Disease reducing the amount of salt (sodium) in your diet, and, in many cases, use of a medication called a

Swelling (Edema) diuretic to eliminate excess fluid. Using compression stockings and elevating the legs may also be
recommended

Definition
When there is excess fluid trapped within tissues of the body, edema – or swelling – can result. This Drugs
condition can affect any part of a child's body, but it most commonly occurs in the hands, arms, Diuretics (Furosemide) medicine that rids the body of extra fluid through urination. limiting the
feet, ankles and legs. amount of salt in the child's water, to discourage water retention. avoiding very hot and very cold
temperatures, and sudden temperature changes. elevating the swollen body part above the heart
Signs and Symptoms for a short period of time.
● Increased abdominal size
● Skin that appears shiny ⸻⸻⸻⸻⸻⸻
● Skin that retains a dimple (known as “pitting”) after being pressed for several seconds
● Stretched skin Disease
● Swelling or puffiness of the tissue directly under the skin Otitis Media

Causes Definition
The causes of edema are varied, and can include: An ear infection (sometimes called acute otitis media) is an infection of the middle ear, the air-filled
● Eating too much salt or salty foods space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely
● Staying in the same position for an extended period of time than adults to get ear infections.
Medical conditions that can cause edema are:
● Cirrhosis (liver damage) Signs and Symptoms
● Congestive heart failure ● earache
● Extreme, long-term protein deficiency ● a high temperature (fever)
● Inadequate lymphatic system (network of vessels that carries a clear fluid called lymph from ● being sick
the tissues into the blood) ● a lack of energy
● Kidney damage ● slight hearing loss - if the middle ear becomes filled with fluid
● Kidney disease
● Weakness or damage to veins in the legs Causes
Being on certain medications can also cause edema. Medications that can cause swelling include:
Otitis media can occur as a result of a cold, sore throat, or respiratory infection.
● A type of diabetes medication knows as thiazolidinediones
● Estrogens (hormone medications)
Treatment/Management
● Hypertension (high blood pressure) medication
● Most patients can be treated effectively with an analgesic such as a nonsteroidal antiinflammatory
Nonsteroidal anti-inflammatory drugs (NSAIDs)
● medication or acetaminophen.
Steroids

Treatment/Management Drugs
Penicillin (Amoxicillin) at a dosage of 80 to 90 mg per kg per day should be the first-line antibiotic
Treatment of edema includes several components: treatment of the underlying cause (if possible),
for most children with acute otitis media. Patients with otitis media who fail to respond to the initial
treatment option within 48 to 72 hours should be reassessed to confirm the diagnosis. the bloodstream.

⸻⸻⸻⸻⸻⸻ What causes the DNA mutation to happen is not yet understood, but known risk factors include:
● previous chemotherapy – if you've had chemotherapy to treat another type of cancer in the
Disease past, your risk of developing acute lymphoblastic leukaemia is increased. The risk relates to
Acute Lymphocytic Leukemia certain types of chemotherapy medicine, such as etoposide, and how much treatment you
had
● smoking – smokers are much more likely to develop acute leukaemia than non-smokers, and
Definition
studies have shown that parents who smoke in the home may increase the risk of leukaemia
Acute lymphocytic leukemia (ALL) is a type of cancer of the blood and bone marrow — the spongy
in their children
tissue inside bones where blood cells are made. The word "acute" in acute lymphocytic leukemia
● being very overweight (obese) – some studies have shown that people who are very
comes from the fact that the disease progresses rapidly and creates immature blood cells, rather
overweight have a slightly higher risk of developing leukaemia than those who are a healthy
than mature ones.
weight
● genetic disorders – a small number of cases of childhood acute lymphoblastic leukaemia are
Signs and Symptoms
thought to be related to genetic disorders, including Down's syndrome
● having a weakened immune system – people with lowered immunity (as a result of having HIV
Most of the symptoms are caused by a lack of healthy blood cells. Symptoms include:
or AIDS or taking immunosuppressants) have an increased risk of developing leukaemia
● pale skin
● feeling tired and breathless
Treatment/Management
● repeated infections over a short time
As acute lymphoblastic leukaemia is an aggressive condition that develops quickly, treatment
● unusual and frequent bleeding, such as bleeding gums or nosebleeds
usually begins a few days after diagnosis.
● high temperature
● night sweats
Treatment is usually done in the following stages: 
● bone and joint pain
● remission induction – the first stage of treatment aims to kill the leukaemia cells in your bone
● easily bruised skin
marrow, restore the balance of cells in your blood and resolve any symptoms you may have
● swollen lymph nodes (glands)
● consolidation – this stage aims to kill any remaining leukaemia
● tummy (abdominal pain) – caused by a swollen liver or spleen
● maintenance – this stage involves taking regular doses of chemotherapy medicines to
● unintentional weight loss
prevent leukaemia from returning
● a purple skin rash (purpura)
In some cases, the affected cells can spread from your bloodstream into your central nervous
Chemotherapy is the main treatment for acute lymphoblastic leukaemia. Other treatments you may
system. This can cause neurological symptoms (related to the brain and nervous system), including:
need include antibiotics and blood transfusions. Sometimes a stem cell transplant may also be
● headaches
needed to achieve a cure.
● seizures or fits
● being sick
● blurred vision Drugs
● dizziness The drug used most often is methotrexate, but sometimes cytarabine or a steroid such as
prednisone may be used as well.

