Recent observations show that cases of mycoplasma pneumonia (MРP) occur not only in the older age group, but also in young children, with severe fever and symptoms of intoxication, and an increase in the number of cases of refractory pneumonia and multisystem complications. Objective: conduct a comparative analysis and identify the features of clinical manifestations and the results of additional examination methods in children with MРР in the Smolensk region for the period from 01.01.23 to 31.12.23 (n = 116) and from 01.01.24 to 31.12.24 (n = 85). Results: Over the studied time periods, the structure of MРР incidence was dominated by children of the older age group. 89% of children in 2024 showed signs of fever intoxication syndrome at the time of hospitalization. Bronchoobstructive syndrome was registered in 8% of patients. 35% of children had bradycardia, a violation of the body's adequate adaptive response to fever in the form of increased heart rate. The main complications during the time periods studied were: respiratory failure of the 1st and 2nd degrees, pleurisy. Cases of co- and superinfections are presented. The most frequently detected changes in peripheral blood were: erythrocytosis, relative lymphocytosis, thrombocytosis, increased ESR and CRP. The initial drug of choice at the outpatient stage was most often amoxiclav, which is due to the absence of «classic» symptoms of MРР, which does not allow one to suspect the atypical etiology of the disease at an early stage. Conclusion. In most cases, MРР in children did not have «classical» clinical and laboratory features, which significantly hampered timely diagnosis and, consequently, lengthened the start time of etiotropic therapy. In addition, there was no parallelism between clinical symptoms and laboratory markers. 

The issues of the pathogenesis of the new coronavirus infection in children of different ages, despite the end of the pandemic, remain relevant. The issue related to the development of delayed reactions after SARS-CoV-2 infection requires further study. The search for markers of the risk of developing post-COVID reactions is also relevant. Purpose: Study of the content of peripheral blood lymphocytes in children with SARS CoV-2 infection in the dynamics of treatment. Materials and Methods: A retrospective analysis of 106 medical records of patients aged 2 to 14 years hospitalized from October 2021 to December 2022 with a confirmed diagnosis of COVID-19 was conducted. Two groups were formed: Group 1 — children aged 2 to 7 years; Group 2 — children aged 8 to 14 years. The levels of lymphocytes in the peripheral blood of children were analyzed over the course of treatment. In each group, the study was conducted four times with an interval of one week. Statistical processing of the obtained results was carried out using the Statistika 10.0 software package. Wilcoxon and Mann-Whitney criteria were used in statistical processing. Results: It was found that 63.71% of children in the younger age group and 73.33% of older children had relative lymphopenia upon admission to the hospital. During treatment, the dynamics of changes in lymphocyte content were similar regardless of age, but differed depending on the initial level of lymphocytes. In groups with lymphopenia, the average values of the indicator increased significantly over time and practically corresponded to the normative values before discharge from the hospital. However, when analyzing individual values of lymphocyte content in the dynamics of treatment in all subgroups, some children had relative lymphopenia. Conclusion. Perhaps a decrease in the level of lymphocytes not only at the onset of the disease, but also the presence of lymphopenia with a significant improvement in the clinical condition (regardless of their initial level) can be a criterion for the risk of developing post-COVID reactions in children who have suffered SARS-CoV-2 infection in the late period.

In the city of Khabarovsk, along with the wide and all-encompassing distribution of the COVID-19 (new coronavirus infection (NCI), complex clinical and epidemiological studies in the acute and post-infectious period were not conducted in children. The purpose: to characterize some clinical and epidemiological characteristics of NСI in children and study the structure of post-COVID syndrome. Materials and methods. The study consisted of two stages. On the first — a retrospective cohort study was carried out. The second is psychological testing (Spielberg test, San, Moca questionnaire) and a sociological survey of parents using an author's questionnaire. The period: July 2021—August 2022. The sample includes 400 children (0—17 years old): 225 (56.25%) boys and 175 (43.75%) girls, with the largest number of cases in the group of 15—17 years. At the second stage, 43 teenagers (11—17 years old) were investigated with a confirmed NСI and a comparison group of 43 healthy adolescents of the same age. Results. Most often, the basis for examining children on the NCI was family contact — 239 patients (59.75%), and the largest share of sick children is determined in the group of 15—17 years (26%). 63.5% of children made subjective complaints in Post-COVID Condition. Moreover, most often recruits were disturbed by violations by the nervous system (79%). When evaluating personal anxiety, a group of recructions showed statistically significant a higher level of 46.74 ± 0.83, unlike a group of not painful children with a moderate level of 35.54 ± 1.26 (p < 0.001). The study showed a statistically significant decrease in activity among adolescents of NCI by 3.83 ± 0.15 (p = 0.049). The cognitive functions of the ill -fledged NCI of adolescents were statistically significantly lower than normal values (23.86 ± 0.37) and lower than in the comparison group (p < 0.001). Conclusion. The study confirms the influence of NCI on the health of children, emphasizing the need for early detection and correction of neuropsychiatric deviations. 

