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Peds Infxs Dz


3 C’s of measles (rubeola) cough, coryza, conjunctivitis
Koplik’s spots oral lesions (enanthem) appear before rash
Second dz tx scarlet fever; Pen VK
Third dz rubella; postauricular & occipital adenopathy
Measles vs rubella: resolution measles self limiting in 7-10 days; rubella in 4 days; Rx = sx for both
Rubella dx: paired sera
Rubella complication arthralgia
Fifth dz s/s mild flu-like; rash at 10-17 days (first: slapped cheeks; reappears for 2-4 wks; second: lacy on arms/legs)
Fifth dz complications arthralgia (symmetric poly in older); fetal / 1st trimester death
Caused by parvo B19, spring/summer; adol/YA; LA, fever, arthralgia, self-limiting in 1-2 wks Papular purpuric glove & sock syndrome
Roseola (6th dz) Exanthem subitum; HHV6 & HHV&; 6 mos-3 yo; abrupt fever to 104 (3-7 days); Defervescence precedes rash
VZV: incubation in ___ & crusts in ___; contagious for ____ 10-20 days; 3-5 days; 1 week
HFMD S/S vesicles; poss genl scarlet rash; low fever, anorexia
HFMD comps myocarditis, substernal chest pain, dyspnea
papular acrodermatitis of childhood AKA: Gianotti-Crosti Syndrome
Gianotti-Crosti Syndrome age onset/etiology 6-14 mos (mean 2 yo); EBV (poss HHV4 or hep B)
Gianotti-Crosti S/S symmetric red-purpuric papules and papulovesicles on face, buttocks, extremities; low fever, LA; self-limiting 3-4 wks
Mumps parotitis is bilateral in ___% of cases 70%
Mumps presentations 2-3 wks incubation; stenson duct red w/yellow d/c; dx w/paired sera, clinical dx
Mumps comps orchitis, pancreatitis, oophoritis, aseptic meningitis
Pearly dome shaped papules with central umbilication: molluscum contagiosum (poxvirus)
Bacterial meningitis epidemiology Highest from birth - 2 yo. Peaks during neonatal and 3-8 months. M > F. Winter-spring. Most at risk are kids <1 y.o.
Bacterial meningitis organisms in newborns GBS, E. Coli, Listeria, H flu, SP, N meningitides
Viral meningitis usually due to: coxsackie / enterovirus (mumps is uncommon)
Pinworm can cause: vaginitis and/or UTIs in prepubescent girls
Kawasaki clinical features (CRASH) Persistent fever (to 105F) up to 5 days. Conjunctivitis. Truncal rash. Cervical LAD. Oropharyngeal erythema & strawberry tongue. Erythema & desquamation of hands & feet.
Kawasaki labs High WBC, ESR, CRP, platelets (late), proteinuria & pyuria.
Kawasaki mgmt Beta-globulin and high-dose aspirin
Fever (>38C), <28 days old Admit, blood cx, ucc, LP; poss cxr; IV amp/gent; NO ROCEPHIN due to kernicterus risk
Fever (>38C), 28 days - 3 mos blood cx, ucc, LP, poss cxr; Rocephin 50 mg/kg; d/c home if cxs neg; f/u in 24 hr
Fever (>39C), 3 mos - 3 yo ucc (M <6 mo, F <2 yo); poss cxr if sxs; poss stool cx; close f/u
< 2mo fever Septic workup: blood Cx, LP
< 5yo fever, seizures = Febrile seizure
Volume of distribution (Vd) and clearance in adult compared to neonate (eg, for gentamicin) Vd of an adult is decreased compared to neonate. Clearance is comparatively increased.
Bacterial meningitis organisms in kids 3 months - 6 yo SP, H flu, N meningitides, Listeria, aerobic GNR
Bacterial meningitis organisms in kids >7 yo SP, N meningitides, Listeria, aerobic GNR
Bacterial meningitis mgmt IV dexamethasone 0.15 mg/kg. <3 mos: CTX or ampicillin. >3 mos: CTX, cefotaxime, or amp + gent. Tx seizures prn
Created by: Abarnard