Pediatric infectious diseases · communicability is possible from 10 to 21 days after exposure ......
Transcript of Pediatric infectious diseases · communicability is possible from 10 to 21 days after exposure ......
common Pediatric
diseases
Prepared by Dr.Latifa Mari’e
Characteristics in infants and
children
Neonates, infants: non-specific initial symptoms (irritability, lethargy, poor feeding)
Specific rashes
Sites of infection
Prevention: vaccination/ immunization
Erysipelas
Superficial inflammation of the skin
Streptococcus pyogenes, Staphylococcus aureus
Complication/ infants: sepsis
Erysipelas (Group A Streptococcus, acute cellulitis and
lymphangitis)
Cellulitis (phlegmone)
Inflammation of the
subcutaneous connective
tissue – may lead to abscess
Ill defined , no systemic sx
Streptococcus pyogenes, Staphylococcus aureus,
Haemophilus influenzae (<2 yrs)
Therapy: penicillin+ clindamycin
Measles (Rubeola, Morbilli, Nine-
Day Measles) Paramyxovirus, RNA virus 7-14 days incubation, prodromal fever Coryza, hacking cough, conjunctivitis Koplik’s spots 2-4 days later Rash: retroauricular, temporal region, then
on the face - maculo-papulous exanthemes
Photophobia, high fever Complications: bacterial super-
infections,encephalitis, cerebellitis, subacute sclerotizing panencephalitis
Measles
(RNA virus, macular rash,
Koplik’s spots)
Koplik’s spots
Resembling tiny grains of white sand surrounded by inflammatory areolae
Buccal mucosa opposite the 1st and 2nd upper molars
Rubella (German Measles, Three-
Day Measles)
Togavirus, RNA
14-21 days incubation
Painful lymphadenopathy: retroauricular, cervical, occipital
Peeling
Congenital rubella syndrome
Rubella (RNA virus, maculopapular rash, occipital
lymphadenopathy)
Congenital rubella syndrome
Infection of seronegative mother during pregnancy
Risk of fetal infection • I. trimenon: 75-90%
• II. trimenon: 20-40%
• III.trimenon: 25-50%
• Fetal lesion 1-8. gest. week: 80%
9-12. gest. week: 30%
13-20. gest. week: 10%
Congenital rubella syndrome
Gestation
• 14- 60. days: embryopathy – cataracta, microphthalmia, hearing loss, congenital heart disease, microcephalia, thymus hypoplasia
Rubella vaccination is prohibited during pregnancy!
Roseola infantum (exanthema
subitum) (Human Herpesvirus-6, high fever,maculopapular rash)
Fever appears suddenly, lasting 3 - 4 days, followed by a raised red rash on the trunk, later spreading to the rest of the body, lasting 1 - 2 days. Most common in infants and preschoolers
Incubation 5 - 15 days from date of contact.
Suggested treatment :Control fever with acetaminophen.
Varicella (chickenpox)
Varicella (chickenpox) (Varicella-Zoster virus, vesicles,
crusting)
Chickenpox
Extremely contagious
14-16 days incubation, communicability is possible from 10 to 21 days after exposure
Rash begins on trunk then spreads allover but sparing palms and soles
Vesicles, crusted lesions variable stages
Varicella (toxic)
Serious complications include:
Bacterial infections of the skin and soft tissues in children, including Group A streptococcal infections
Infection of the lungs (pneumonia)
Infection or inflammation of the brain (encephalitis, cerebellar ataxia)
Bleeding problems
Bloodstream infections (sepsis)
Infectious mononucleosis
(Epstein- Barr virus infection)
Infectious mononucleosis (Epstein-Barr virus, enanthema=pharyngeal
petechiae)
Infectious mononucleosis
Scarlat fever (Group A Streptococcus, erythrogenic toxin,
fine papular exanthem, palmar/ plantar
peeling,sandpaper rash )
Kawasaki disease
(Multisystem vasculitis,medium
sized muscular arteies )
Kawasaki disease is characterized by fever high grade for 5 days, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and unilateral cervical lymphadenopathy
Usually affect children <5 years old
Coronary artery aneurysms or ectasia develop in ≈15% to 25% of untreated children with the disease and may lead to myocardial infarction (MI), sudden death, or ischemic heart disease.
treatment
Aspirin
IVIG
Corticosteroids
Mumps
Mumps (Epidemic Parotitis)
Paramyxovirus, infected salivary glands mainly parotids
Headache, anorexia, malaise, fever
Pain on chewing or swallowing acidic liquids
Parotid and other salivary glands are tender, tissue edema
The oral duct openings of the glands are „pouting” and inflamed
Fever, headache and inflammation of the salivary glands causing the cheeks to swell painfully. Sometimes there is no swelling.
Method of Spread by sneezing or coughing, or by direct contact with Spread nose and throat secretions
Incubation Usually 16 - 18 days
mumps can lead to viral meningitis if the virus moves into the outer layer of the brain. Other complications include swelling of the testicles or ovaries (if the affected person has gone through puberty).
It may lead to type 1 dm
Hand foot mouth diseas
Hand / Foot / Mouth Disease (Coxsackie virus)
Symptoms Sudden onset. Fever, sore throat, small greyish blisters in mouth lasting 4 - 6 days. Blisters may also appear on palms, fingers and soles for 7 - 10 days.
Method of Spread by coughing and sneezing. Direct contact with nose Spread and throat secretions and feces of infected persons. Incubation 3 - 5 days from date of contact.
Control: Avoid close contact. Careful disposal of articles soiled with discharge. Careful hand-washing, especially after toileting. Isolation of case and children with fever.
Control fever with acetaminophen. Treatment Prevention Promote hand-washing and hygiene measures
Influenza Viral Infection
RNA orthomyxoviruses, types A, B, C
Young children: bronchiolitis, pneumonia, myositis
Secondary bacterial infection of the respiratory tract
Salicylates should be avoided (risk of Reye syndrome)
Th: oral oseltamivir (Tamiflu)
Bronchiolitis is blockage of the small airways in the lungs due to a viral infection. It usually only occurs in children less than two years of age
Some signs of severe disease include:
poor feeding
significantly decreased activity
history of stopping breathing
respiratory rate >70/min
presence of nasal flaring and/or grunting
severe chest wall recession hoover’s sign
most commonly caused by respiratory syncytial virus
Treatment:nebulized epinephrine,nasal suction
Treatments which the evidence does not support include salbutamol, steroids, antibiotics, antivirals, continuous positive airway pressure(CPAP), chest physiotherapy, and cool mist
Ribavirin is an antiviral drug which does not appear to be effective