The Aim: To analyze the state of lipid metabolism, body composition, and liver parenchyma structure in children with chronic hepatitis C (СHC). Methods. The study group consisted of 63 children with СHC aged 3—17 years without concomitant endocrine pathology, who were examined in 2022—2024 at the NCCIB. The control group consisted of 37 healthy children aged 9—17 years. All underwent anthropometry, laboratory examination (HCV RNA PCR, lipidogram), liver elastography with assessment of steatosis. Results. Children with СHC are significantly more likely to have hypolipidemia in the form of a decrease in total cholesterol and low-density lipoprotein (LDL) levels (p < 0.05), while in healthy children there is a decrease in high-density lipoproteins (HDL) and an increase in the coefficient of atherogenicity (p < 0.05). In the study group, abnormalities in lipid metabolism were found in 39.6% of children, while the majority (64%) had a «healthy weight». An increase in the level of non-HDL cholesterol was more often recorded in children with a «healthy weight» and was associated with genotypes 1 and 2 (non-3) of the virus (p < 0.05). Almost half (43.2%) of children with СHC had liver steatosis associated with the non-3 genotype of the virus (p < 0.05). Children with СHC without obesity are significantly more likely to develop steatosis compared with the control group (p < 0.05). Conclusions. Virus-induced changes in lipid metabolism parameters, regardless of the presence or absence of overweight, associated with the non-3 genotype of the virus, were found in children with СHC. Hypolipidemia is significantly associated with HCV. Liver steatosis is significantly more common in children with СHC without excess weight compared to healthy children, which further confirms the effect of the virus on the lipid profile.

The aim of the study is to identify the characteristics of the intestinal microbiocenosis and the level of protection of the intestinal barrier in young children with functional disorders of the digestive organs. Methods. The article presents a study of the intestinal microbiota using gas chromatography-mass spectrometry of microbial markers in 25 young children with functional disorders of the digestive system. Results. It was revealed that these were children at risk for the development of infectious and inflammatory diseases. All of them had a violation of the formation of intestinal microbiocenosis in the form of a deficiency of normal microbiota representatives with an excessive growth of opportunistic bacteria associations of 6—20 species. High levels of endotoxin were detected in 18 of the 25 children. Conclusion. A close relationship was established between the degree of intestinal microbiota imbalance and the concentration of endotoxin, which determines the basic level of inflammation and the level of protection of the intestinal barrier/increased permeability, as well as the degree of inflammatory changes in the coprogram.

The aim of the study was to analyze the relationship between comorbid diseases and the severity of COVID-19 in children to develop a stratified approach to the management of pediatric patients. The study methods included a comprehensive analysis of data from 370 children with confirmed COVID-19, divided into a main group of 273 children with comorbid conditions and a control group of 97 children without comorbidities. Clinical methods for assessing the severity of the course, laboratory diagnostics of inflammatory markers, the pSOFA scale for assessing multiple organ failure, statistical analysis using logistic regression and machine learning algorithms were used. The results showed that the comorbidity structure was characterized by the predominance of anemia in 49.5% of patients and immunodeficiency states in 11.4% of children with significant age differences. Severe and extremely severe forms of COVID-19 accounted for 49.8% of cases in the comorbidity group versus a significantly lower proportion in the control group. A direct correlation was established between the levels of C-reactive protein and ferritin with the severity of the disease. Anemia reached a maximum frequency of 65.7% in the age group of 0—3 years, while immunodeficiency states prevailed in adolescents aged 14—18 years with a frequency of 47.8%. The developed mathematical models based on the pSOFA scale and logistic regression demonstrated high prognostic significance for assessing the risk of an unfavorable course of COVID-19 in children with comorbid conditions, which justifies the need for a personalized approach to the diagnosis and treatment of this category of patients.

