Smecta significantly reduced the duration of diarrhoea, was safe and well tolerated, and had no impact on the adsorption of electrolytes. Smecta could be used together with ORS in children suffering from acute gastroenteritis (without uncontrollable vomiting) with mild and moderate dehydration.

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BackgroundIn Lithuania, the vaccination coverage against pertussis is high. Nevertheless, there is a significant increase in pertussis cases in fully immunized children. The aim of our study was to determine the frequency of classical symptoms of laboratory confirmed pertussis and describe its epidemiology in children fully vaccinated against pertussis.MethodsFrom May to December 2001, 70 children aged 1 month to 15 years, suffering from prolonged cough were investigated in the Centre of Paediatrics, Vilnius University Children's Hospital. The collected information included personal data, vaccination history, clinical symptoms of the current illness, and treatment before hospitalization. At the admission to the hospital blood samples were taken from all studied children for Bordetella pertussis IgM and IgA.ResultsA total of 53 (75.7%) of the 70 recruited patients with prolonged cough showed laboratory evidence of pertussis. 32 of them were fully vaccinated with whole cell pertussis vaccine (DTP). The age of fully vaccinated patients varied from 4 to 15 years (average 10.9 ± 3.1; median 11). The time period between the last vaccination dose (fourth) and the clinical manifestation of pertussis was 2.6–13 years (average 8.9 ± 3.0; median 9). More than half of the children before the beginning of pertussis were in contact with persons suffering from long lasting cough illness in the family, school or day-care center. The mean duration from onset of pertussis symptoms until hospitalization was 61.4 ± 68.3 days (range, 7 to 270 days; median 30). For 11 patients who had had two episodes (waves) of coughing, the median duration of cough was 90 days, and for 21 with one episode 30 days (p < 0.0002). Most of the children (84.4%) had paroxysmal cough, 31.3% had post-tussive vomiting, 28.1% typical whoop, and 3.1% apnea. Only 15.6% children had atypical symptoms of pertussis.ConclusionFully vaccinated children fell ill with pertussis at the median of 11 years old, 9 years following pertussis vaccination. More than half of the children could catch pertussis at home, at school or day-care center. Clinical picture of pertussis in previously immunized children is usually characterized by such classical symptoms as prolonged and paroxysmal cough, rarely by whopping and post-tussive vomiting, and very rarely by apnea.

Aetiology of bacterial meningitis (BM) can be confirmed by various microbiological methods. The aim of this study was to assess the role of microbiological methods used for confirmation of BM in children and determine the influence of the aetiological agent, patient age and antibacterial treatment on study results. Over a 5-y period (1998-2002) BM was diagnosed in 90 children at Vilnius University Centre for Paediatrics. Aetiology was confirmed by cerebrospinal fluid (CSF) and blood culture, microscopic CSF smear examination, CSF and blood latex agglutination test. CSF and blood cultures were positive in 53% and 39% of cases, respectively. Microscopic CSF smear examination was positive for 57% of the specimens. CSF latex agglutination was positive in 64% and blood in 47% of cases. Causative agent and received antibiotic therapy prior to investigation of obtained material affected some final microbiological results. However, no influence of patient age was found. Microbiological confirmation was achieved in 59% of cases using CSF and/or blood culture and in 78% of cases using all available methods in practice. The most common pathogens of bacterial meningitis were H. influenzae type b, N. meningitidis and S. pneumoniae.

This paper describes the first diagnosis of myiasis with identification of the Hypoderma bovis larvae in Lithuania, in 2004.