Objective: to study the causes of fatal outcomes in patients with generalized forms of meningococcal infection (GFMI). Materials and methods: a retrospective analysis of case histories and pathological examination results of 10 children with GFMI who died in the intensive care unit of the infectious diseases hospital of the Krasnoyarsk City Children's Clinical Hospital No. 1 in Krasnoyarsk for the period 2012-2022 is presented. Results. The most important risk factor for the development of an unfavorable outcome of GFMI is age; 90% of the deaths were children in the first three years of life. The leading clinical form of MI was meningococcemia (80 ± 12.6%) with the development of septic shock (80 ± 12.6%), disseminated intravascular coagulation (60 ± 15.5%), acute adrenal insufficiency (90 ± 9.5%). Despite the timely request of parents for medical help, only 30 ± 14.5% (4/10) of patients were hospitalized in the hospital after the first visit, most of the children were hospitalized in the hospital after 3—4 calls with an erroneous diagnosis (50 ± 15.8%), underestimation of the severity of the condition and the degree of septic shock, without providing emergency medical care at the prehospital stage (60 ± 15.5%), which contributed to the development of a tragic outcome.

Purpose: to establish clinical and laboratory features of parvovirus B19 infection (PVI) in children at the present stage.

Materials and methods: a retrospective analysis of hospitalization records from 01.01.2023 to 01.07.2023 was conducted at Pediatric Research and Clinical Center for Infectious Diseases. The study included 101 children aged from 1 month to 17 years old inclusive who had confirmed PVI (positive for specific antibody IgM by enzyme immunoassay (ELISA) and/or viral DNA detected in the blood using polymerase chain reaction (PCR).

Results: most cases of PVI were reported from April to June (76%). Children were admitted to the hospital mainly in the early stages of the illness (4.4 ± 0.4 days). The age structure was dominated by school-age children (64%), patients of early and preschool age were hospitalized with the same frequency (16% and 17%, respectively). Infants were admitted in isolated cases (3%). PVI was mild to moderate in 97% of patients. 88% of children had a fever of varying intensity. The main clinical manifestations were rhinitis (68%) and exanthema (92%). The most common were spotted (39%), spotted papular (33%) and hemorrhagic rash (20%). The «lace» nature of the rash, which often described in literature, was observed in 8% of patients. The characteristic symptom of a «slap in the face» was recorded in only 40% of children. There were no significant changes red blood cell production or shifts in the white blood cell count in the complete blood count. When evaluating the results of the etiological examination, it was found that in the first three days of the illness, the majority of positive results were by PCR, which provided a decryption in 97% of cases. The significance of this technique has decreased over time, and by the eighth day of the illness the most useful serological test has been ELISA, which determines IgM and IgG specific antibodies. In 35% of children, the diagnosis was confirmed using a combination of methods, and IgM and IgG antibodies were detected alongside DNA parvovirus B19. The determination of specific IgG on 4.5 ± 0.7 day of illness in 34% of cases does not exclude the reactivation of persistent PVI, which confirms the relevance of further researches.

Рertussis is one of the common diseases in young children around the world. In 2023, the incidence of pertussis was recorded in all constituent entities of the Russian Federation, the incidence rate of pertussis in children in the first year of life increased by 13.8 times compared to last year, and the incidence rate in children aged 1 to 2 years was 159.7 per 100 thousand population of this age. Objective: assessment of the course of whooping cough in children of the first three years of life. Materials and methods: a retrospective analysis of 199 medical records of children hospitalized in St. Petersburg State Budgetary Institution Children's City Clinical Hospital No. 5 named after. N. F. Filatova in the period from 2019—2024. Results: Most often, children in the first 6 months of life require hospitalization. Immunization against pertussis was absent in almost all cases. As a rule, the source of infection was the older children in the family and parents. The preconvulsant period was often 4—6 days. The majority of children (89%) were admitted to the hospital at the end of the first — beginning of the second week of the convulsive period. In 81% of cases, the disease was of moderate severity, and severe — 19%. Respiratory rhythm disturbances were observed in 29% of patients. Pertussis was more often complicated by obstructive bronchitis; pneumonia was recorded in 9% of cases, acute bronchiolitis (2.5%) mainly in children in the first 6 months of life. The disease occurred against the background of perinatal damage to the central nervous systemin 13% of cases, atopic dermatitis in 10%, urinary tract infectionin 3.5%, and in 4 patients against the background of acquired CMV infection. Among the concomitant pathologies, ARVI was more often detected. The diagnosis was confirmed by PCR. Conclusion: the persistence of high morbidity rates in the child population and the severity of the disease in young children necessitates the need to achieve a high percentage of coverage of the child population with specific prevention.

