Pneumonia In Children Research Articles

Constructing a diagnostic prediction model to estimate the severe respiratory syncytial virus pneumonia in children based on machine learning.

Severe respiratory syncytial virus (RSV) pneumonia is a leading cause of hospitalization and morbidity in infants and young children. Early identification of severe RSV pneumonia is crucial for timely and effective treatment by pediatricians. Currently, no prediction model exists for identifying severe RSV pneumonia in children. This study aimed to construct a diagnostic prediction model for severe RSV pneumonia in children using a machine learning algorithm. We analyzed data from the Gene Expression Omnibus (GEO) Series, including training dataset GSE246622 and testing dataset GSE105450, to identify differential genes between severe and mild-to-moderate RSV pneumonia in children. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the differential genes, followed by the construction of a protein-protein interaction (PPI) network. An artificial neural network (ANN) algorithm was then used to develop and validate a diagnostic prediction model for severe RSV pneumonia in children. We identified 34 differentially expressed genes between the severe and mild-to-moderate RSV pneumonia groups. Enrichment analysis revealed that these genes were primarily related to pathogenic infection and immune response. From the PPI network, we identified 10 hub genes and, using the random forest algorithm, screened out 20 specific genes. The ANN-based diagnostic prediction model achieved an area under the curve (AUC) value of 0.970 in the training group and 0.833 in the testing group, demonstrating the model's accuracy. This study identified specific biomarkers and developed a diagnostic model for severe RSV pneumonia in children. These findings provide a robust foundation for early identification and treatment of severe RSV pneumonia, offering new insights into its pathogenesis and improving pediatric care.

A one-pot, one-step CRISPR platform (CRISPR-one) for nucleic acid detection: Application for the detection of Mycoplasma pneumoniae

The conventional CRISPR-mediated detection technologies typically involve two separate steps: target pre-amplification and CRISPR-mediated signal detection. This multi-step procedure is not only cumbersome but also prone to cross-contamination. Here, we propose a new CRISPR-mediated nucleic acid detection methodology, termed CRISPR-one (CRISPR-mediated testing in one-tube, one-pot). At a constant temperature, CRISPR-one carries out both multiple cross displacement amplification (MCDA) for target pre-amplification and CRISPR/AapCas12b-based cleavage for signal detection in a single reaction pot. The novel CRISPR-one technique is employed for detecting Mycoplasma pneumoniae (M. pneumoniae), a causative agent for community-acquired pneumonia in children. M. pneumoniae CRISPR-one targets the CARDS (community-acquired respiratory distress syndrome toxin) gene and performs at 60 ºC for 50 min with only basic instrumentation required. The results can be easily visualized through a real-time fluorescence instrument, with the entire process taking less than an hour. The lowest detection limit of M. pneumoniae CRISPR-one was 50 fg (∼55 copies) of genomic DNA per reaction, and no cross-reactivity with non-M. pneumoniae templates was observed. In clinical applications, the CRISPR-one assay demonstrated a high level of agreement with both the microfluidic chip method (Kappa value: 0.95) and real-time PCR (Kappa value: 0.93) when analyzing 135 oropharynx swab samples. There is no statistical difference in detection efficiency between our assay and other methods. Together, the CRISPR-one developed here offers a rapid, convenient, highly sensitive, and specific approach for pathogen detection (e.g., M. pneumoniae), serving as an invaluable tool for clinical diagnosis and epidemiologic surveillance, particularly in resource-limited laboratories.

Economic burden and influence factors among hospitalized children with bronchiolitis or pneumonia: a multiregional study in China.

