High Rate of Febrile Seizures in Japanese Children With Occult Bacteremia

Kamidani, Satoshi; Shoji, Kensuke; Ogawa, Eiki; Funaki, Takanori; Mishina, Hiroki; Miyairi, Isao

doi:10.1097/pec.0000000000001274

Cited by 8 publications

(12 citation statements)

References 23 publications

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“…The prevalence of OPB in patients with febrile seizures was 24–42% in the pre‐PCV era, and 28% in the post‐PCV era in the USA . Previous studies in Japan showed high prevalence rates of febrile seizures of 53% and 55% . This difference may be explained by the known higher overall prevalence of febrile seizures in Japan compared with Western countries (8.3–9.9% vs 2–5%) .…”

Section: Discussionmentioning

confidence: 85%

“…7 Previous studies in Japan showed high prevalence rates of febrile seizures of 53% and 55%. 1,15,16 This difference may be explained by the known higher overall prevalence of febrile seizures in Japan compared with Western countries (8.3-9.9% vs 2-5%). [17][18][19] The reason for the relatively high rates of febrile seizures in patients with OPB is unknown, but it suggests that screening for OPB may be more effective in this patient population.…”

Section: Discussionmentioning

confidence: 99%

“…Occult pneumococcal bacteremia is occasionally accompanied by febrile seizures . On retrospective analysis, 53% of children aged 3–36 months with OPB who presented at a pediatric emergency department (ED) in Japan had febrile seizures . Therefore, we hypothesized that the presence of febrile seizures in combination with other clinical criteria may effectively predict OPB, even in the post‐PCV era.…”

mentioning

confidence: 99%

“…In the pre-pneumococcal conjugate vaccine (pre-PCV) era, 2.8-11.1% of febrile children who met the risk criteria 3-36 months old, body temperature >39°C and white blood cell (WBC) count >15 000/mm 3 , were known to have occult pneumococcal bacteremia (OPB). [1][2][3][4] In approximately 4% of OPB cases, the patients were shown to be at risk of developing bacterial meningitis without antibiotics; [2][3][4] therefore, empirical antibiotic treatment was recommended in the 1994 Agency for Health Care Policy and Research guidelines for fever without focus in children aged 3-36 months. 2,5 After the introduction of PCV, however, the prevalence of OPB decreased to 0.17-1.3% of febrile children meeting the risk criteria.…”

mentioning

confidence: 99%

“…7,[11][12][13] On retrospective analysis, 53% of children aged 3-36 months with OPB who presented at a pediatric emergency department (ED) in Japan had febrile seizures. 1 Therefore, we hypothesized that the presence of febrile seizures in combination with other clinical criteria may effectively predict OPB, even in the post-PCV era. We focused on the risk criteria age 3-36 months old, body temperature >39°C, and WBC count >15 000/mm 3 because historically these criteria have been well adopted as a predictor of OPB.…”

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confidence: 99%

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Febrile seizures with leukocytosis as a predictor for occult bacteremia

Ogawa

Shoji

Kamidani

et al. 2019

Pediatrics International

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Background Febrile children 3–36 months old, who had a body temperature >39°C and white blood cell (WBC) count >15 000/mm3 were known to be at risk for occult pneumococcal bacteremia (OPB) in the pre‐pneumococcal conjugate vaccine (PCV) era. The positive predictive value of these criteria, however, decreased dramatically after the introduction of PCV, indicating a need for alternative criteria. A high rate of febrile seizures has been noted in children with OPB, suggesting that screening may still be practical in this population. We performed a retrospective analysis to evaluate factors that predict OPB in patients visiting the emergency department (ED) with febrile seizures. Methods Children 3–36 months old who visited the ED for febrile seizures and had blood cultures taken were included. Patients with underlying diseases were excluded from analysis. We performed statistical analyses comparing patient demographics according to the presence or absence of OPB. Results One thousand and eighty‐two patients visited the ED with febrile seizure, and blood cultures were taken in 397, of whom 87% had received more than three doses of PCV. Of the nine patients with OPB, eight (89%) met the risk criteria. In contrast, only 12% (48/388) of those without OPB met the criteria. In this population, those who fulfilled the risk criteria were more likely to have OPB than those who did not (14.3% vs 0.3%; likelihood ratio, 7.17). Conclusions High WBC count and fever may effectively predict OPB in pediatric patients with febrile seizure in the post‐PCV era.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Febrile seizures with leukocytosis as a predictor for occult bacteremia

Ogawa

Shoji

Kamidani

et al. 2019

Pediatrics International

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Influenza A as a Common Viral Cause of Complex Febrile Seizures

