58%) had indicators of seroconversion of HBsAg — anti-HBs-antibodies. This indicates the fact of long-lasting Grund immunity — 10—17 years after timely 3-fold immunization against hepatitis B according to the standard scheme at a standard dose (10 mcg of recombinant HBsAg in the first year of life in the absence of Wooster immunization (revaccination) in subsequent age periods, including children with a burdened premorbid background (87.1% among those observed). Since among those observed were children with invasive medical interventions (50%), the established fact reflects the protective effect of standard Grund immunization even in children at risk — with a positive parenteral history. At the same time, the total assessment of serological and molecular biological results found that after triple immunization against hepatitis B according to the standard scheme in the first year of life, out of 62 children aged 10—17 years, the proportion of seronegative was 42%. Low levels of antibodies (10—100 IU/l) were detected in 43% of cases, high (100—1000 IU/l) — in 15% of cases. No child had an antibody level exceeding >1000 IU/l. These results require the development of new approaches to immunization of children against hepatitis B with mandatory revaccination at an older age.

Parvovirus B19 infection is best known as erythema infectiosum. However, infection with parvovirus B19 can lead to damage to various organs and systems, the development of severe complications up to death. The infection is most dangerous for people with immunodeficiency and hematological diseases. Serious consequences are possible with intrauterine infection of the fetus. Knowledge about the characteristics of the pathogen, the pathogenesis of the disease, the variety of clinical manifestations will allow the doctor to avoid diagnostic errors and provide the patient with timely medical care.

Numerous works of domestic and foreign colleagues have proved that obesity is an independent risk factor for severe COVID-19 among patients of all age groups. Of particular interest is the study of the effect of overweight on the course of a new coronavirus infection in children and adolescents.

Objective. Demonstration of a clinical case of fatal outcome of COVID-19 in a patient with morbid obesity; analysis and generalization of current data on the effect of obesity on the course of a new coronavirus infection in pediatric patients.

The article presents a general understanding of the pathogenetic relationship between the two pathologies, as well as a case of a fatal outcome of a new coronavirus infection in a 9-year-old 4-month-old girl with morbid obesity (BMI — 39 kg/m2, SDS BMI +4.98σ). Emphasis is placed on the lack of parallelism between the results of the procalcitonin test and the development of the septic process.

Conclusion. Studies of domestic and foreign colleagues, as well as the clinical case we have cited, confirm that morbid obesity is a risk factor for the adverse course of COVID-19 in children.

The ongoing pandemic of the new coronavirus infection allows us to discover new information concerning the clinical course of the disease. Despite the rarer registration and mild course of COVID-19 in children, we get new data on more severe manifestations in the form of damage to various organs including cardiovascular system. SARS-CoV-2 can lead to myocarditis development, arrhythmia, heart failure, etc.

According to an infectious diseases hospital in Omsk, heart changes were recorded in 5.8% of hospitalized children with COVID-19. The article presents a clinical case of the new coronavirus infection in a child of 15 years old who was on treatment in the infection diseases hospital of Budgetary Healthcare Institution of Omsk Oblast City Children's Clinical Hospital №3 of Omsk. The diagnosis was confirmed by examining nasopharyngeal smears for evidence of RNA SARS-CoV-2 by PCR. The course of infection in this patient is characterized by myocarditis development following medium severity disease without comorbid pathology.

Children are more likely to have asymptomatic and mild forms of novel coronavirus infection, as well as a more favorable outcome of the disease compared to adult patients. Children account for about 15% of all cases of COVID-19 recorded in the country. There are more and more reports of severe and even fatal cases of a new coronavirus infection in children. The development of severe forms of COVID-19 is typical for children at risk. Of particular interest are special groups of pediatric patients, such as children with immunodeficiencies of various etiologies.

A clinical case of a new coronavirus infection with a fatal outcome in a 10-year-old child with severe secondary immunodeficiency associated with hematopoietic stem cell transplantation against the background of acute lymphoblastic leukemia is presented.

Chickenpox is a controlled infection, even a single vaccination effectively prevents the development of severe forms (up to 98%).

Purpose — to demonstrate a case of severe chicken pox in a child aged 3.8 years with secondary infection of the skin of the right subscapular region and subcutaneous fat (phlegmon of the trunk) of streptococcal etiology.

The diagnosis of varicella was confirmed by the detection of Varicella-Zoster virus DNA by PCR from the skin. Surgical treatment was performed — opening and drainage of phlegmon, purulent-serous discharge was obtained, sowing was performed, Streptococcus pyogenes was isolated.

The child received antibiotic therapy — cefepime sulbactam, amikacin, acyclovir, infusion therapy, local treatment.

Conclusions. The given clinical case demonstrates the development of a severe bacterial complication of chicken pox, which required surgical treatment and substantiates the need for vaccination against chicken pox and its possible complications.

Yersinia infection continues to be a significant problem in infectology due to the prevalence, polymorphism of clinical manifestations, difficulties in laboratory diagnosis, often severe and complicated course of the disease, and the possibility of adverse outcomes.

The article presents a clinical case of a generalized form of yersinia infection with the development of acute renal failure in a 10-year-old child.

Natural focal infections with transmissible transmission caused by viruses of West Nile Fever, Batai, Inco, Sindbis, Tyagin are registered in various territories of Russia, in the form of sporadic cases, characterized by polymorphism of clinical symptoms, from inapparent forms to severe, occurring with Central nervous system damage (meningitis, meningoencephalitis), which complicates the timely diagnosis and treatment of this pathology.

Purpose: to describe our own clinical observations of five cases of arbovirus fevers.

Results. Arbovirus fevers (West Nile Fever, Batai, Inko, Tyaginya) in the five clinical cases we have presented occurred in two clinical forms: catarrhal with hypertension syndrome, febrile fever and intense headache, vomiting in the absence of signs of inflammation in the CSF; and with damage to the central nervous system (meningitis). Catarrhal forms of arboviral fevers must be differentiated from ARVI, influenza, mononucleosis. Arbovirus fevers occurring with Central nervous system lesions (meningitis) had a significant similarity with enteroviral meningitis, both in terms of seasonality and clinical symptoms.

Conclusion. In the territories of Russia endemic for mosquito fevers, in the summer period of the year, febrile patients with cerebral symptoms and / or meningeal symptoms should be examined for a group of arbovirus fevers.