Bronchiolitis and pneumonia are both significant lower respiratory tract infections with a profound impact on children's health. The purpose of this study is to explore the economic burden and related influence factors of pediatric patients with bronchiolitis and pneumonia in China. A face-to-face interview was employed for the investigation of hospitalized patients (≤5 years old) with bronchiolitis and pneumonia, along with their guardians from January to October 2019. Demographic and costs were collected from Shanghai, Zhengzhou, and Kunming, representing three regions with different levels of economic development in China. Multiple linear regression analysis was used to explore factors associated with the economic burden of the diseases. A total of 338 patients with bronchiolitis and 529 patients with pneumonia were included in the analysis. The average hospitalization and total cost for patients with bronchiolitis are 4,162 CNY and 5,748 CNY, respectively, while those with pneumonia are 6,096 CNY and 7,783 CNY. Patients from Shanghai, both bronchiolitis and pneumonia, exhibited the lowest cost expenditures, with average total costs of 3,531 CNY and 3,488 CNY, respectively. Multiple regression analysis indicated that, among bronchiolitis patients, factors such as region, medical insurance, relationship, loss of work time, and length of stay were found to be significantly associated with both hospitalization cost and total cost (p < 0.05). For pneumonia patients, the hospitalization cost and total cost were significantly impacted by region, medical insurance, and length of stay (p < 0.05). Bronchiolitis and pneumonia in children put substantial economic burden on families of affected children. The financial strain varies significantly across different regions, with families in underdeveloped areas and those dealing with pneumonia facing particularly daunting challenges. Targeted policies to reduce healthcare costs and improve insurance coverage, especially in economically disadvantaged regions are needed.

Application value of P-selectin and Clara cell secretory protein 16 expression in children with severe adenovirus pneumonia.

This study investigated the roles of P-selectin and Clara cell secretory protein 16 (CC16) levels in the pathogenesis of severe adenovirus (ADV) pneumonia in children and evaluated their ability to predict disease. Fifty-one children (age, 1-5 years) with ADV pneumonia who were admitted to Xiamen Children's Hospital were included in this study and divided into the mild group (24 patients) and severe group (27 patients). A control group comprising healthy children of the same age who underwent routine physical examinations during the same period (30 patients) was also included. The univariate analysis demonstrated that the levels of the white blood cell count and C-reactive protein, procalcitonin, d-dimer, and P-selectin were increased in a severe group compared with a mild group, while CC16 levels were significantly decreased (p < 0.05). The logistic regression analysis revealed that P-selectin and CC16 levels were independent risk factors for severe ADV pneumonia in children. The areas under the ROC curves suggested that P-selectin and CC16 exhibited high predictive value for severe ADV pneumonia. P-selectin values more than 898.58 pg/mL and CC16 values less than 11.355 ng/mL predicted severe ADV pneumonia. P-selectin and CC16 levels are correlated with the severity of ADV pneumonia in children.

Surge in Mycoplasma Pneumoniae infection and Respiratory Viruses Co-infection in Children With Community-Acquired Pneumonia in the Post-Pandemic.

During the COVID-19 pandemic, multifaceted non-pharmaceutical interventions have not only reduced the transmission of SARS-CoV2 but also affected the prevalence of other respiratory pathogens. With the lifting of many restrictions, a surge in cases of pneumonia in children has been reported in many hospitals in China. The study assessed the changes in pathogen and symptoms of children with community-acquired pneumonia (CAP) before and after the adjustments of prevention and control measures of epidemic and provided recommendations for CAP in children. Children diagnosed with CAP were enrolled in the study from 2022 to 2023. A cross-sectional retrospective study was conducted in a general hospital. We analyzed the data about demographic data, clinical symptoms, pathogens, and medical treatments. The Chi-square and Mann-Whitney U-test were used to assess the statistical significance of groups. We studied 1103 children, 339 in 2022 and 764 in 2023. Compared with children in 2022, more children were diagnosed with CAP in 2023 and these children had a higher body temperature and levels of CRP and PCT, which indicated these children got severe inflammation. The positive rate of the pathogen was also higher in 2023, especially the detective rate of Mycoplasma pneumoniae. The number of children infected with more than two pathogens was higher in 2023, especially those co-infected with the virus and M. Pneumoniae. Concerning the medicine therapy, the usage of β-lactam antibiotics, Macrolide antibiotics, and antiviral drugs kept rapid growth. After the adjustment of epidemic prevention and control policies in 2023, more children got CAP with severe clinical symptoms, and more antibiotics and antiviral drugs were used. Further study is needed to explore the reasons for the increase in children with CAP and to explore the rationality of treatment.