Esen

Seçilmiş

Doğan

et al. 2021

Journal of Pediatric Infectious Diseases

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Objective The most common childhood convulsive disorder happens to be febrile seizure (FS), which is an important health problem leading to economic burden and parental anxiety. Further investigation into the etiological causes of FS will guide us for appropriate measures during the follow-up period. The aim of study is to identify the percentage of viral and bacterial pathogens in the etiological causes of children with FS, and also if there is any difference between simple and complex FSs. Methods This prospective study randomly enrolled 100 pediatric patients with FS between January 2017 and July 2017. Nasopharyngeal swabs were obtained from all children at presentation. The respiratory panel was performed with a multiplex real-time polymerase chain reaction method to detect the 21 most common viruses. A complete blood count, absolute neutrophil count, absolute lymphocyte count, C-reactive protein, erythrocyte sedimentation rate, procalcitonin, blood culture, throat culture, urine analyses, urinary culture, and stool tests analysis were performed in all the patients. Results During the study period, at least one virus was detected in 87% of patients. Bacterial agents were detected in only 13% of patients. Coinfections of the viruses and bacterial pathogens were found in 24% of patients. The most frequently detected virus was influenza A (Inf A) (18%), followed by rhinovirus (12%). Coinfections of the viruses and bacterial pathogens, mixed viral infections, and Inf A were common in children who experienced complex FS. Inf A was detected in 16% of patients with simple FSs and 30% of patients with complex FSs and a significant difference between them (p < 0.01). Conclusion The results of this study showed that respiratory viral and bacterial pathogens are important in the etiology of FS in children. It is considered that complex FSs may be triggered by Inf A. The fact is viral pathogens are very common; therefore, antibiotics must be carefully prescribed. These results also draw attention to the use of the quadrivalent influenza vaccine in the prevention of FS related to the flu.

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Burden of illness associated with pneumococcal infections in Japan - a targeted literature review

Igarashi

Ueyama²,

Idehara³

et al. 2021

Journal of Market Access & Health Policy

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Introduction: Pneumococcal diseases (PDs) are among the leading causes of mortality and morbidity worldwide. However, the evidence on epidemiology, health economic, and patient-reported outcomes has not been systematically reviewed and published in Japan. This study aimed to assess the burden, treatment adherence and compliance, and serotype distribution associated with PDs in Japan. Method: One hundred and eight studies were identified between January 2005 and June 2020. The identified studies were mostly regional and with a limited scale, clinical settings, and populations. Results: In 2013–2017, invasive PD incidence rates were 4.98–9.47/100,000 in <4-year-olds, 0.36/100,000 in 5–14-year-olds, 0.46/100,000 in 15–64-year-olds, and 1.50–5.38/100,000 in the elderly. The incidence of invasive PDs in children decreased from 24.6/100,000 in 2008 to 10.7/100,000 in 2013 after the introduction of PCV7 and further declined to 10.3/100,000 in 2014 after PCV13 was introduced. From 2014, the prevalence of PCV13 serotypes decreased across all age groups along with a decrease of PPV23 serotypes, but an increase of PPV23 serotypes not included in PCV13 among adults and the elderly. No study reported health-related quality-of-life data for PDs. In children, direct costs were 340,905–405,978 JPY (3,099–3,691 USD) per pneumococcal bacteraemia, 767,447–848,255 JPY (6,977–7,711 USD) per pneumococcal meningitis, and 79,000 JPY (718 USD) per pneumococcal acute otitis media episodes. In adults and the elderly, the direct cost of pneumococcal pneumonia was 348,280–389,630 JPY (3,166–3,542 USD). The average hospital stay length was 7.2–31.9 days in children, 9.0 days in adults and 9.0–28.7 days in adults and the elderly. Conclusions: The epidemiological burden of PDs remains high in Japan, especially among children and the elderly with invasive PDs accounting for a very small proportion of all PDs. A significant impact of the PCV13 vaccine program was reported, while the PPV23’s impact remains unclear. A substantial decrease in quality-adjusted life years in adults and the elderly and a high economic burden may exist.

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High Rate of Febrile Seizures in Japanese Children With Occult Bacteremia

Cited by 8 publications

References 23 publications

Febrile seizures with leukocytosis as a predictor for occult bacteremia

Febrile seizures with leukocytosis as a predictor for occult bacteremia

Influenza A as a Common Viral Cause of Complex Febrile Seizures

Burden of illness associated with pneumococcal infections in Japan - a targeted literature review

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