Objective: To describe a cohort of pediatric patients with encephalitis and their risk factors for admission to the pediatric intensive care unit (PICU). Study Design: Children (<18 years old), with encephalitis evaluated by conventional microbiology and syndromic, multiplex test in cerebrospinal fluid (CSF) between July 2017 and July 2020, were recruited from 14 hospitals that comprise the Colombian Network of Encephalitis in Pediatrics. Multivariate analyses were used to evaluate risk factors associated with the need for PICU admission. Results: Two hundred two children were included, of which 134 (66.3%) were male. The median age was 23 months (IQR 5.7–73.2). The main etiologies were bacteria (n = 55, 27%), unspecified viral encephalitis (n = 44, 22%) and enteroviruses (n = 27, 13%), with variations according to age group. Seventy-eight patients (38.6%) required management in the PICU. In multivariate analysis, factors associated with admission to the PICU were the presence of generalized seizures (OR 2.73; 95% CI: 1.82–4.11), status epilepticus (OR 3.28; 95% CI: 2.32–4.62) and low leukocyte counts in the CSF (OR 2.86; 95% CI: 1.47–5.57). Compared with enterovirus, bacterial etiology (OR 7.50; 95% CI: 1.0–56.72), herpes simplex encephalitis (OR 11.81; 95% CI: 1.44–96.64), autoimmune encephalitis (OR 22.55; 95% CI: 3.68–138.16) and other viral infections (OR 5.83; 95% CI: 1.09–31.20) increased the risk of PICU admission. Conclusions: Data from this national collaborative network of pediatric patients with encephalitis allow early identification of children at risk of needing advanced care and can guide the risk stratification of admission to the PICU.

Este artículo fue aprobado para publicación en el v68n3 de la Revista de la Facultad de Medicina teniendo en cuenta los conceptos de los pares evaluadores y los cambios realizados por los autores según estos conceptos. Por lo tanto, se publica la versión preliminar del artículo para su consulta y citación provisional, pero debe aclararse que esta puede diferir del documento final, ya que no ha completado las etapas finales del proceso editorial (corrección de estilo, traducción y diagramación) y solo los títulos, datos de autores, palabras clave y resúmenes corresponden a la versión final del artículo.Esta versión puede consultarse, descargarse y citarse según se indique a continuación, pero debe recordarse que el documento final (PDF, HTML y XML) puede ser diferente.

PurposeHuman T-lymphotropic Virus type 1 (HTLV-1) was the first retrovirus to be identified and associated with oncogenic activity. It is estimated that approximately 10–20 million people in the world are infected with it. The clinical manifestations most commonly associated with HTLV-1 infection include T-cell leukemia/lymphoma and myelopathy associated to HTLV-1 infection. The purpose of this study is to describe clinical and demographic characteristics in pediatric patients with HTLV-1 infection.Methodology and PatientsAmbispective case series analysis, with collection of medical records and subsequent description of demographic data (sex, origin, age) and clinical characteristics in 16 patients with HTLV-1 infection were collected. Twelve of these patients were part of an initially reported cohort and four were recruited later in the study. The patients were collected between January 2017 and July 2021 in a pediatric institution in Cali, in a reference hospital in the southwest region of Colombia.ResultsThirteen of a total of sixteen patients came from the Colombian Pacific coast, where nine were with significant nutritional deficiencies. Seven showed dermatological compromise. Eight patients presented images compatible with inflammation and chronic lung injury, and six of the eight patients were with opportunistic infections. Coinfection with other microorganisms was also observed where one case presented with meningeal tuberculosis, another patient presented with simultaneous infections, namely, malaria, leptospirosis and toxoplasmosis, and a third patient presented intestinal parasitosis and soft tissue infection by Streptococcus pyogenes. Three patients had concomitant autoimmune diseases and a fourth patient was highly suspicious of having polymyositis.ConclusionsThe different clinical findings with simultaneous HTLV-1 infection broaden the panorama to suspect infection by this virus. More studies are required to achieve a direct association between structural lung disease, autoimmune diseases, immunodeficiency and HTLV-1 infection. This study aims to raise interest and awareness of an ancient but neglected disease.

Introducción: La enfermedad meningocócica es causada por la bacteria Neisseria meningitidis, comensal de la nasofaringe en 10% de la población. Ocasiona meningitis o septicemia meningocócica, el objetivo del estudio es describir la situación epidemiológica de la enfermedad meningococica en pediatría en una Institución Prestadora de Salud (IPS) Cali, Colombia. Métodos: Estudio observacional de corte transversal retrospectivo durante 01 de enero de 2011 hasta el 31 de enero del 2018. Resultados: se incluyeron 10 pacientes los cuales presentaron infección por Neisseria meningitidis (meningococo) de 157 pacientes que cursaron con infección bacteriana del Sistema Nervioso Central (SNC), una prevalencia del 6,4%. Con igual distribución para hombres y mujeres. 5 casos se presentaron en menores de un año, tres casos entre los 1-5 años y dos entre los 6-10 años. 75 % fueron de nivel de estrato socioeconómico bajo y 25% medio. En dos casos se serotipifico Neisseria Meningitidis B. siete de diez casos presentaron como síntoma principal fiebre. el 40% presento duración mayor a 5 días de tratamiento y el antimicrobiano más utilizado fue ceftriaxona, el tratamiento rápido permitió una mejoría de la sintomatología en un promedio de 4 días. Se presentó un fallecimiento (letalidad del 0,01%). Conclusión: Se evidencia aumento de aproximadamente el 15% de la notificación de casos los últimos 2 años. La afectación aun predomina en menores de 1 año sin preferencia sexual, perteneciente a bajo estrato socioeconómico y sociodemográfico, en donde el 20% de los casos se identifica el serogrupo.