Determinants of Pneumonia Status in Under-five Children in Indonesia

Background: Pneumonia is a communicable disease that causes the largest under-five children death in the world. Meanwhile, Indonesia contributed 19.000 cases of under-five deaths due to pneumonia in 2018. Pneumonia can inhibit the growth and development in under-five children, cause decreased lung function or even lead to death. The pneumonia symptoms is less specific and almost the same as the flu or a common cough, makes this disease difficult to detect and difficult to treat optimally. This study was aimed to determine variables that affect the pneumonia in under-five children in Indonesia in 2018.Methods: This study used descriptive analysis and multilevel binary logistic regression. It used secondary data from the Riskesdas 2018, publication of Profil Kesehatan Indonesia 2018, and official website of Badan Pusat StatistikResult: The results indicated that in 2018, there were about 6.4 percent of under-five children who experienced pneumonia. The age of under-five children, gender, nutritional status, maternal education level, type of residence, house’s ventilation, and poverty rate per province significantly affected the status of pneumonia in under-five children in Indonesia.Conclusion : This study was expected to be able to increase public awareness about pneumonia in under-five children and can prevent under-five deaths due to pneumonia. Further research can use more up-to-date primary data and can also focus on provinces that have high rates of pneumonia in under-five children.

Evaluating the Diagnostic Accuracy of C-Reactive Protein in Diagnosing Pneumonia in Children Using Blood Culture as the Gold Standard

Evaluating the Diagnostic Accuracy of C-Reactive Protein in Diagnosing Pneumonia in Children Using Blood Culture as the Gold Standard

The Association Between The Physical Condition of the House and the Smoking Habits of Residents with the Incidence of Pneumonia In Children Under Five Years

Pneumonia is leading cause of death worldwide, with a prevalence of 44%, and is second leading cause of death among under-fives in Indonesia, at 15.5%. Pneumonia is caused by viruses and bacteria that are associated with physical conditions, air quality, and smoking habits in house. This study aimed to determine association between physical house conditions and smoking habits with incidence of pneumonia in children under five years in Cengkareng Health Center working area. This study was a case-control design analytic observational study. Population involved chindren under five aged 12-59 months with a sample of 43 cases and 43 controls calculated using Lemeshow’s formula, taken using purposive sampling technique. Independent variables included floor and wall types, ventilation, occupancy density, temperature, humidity, light intensity, PM10 and PM2.5 levels, and smoking habits. Dependent varariable are incident of pneumonia. Data were collected through observation, sanitarian kits, and questionnaires. Data were analyzed using chi-square and logistic regression with 95% CI and alpha 0.05. The results showed that PM2.5 levels (p=0.010, OR=3.290, 95% CI=1.323-8.181) and indoor smoking (p=0.044, OR=2.758, 95% CI=1.027-7.410) were most significant factors associated with pneumonia. This study recommends optimizing educational programs regarding PM2.5 exposure and smoking habits to improve healthy living practices and reduce risk of pneumonia

Persistence of immunity in children aged 2 months and 7 months – 5 years old after primary immunization with 13-valent pneumococcal conjugate vaccine

Background: Pneumococcus is a common cause of pneumonia, meningitis, and other serious infections in children. The previous study has proved that the 13-valent pneumococcal conjugate vaccine (PCV13) has sufficient immunogenicity in children. The data on long-term persistence of immunity will help the follow-up development work of pneumococcal vaccines.Methods: Children who received the full vaccination course of the tested PCV13 in the previous clinical trial were enrolled again, and these who received other pneumococcal vaccines, or were infected with one or more serotypes of S. pneumoniae corresponding to PCV13 before enrollment were excluded. Participants were divided into four groups by age which is same as that of previous trial. The study lasted for 5 years, during which we measured pneumococcal antibodies of 13 serotypes included in PCV13 at particular points in time. Geometric mean concentrations (GMCs) and seropositive rates (the rate of IgG concentration ≥0.35 μg/mL) of antibodies against 13 serotypes were calculated.Results: For the participants aged 2 months, five years after primary vaccination, except for serotypes 3 and 4, seropositive rates were 100%. GMCs of IgG antibodies against 13 serotypes ranged from 0.733 to 15.160 μg/mL. All of the participants aged 7–11 months had the serotype-specific IgG concentration ≥0.35 μg/mL four years after primary vaccination with the exception of serotypes 3, 4, 6 A and 9 V. IgG GMCs were 0.753–11.031 μg/mL. All participants aged 12–23 months and 2–5 years old had the serotype-specific IgG concentration ≥0.35 μg/mL three or two years after primary vaccination respectively, except for serotype 3. IgG GMCs ranged from 0.815 to 13.111 μg/mL, and 0.684 to 12.282 μg/mL respectively.Conclusion: PCV13 was applied to the population aged 2 months and 7 months - 5 years old with a good immune persistence, providing more extensive evidence of long-term efficacy for that vaccine.Trial Registration: The trial was registered with ClinicalTrials.gov, number NCT06210737.