Helminthiases remain a significant global health issue, affecting billions of people. The increase in the introduction of tropical parasitic diseases into non-endemic regions, as well as the potential development of resistance to existing drugs, highlight the need to update knowledge and adapt treatment strategies. Objective: to present a systematized literature review on the effectiveness of anthelmintics. Methods: a review of modern domestic and foreign literature was carried out, the search was carried out using the keywords «treatment of helminthiasis», «treatment of nematodes», «treatment of trematodes», «treatment of cestodes» using the databases PubMed, Scopus, and the scientific library eLibrary.RU. Results: information on the main anthelmintic drugs is presented, the advantages and limitations of combination treatment regimens are considered, modern WHO recommendations for the treatment of various helminthiasis are summarized, and a summary table is presented with an overview of the drugs used to treat helminthiasis, indicating their spectrum of action and effectiveness. Conclusions: current approaches to helminthiasis treatment are characterized by a shift from narrowly focused methods to integrated strategies that include a combination of individual treatment with mass preventive measures. Despite the advances made, it is necessary to continue monitoring the susceptibility of helminths to drugs and adapt treatment regimens in a timely manner to effectively control the spread of parasitic diseases.

Coxiellosis belongs to the group of zoonotic rickettsioses. One of the main foci of this rickettsiosis in the Russian Federation is the Astrakhan region. The clinical symptoms of coxiellosis are polymorphic, which presents significant difficulties for diagnosis, and a number of drugs recommended for the treatment of coxiellosis have age restrictions on use in children, which requires improved approaches to the treatment of this pathology. The aim of the study was to evaluate the effectiveness of treatment of coxyellosis in children with azithromycin as a monovariant and in combination with the immunopreparation meglumine acridone acetate (cycloferon). Мethods: the duration of the main symptoms of coxiellosis was analyzed: fever, scleroconjunctivitis, myalgia, hepatomegaly, the duration of the disease in children treated with azithromycin (n = 35) or azithromycin + meglumine acridone acetate (n = 35). The results. The duration of the main symptoms of coxyellosis (fever, scleroconjunctivitis, myalgia, hepatomegaly) in children treated with azithromycin+ meglumine acridone acetate had statistically significant differences with similar data in children treated with azithromycin alone (p < 0,050). Conclusion. Treatment of coxyellosis in children using azithromycin+meglumine acridone acetate is more effective than azithromycin monotherapy.

Recurrent respiratory infections are one of the most common reasons for visiting a pediatrician in preschool age. In domestic practice, the term «frequently ill children» is traditionally used, but to date there is no unified clinical interpretation of this condition. International reviews use the concept of recurrent respiratory infections (RRIs), the approach to which is based on the exclusion of severe chronic diseases, atopy and immunodeficiencies. The review presents data from modern international consensuses and practical algorithms. The criteria for the frequency of recurrent respiratory infections by age groups, features of infectious and allergic anamnesis, key laboratory markers and approaches to the interpretation of molecular biological and microbiological studies are covered. Particular attention is paid to the diagnosis of primary and secondary immunodeficiencies in children, including on the basis of clinical and anamnestic signs. The necessity of a personalized rather than a template approach to the management of frequently ill children is substantiated, taking into account the individual clinical context and infectious profile.