Since the beginning of the 21st century, the number of international trips has been increasing in the world. Outbound and domestic tourism is expanding in Russia. During a trip, there are various types of health risks for the traveler, especially for children. These risks include infectious diseases, among which in children intestinal infections come first. That is why this research is important for studying the epidemiology and clinical processes of intestinal infections in childhood in patients returning from travel. The goal is to analyze the clinical and epidemiological characteristics of imported intestinal infections in children who traveled to other countries and in children who returned from Russian regions. Materials and methods. A single-center prospective study using questionnaires and clinical observation was conducted from June to September 2022 in the children's infectious diseases hospital of the Moscow Multidisciplinary Clinical Center «Kommunarka» (MMCC «Kommunarka»). An analysis of the data of 128 travelers who fell ill during or after travel and were admitted to the MMCC «Kommunarka» was carried out. 2 groups were identified — those who traveled to the regions of Russia or other countries. The clinical and epidemiological features of children's disease cases and their vaccination status were analyzed. Results. The children's ages ranged from 1 month to 17 years, and the gender distribution was even. Among the regions of departure, the Krasnodar Territory and Mediterranean coast of Turkey were the most common. There were no differences in travel duration, with a median of 10 days. In the group of people who traveled across Russia, the leading purpose was to visit friends and relatives, while tourists stayed mainly in the private sector. In the case of traveling abroad, the prevailing purpose was tourism, with equal proportions staying in a hotel or private sector. Imported intestinal infections most often occurred with symptoms of gastroenteritis, were assessed by CDS at 5 points, and rotavirus predominated in the etiological structure.

The results of a prospective study of patients with infectious mononucleosis (MI) hospitalized in City hospital of infectious diseases No. 1 are presented. The aim of the research was to study the etiology of the purulent-inflammatory process in the oropharynx in MI, as well as to identify some risk factors leading to its development. Мaterials and methods. All 120 patients under the age of 18 years were analyzed with clinical and laboratory parameters, as well as bacteriological examination of a smear from the mucous membranes of the tonsils. Results. In the examined patients, symptoms of intoxication, an increase in body temperature ≥ 38°C, headaches, enlargement and soreness of all groups of lymph nodes, sore throat when swallowing, difficulty breathing through the nose were revealed in 100% of cases. Changes in the tonsils in all patients had inflammatory changes in the mucous membranes, hyperemia and hypertrophy of the palatine tonsils with purulent or curdled plaque of gray-yellow color (48.3%), and in other cases, catarrhal manifestations in the form of a mucous easily removable plaque were noted on hyperemic and hypertrophied tonsils (51.7%). Pathogens was isolated in 58/48.3% of cases, Staphylococcus aureus was isolated in 26/21.7% of cases, Streptococcus pyogenes — in 12/10.0% of cases. Also, Candida albicans was isolated in 13/10.8% of cases and in 7/5.8% of cases, a bacterial-fungal association was detected, which shows the role of these pathogens in the development of purulent-inflammatory manifestations in the oropharynx of patients. Positive result of bacteriological examination (n = 58), anemia of varying severity was noted in 17/29.3% of cases, frequent respiratory infections in 18/31.1% of cases, chronic diseases of the ENT organs (chronic tonsillitis, sinusitis, otitis media) in 23/39.6% of cases, in 6/10.3 In % of cases — chronic bronchitis, which was significantly more common compared with patients with a negative result of bacteriological examination.