Contributing Risk Factors to Pneumonia in Children Under Five Years in Madhesh Province of Nepal

Introduction: Pneumonia is the significant cause of morbidity and mortality in under five year children worldwide. In Nepal, pneumonia is the second most common cause of childhood mortality. Exclusive breastfeeding and basic immunization in preventing pneumonia cannot be underestimated. This study aims to assess the contributing risk factors associated with childhood pneumonia among children aged 16 months to under-5 year.  Methods: A case-control study was conducted from January to July 2022 including children under 5 years visiting the pediatric out-patient department of JMCTH. A total of 200 subjects aged 16–59 months were enrolled, in which ‘cases’ included 100 patients diagnosed with pneumonia and ‘controls’ included 100 patients with non-pneumonia illnesses, matched by age and setting. The WHO guideline was followed for the diagnosis of pneumonia. The data on contributing risk factors were collected from both cases and controls via interview method from their parents.  Results: The study showed non-exclusive breastfeeding [odds ratio (OR) =7.82 in 95% confidence interval (CI)], indoor air pollution [OR=7.47 in 95% CI], incomplete basic immunization [OR= 4.44 in 95% CI], low birth weight [OR=3.11 in 95% CI] and severe acute malnutrition i.e. high degree of wasting [OR=2.70 in 95% CI] were the major contributing factors of pneumonia in children under age five in the Madhesh Province of Nepal. However, nutritional status (height-for-age z score), age, sex, and educational status of mother did not appear to be contributing risk factors for pneumonia.  Conclusion: This study highlights non-exclusive breastfeeding, indoor air pollution, incomplete basic immunizations, low birth weight, and severe acute malnutrition significantly increase the risk of childhood pneumonia. Exclusive breastfeeding plays a vital role, while gender seems to influence the relationship between exclusive breastfeeding and pneumonia incidence.

Prevalence and predictors of radiographic pneumonia in children with wheeze: A systematic review and meta-analysis.

Diagnostic uncertainty exists surrounding the identification of radiographic pneumonia in children with wheeze. It is important to determine the prevalence and clinical predictors of pneumonia in this population to limit chest radiography (CXR) and promote judicious antibiotic use. The objectives were to (1) estimate the prevalence of radiographic pneumonia in children with wheeze and (2) systematically review the diagnostic accuracy of clinical findings for the identification of radiographic pneumonia. Data sources were MEDLINE, PubMed Central, Cochrane Library, CINAHL, and Web of Science (January 1995 to September 2023). For study selection, two reviewers identified high-quality studies reporting on clinical characteristics associated with radiographic pneumonia in wheezing children (age 0-21 years). Using Covidence software, data regarding study characteristics, methodologic quality, and results were extracted. Data were pooled using random-effects meta-analysis. A total of 8333 unique titles and abstracts were reviewed. Twelve studies, representing 7398 patients, were included. Fifteen percent of children with wheeze undergoing CXR had pneumonia. Findings associated with radiographic pneumonia included temperature ≥ 38.4°C (positive likelihood ratio [LR+] 2.1, 95% CI 1.2-3.6, specificity 85%), oxygen saturation < 92% (LR+ 3.6, 95% CI 1.4-8.9, specificity 89%), and grunting (LR+ 2.7, 95% CI 1.6-4.4, pooled specificity 91%). Factors associated with the absence of radiographic pneumonia included lack of fever (negative likelihood ratio [LR-] 0.67, 95% CI 0.52-0.85) and oxygen saturation ≥ 95% (LR- 0.64, 95% CI 0.42-0.98). Tachypnea and auscultatory findings were not associated with radiographic pneumonia. Heterogeneity across studies limits generalizability. Additionally, all included studies overestimate the rate of radiographic pneumonia given the fact that all subjects had a CXR performed due to clinical suspicion of pneumonia. Radiographic pneumonia occurs in 15% of wheezing children undergoing CXR for pneumonia. Auscultatory findings and tachypnea do not differentiate children with and without pneumonia, and the rate of radiographic pneumonia is very low in the absence of fever and hypoxemia.

