This is a new feature on PEMBlog. I will be summarizing recent articles in 50 words (or less). I know that all of you are busy, so I wanted to give a quick synopsis of current literature, and offer you a chance to see what’s out there. I highly encourage you to look at the individual studies to see what conclusions you’ll draw on your own of course.

Herpes Simplex Virus Infection in Infants Undergoing Meningitis Evaluation

HSV study group of the PEMCRC and Cruz et al.

Pediatrics, 2018

This multi center retrospective cross-sectional study of infants <60 days old who had CSF studies sent. 112 of 26,533 had HSV identified with >80%  in weeks 1 to 4; median age 14 days. HSV was more common in 0-28 days vs 29-60 days (OR 3.9; 95% CI: 2.4-6.2).

National Imaging Trends of Recurrent Pediatric Urolithiasis

Barrick et al.

Pediatric Emergency Care, 2018

A review of nearly 5,000 encounters for urolithiasis in children saw a 14% decrease in CT as the first imaging modality and subsequent imaging modality. Concordantly, ultrasound use increased by 15%.

What happens next? Recurrence Rates for First Unprovoked Seizures in Children

Wendt et al.

Academic Emergency Medicine, 2018

Unprovoked seizures are more likely to see recurrent seizures than febrile seizures (which are approximately 33%). The risk is estimated at 29%, 37%, 43%, and 46% at 1, 2, 5, and 10 years, respectively.

Point-of-care C reactive protein to identify serious infection in acutely ill children presenting to hospital: prospective cohort study

Verbal et al.

Arch Dis Child, 2017

This prospective Belgian study incorporated CRP + assessment and vitals into an algorithm for febrile children. CRP >75mg/L had a 26.8% risk of serious infection requiring admission. Well appearing kids had lower CRPs. It’s not validated in a multi-center manner yet; don’t use CRP alone to determine sick vs not.

Association of Broad- vs Narrow-Spectrum Antibiotics With Treatment Failure, Adverse Events, and Quality of Life in Children With Acute Respiratory Tract Infections

Gerber et al.

JAMA, 2017

A retrospective cohort study of 6 months – 12 years with acute respiratory tract infection prescribed an oral antibiotic showed that broad-spectrum treatment (augmenting, cefdinir vs amox) was not associated with a lower rate of treatment failure but was more likely to have adverse events.

Relationship between iron deficiency anemia and febrile seizures in children: A systematic review and meta-analysis

Kwak et al.

Seizure, 2017

Interestingly, a meta analysis showed that iron deficiency anemia is significantly associated with febrile seizures (OR, 1.98; 95% CI, 1.26-3.13; P=0.003). You still don’t need to send ion levels/ferritin in the ED at this point though. Treatment doesn’t necessarily reduce the risk of recurrence.