The leucocyte esterase test showed the same accuracy in young febrile infants as previously reported findings for older children. It predicted positive urine cultures and also revealed important gender differences.

We have derived a highly accurate prediction model for IBI in febrile infants with altered urinalysis. Given these results, outpatient management might be suitable for 1 of each 4 infants diagnosed, with a considerable improvement in resource utilization.

It might be inadequate to use a threshold of 50,000 cfu/mL to consider a urine culture as positive in young febrile infants given the fact that it would misdiagnose several UTIs.

Abstractscan be useful when planning screening programs for children in the first year of life. doi:10.1136/archdischild-2012-302724.1473 PANCREATIC NEUROENDOCRINE TUMORS IN CHILDREN S Sayyahfar. Tehran University of Medical Sciences, Tehran, IranObjectives Neuroendocrine tumors of the pancreas are rare specifically in pediatric age group. We report a 3.5-year-old girl with four weeks of icterus and primary misdiagnosis of hepatitis A and final diagnosis of well differentiated low grade neuroendocrine carcinoma of the pancreas. With our best knowledge this is the first report of this tumor in under -5-year-group.We highlight the patient's presentation, examination, and management as well as review the characteristics of pancreatic neuroendocrine tumors. Methods A retrospective case study of a 3.5-years-old girl with history of 4 weeks Jaundice, weight loss, hepatomegaly and positive total anti HAV antibody without fever, abdominal pain, vomiting, or palpable mass in abdominal examination. Results IgM anti HAV, HBs Ag, and HCV Ab were all negative except for IgG anti HAV. Abdominal CT scan with oral and IV contrast revealed an intermediate enhancing mass in pancreatic head suggesting hypervascular pancreatic mass lesion. Examination and immunohistochemical staining of the tumor revealed well differentiated neuroendocrine carcinoma with extension to duodenal wall and lymph node metastasis. Conclusion Despite of low incidence, the pediatricians should be aware and consider tumors in differential diagnosis of jaundice in children specifically if prolonged. In addition total anti HAV Ab test for diagnosis of hepatitis A should be discouraged. A 7-month old girl with the complaints of crying, cyanosis and breathing rapidly was brought to a hospital by her family. After taking nebulised salbutamol, the symptoms relieved. However, the symptoms reoccurred despite appropriate acute bronchiolitis treatment. She was hospitalized due to massive right thoracic infiltration in the chest x-ray. During evaluation, thoracal ultrasound showed a suspicious solid mass at the posterior mediastinum. Thorax computerised tomography revealed a right hemithoracal and posterior mediastinal gross solid mass. As the staging procedure, bone marrow aspiratıons were done which resulted in normal findings. The trucut biopsy of the thoracal mass resulted as small round blue malignant tumor cells consistent with peripheral neuroectodermal tumor/ewing sarcoma whıch was very rare in this age group. Introduction ALL and LL as the most common malignant diseases in childhood are two related malignancies that are treated by the same protocols. Aim The aim of the study is to see the outcome of the application of protocol BFM-95 in the treatment of ALL and LL in childhood in Macedonia in the period 2000-2007. Method We analyzed the medical records of 88 pediatric patients treated at Department of Hematology and Oncology at the University Pediatric Clinic in Skopje, 69 of which with ALL and 19 with LL. Results The annual average registered patients wit...