In the Repiblic of Kazakhstan in 2018, there was an increase in generalized meningococcal infection (GFMI), which potentially has a risk of high mortality. The aim of the study was to study the clinical features of generalized meningococcal infection (meningococcal meningitis, meningococcal meningitis and mixed-form meningococcal meningitis) during the epidemic upsurge, as well as to evaluate early symptoms of the disease according to new international criteria, 2018. Material and methods. The article describes 59 children aged from 5 months. up to 16 years old. Of these, 35 children (26 boys) with generalized meningococcal infection (GMI): 1 group, age from 0.5 to 10 years with meningitis and meningococcemia (combined GMI) and 2 group, age from 2 to 16 years with meningococcemia - 24 (15 boys). All children underwent a complete clinical and laboratory examination. All children with a retrospective assessment of "red flag" symptoms was performed according to the latest recommendations supported by who the Severity of combined GMI and isolated meningococcemia is almost identical in mortality (8.6% for combined meningitis and meningococcemia and 8.4% for isolated meningococcemia). Results and discussion. In combined GMI, the severity is determined by pleocytosis in the CSF and correlates with inflammatory blood parameters; in isolated meningococcemia, the severity is due to symptoms of shock, primarily cardiovascular insufficiency. Conclusions. Red flag symptoms are particularly significant in children over 3 years of age and adolescents and are specific predictors of septic shock, especially in isolated meningococcemia (83%), but to a slightly lesser extent in combined GMI (71%). Keywords: generalized meningococcal infection, children, epidemic upsurge, meningococcemia, meningitis.
In the perinatal and early postnatal period, congenital (antenatal) and intrauterine (intra- and perinatal) CMV are more often manifested by lesions of the liver, brain and organ of vision. Objective. To study the effect of pathogenetic therapy with the metabolic and hepatoprotective drug N-Pentoxinial on the course of persistent CMV/EBV infection of perinatal genesis in children. Material and Methods. The course of latent perinatal cytomegalovirus (CMV) and Epstein-Bar viral infections in children was studied against the background of antiviral treatment (specific against CMV/ EBV immunoglobulin - Neocytect and recombinant alpha-interferon - Viferon No. 10), followed (immediately after 5-7 days after antiviral) by the appointment of 1-2 courses of N-Pentoxinal for 10-20 days. The main group consisted of 20 children (average age 5.4±1.4 years), the control group consisted of 10 children (average age 5.1±1.7 years). All underwent general clinical and virological studies to confirm the diagnosis. Result and discussions. The results obtained indicate that the addition of N-pentoxynial to the basic antiviral therapy for CMV and EBV infection in children improves (accelerates) the elimination of the virus from biological fluids (blood and urine), as well as more rapid normalization of transaminases and alkaline phosphatase. There were no reliably proven allergic reactions. Conclusions. The drug N-Pentoxinial can be prescribed after antiviral therapy for perinatal CMV, EBV infection in order to consolidate the results of antiviral treatment and normalize liver function, especially bile secretion. Keywords: latent perinatal cytomegalovirus/Epstein-Barr viral infection, children, therapy.
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