Causes
Different combinations of chemo drugs might be used, but they typically include:
A genetic change (mutation) in the stem cells causes immature white blood cells to be released into
 Treatment for AML is often carried out in 2 stages:
Vincristine.
Dexamethasone or prednisone. ● induction – this first stage of treatment aims to kill as many leukaemia cells in your blood and
An anthracycline drug such as doxorubicin (Adriamycin) or daunorubicin. bone marrow as possible and treat any symptoms you may have
● consolidation – this stage aims to prevent the cancer coming back (relapsing) by killing any
⸻⸻⸻⸻⸻⸻ remaining leukaemia cells in your body

Disease The induction stage of treatment is not always successful and sometimes needs to be repeated
before consolidation can begin.
Acute Myeloid/Myelogenous Leukemia (AML)

Drugs
Definition
Arsenic trioxide and all-trans retinoic acid (ATRA) are anticancer drugs that kill leukemia cells, stop
Acute myeloid leukemia (AML) is a cancer of the blood and bone marrow. It is the most common
the leukemia cells from dividing, or help the leukemia cells mature into white blood cells. These
type of acute leukemia in adults. This type of cancer usually gets worse quickly if it is not treated.
drugs are used in the treatment of a subtype of AML called acute promyelocytic leukemia.
AML is also called acute myelogenous leukemia and acute nonlymphocytic leukemia.

Signs and Symptoms

⸻⸻⸻⸻⸻⸻
The symptoms of AML usually develop over a few weeks and become worse over time.
Symptoms can include:
Disease
● looking pale or "washed out" Ewing Sarcoma
● feeling tired or weak
● breathlessness Definition
● frequent infections Ewing sarcoma is a type of tumor that forms from a certain kind of cell in bone or soft tissue.
● unusual and frequent bruising or bleeding, such as bleeding gums or nosebleeds
● losing weight without trying to Signs and Symptoms
Symptoms include:
Causes ● bone pain – this may get worse over time and may be worse at night
It's not clear exactly what causes AML and, in most cases, there's no identifiable cause. ● a tender lump or swelling
But some things can increase your risk of getting AML, including: ● a high temperature that does not go away
● feeling tired all the time
● previous chemotherapy or radiotherapy ● unintentional weight loss
● exposure to very high levels of radiation (including previous radiotherapy treatment)
● smoking and other exposure to benzene, a chemical used in manufacturing that's also found Affected bones may also be weaker and more likely to break. Some people are diagnosed after they
in cigarette smoke have a fracture.
● having a blood disorder or some genetic conditions, such as Down's syndrome
The legs (often around the knee), pelvis, arms, ribs and spine are the main areas affected by Ewing
Treatment/Management sarcoma.
 ● Sore throat, sores in the mouth, or a toothache
Causes ● Abdominal pain
There is no known cause of Ewing's sarcoma. ● Pain near the anus
● Pain or burning when urinating, or urinating often
● Diarrhea or sores around the anus
Treatment/Management
● A cough or shortness of breath
Treatment for Ewing sarcoma often involves a combination of:
● Any redness, swelling, or pain (especially around a cut, wound, or catheter)
● Unusual vaginal discharge or itching
● radiotherapy – where radiation is used to kill cancer cells
● chemotherapy – where medicine is used to kill cancer cells
● surgery to remove the cancer Causes
Several things related to cancer and its treatment can cause a low level of neutrophils, including:

