Evaluation of post-infectious inflammatory reactions in a retrospective study of 3 common invasive bacterial infections in pediatrics. Issue 38 (23rd September 2022)

• Record Type: Journal Article
• Authors: Abraham, Pauline; Marin, Gregory; Filleron, Anne; Michon, Anne-Laure; Marchandin, Hélène; Godreuil, Sylvain; Rodière, Michel; Sarrabay, Guillaume; Touitou, Isabelle; Meslin, Pauline; Tournier, Carine; Van de Perre, Philippe; Nagot, Nicolas; Jeziorski, Eric
• Is Part Of: Medicine. Volume 101:Issue 38(2022)
• Page Start: e30506
• Publication Date: 2022-09-23
• Subjects: innate immunity -- invasive bacterial infection -- Neisseria meningitidis -- pediatrics -- post-infectious inflammatory -- Streptococcus pneumonia -- Streptococcus pyogenes; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000030506
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Infectious diseases can result in unanticipated post-infectious inflammatory reactions (PIIR). Our aim was to explore PIIR in 3 frequent pediatric bacterial invasive infections in France by a retrospective monocentric study. We included children hospitalized between 2003 and 2012 for Streptococcus pneumonia e (SP), Neisseria meningitidis (NM), or Streptococcus pyogenes invasive infections. The PIIR had to have occurred between 3 and 15 days without fever despite an individually tailored antibiotic therapy. A descriptive analysis was carried out to determine PIIR risk factors. We included 189 patients, of whom 72, 79, and 38 exhibited invasive infections caused by S pyogenes, SP, and NM, respectively. The mean age was 44 months. PIIR were observed in 39 cases, occurring after a median of 8 days (5–12), with a median duration of 3 days (2–6). Fever, arthritis, and pleural effusion were observed in 87%, 28.2%, and 25.6%, respectively. In multivariate analysis, PIIR were associated with pleuropneumonia, hospitalization in an intensive care unit (ICU), and elevated C-reactive protein (CRP). PIIR were observed in 20% of children after SP, NM, or S pyogenes invasives infections. Their occurrence was associated with the initial severity but not the etiological microorganism. Further studies are warranted to confirm these findings.