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Notes in Pediatric Infectious Diseases. Senior & Junior Peds Rotations.

3rd ed. 2002/03

Infections  Congenital CMV infection (commonest infection in developed world): o Head = microcephaly. o Brain = Peri-ventricular calcification. (MCQ) o Eyes = choreo-retinitis. o GI = same as rubella + IUGR. o Skin = purpura.  Congenital Toxoplasmosis: o Head = Microcephaly + hydrocephalus. o Brain = Intra-cerebral calcification  seizures. o Eyes = Microphthalmia + Choreo-retinitis.
 Congenital Rubella:


o o o o o

CVS = peripheral pulmonary stenosis + ASD + VSD. Eyes = same as Toxo + cataract + glaucoma. Ear = deafness. GI = hepatosplenomegaly + FTT + jaundice. Skin = Blue-berry muffin rash.

 Hepatitis A: ALT AST church shaped 1 week N.B. ALT = > specific for Liver.  Hepatitis B & C: ALT AST mosque shaped time  HBV mother can breast-feed, even though virus is excreted in milk.
Dr. Khalid A. Yarouf Al-Naqbi. (Intern) Page 1 of 5

 Hemoptysis + clubbing = rare. CBC  Lymphocytosis.  Tuberculosis (TB):  Interpretation of induration of PPD: o ≥ 10 mm  (+)ve TB. generalized lymphadenopathy. N. Ix: The 3 classic criteria for lab confirmation are 1.  CFx:  Loss of weight & appetite. Infectious mononucleosis:    Cause: Epstein-Barr virus (EBV). Senior & Junior Peds Rotations.  Gastric aspirate  for children 3X in early morning in family contact. (Intern) Page 2 of 5 .  Early antigens (EAs).  Previous BCG. gives false (-)ve. Yarouf Al-Naqbi. 3. Khalid A. N.Notes in Pediatric Infectious Diseases. Monospot test has low sensitivity (63-84%). and hepatosplenomegaly. 0  if on steroid. 2002/03 o Baby is infected already.  Epstein-Barr nuclear antigen (EBNA).B.B.  Evening fever & sweating.  Coughing. Positive serologic test for EBV:  Viral capsid antigen (VCA). 3rd ed. Physical exam: fever. < 5 mm  (-)ve.  o o  Cavitation is extremely rare in children. 2. o 5-9 mm: If child has (+) FHx  he's (+)  Cause: atypical mycobacterium. Peripheral blood smear: presence of at least 10% atypical lymphocytes. Treatment with amoxicillin or ampicillin is associated with rash in 80% of patients. Heterophile antibody tests include detecting heterophil antibody titers and Monospot test (Rapid slide agglutination test). pharyngitis. Dr.

Stronglyloides stercoralis. 2. 3rd ed.  Not in local UAE. Trichinellosis. Round worm (ascariasis).  Filariasis  elephantiasis. 3. 5. Campylobacter. Malaria  P. Pharyngitis. Ancylostoma duodenale. Nematodes: 1. 4. o Traumatic LP:  For 100 RBC  1 WBC is introduced. Senior & Junior Peds Rotations. (Intern) Page 3 of 5 . Yarouf Al-Naqbi. Hookworm  1 worm can suck 1 ml of blood /day. Viral conjunctivitis. Salmonella. Pinworm (E. 3. donovani. Hepato-splenomegaly + spiky fever (but healthy look) + LNs enlargement + neutropenia.  Causes of bloody diarrhea in childhood:  Infectious: (S2CEY = Shigella. E. Toxocara canis & catis. Tropical Medicine Protozoa: 1. coli. o Cow's milk colitis. vermicularis). Giardia  malabsorption (mimics celiac disease). Dr. Whip worm (Trichuris trichura). 7. Yersinia). Khalid A.Notes in Pediatric Infectious Diseases. Kalazar  L. falciparum. Necator americanas. cuz ♀anopheles mosquitoes … 2.  Lumbar puncture: o CSF in a normal child > 1 week  WBC < 3. 2002/03  LN enlargement occurs in: 1.  Non-infectious: o Inflammatory Bowel Disease (IBD). 4. Amebiasis. 2. 6.

Yarouf Al-Naqbi. (MCQ) 4. 4. MMR. Vaccination  Types of vaccines: 1. Live attenuated: o Made from living organism whose virulence has been reduced by attenuation o e.B. (MCQ) N. Hib (from its capsular polysaccharide). diphtheria. Kalazar. o e. influenza. Toxoids: o Produced from bacterial toxins artificially made harmless.  Ab-Ag Salmonella. aluminum phosphate or aluminum hydroxide included in the DTP vaccine. 2. Khalid A. OPV. Typhoid: o Salmonella typhi (obligate human pathogens) o Ix: Widal test = Tube agglutination test (best). 2. o Tinea solium.g. Malaria.e. 3rd ed. tetanus toxoids. Pertussis. 2002/03 8. This can sometimes be enhanced by use of adjuvants e.g.  ↑ “O” antigen titer of 1:320 (↓ sensitivity & specificity). Senior & Junior Peds Rotations. BCG.Notes in Pediatric Infectious Diseases.g. Brucella: intra-cellular  Ix: tube agglutination test. IPV.g. (Intern) Page 4 of 5 . Vaccines vary in their antigenic potency i. PUO (Pyrexia of Unknown Origin): One of the Differential Dx is Infections: 1. Component vaccines: o Contain component antigens of organism  provoke protective antibody response. Killed = inactivated: o Made from whole organisms which are killed during manufacture.  Cystoda: ‫الدودة الشريطية‬ o Tinea saginatum: in Europeans. o e. 3. 3.g. Schistosomiasis. their capacity to induce formation of protective antibody. o e. Dr.

Yarouf Al-Naqbi. Khalid A. (Intern) Page 5 of 5 . 2 months.e. Senior & Junior Peds Rotations. 2002/03  Infants who were borne prematurely should be vaccinated at the recommended ages i. 2. Dr.  General contraindications to vaccination: 1. 3rd ed. If child has Hx of severe local / general reaction to a preceding dose.Notes in Pediatric Infectious Diseases. If child has a current acute or febrile illness. 3 months etc.

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