Purpose of the study: to study the characteristics of physical development in 174 children with cerebral palsy using various rating scales (specialized centile tables, international standards of the World Health Organization, as well as regional tables). Research results. When assessed by regional standards, underweight was noted more often (29.9%) than by specialized standards only 20.7% (n = 36). According to WHO standards, excess weight was recorded more often (12.6%). Low growth was noted in 20.7% of children (n = 36) according to WHO standards (SDS < –2), of which almost a quarter (22.2%) had dwarfism (SDS < –3). When assessed by specialized standards, 11.5% of children had a significant decrease in body weight and entered the so-called «red zone». In the group of patients with moderate motor impairment (GMFCS 1—2), the proportion of children with low weight was almost the same when assessed according to WHO standards (23.9%) and specialized tables (22.4%) (p > 0.05). However, with severe motor impairment, the number of cases of underweight increased when WHO standards were applied.

Norovirus infection (NVI) ranks second in the structure of intestinal infections of viral etiology in children, is the main cause of outbreaks in all age categories and accounts for up to 50—90% of group cases. The incidence of NVI in the Russian Federation and the Yaroslavl region remains at a fairly high level. Purpose of the study: analyze the clinical and laboratory features of norovirus infection in children. Materials and methods: the article presents literature data on the significance of the problem of NVI in children at the present stage and the results of our own observations of 1332 children hospitalized in the Infectious Diseases Clinical Hospital of Yaroslavl in the period from 2017 to 2022. Results: in the age structure of cases, children of the first three years of life predominated (59.0%); children under 1 year old were 10.3%. An increase in the number of severe forms of NVI has been noted. The severity is due to toxicosis with exicosis. In recent years, NVI occurs in combination with other pathogens of intestinal infections, as well as respiratory viruses, which aggravates the course of the underlying disease, creating an important practical significance of the problem.

Enteropathogenic escherichiosis (ЕРЕС) remains to date one of the common causes of the development of gastrointestinal pathology in young children and, depending on the serovar, ЕРЕС can be severe with the development of urgent conditions threatening the patient's life.

The purpose of the study: to establish the clinical features of enteropathogenic escherichiosis (ЕРЕС) in young children, depending on the severity of the disease.

Materials and methods: the analysis of clinical and laboratory data of 105 cases of ЕРЕС in young children treated at the Regional Infectious Diseases Clinical Hospital named after A.M. Nichoga in Astrakhan during 2013—2023 was carried out.

The results: According to the results of our study, it was found that the disease was more often caused by serovars ЕРЕС O111 (59%), O55 (32,4%). Mild and moderate forms of ЕРЕС were 74,3%. Severe forms of HERES (25,7%) are characterized by: acute onset, prolonged (7,9 ± 0,4 days) febrile fever (66,7%); repeated vomiting (91,3%), diarrhea for 9,9 ± 1,8 days with a stool frequency of more than 10 times a day (59.3%) of an abundant, watery nature (96.3%), dehydration of II—III degree (88,9%), the presence of intestinal dysbiosis (96%). In 45,7% of children, ЕРЕС occurred in a moderate form, characterized by subfebrile fever (93.7%) for 5.8 ± 0,9 days, vomiting for 2—3 days (85,4%), watery diarrhea up to 10 times a day (68,7%) lasting 5,9 ± 0,8 days, dehydration of I—II degree (85,4%), intestinal dysbiosis (52%). The difference between mild forms of ЕРЕС (28,6%) was the absence of fever (70%), vomiting (60%), dehydration (100%), and the presence of intestinal dysbiosis in only 16% of children. The nature of the fever, the frequency of vomiting, at the beginning of the disease and subsequently, allows us to judge the severity of the disease, its possible duration, and the effectiveness of treatment. An increase in body temperature to febrile figures, on the 2rd—4th day of the disease, indicates the development of a severe form of ЕРЕС.