Drugs
● Some types of chemotherapy
Children and young adults with Ewing sarcoma should receive cyclophosphamide (Cytoxan,
● Cancers that affect the bone marrow directly, such as leukemia, lymphoma, and multiple
Neosar), doxorubicin (Adriamycin), etoposide (Toposar, VePesid), ifosfamide (Ifex), and/or
myeloma
vincristine (Oncovin, Vincasar PFS).
● Cancer that has spread
● Radiation therapy to several parts of the body or to bones in the pelvis, legs, chest, or
⸻⸻⸻⸻⸻⸻
abdomen

Disease
Febrile Neutropenia
Definition
A condition marked by fever and a lower-than-normal number of neutrophils in the blood. A
neutrophil is a type of white blood cell that helps fight infection. Having too few neutrophils
increases the risk of infection.
Signs and Symptoms
Neutropenia itself may not cause any symptoms. People usually find out they have neutropenia from
a blood test or when they get an infection. Some people will feel more tired when they have
neutropenia. Your doctor will schedule regular blood tests to look for neutropenia and other blood-
related side effects of chemotherapy.
For people with neutropenia, even a minor infection can quickly become serious. Talk with your
health care team right away if you have any of these signs of infection:
● A fever, which is a temperature of 100.5°F (38°C) or higher
● Chills or sweating
Some people with cancer are more likely to develop neutropenia, including:
● People who are age 70 or older
● People with a lowered immune system from other causes, such as having HIV or an organ
transplant
Treatment/Management
An important part of cancer care is relieving the side effects of treatment. This is called palliative
care or supportive care. Talk with your health care team about any symptoms you have or any
changes in symptoms.
While taking chemotherapy, sometimes your neutrophil level does not return to normal fast enough.
Or you develop neutropenia. In this case, your doctor may take certain precautions, including:
● Delaying the next round or lower the dose of chemotherapy.
● Recommending antibiotics during longer periods of neutropenia to prevent infections.
● If you are at risk of developing neutropenia with a fever, called febrile neutropenia, your
doctor may give you medications called white blood cell growth factors or colony-stimulating
factors (CSFs). Your risk depends on your diagnosis, age, other health conditions in addition
to cancer, and the chemotherapy regimen given. Most chemotherapy regimens are not linked
 ●

with a high risk of developing febrile neutropenia. Examples of CSF medications include ● generally feeling unwell – including lethargy and body aches.
filgrastim (multiple brand names), sargramostim (Leukine), and pegfilgrastim (multiple brand
names). They help the body make more white blood cells to fight off infection. These Causes
medications may cause bone pain. This is a sign that they are working because the pain is Gastroenteritis is caused by different things – including viruses, bacteria, bacterial toxins, parasites,
caused by the bone marrow making more blood cells. particular chemicals and some drugs.
If your child gets gastro more than once the cause may be different each time.
Drugs
Risk-Based Treatment of Febrile Neutropenic Patients: Common Regimens for Empiric Antibiotic Treatment/Management
Therapy Treatment is primarily supportive and is directed at preventing or treating dehydration. When
possible, an age-appropriate diet and fluids should be continued. Oral rehydration therapy using a
● Ciprofloxacin + amoxicillin/clavulanate. commercial pediatric oral rehydration solution is the preferred approach to mild or moderate
● Ciprofloxacin + clindamycin or azithromycin. dehydration.
● Moxifloxacin or levofloxacin.
Rehydration is the key treatment for AGE, and active treatment of diarrhea with probiotics or
⸻⸻⸻⸻⸻⸻ diosmectite should always be considered, independent of etiology. Antibiotics are generally not
necessary and can even be harmful in children, but they should be given in selected circumstances.
Disease
Acute Gastroenteritis (AGE) - Pediatrics Drugs
Co-trimoxazole and metronidazole are to be considered for oral administration. Azithromycin and
Definition rifaximin may also be used, based on local consideration or if signs of colitis are observed.
A uniform definition of acute gastroenteritis does not exist. The AAP defines acute gastroenteritis Ceftriaxone, metronidazole, and ciprofloxacin may be considered in children with systemic and
as “diarrheal disease of rapid onset, with or without accompanying symptoms or signs such as invasive diseases.
nausea, vomiting, fever or abdominal pain.” The hallmark of the disease is increased stool frequency
with alteration of stool consistency.

Signs and Symptoms

Children may not have all symptoms, but in general, gastroenteritis symptoms can include:

● loss of appetite
● bloating
● nausea
● vomiting
● abdominal cramps
● abdominal pain
● diarrhoea
● bloody stools (poo) – in some cases
● pus in stools – in some cases