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The purpose of the study was to evaluate the clinical and laboratory features of infectious mononucleosis with liver damage in children hospitalized in an infectious diseases hospital.Materials and methods. A comparative retrospective study was conducted from January 2018 to June 2021. 200 Medical records of an inpatient were selected by random sampling. Inclusion criteria: age from 1 to 17 years, clinical presentation of infectious mononucleosis, absence of severe concomitant pathology. All patients underwent a standard laboratory examination, additionally determined the DNA of herpes viruses in the blood by PCR. Depending on the presence of cytolysis syndrome (ALT level > 31 U/l), all patients were divided into 2 groups: children with hepatic manifestations of IMN – 80 patients (40%) and without them – 120 (60%). Statistical analysis of the obtained results was carried out using the statistical program Statistica 8 (USA).Results. Epstein – Barr virus was the cause of the development of IMN clinic in 59% (118/200) of cases of monoinfection and in 14.5% (29/200) in combination with other herpesviruses. All participants in the study had moderate disease. An increase in the level of alanine aminotransferase (ALT) above 150 U/L was recorded in 9.5% (19/200) of the examined, no one had more than 1000 U/L, the median was 72.5 (MKR 48–138.5) U/L. Liver damage was more often recorded in children older than 3 years, girls predominated (53.8%, p = 0.017). In patients with liver damage, the following were recorded: moderately severe fever and lymphadenopathy (p < 0.05), hepatosplenomegaly (p < 0.001), lymphocytic leukocytosis (p < 0.05), thrombocytopenia (p < 0.001), atypical mononuclear cells were detected more often (p < 0.001), less often an increase in the level of CRP (p = 0.008).Conclusions. Our study showed that liver damage in IMN is registered in 40% of hospitalized children. Obviously, children with moderate forms of IMN need laboratory and instrumental monitoring of the state of the hepatobiliary system and appropriate correction of therapy.

Prolonged subfebrile condition (PSC) is a complex diagnostic and therapeutic problem caused by a wide variety of reasons, which often require a wide and expensive examination, consultations of various specialists, and repeated hospitalizations. Most often, PSC is associated with infections, some non-infectious diseases (predominantly connective tissue) and growths. To infectious causes of DS include: acute respiratory viral infections, herpes virus infections, toxoplasmosis, chlamydia, borreliosis, bartonellosis, etc. Separately, “psychogenic fevers”, subfebrile condition associated with taking drugs, and artifical subfebrile condition are distinguished. The condition of the children, as a rule, is benign and in most cases goes away on their own within 6-24 months.

Objective: to study the activity of HSV 1,2, EBV, CMV, HHV6, HHV7 in children of different age groups, to determine the frequency of various symptoms and syndromes in the examined children depending on hhv7 monoinfection and combined herpetic infection in the age aspect.Materials and methods: 56 children aged 2 to 18 years were examined at the state MEDICAL research Institute named after Prof. A. F. Agafonov in Kazan, at the BIOMED medical and diagnostic center in Kazan and at the LUCH children’s clinic in Naberezhnye Chelny (boys accounted for 62.5% of cases, girls-37.5%). Verification of the diagnosis and evaluation of the dynamics of etiological markers of the infectious process in all observed children was performed by PCR. Blood and saliva were examined to detect markers of human herpes virus type 7 (in qualitative PCR), and blood, oropharyngeal flushing, and urine were examined in semiquantitative PCR to determine other viruses from the herpes family (HHV6, CMV, EBV). In enzyme immunoassay is determined At the same time, we studied options for combining laboratory markers of herpesvirus activity and changes in the main laboratory parameters used in routine practice. We studied the dynamics of the observed parameters against the background of complex antiviral therapy for the next 3 months after the initial examination. The frequency of occurrence of various symptoms and syndromes was determined depending on the activity of various representatives of the herpes family, their combination, and the age of the subjects.Results of the study: HHV7-monoinfection is more typical for the age group of 7-14 years. The significance of mixed HHV6+HHV7 infection decreased with age. The combination of activity of 4 herpesviruses was more often registered in the age categories 2-7 years and 14-18 years. More often, patients had tonsillitis, generalized cervical lymphadenopathy, periodic temperature rise to subfebrile or febrile numbers, pharyngitis, recurrent ARI, rhinitis, which allows us to consider them as the main manifestations of HHV7 infection.Conclusion: HHV7 infection is significant in the modern pathology of the child. The presence of such syndromes as recurrent tonsillitis, cervical lymphadenopathy or isolated enlargement of submandibular lymph nodes, periodic fever, pharyngitis, recurrent ARI in combination with hepato - and/ or splenomegaly, fatigue, and headache is often associated with HHV7. HHV7-viremia is relatively rare, despite obvious clinical and laboratory signs of inflammation indicating the presence of a viral disease, which, apparently, and is the cause of underdiagnosis and lack of proper attention to this infection.

