Common Childhood Illnesses

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Common Childhood Illnesses

• Bruce D. Banwart, MD
• Pediatric Critical Care
• Childrens Mercy Hospital
• Assistant Professor of Pediatrics
• University of Missouri Kansas City
• 03 June 2009

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Integrated Management of Childhood Illness - IMCI

• Developed by UNICEF and WHO for children lt 5
  years of age
• Help health programs to move beyond the single
  disease and address the overall health of the
  child
• Children can present with overlapping illnesses
• Addresses nutrition, immunization and
  preventative care and health promotion
• Suggested reading
• www.emro.who.int/cah/PDF/IMCI-Adaptation-Yem.pdf

3
This is the result of?

• Dry Scalp
• Pediculosis capitis
• Pediculosis corporis
• Seborrhoeic dermatitis

4
Head Lice can cause?

• Louse-borne typhus
• Louse-borne relapsing fever
• Trench fever
• None of the above, head lice are not disease
  vectors

5
If a shampoo containing lindane or pyrethrin is
not available for the treatment of lice, you
could recommend?

• Gasoline/kerosine
• Vinegar and oil
• Shaving the head
• Combing the hair daily for 3-10 minutes for 14
  days

6
This hair pattern is caused by?

• Impetigo
• Seborrhoeic dermatitis
• Tinea capitis
• Trichotillomania

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Tinea Capitis

• Black Dot Ringworm
• Kerion
• Boggy inflammatory mass
• Misdiagnosed as impetigo, abscess, cellulitis
• Topical Treatment
• Sulfa/lard
• Selenium Sulfide Shampoo
• Unlikely to be effective
• Griseofulvin
• Treat for 2 weeks after resolution
• Dont share personal items

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Conjunctivitis
Treat bacterial conjunctivitis with antibiotic
ophthalmic solution or ointment 4 times a day and
keep the area clean
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Acute Otitis Media

• Treat with Amoxicillin 25-50 mg/kg/d divided 3
  times a day for 5-10 days
• If it ruptures, keep the area clean but do not
  plug with cotton, stick or leaves
• Pain while pulling the ear lobe is otitis externa
  and can be treated with ear drops
• Chronic perforation can be a cause of conductive
  hearing loss

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The most common sight for Group A Streptococcal
infections is?

• Heart
• Joints
• Muscle
• Throat
• Skin

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Which one of the following is NOT a major Jones
Criteria in the diagnosis of Rheumatic Fever?

• Polyarthritis
• Elevated white blood cell count
• Carditis
• St Vitus dance
• Erythema Marginatum

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Major Jones Criteria

• J Joints (Migratory Polyarthritis)
• ? - Heart (Carditis)
• N Nodules (Subcutaneous Nodules)
• E Erythema Marginatum
• S Sydenhams Chorea (St Vitus Dance)
• Minor Criteria Fever, arthralgia, ?d ESR, ?d
  WBC, EKG w/ Heart Block, ASO

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What is the first respiratory sign of pneumonia
in children?

• Cyanosis
• Nasal flaring
• Subcostal Retractions
• Tachypnea
• Wheezing

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Pneumonia

• One of the main causes of death in children lt5
  years in developing countries
• Risk factors poverty, restricted family income,
  low parental education, LBW, malnutrition, lack
  of BFing
• Etiology Strep pneumo, H. flu, Staph aureus,
  RSV, Influenza,
• Opportunistic infections ?ing with HIV/AIDS
• lt2 months of age admit to hospital for IV
  atbxs
• gt2 mos Tachypnea with retractions require
  admission no retractions tx at home

Cashat-Cruz et al. Semin Pediatr Infect Dis 2005
1684-92
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Treatment Outcomes of Non-Severe Pneumonia
Bhutta, ZA, Arch Dis Child 200792286-288
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The noise from wheezing is?

• Extrathoracic on exhalation
• Extrathoracic on inspiration
• Intrathoracic on exhalation
• Intrathoracic on inspiration

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This baby?

• Has colic
• Has an umbilical hernia
• Has constipation
• Thinks she is fat

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Abdominal Pain in Children

• Constipation
• Intestinal parasites
• The closer it is to the umbilicus the less likely
  it is from serious pathology

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Helminthic Infections

• Affect up to 90 of school aged children in some
  areas
• Contributes to malnutrition and iron deficiency
  anemia
• May make host more susceptible to HIV and hasten
  viral load
• Treatment has been felt to improve school
  performance and cognitive function but clinical
  trials have been variable

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Umbilical Hernias

• More common in African descent
• More frequent in females
• Most close by 5 years of age
• gt90 will close if lt2cm
• gt85 overall
• Taping a coin over it is not beneficial and may
  lead to strangulation if bowel is caught under
  coin

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This rash is from?

• Candidiasis
• Psoriasis
• Scabies
• Staph scalded skin syndrome

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What is the cause of this rash that has been
described as a dew drop on a rose petal?

• Measles
• Scabies
• Staphylococcus
• Varicella

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Scabies

• The Seven Year Itch
• Burrow is rarely seen
• Occurs on face and scalp in infants
• Can have a vesicular component in children
• Treat all family members
• Cut finger nails short
• Lindane
• not to be used in children lt1y/o
• 1 part lindane to 15 parts Vaseline
• 4 drops lindane on a half lemon
• Sulfur
• 1 part Sulfur to 10 parts Vaseline or lard
• 3xs a day for 3 days

25
All are signs or symptoms of anemia EXCEPT?

• Fatigue
• Jaundice
• Pallor
• Pica (likes to eat dirt)

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Anemia

• Pale conjunctiva, gums, palms fingernails
• Eats Dirt
• Causes diet poor in iron, intestinal parasites,
  hookworm, malaria, sickle cell disease
• Eat iron rich foods
• Meat and eggs
• Beans, lentils, peanuts, dark green vegetables
• Treat the underlying cause
• If necessary, give Fe supplements