Chandy C. John, MD, MS, Editor

Because pediatrics starts with the neonate, the first 3 articles address key neonatal infections. Drs Beth Swanson and Mark Schleiss start with an article summarizing the latest findings on congenital cytomegalovirus (CMV) infection, the most common cause of acquired hearing loss in children. They outline advances in diagnosis and treatment and provide a simple algorithm for evaluation of the child with suspected CMV and assessment of whether a child with known CMV infection requires ganciclovir treatment. Dr Schleiss, who has been at the forefront of CMV vaccine development, also gives a brief update on the current state of CMV vaccines. Drs Swetha Pinninti and David Kimberlin follow with an article on neonatal herpes simplex virus (HSV) infection, highlighting advances in this area and providing guidelines for evaluation and treatment of mothers with genital HSV infection and infants born to these mothers. Data from Dr Kimberlin’s 2011 New England Journal of Medicine article provide the rationale and criteria for follow-up treatment of children with neonatal HSV infection with oral acyclovir, after initial intravenous acyclovir treatment. Drs Andres Camacho-Gonzales, Paul Spearman, and Barbara Stoll review the latest information on diagnosis and treatment of neonatal sepsis. The authors provide insight on which of the many diagnostic markers currently being studied may become clinically useful and discuss the risks for development of antibiotic-resistant bacteria in neonatal intensive care units.

The next section focuses on common childhood infections. Dr Michael Pichichero leads off this section with an update on acute otitis media. Dr Pichichero, who has studied and published on otitis media for decades, carefully delineates the criteria for a diagnosis of acute otitis media and compares this condition (and its prognosis) with otitis media with effusion. Dr Pichichero notes that tympanocentesis aspirates from children in Rochester, New York in 2011 showed a predominance of nontypable Haemophilus influenzae and Moraxella catarrhalis , most of which were β-lactamase–producing organisms. The shift to these organisms may reflect effectiveness of the current 13-valent pneumococcal conjugate vaccine. Dr Pichichero notes that, in areas where H influenzae and M catarrhalis predominate as causes of acute otitis media, amoxicillin-clavulanate may be a more appropriate first choice for treatment than amoxicillin. Dr Itzhak Brook then discusses the evaluation, diagnosis, and treatment of acute and chronic sinusitis. Dr Brook’s research on the contribution of anaerobic organisms to chronic sinusitis transformed our understanding of that condition, and his concise and informative article on acute and chronic sinusitis provides an excellent update on these common yet sometimes difficult-to-diagnose conditions in children. Drs Markus Pääkkönen and Heikki Peltola’s article on bone and joint infections outlines their pioneering studies of these infections. In these studies, they demonstrated that for uncomplicated osteomyelitis and septic arthritis, short courses of intravenous therapy, followed by high-dose oral therapy, are as effective as the traditional longer courses of intravenous therapy. Their review provides a new, evidence-based approach to the evaluation and therapy of acute osteomyelitis and septic arthritis. Dr Pui-Ying Iroh Tam then provides a succinct evidence-based review of community-acquired pneumonia in children, outlining current standards for evaluation and diagnosis of pneumonia, and highlighting areas of controversy in treatment of pneumonia in children.

The section on tick-borne and parasitic infections in children starts with a review by Dr Charles Woods, an expert in many areas of clinical pediatric infectious disease research, on Rocky Mountain spotted fever. Dr Woods discusses new findings in the evaluation and diagnosis of Rocky Mountain spotted fever, including the utility of a PCR-based diagnosis. Drs Meagan Barry, Jill Weatherhead, Peter Hotez, and Laila Woc-Colborn review parasitic infections endemic to the United States. Parasitic infections in the US are more common than is often realized, so the article provides a much-needed synthesis of information on the current approach to diagnosis, evaluation, and treatment of these infections, delivered by experts from the new National School of Tropical Medicine at the Baylor College of Medicine.

The final section focuses on infections in immigrant and traveling children. Nearly ten thousand children are adopted every year from other countries to the United States. Dr Judith Eckerle and I review the infectious problems common to these children, which are quite different from those of children born in the United States. Our recommendations come from the current literature and from our clinical experience at the University of Minnesota International Adoption Clinic, the first and still busiest international adoption clinic in the United States. Travel by parents and children to countries in Asia, South America, and Africa is increasing, making travel-related infection an important topic for the pediatrician. The comprehensive overview of travel-related infections in children by Drs Thomas Fox, John Manaloor, and John Christenson provides up-to-date information on how to prepare children for international travel and how to evaluate the ill child returning from international travel.

Together, these articles provide an excellent and current overview of common infections in children, from the neonate to the traveling or immigrant child. They are highly relevant to the practice of clinical pediatrics and should stand as valuable reference articles for years to come. I hope you enjoy reading them as much as I did and find them useful to your clinical practice.