Epidemiological characteristics and early predict model of children Mycoplasma Pneumoniae Pneumonia outbreaks after the COVID-19 in Shandong

Since October 2023, a significant outbreak of Mycoplasma Pneumoniae Pneumonia (MPP) has been observed in children in northern China. Chinese health authorities have attributed this epidemiological to immune debt resulting from the relaxation of coronavirus disease 2019 (COVID-19) control measures. This study described the epidemiological features of Mycoplasma pneumoniae (MP) prevalence in children and developed a straightforward prediction model to differentiate between MPP and viral pneumonia in children. The infection rate of MP in children notably increased from 8.12 in 2022 to 14.94% in 2023, peaking between October and November, especially among school-age children. Logistic regression screening identified four key indicators: Age, D-Dimer levels, erythrocyte sedimentation rate, and gender. The developed nomogram exhibited a receiver operator characteristic curve-area under the curve (ROC-AUC) of 0.858, with external validation confirming an ROC-AUC of 0.794. This study examined the epidemiological characteristics of MPP prevalence in children in Shandong Province during and after the COVID-19 pandemic. An early predict model was developed and validated to differentiate between Mycoplasma Pneumoniae and viral infections.

Relationship between serum zinc levels and the burden of treatment in children with pneumonia

Background: Pneumonia is a common childhood disease often requiring hospitalization, with the potential for rapid progression and complications, particularly in children under five years old. Zinc plays a crucial role in various organ systems, especially the respiratory system. However, data on zinc levels and pneumonia in Vietnamese children remain limited. This study aimed to investigate the relationship between serum zinc levels and the treatment burden in children with pneumonia. Methods: A prospective observational study was conducted involving 200 children aged 2 to 59 months who were diagnosed with pneumonia and hospitalized at Can Tho Children's Hospital, Vietnam. Serum zinc levels were measured, and treatment characteristics were monitored, including the need for respiratory support, antibiotic escalation, and treatment duration. Data were analyzed using descriptive statistics, independent t-tests, simple linear regression and multivariable linear regression to determine associations between serum zinc levels and treatment outcomes. Results: Children who were not exclusively breastfed for the first six months had significantly lower serum zinc levels compared to those who were exclusively breastfed (p&lt;0.001). Lower serum zinc levels were significantly associated with the need for respiratory support (p=0.001), antibiotic escalation (p=0.002), prolonged antibiotic use (p=0.01), and longer treatment duration (p=0.011). Multivariate linear regression revealed that each unit decrease in serum zinc levels increased treatment duration by 0.218 days (p=0.015). Conclusion: Low serum zinc levels are associated with increased treatment burden in children under five years old with pneumonia.

Outcome of Community-Acquired Pneumonia in Children Admitted to PICU at Minia Children University Hospital.

Outcome of Community-Acquired Pneumonia in Children Admitted to PICU at Minia Children University Hospital.

The Management of Bronchial Asthma (Tamak Shwasa) through Panchakarma Procedure with Ishvaku (Lagenariasiceraria) Vamana: A Case Report