Objective. To study the clinical characteristics and principles of therapy of acute stenosing laryngotracheitis in young children with acute respiratory infection (ARI). Materials and methods. A clinical study was conducted on 30 children aged 1 to 7 years with ARI and acute stenosing laryngotracheitis hospitalized in the Dushanbe City Clinical Hospital of Pediatric Infectious Diseases in October–December 2020. The diagnosis was confirmed by PCR; 53.3% of patients had influenza, 26.7% had parainfluenza, 13.3% had respiratory syncytial virus infection, and 6.7% had adenovirus infection. Results. All patients presented with catarrhal symptoms for 1–3 days, accompanied by subfebrile fever in 23.3% patients and febrile fever in 66.7% children. The onset of the disease in all children was sudden, with the appearance of signs of stenosing laryngotracheitis mainly in the evening and at night and rapid progression in the duration of the attack, from several minutes to 1-2 days. The majority of young children with ARI (22/73.3%) were noted to have the second degree of stenosing laryngotracheitis with characteristic stenotic breathing, sleep disturbance, periodic agitation and an increase in all clinical symptoms at rest, 5 (16.7%) children were observed to have the first degree with mild hoarseness and periodic «barking» cough, and 3 (10%) children with the third degree of stenosing laryngotracheitis were admitted to the intensive care unit in a serious condition with constant dyspnea, severe anxiety, alternating with lethargy, drowsiness, as well as a sharp hoarse voice, up to aphonia. All children were prescribed recombinant interferon-alpha-2b with antioxidants (VIFERON®) as part of combination therapy at an age-appropriate dosage of 150,000 IU, one suppository twice daily, for a 5-day course. Conclusion. Stenosing laryngotracheitis in young children with acute respiratory infection most often occurred in the second and third stages (83.3%), with pronounced signs of acute respiratory failure (66.7%).

Post-infectious bronchiolitis obliterans (PIBO) is a chronic obstructive lung disease that develops in children following lower respiratory tract infections (LRTI). The pathogenesis is based on impaired reparative processes in the bronchiolar epithelium, productive-sclerotic inflammation, and the formation of peribronchiolar fibrosis, accompanied by chronic neutrophilic-lymphocytic inflammation and cytokine imbalance. The clinical presentation of PIBO is characterized by chronic cough, expiratory dyspnea, hypoxemia, and prolonged bronchial obstruction. The diagnosis is established based on a history of severe LRTI, persistent clinical signs of airway obstruction, and characteristic findings on chest computed tomography, including mosaic attenuation and air-trapping phenomena. Despite the use of various pharmacological strategies, including systemic and inhaled corticosteroids, macrolides, and leukotriene receptor antagonists, a standardized therapy protocol for PIBO has not yet been established. The disease course is variable: most patients demonstrate a reduction in respiratory symptoms and improvement in functional parameters with age, whereas others may experience slow disease progression. Computed tomography features of small airway involvement may persist or vary over time.

Over the past 20 years, human herpes virus infections have continued to occupy leading positions in statistics. Frequent infection of newborns with several herpes viruses at once causes an atypical course of the infectious process. The development of neonatal chickenpox is associated with maternal infection with Varicella Zoster Virus in late pregnancy, which poses a serious threat to the life and health of the newborn. The carriage of the chromosomally integrated form of herpes type 6 by parents causes the transmission of the genetic material of the virus in several generations. The high probability of transmission of infectious agents from mother to newborn necessitates the development of algorithms for pregravid preparation that increase the probability of the birth of a healthy full-term child. The aim of the work was to present a clinical case of vertical transmission of herpes viruses types 3 and 6 from mother to newborn, with the implementation of a combined herpesvirus infection already in the early neonatal period. Materials and methods: an analysis of the medical records of a child who was hospitalized in a children's multidisciplinary hospital with a diagnosis of neonatal varicella was conducted; a review of modern literature, an analysis of statistical and regulatory documents using the PubMed, NIH, Scopus, scientific library eLibrary.RU, ResearchGate databases were conducted.

Methods. The article presents a clinical case of convulsive syndrome in a 4.5-month-old child in the post-vaccination period. 8 hours after the administration of several vaccines, there were an increase in body temperature to 38.5°C, doubly loose stools. During the following two days condition of the child remained satisfactory, but on Day 3, despite overall well-being, seizure syndrome had occurred, lasting for four following days. During the hospital stay the seizures were observed while the body temperature remained normal and in the absence of electrolyte disorders. The sleep EEG, epileptiform activity was not detected on two occasions, and genetic testing for metabolic disorders returned negative. No structural brain changes were identified on the MRI scan and the ultrasound imaging. According to the results of PCR and ELISA studies, the etiology of the virus causing the disorder could not be determined. Conclusion. The described clinical case matches the characteristics of benign convulsions with mild gastroenteritis (CwG) in viral diarrheas, first described by Morooka in 1982. In subsequent years, this syndrome has been reported in association with various viral diseases; however, data on it remain limited in domestic literature. Given the insufficient awareness of pediatricians regarding this syndrome, through our clinical observation, we would like to draw attention to the discussion on this topic.