Myocarditis represents a potential complication of various infectious and noninfectious agents and a common diagnostic challenge for clinicians. Data regarding Campylobacter-associated myocarditis are limited. Here, a case of a 13-year-old female with Campylobacter jejuni gastroenteritis complicated by myocarditis is presented, followed by a literature review in order to retrieve information about Campylobacter-associated carditis in the pediatric population. A search on MEDLINE/PubMed yielded 7relevant cases in the last 20 years. Most of them (six/seven) were males and the mean age was 16.1 years. All patients presented with gastrointestinal symptoms followed in six/seven cases by chest pain within two to seven days. Campylobacter was isolated from stool cultures in six patients; abnormal electrocardiographic findings were detected in six; and abnormal echocardiographic findings in three of the cases. Five patients were treated with antibiotics. Full recovery was the clinical outcome in six patients, whereas one patient died. Concerning the nonspecific symptoms of patients with myocarditis, high clinical suspicion of this complication is necessary in cases where patients with a recent infection present with chest pain and elevated cardiac biomarkers.

Background: Foreign body aspiration (FBA) in the tracheobronchial tree is a common problem in the pediatric population. Rigid bronchoscopic procedure is currently the gold standard method for treatment in pediatric patients, whereas recent reports present flexible bronchoscopy as an alternative method. The aim of this study was to summarize all available evidence regarding the application and the success rate of flexible bronchoscopy in foreign body (FB) removal. Methods: Systematic review of the use of flexible bronchoscopy as the first-line treatment in FBA cases in PubMed from 2001 to 2021. Results: Out of 243 citations, 23 studies were included on the use of flexible bronchoscopic procedure as a treatment of choice in 2,587 children with FBA. The FBs were successfully removed in 2,254/2,587 (87.1%) patients with a low complication rate. The majority of FBs retrieved were organic materials 1,073/1,370 (78.3%), and they were most commonly lodged in the right bronchial tree 708/1,401 (50.5%). General anesthesia was applied in most studies (14/23) before proceeding to a flexible bronchoscopy and laryngeal mask airways (LMAs) were mostly used (10/23 studies) to secure the airway during the procedure. Ancillary equipment, usually forceps 1,544/1808 (85.4%) assisted in the FB retrieval. Conclusion: The use of flexible bronchoscopy is shown to be a feasible and safe alternative therapeutic procedure in FBA cases. There is a need for development of extraction equipment and techniques to assist the procedure. Finally, future studies focusing on the comparison between clinical outcomes of flexible and rigid bronchoscopies are necessary.

Nocturnal oximetry results represent one of 3 facets describing sleep-disordered breathing (SDB) severity in infancy, the other 2 being exam/DISE findings and caregiver sleep concerns. We speculated that oxygen desaturation (>=3%) index (ODI3) and/or McGill oximetry score (MOS) can discriminate infants with clinically apparent upper airway obstruction (UAO) from those without (controls). Methods: ODI3 values in 1-12 m.o. infants with UAO or controls were compared to published age-adjusted, upper reference ODI3 values (Kaditis and Gozal. Children 2022). Sensitivity, specificity, PPV and NPV of abnormal ODI3 and MOS>1 for UAO were calculated. Results: Data from 20 infants with UAO (Apert syndrome;choanal atresia; hypoplastic mandible/Robin sequence; laryngomalacia), median age 2.2 m (1.1-7.3) and median ODI3 13.3/h (0.9-38.8) and from 88 controls (age 3.5 m;1-12.2) (Table 1) were analyzed. TABLE 1. erj;64/suppl_68/PA1361/TB1 T1 TB1 Controls:Age subgroups 1-2 mo (n=39) 3-4 mo (n=15) 5-6 m (n=16) 7-8 m (n=6) 9-10 m (n=7) 11-12 m (n=5) ODI3 values in controls: median (10th-90th percentile) 6.7 (1.9-14.4) 5.3 (2.7-15.3) 4.2 (2-10.8) 6 (0.9-7) 4.2 (1.1-6.9) 4.3 (0.9-5.8) 5 of 20 (25%) infants with UAO had abnormal ODI3, 15 of 20 (75%) MOS>1 and 5 of 20 (25%) both abnormal ODI3 and MOS (kappa 0.158-weak). MOS>1 but not abnormal ODI3 has modest sensitivity and adequate NPV for detecting UAO (Table 2). TABLE 2. erj;64/suppl_68/PA1361/TB2 T2 TB2 Sensitivity Specificity PPV NPV Abnormal ODI3 5/20 (25%) 88/88 (100%) 5/5 (100%) 88/103 (85.4%) Abnormal MOS 15/20 (75%) 64/88 (72.7%) 15/39 (38.5%) 64/69 (92.8%) Conclusion: To assess UAO severity in infancy, oximetry results should be interpreted in the context of exam/DISE findings and caregiver reported sleep concerns.