A clinical case of development of secondary hemophagocytic syndrome is presented on the background of sepsis caused by Serratia proteamaculans, in a child of monthly age, culminating in recovery. Hemophagocytic syndrome in the child developed on the 32nd day of life and was accompanied by fever, hepatosplenomegaly, anemia, thrombocytopenia, elevated blood levels of triglycerides and ferritin. Blood culture was positive for Serratia proteamaculans. Isolate of Serratia proteamaculans was resistant to aminopenicillins (including protected ones), 1–4 generations of cephalosporins and aminoglycosides but sensitive to ciprofloxacin and moderately sensitive to imipenem and meropenem. The duration of fever in the child was seven days, thrombocytopenia, hyperfertritinemia and hypertriglyceridemia – 28 days. The normalization of the indices of ferritin, triglycerides and platelets coincided with the reduction of bacteremia and high values of the C-reactive protein. The duration of bacteremia was three weeks: the isolation of Serratia proteamaculans from the blood occurred three times. Elevated levels of C-reactive protein in the blood were noted for 30 days. Reduced hemoglobin and red blood cells counts were noted for eight weeks. Positive dynamics of the hemophagocytic syndrome occurred as a result of measures aimed at treating sepsis – antibiotic therapy with imipenem in combination with ciprofloxacin, appointed by the decision of the medical commission on the basis of the sensitivity of Serratia proteamaculans to antibiotics, intravenous immunoglobulin, and infusion therapy. Glucocorticosteroids and cytotoxic agents (etoposide, cyclosporin A) have not been used in this case.

The purpose was to study the clinical and epidemiological features of respiratory syncytial virus infection in hospitalized children the first year of life with lower respiratory tract diseases in different regions of the Russian Federation (Russia) during the 2015–2016 epidemic season.Materials and methods: in the original study data of a multicentre observational study conducted on the basis of children’s hospitals in St. Petersburg, Arkhangelsk, Kazan, and Saratov are presented. Etiology of acute respiratory viral infections were confirmed by examination of smears from the posterior pharyngeal wall by polymerase chain reaction. The study sample included 991 child’s first year of life with lesions of the lower respiratory tract.Results. In the etiological structure of the surveyed children in the season of 2015-2016, RSVI ranged from 14% to 46,2%, an average of 33%. RSVI dominated in the Centers of St. Petersburg (38,3%), Arkhangelsk (36.2%) and Kazan (42.5 per cent).RSVI significantly more often (p

Infection-associated hemophagocytic syndrome is a life-threatening condition characterized by prolonged fever, hepatosplenomegaly, and cytopenia—most commonly, thrombocytopenia and anemia. It is characterized by proliferation and activation of benign histiocytes, causing dysfunction of various organs. Herein, we report about two clinical cases of hemophagocytic syndrome, associated with cytomegalovirus and Epstein – Barr virus.

The paper focuses on questions of etiotropic, pa diarrhea in children. The recommendations are given with the basic principles of evidence-based medicine including summary data from randomized clinical trials and metaanalyses. The new lines of the treatment are discussed suchas the possibility of application of antiemetic, antidiarrheal, antisecretory, probiotic drugs in pediatric practice.

The paper focuses on questions of etiotropic, pathogenetic, and symptomatic treatment of acute infectious diarrhea in children. The recommendations are given with the basic principles of evidence-based medicine including summary data from randomized clinical trials and metaanalyses. The new lines of the treatment are discussed such as the possibility of application of antiemetic, antidiarrheal, antisecretory, probiotic drugs in pediatric practice.