19- Common pediatric infectious dieases 2✅☑️.pdf

Common pediatric infectious diseases /Part two Common clinical syndrome SS mangut Common pediatric infectious M diseases /Part two does NeedsHigh Common clinical syndrome I  Pharyngitis Acute otitis media Acute bacterial...

Common pediatric infectious diseases /Part two Common clinical syndrome SS mangut Common pediatric infectious M diseases /Part two does NeedsHigh Common clinical syndrome I  Pharyngitis Acute otitis media Acute bacterial sinusitis Skin and soft tissue infection Urinary tract infection  viral Layers 74 years strepA Case 1 Adeno EBV Enter Ryusuke Case 2 oldmisidentify with high fevertt fggzf Moreofviral to 3 year old with low grade yearAstrep 6 group fever, runny nose ,cough and and severe sore throat sore throat viral Bacteria supportive hydratia tietoavoidacuterumatic fsandpercrasil feverByAntibiotic lodged exudate ofAmoxicill smap RapidAG 9 Days  go Pharyngitis Infection of the pharynx and/or tonsils Causes of Pharyngitis Clinical manifestations But usually Modified Centor criteria Adult W pedia can giveyouhint  Diagnostic test I ve youneedtorepeat theculture Z  Should we treat group A Streptococcal pharyngitis? Complications of GAS pharyngitis nearby Treatment Penicillin V Alternative therapy: Amoxicillin Beta-lactam allergic patients: Macrolide or Clindamycin Clinical approach notest parbutexpensive  D Bilateral indicativeofsanity Case 3 f 22yd 6 months old infant with fever, vomiting and excessive crying. Ear examination showed the following: tem Antibioticbemostcommonarebacteria althoughits panicmembranebulgingante to sipititivetitis media redness selflimitingweneedto iflessthan ayespGm causeof arateofcomplications Approachsym p resolvedwithinnon72hnoneedsofAntibioticonlysupportive today sym p persist startantibiotic iflessthanaywegiveforcdoaystopreventexfailuresymp improvedbyday5  URT Is EE Dose I maroxilla BGf sg.gg 1 6 FIist n Anoxide or 14 Pay for 22 yen 5Days for 75 Acute otitis media years AOM  Mainly leadto veairpressureinear Aon Clinical presentations Symptoms: Signs: - Ear pain (ear tugging in - Dullness of TM infant) - Absence of light reflex - Bulging TM hallmark - Irritability/crying - Fever - Limited or absent mobility - Ear discharge - Air fluid level - Otorrhea Etiology Bacteria:(60%-80%)* - S. Pneumoniae: 30% although we have vaccine But we have asubtypesid vaccinecover13 - H. Influenzae: 20%nontype able - M. catarrhalis: 20% Viruses: (20%-40%) * Spontaneous resolution: 50%  Clinical approach now madams + bilateral OM usuanyanee to resistance rare 5 Days equal to 7 days in children > 2 years Complications of acute otitis media Tympanic membrane perforation Conductive hearing loss Mastoiditis Labyrinthitis Brain abscess Epidural abscess Otic hydrocephalus ( Increased ICP W/O hydrocephalus) Acute bacterial sinusitis usuallyprecede by Uri obstructed dueto Url  9 Y goodmediaforbacteriato growth sinusitis Pathogenesis The respiratory mucosa in the paranasal sinus is continuous with the nasal mucosa. Most cases of ABS followed URTI Three key elements to normal physiology of the sinuses : 1. Patency of the ostia ( Can be obstructed following URTI) 2. Function of ciliary apparatus ( if impaired bacteria multiply ) 3. Quality of the secretions ( Over production occur with URTI) notthe resolvetherecurrentagain Etiology Streptococcus pneumoniae : 30-40% Hemophilus influenzae : 20% Moraxella catarrhalis : 20% Viruses : 10% Staphylococci & anaerobes are uncommon in Acute bacterial sinusitis fungal in immunecomp Diagnosis In case of uncomplicated sinusitis no imaging indicated Clinicalenough Bcfindingnotspecificwe gonnafind ur finding Sinus aspiration indicated in special situation only not respondingto tie or immune comp Clinical approach otherBacterial frontal sinosity Cuz brin cheep me may resistance ApaysAb Case 4 6-year-old boy presented with redness and swelling of the chin with golden crusts hunglesias -What is your management