COMMON PED ILLNESS AND CONDITIONS Flashcards
what are the common pediatric illnesses?
❖Streptococcal Pharyngitis ❖Acute Otitis Media ❖Acute Otitis Externa ❖Conjunctivitis ❖Croup ❖Hand Foot Mouth ❖Mononucleosis ❖Fifth’s Disease ❖Eczema
what is this?
❖Clinical Manifestations
❖Causative agent: Group A streptococcus
❖Sudden onset of fever (high), headache (cap), pharyngitis, abdominal complaints (nausea, vomit), cough
❖Preschool to middle school aged
❖Diagnosis
❖Centor criteria
❖Rapid antigen strep test or throat culture
❖Treatment
❖First-line: Penicillin
❖Second-line/PCN allergy: Cephalosporin
Streptococcal Pharyngitis
what is this?
❖Clinical Manifestations
❖Upper respiratory infection with development of fever, otalgia
❖Nonspecific symptoms: tugging at ears, not sleeping, won’t lay flat, won’t nurse or take bottle
❖Diagnosis
❖Otoscopy – hyperemic, opaque TM with distorted or absent light reflex & indistinct landmarks
❖Etiology – Haemophilus influenza, Moraxella catarrhalis, Streptococcus pneumoniae
❖Treatment
❖Amoxicillin – first line; resistant – Augmentin
❖Cephalosporins - cefdinir
Otitis Media
what is this?
❖Clinical Manifestations
❖History of swimming/diving, repetitive ear cleaning with soapy water & cotton-tipped swabs
❖Ear pain, itching, fullness
❖Pain exacerbated by manipulation of the pinna or tragus
❖Canal walls diffusely erythematous & edematous. Ipsilateral cervical lymph node enlargement may be noted
❖ Purulent discharge may be present
❖ Usually afebrile
❖Diagnosis ❖Based on clinical observation ❖Causative agents: ❖ Bacterial: Staphylcoccus aureus; Pseudomonas aeruginosa; Group A Strep ❖ Fungal: Candida, Asperigillus ❖ Trauma, cerumen
❖Treatment
❖Topical antibiotics (usually fluoroquinolone with hydrocortisone)
Otitis Externa
what is this?
❖Clinical Manifestations
❖Preschool age & younger – common cold: coryza, nasal congestion, sore throat, cough with variable
fever. Cough becomes prominent with seal-like barking cough, hoarse voice & stridor
❖Symptoms usually worsen in the evening – often presenting suddenly between 12 – 3 am
❖Causative agent parainfluenza – usually lasts 3-5 days with the 2nd night being the worst
❖Diagnosis
❖Based on clinical observation, generally lungs sounds clear given that it’s an upper airway condition
❖Stridor may be noted immediately prior to coughing, laughing or crying
❖Treatment
❖Symptom management – supportive; moist heat and/or cold.
❖Burst of low-dose PO or inhaled steroid
Croup – Acute Laryngotracheitis
what is this?
❖3 Types
❖Infectious
❖Allergic
❖Traumatic
❖Clinical Manifestations
❖Bacterial: conjunctival hyperemia, moderate to copious purulent discharge
❖Viral: mild purulent discharge, tearing & lid swelling
❖Allergic: white stringy discharge, itchy, injected sclera
❖Diagnosis
❖Based on history and clinical findings
❖Treatment
❖Topical antibiotic drops – sulfa preparations; fluoroquinolones
Conjunctivitis
what is this?
❖Clinical Manifestations
❖Sudden onset of fever, decreased appetite, sore throat, & malaise.
❖1-2 days after the onset of the fever, herpangina & vesiculopapular lesions
❖Predilection of lesions on palms, soles but can also be found on face, buttocks, arms, legs
❖Diagnosis
❖Clinical presentation
❖Treatment
❖Supportive care
Coxsackie Virus (Hand-Foot-Mouth)
what is this?
❖Clinical Manifestations
❖Epstein-Barr Virus – most common cause
❖CMV, toxoplasmosis, HIV, Rubella, HAV, HBV, HCV, Adenovirus
❖Incubation period 28 to 60 days post-exposure. Symptoms generally progress slowly (or not at all)
❖Fatigue, fever, malaise, pharyngitis, abdominal pain, rash, hepatosplenomegaly
❖Spleen enlargement generally peaks @ 3 weeks – fatigue may persist for weeks to months
❖Diagnosis
❖Clinical presentation
❖MonoSpot
❖EBV titers
❖Treatment
❖Rest, support, steroids
Mononucleosis
what is this?
❖Fifth disease comes from its place on the standard list of rash-causing childhood diseases (measles,
scarlet fever, rubella, Dukes’ disease, erythema infectiosum, roseola
❖Clinical Manifestations
❖Viral infection – “slap-cheek”, “slap-face” – caused by parvovirus 19
❖Low-grade fever, headache, rash & cold-like symptoms. Symptoms pass then rash appears
❖Bright red rash commonly appears in the face (cheeks), develop lacy red rash on upper arms, torso
❖Lasts few days, may be pruritic (may also last for weeks). Not contagious once rash appears
❖Teenager/adults: self-limited arthritis. Joint swelling – difficulty walking, bending joints (wrists, ankles, fingers,
shoulders)
❖Diagnosis
❖Clinical presentation
❖Treatment
❖Supportive
Fifth Disease (Erythema Infectiosum)
what is this?
❖Clinical Manifestations
❖“The itch that rashes”
❖Patches of skin becomes inflamed, itchy, red, cracked & rough. Vesicles/bullae may appear. Susceptible
to secondary bacterial infection
❖Predilection to antecubital, popliteal. For infants may be scattered patches over body
❖Definite “allergic” predisposition
❖Diagnosis
❖Clinical examination
❖Treatment
❖Focuses on healing damage skin & alleviating symptoms
❖Emollients, moisturizers, topical steroids, antihistamines, immunomodulators
Eczema
