Pediatric infectious diseases · communicability is possible from 10 to 21 days after exposure ... Bleeding problems ... Direct contact with nose Spread and throat secretions and

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