Background Bronchial asthma, a hypersensitivity illness, is rising quickly in the modern world, particularly in wealthy nations. However, according to clinical features, bronchial asthma and Ayurvedic Tamaka Shwasa are similar diseases. Asthma is incurable, according to traditional medical knowledge. Both patients and doctors are looking at complementary and alternative systems of medicine as options because current prescriptions do not offer adequate treatment for terminal and long-term cures. Ayurvedic medicine has the potential to be a viable and efficient treatment option for bronchial asthma. Vaman karma is helpful for treatment globally so that people worldwide can keep faith in it based on scientific evidence. The first line of treatment for Tamakshwasa’s Utkleshita vastha is Vamana. To determine Vamana Karma’s involvement in Tamak shwas, a season it connected to Tamak shwasa has been searched for and attempted to be established in this case study. Purpose This study aimed to assess the efficacy of Ayurvedic management, including specific Ishwaku vaman karma, in Tamaka Shwasa. Materials and Methods A single case study of a 21-year-old man diagnosed with bronchial asthma. He was presented with frequent allergy due to dust, had an onset of sneezing due to cold weather, had a complaint of cold and cough on and off since childhood, and had a history of pneumonia in childhood. Observation and Outcome A 9-day symptomatic patient assessment was completed. The patient’s overall quality of life was greatly enhanced, and the outcome was satisfactory. In conclusion, the above-mentioned regimen significantly improved the management of bronchial asthma.

FLUEnT: Transformer for detecting lung consolidations in videos using fused lung ultrasound encodings

Pneumonia is the leading cause of death among children around the world. According to WHO, a total of 740,180 lives under the age of five were lost due to pneumonia in 2019. Lung ultrasound (LUS) has been shown to be particularly useful for supporting the diagnosis of pneumonia in children and reducing mortality in resource-limited settings. The wide application of point-of-care ultrasound at the bedside is limited mainly due to a lack of training for data acquisition and interpretation. Artificial Intelligence can serve as a potential tool to automate and improve the LUS data interpretation process, which mainly involves analysis of hyper-echoic horizontal and vertical artifacts, and hypo-echoic small to large consolidations. This paper presents, Fused Lung Ultrasound Encoding-based Transformer (FLUEnT), a novel pediatric LUS video scoring framework for detecting lung consolidations using fused LUS encodings. Frame-level embeddings from a variational autoencoder, features from a spatially attentive ResNet-18, and encoded patient information as metadata combiningly form the fused encodings. These encodings are then passed on to the transformer for binary classification of the presence or absence of consolidations in the video. The video-level analysis using fused encodings resulted in a mean balanced accuracy of 89.3 %, giving an average improvement of 4.7 % points in comparison to when using these encodings individually. In conclusion, outperforming the state-of-the-art models by an average margin of 8 % points, our proposed FLUEnT framework serves as a benchmark for detecting lung consolidations in LUS videos from pediatric pneumonia patients.

Lung Ultrasound Efficacy in Monitoring Post-SARS-CoV-2 Pneumonia and Inflammatory Biomarkers in Pediatric Patients.

Background and Objectives: Recognizing the crucial gaps in our understanding of pediatric pneumonia post-SARS-CoV-2 infection, this study aimed to assess the relationship between Pediatric Pneumonia Ultrasound Scores (PedPne) and inflammatory biomarkers. The primary objective of this study is to evaluate the predictive value of PedPne in comparison with inflammatory biomarkers (IL-6 and dNLR) for the development of pneumonia in pediatric patients following SARS-CoV-2 infection. Materials and Methods: This longitudinal observational study collected data from pediatric patients diagnosed with pneumonia after an acute SARS-CoV2 infection. The study focused on analyzing changes in PedPne scores and inflammatory markers such as IL-6 and dNLR from initial admission to follow-up at 7 days. Statistical analysis involved calculating the sensitivity, specificity, and Area Under the Curve (AUC) for each biomarker, alongside regression analysis to determine their hazard ratios for predicting pneumonia development. Results: The analysis identified significant cutoff values for dNLR at 1.88 (sensitivity 77.0%, specificity 85.7%, AUC 0.802, p < 0.001), IL-6 at 6.1 pg/mL (sensitivity 70.3%, specificity 92.9%, AUC 0.869, p < 0.001), and PedPne score at 3.3 (sensitivity 75.7%, specificity 78.6%, AUC 0.794, p < 0.001). Conversely, NLR showed lower diagnostic performance (AUC 0.485, p = 0.327). Regression analysis further highlighted the strong predictive power of these markers, with IL-6 showing a fourfold increase in pneumonia risk (HR = 4.25, CI: 2.07-9.53, p < 0.001), dNLR indicating more than a twofold increase (HR = 2.53, CI: 1.19-6.97, p = 0.006), and PedPne score associated with more than a doubling of the risk (HR = 2.60, CI: 1.33-5.18, p < 0.001). Conclusions: The study conclusively demonstrated that both PedPne ultrasound scores and specific inflammatory biomarkers such as dNLR and IL-6 are significant predictors of pneumonia development in pediatric patients post-COVID-19 infection. These findings advocate for the integration of these biomarkers in routine clinical assessments to enhance the diagnostic accuracy and management of pneumonia in children following SARS-CoV-2 infection.