Congenital viral infections are one of the pressing issues in modern neonatology. Due to the fact that viremia is a common stage in the infection process, the fetus is at high risk of intrauterine hematogenic infection, which can harm various organs and systems. The most frequently observed manifestations of congential viral infections are: intrauterine growth restriction (IUGR), micro- and macrocephaly, fetal hydrocephalus, hepatosplenomegaly, pneumonia, bone lesions, rash and haematological abnormalities. Even though these clinical manifestations are not specific, identifying the etiological factor is often a necessary step to determine the future management of the newborn. The aim of this paper is to collect and summarize literary data on lymphocytic choriomeningitis virus (LCMV) and Zika virus. Results: congenital infections caused by LCMV and Zika virus share similar clinical features. Laboratory and instrumental diagnostic methods facilitate carrying out the differential diagnosis and establishing prognosis and the best clinical approach to the patient.

The relevance of the problem of the visceral (hepatosplenic) form of bartonellosis in children is due to the fact that the disease is one of the causes of the development of the so-called «fever of unknown origin», manifested by the formation of focal lesions in the internal organs and requires antibacterial therapy. The purpose of the work is to study the data available in the literature regarding the visceral (hepatosplenic) form of bartonellosis, and to demonstrate our own clinical cases. Materials and methods: a review of domestic and foreign literature over the past 10 years was carried out, including Internet resources, and our own clinical observations of children with the visceral (hepatosplenic) form of bartonellosis were presented. Conclusion. The visceral (hepatosplenic) form of bartonellosis in children occurs with febrile fever, accelerated ESR, increased levels of C-reactive protein, visualization of multiple foci in the liver and spleen, and possible damage to the lungs and kidneys. Treatment is with antibiotics; usually a combination of different drugs.

Objective:To study the features of chronic hepatitis C in a 17-year-old patient with metabolic syndrome. Results: The article presents a clinical example of the course of chronic hepatitis C (HCV) in a 17-year-old patient with metabolic syndrome. He fell ill at the age of 13 and was seen by an infectious disease specialist. Antiviral therapy was not prescribed. A complete examination was conducted with an assessment of laboratory data. Biochemical activity, severity of liver fibrotic changes and signs of metabolic syndrome (MS) were compared. To assess the component composition of the body, a bioimpedance analysis was performed. Additionally, in order to identify associative links between gene polymorphism and MS components, the genetic profile of the patient and his parents was studied. Conclusion: A patient with genetic predictors of metabolic syndrome should be previously prescribed antiviral therapy for chronic hepatitis C.

Purpose: to demonstrate a clinical case of whooping cough associated with rhinovirus and parainfluenza infections with an unfavorable outcome in a child 2 months of age. Results. The illness in the infant began acutely with the development of catarrhal syndrome in the form of a moderately expressed serous-mucous discharge from the nose, rare coughing, the addition of intoxication syndrome on the 2nd day (increase in body temperature to 39°C) and an increase in paroxysmal cough by the 5th day from the onset of the disease to 20 times a day, symptoms of respiratory failure. Based on clinical and laboratory data, a diagnosis was made: Whooping cough caused by Bordetella pertussis. Typical. Severe severity. PCR confirmed. Concomitant diagnosis: Viral infection of mixed etiology (Parainfluenza virus type 2, Human Rhinovirus). PCR confirmed. Complications: Community-acquired bilateral polysegmental pneumonia. Severe severity. Respiratory failure III degree. An unfavorable course of the disease was noted with the development of infectious toxic shock, disseminated intravascular coagulation syndrome and multiple organ failure, which led to death on the 12th day from the onset of the disease. This case convincingly shows that the combination of whooping cough with respiratory pathogens is the leading factor determining the complicated course and unfavorable outcome of the disease.

Infectious mononucleosis is a current problem of pediatric practice, which tends to increase the incidence in the Russian Federation and other countries. Liver dysfunction of varying severity in infectious mononucleosis occur with a frequency of 17—90% of cases while Epstein-Barr neuroinfections of viral etiology occur in no more than 5% of patients. This article presents a clinical case of infectious mononucleosis with liver damage and right facial neuropathy in a 15-year-old child.