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This study was conducted to survey US pediatric specialists about administration of respiratory syncytial virus (RSV) immunoprophylaxis, communication patterns among physicians and parents, and barriers to access. Separate surveys were sent to neonatologists, pediatricians, pediatric pulmonologists, and pediatric cardiologists. Most physicians (≥93.5%) routinely recommended immunoprophylaxis to high-risk children. Most respondents (≥71.8%) reported that >50.0% of eligible infants and young children received each monthly dose throughout the RSV season, with the first dose most commonly administered before discharge from the birth hospitalization. To ensure receipt of subsequent doses, specialists frequently scheduled a follow-up visit at the end of the current appointment. All specialists reported insurance denials as the biggest obstacle to the administration of immunoprophylaxis to high-risk children. These findings may be used to improve adherence to immunoprophylaxis by enhancing education and physician-parent communications about severe RSV disease prevention, and by reducing known barriers to use of this preventive therapy.

Although fever is common in neutropenic children, a microbiological etiology is determined in only 15% to 30% of cases. The authors investigated the frequency of respiratory virus detection in the upper airways of febrile neutropenic children with negative bacterial cultures.This is a 3-year prospective study of children younger than 19 years, hospitalized with febrile neutropenia and negative bacterial cultures. Respiratory samples were obtained for amplification of viral nucleic acids via Luminex xTAG technology.There were 50 febrile neutropenic episodes among 42 patients. Respiratory viruses were detected in 26 (52%) febrile episodes. A single virus was detected in 22 febrile episodes; multiple viruses were detected in the remaining 4. Rhinovirus/Enterovirus was most frequently detected.Respiratory viruses were detected frequently in nasopharyngeal samples from febrile neutropenic patients with negative bacterial cultures, thus providing an impetus to determine the relationship between virus detection, infection, and pathology in this unique patient population.

Background: Respiratory infections are a leading cause of pediatric hospitalizations. This study investigated whether virus—virus or virus— Bordetella co-infections are more frequent or more severe than previously recognized. Methods: This is a 3-year prospective study of children younger than 24 months hospitalized with a febrile respiratory illness. Viral pathogens were detected using multiplex polymerase chain reaction (PCR), enzyme-linked immunoassays, and/or viral cultures from nasopharyngeal samples. Bordetella infections were detected by PCR. Results: A total of 201 patients were enrolled. Respiratory viruses were detected in 187 (93%) patients, with 52 (28%) multipathogen infections. The most common viruses detected were respiratory syncytial virus and rhinovirus/enterovirus. There were no differences in illness severity when comparing patients infected with one pathogen and those with multipathogen infection. Conclusion: Virus co-infection in young children hospitalized with an acute febrile respiratory infection is common but does not appear to be associated with illness severity.

Pinworm infection is a very common diagnosis in young children that is not always confirmed through laboratory evaluation before empiric therapy is prescribed. This article describes a toddler who was treated several times for pinworms because small white worms were seen in her perianal area. Laboratory analysis of parasite material found in her diaper later confirmed a diagnosis of dipylidiasis. Because the signs of dipylidiasis and pinworm infection overlap and the treatments for these parasitic infections are different, the laboratory should clinically confirm suspected persistent or recurrent pinworms.