Single Mutation different Clinical Findings: IGLL1 Defect

Agammaglobulinemia is a rare inherited immunodeficiency disorder characterized by low or absent B cells with absent immunoglobulins. While X-linked agammaglobulinemia (XLA) is the most common type other genetic forms of agammaglobulinemia have been identified. During early childhood, passively transferred maternal Immunoglobulin G protects against various infections. The depletion of these antibodies begins between 6 and 12 months of age, resulting in recurrent sinusitis, bronchitis, and pneumonia in children with X-linked agammaglobulinemia. However, less common autosomal recessive forms of agammaglobulinemia present with more severe clinical features, leading to earlier diagnosis. Herein we present the case of a two-month-old male with IGLL1 gene defect and different clinical findings of family members with the same mutation.

Persistent elevation in incidence of pneumonia in children in England, 2023/24.

Since November 2023, the absolute number of attendances at emergency departments for pneumonia among children aged 5-14 years in England have been above expected levels for the time of year. This increased signal peaked during March 2024 but then persisted into early summer 2024 despite decreases in prevalence of seasonal respiratory pathogens. Record linkage between emergency department and laboratory databases points to this unusual activity being driven largely by Mycoplasma pneumoniae.

Distinguishing types and severity of pediatric pneumonia using modified lung ultrasound score.

This study aimed to investigate the diagnostic utility of the modified lung ultrasound score (MLUS) in distinguishing between Mycoplasma pneumonia and viral pneumonia in children and evaluate their severity. A prospective collection of 137 suspected cases of community-acquired pneumonia in children admitted to the Quanzhou Maternity and Children's Hospital in Quanzhou City, Fujian Province, from January 2023 to December 2023 constituted the study cohort. All patients underwent lung ultrasound examinations, and MLUS scores were assigned based on ultrasound findings, including pleural lines, A-lines, B-lines, and lung consolidations. Based on the pathogenic results, the patients were categorized into the Mycoplasma pneumonia (74 cases) and viral pneumonia (63 cases) groups. The severity was classified as mild (110 cases) or severe (27 cases). The diagnostic value of MLUS for Mycoplasma pneumonia and viral pneumonia in children was analyzed. (1) MLUS scores were significantly different between the Mycoplasma pneumonia (15, 10-21) and viral pneumonia (8, 5-16) groups (P = 0.002). ROC curve analysis indicated that using a cut-off value of 11, MLUS exhibited a sensitivity of 70.3%, specificity of 58.7%, and an area under curve (AUC) of 0.653 for diagnosing Mycoplasma pneumonia. Furthermore, large-area lung consolidation on ultrasound images demonstrated good diagnostic performance for predicting Mycoplasma pneumonia, with an AUC of 0.763, a sensitivity of 71.6%, and a specificity of 81.0%. (2) MLUS scores were significantly different between the mild pneumonia (10.5, 5-17) and severe pneumonia (21, 16-29) groups (P < 0.001). ROC curve analysis using a cut-off value of 16 showed a sensitivity of 77.8%, specificity of 73.6%, and AUC of 0.818 for diagnosing severe pneumonia. Multivariate regression analysis revealed that both MLUS and white blood cell count were independent factors influencing the severity. The constructed nomogram model demonstrated robust stability with a sensitivity of 85.2%, a specificity of 74.5%, and an AUC of 0.858 for predicting severe childhood pneumonia. MLUS, coupled with ultrasound signs of large-area lung consolidation, had reference significance for the differential diagnosis of Mycoplasma pneumonia and viral pneumonia in children and can be a preliminary assessment of the severity of viral pneumonia or mycoplasma pneumonia in children.