if looks impetigo groupaster well and afebrile ? If ill topicalAntibiotic and febrile systematic tu staph bully stapha Nonballs StepA Skin and soft tissue infections  moredeep superficial demarcated'fouownymphatic syst aroupa andstaph ME chest Deep 7 6 Highinfectious Moresuperficial nacroliccentré moreserious eitetpitadeenan  gramvexpsuedomonas furuncle lesions espimmunocompromised metropely topicalantiseptican Bloodculture antipsudomo.dk's antibiotic To staphgroupa Impetigo cuz localized, highly contagious caused by S. aureus and GAS. Duetotoxin I and nonbullous Impetigo occurs in two forms, bullous 2 staph Duetotoxinnot 5aureus groups the organism Children between 2 and 5 years of age are affected most often healwithno scare Management wen puts syst tu bye Topical antibiotics (e.g. mupirocin) are sometimes effective for mild cases. Narrow- spectrum systemic antibiotics (e.g. flucloxacillin) are generally needed for more severe infections Folliculitis onlyepidermis Bacterial folliculitis is a superficial infection of the hair follicle that manifests as discrete, 2- to 5-mm papules and pustules on an erythematous base. The lesions can be single or grouped, and a hair shaft often is seen in the center of the lesion S. aureus is the predominant pathogen Management Simple bacterial folliculitis often resolves spontaneously without scarring. for mild infection, topical antibiotic cleansers such as chlorhexidine, topical antibacterial agents (e.g., mupirocin, clindamycin), and benzoyl peroxide usually are effective. Furuncles and Carbuncles epitdermis A furuncle (i.e., boil) is an infection of the hair follicle, but unlike folliculitis in which the infection remains in the epidermis, the inflammation in furuncles extends deep into the dermis A carbuncle is a painful infection involving an aggregate of contiguous follicles, with multiple drainage points and inflammatory changes in the surrounding connective tissue.  The causative agent of furuncles and carbuncles is almost always S. aureus Treatment consists of frequent application of a hot, moist compress to promote drainage. Large furuncles and most carbuncles require surgical drainage Ecthyma A rare, deep ulcerative infection of the skin that penetrates down to the dermis Most commonly caused by S. pyogenes. Systemic antibiotic therapy with an agent effective against streptococci is recommended Ecthyma gangrenosum It is serious and characteristic skin lesion associated with gram- negative organisms, especially Pseudomonas aeruginosa. Effective treatment requires prompt initiation of an antibiotic effective against P. aeruginosa or other likely causative organisms. Erysipelas It is a superficial skin infection affecting the upper dermis and the lymphatic system. In most cases, GAS is causative, but group B, C, and G streptococci occasionally cause the infection 7 10days Treatment of erysipelas consists of oral anti-streptococcal agent for 7- 14 days Cellulitis It is an acute infection of the skin involving the dermis and subcutaneous tissues that manifests as edema, warmth, erythema, and tenderness of the skin. The most common etiologic agents are S. pyogenes and S. aureus. Uncomplicated cellulitis in treated with antimicrobial therapy targeting streptococci and staphylococci. Case 5 UTI A 9 month old infant presented with fever for three days; on examination: well, T:38.9°C, no focus. What is your next step? urinanalysis highgood ve ve value forv10 Urinary tract infection the onlysymyBe notto asympBe  Defined as significant bacteriuria of urinary pathogen in a symptomatic patients 05  Pathogenesis Colonization of periurethral mucosa with gastrointestinal bacteria→ Ascend into the bladder, ureters, and kidneys notfromblood Bacteria virulence factors Host risk factors : obstruction to normal flow of urine with urostasis (e.g. calculi, tumor, constipation), neurogenic bladder, Vesicoureteral reflux obstruction Circumcision reduces the frequency of UTI in boys