Pediatric SARS

1
Pediatric SARS

• Bernd Sebastian Kamps
• Christian Hoffmann

Prepared by Tamrakar Renuka
2
Pediatric SARS

• Initial Signs Symptom
• Persistent fever
• Productive cough
• Runny nose

3
Signs Symptom

• May have
• Malaise
• Myalgia
• Chill
• Rigor

4
Laboratory Data

• Hb- Normal
• WBC- low
• Lymphopenia
• Thrombocytopenia

• LDK- high
• CPK- high
• ALT- high
• APTT-elevated
• D-dimer - elevated

5
Radiological features

• Chest X-ray
• Pneumonic changes
• Unilateral focal opacity
• CT
• Ground- glass- opacity
• Multifocal air-space
• consolidation

6
Treatment Protocol for pediatric SARS

• If a diagnosis of SARS is suspected on admission
  then
• IV Cefotaxim, or clarithromycin, and PO ribavirin
  40mg/kg daily, in 2 or 3 doses, given for 1-2
  weeks
• If fever persists gt48 h
• Prednisolone 0.5 mg/kg PO daily to 2.0 mg/kg
  daily
• Immediately after admission, if patients with
  moderate symptoms of high fluctuating fever and
  notable malaise then
• IV ribavirin 20mg/kg daily, in 3 doses and
  hydrocortisone 2mg/kg every 6hr
• When persistent fever and progressive worsening
  clinically or radiologically is noticed then
• Pulse IV mythylprednisolone 10 20mg/kg

7
Clinical Course

• Difference between young children with teenagers
  and adults
• milder and shorter
• less aggressive
• Radiological changes
• milder
• resolution within 14 days

8
Conclusions

• Mostly infected those, who had been in close
  contact with infected adults
• Fever is the consistent symptom with productive
  cough and rhinorrhoea