Background: The study aimed to determine the differences between COVID-19 and Respiratory syncytial virus (RSV) infections in young children hospitalized in the pediatric department. Methods: This retrospective study included 52 children with COVID-19 and 43 children with RSV infection younger than 36 months hospitalized in a pediatric department between September 2021 and March 2022. Clinical and laboratory findings, methods of treatment and hospitalization length were compared. Results: In the RSV group, significantly higher rates of cough (93.2% vs. 38.5%), rhinitis (83.7% vs. 50%), dyspnea (83.7% vs. 21.1%), crackles (69.8% vs. 5.8%) and wheezes (72.1% vs. 9.6%) were observed. The COVID-19 group had significantly higher rates of fever (80.8% vs. 37.2%) and seizures (13.5% vs. 0%). Patients with RSV infection had significantly higher rates of bronchodilator therapy (88.37% vs. 5.77%) and oxygen therapy (48.8% vs. 7.7%) and required a longer hospital stay (8 vs. 3 days). In admission, the majority of the patients from both groups were not treated with antibiotics, but because of clinical deterioration and suspected bacterial co-infections, antibiotics were administered significantly more frequently in the RSV group (30.2% vs. 9.6%). Conclusions: RSV infection in infants and small children had a more severe course than COVID-19 infection. RSV infection was associated with a longer hospitalization period and required more elaborate treatment.

Toxoplasmosis, both congenital and postnatally acquired, is a parasitic disease caused by infection with the protozoan Toxoplasma gondii. The most serious manifestation of this disease is congenital toxoplasmosis, resulting from transplacental infection of the foetus during pregnancy. Retinochoroiditis, intracranial calcifications, and hydrocephalus are considered the classic triad of congenital toxoplasmosis. This article describes four cases of severe neurologic and ocular manifestations in paediatric patients diagnosed with toxoplasmosis. The main aim was to examine the nature of clinical presentation as well as to emphasise the necessity of properly administered antiparasitic therapy and underline the importance of prenatal screening to reduce the risk of congenital transmission to the foetus.

Sirtuin 1 (SIRT1) inhibits growth hormone (GH) intracellular signaling for the insulin-like growth factor 1 (IGF-1) synthesis via the janus kinase (JAK)/signal transducer and activator of transcription proteins (STATs) pathway. The aim of this study was to compare SIRT1 concentrations in children with GH deficiency (GHD) and so-called idiopathic short stature (ISS, non-GH deficient), in order to determine the possible impact of changes in serum SIRT1 concentrations on the GH-IGF-1 axis. The study group included 100 short-stature children: 38 with GHD and 62 with ISS (maxGH in two stimulation tests <10 and ≥10 ng/mL, respectively). The control group consisted of 47 healthy, normal-height children. For each child, the concentrations of SIRT1, IGF-1 and insulin-like growth factor-binding protein 3 (IGFBP-3) were determined and the IGF-1/IGFBP-3 molar ratio was calculated. The level of SIRT1 was significantly higher in both groups of short children than in the controls (p < 0.0001), but there were no differences between GHD and ISS (mean ± SD: 0.89 ± 0.45 for ISS; 1.24 ± 0, 86 for GHD; and 0.29 ± 0.21 for controls). A significant negative correlation was found between SIRT1 and height standard deviation score (SDS), IGF-1 and IGF-1/IGFBP-3, but not between SIRT1 and maxGH. Elevated SIRT1 levels may serve as one of the mechanisms through which the secretion of IGF-1 is reduced in children with short stature; however, further research is required to confirm this issue.

This case report describes a diagnostically challenging presentation of nephrotic syndrome in a two-year-old boy initially suspected to have testicular torsion due to prominent scrotal oedema. The case demonstrates how the characteristic features of nephrotic syndrome – generalised oedema, proteinuria, and hypoalbuminaemia – may be initially obscured by focal symptoms mimicking surgical emergencies. The patient underwent scrotal exploration for suspected appendix testis torsion based on ultrasonography findings; however, postoperative persistence of oedema and development of ascites prompted recognition of the underlying nephrotic syndrome. Prompt initiation of corticosteroid therapy led to rapid resolution of proteinuria and clinical improvement. This report contributes to the existing literature by illustrating how nephrotic syndrome may present atypically, potentially delaying diagnosis when focal symptoms dominate the clinical picture.