It is an honor and pleasure to guest edit this issue of Pediatric Annals on infectious diseases. Infectious disease medicine is a stimulating field, with new challenges constantly presenting themselves. Whether it is an emerging infection, resurgence of old diseases, increasing antimicrobial resistance, complications of management of infections, or misconceptions and misinformation inhibiting appropriate immunizations, there is always, in baseball parlance, a curveball to keep the clinician at the ready.
In this issue, we present a spectrum of topics that highlight some of the important infectious diseases issues facing the clinician today. I hope readers find them useful. Drawing on my passion for baseball, to paraphrase the vision of the great catcher and pundit Yogi Berra, hopefully you will draw on these articles from an all-star cast of authors who “learned you all their experience.”1
Leading off, in their article, “Evaluation of Prolonged and Recurrent Unexplained Fevers,” Drs. Victoria A. Statler and Gary S. Marshall provide an overview and approach to the febrile child. Febrile illnesses remain a leading cause of sick visits and parents often worry about prolonged or recurrent episodes of fever. Following Yogi's advice, the authors demonstrate that “you can learn a lot by watching.”1
Antibiotic resistance and a limited armamentarium of new antimicrobial agents are another challenge in medicine today because as Yogi teaches, “we made too many wrong mistakes.”1 In the article, “Antibiotic-Resistant Bacteria and the Use of Novel Antibiotics in Children,” Evelyn Lai and Dr. Jeffrey M. Bender provide an update and information on some of the novel antibiotics and their potential role in pediatrics.
Another cost of our approach to antibiotic usage has been increasing rates of Clostridium difficile infection. Although less common in children than adults, in the article, “Clostridium difficile Infection in Children,” Dr. Asif Noor and myself detail how C. difficile infection is an important consideration in certain groups of children. We need to improve our antibiotic usage to help address this issue so we are not left bemoaning our mistakes or as Yogi said, we are not feeling that “the future ain't what it used to be.”1
On another front, we continue to see outbreaks of vaccine-preventable diseases and experience continued encounters with families expressing hesitance or resistance to vaccination, or as Yogi said, “it is déjà vu all over again.”1 In the article, “Addressing Vaccine Hesitancy in Clinical Practice,” Drs. Annabelle de St. Maurice, Kathryn M. Edwards, and Jesse Hackell provide a framework for addressing a number of these vaccine concerns.
Finally, in the article, “Preventing Pediatric Respiratory Syncytial Virus Infection,” Dr. Joseph Domachowske, Jodi Halczyn, and Cynthia A. Bonville provide an update on progress toward developing more effective treatment, improved prevention agents, and safe and effective vaccination against respiratory syncytial virus (RSV) infection. As the article details, great progress has been made in these areas in recent years; however, as Yogi cautions, “It ain't over ‘til it's over1” and RSV continues to be a leading cause of morbidity in young children.
In conclusion, this collection of articles provides useful information for clinicians and is helpful in practice because as Yogi has taught us, “If you don't know where you're going, you may never get there.”1
- Berra Y, Kaplan D. When you come to a fork in the road take it!: inspiration and wisdom from one of baseball's greatest heroes. New York, NY: MJF Books; 2001.