Category: Infectious Diseases

My Mastodon account @bradsobo

References

Rafei K, Lichenstein R. Airway infectious disease emergencies. Pediatr Clin North Am 2006; 53:215.

Sobol SE, Zapata S. Epiglottitis and croup. Otolaryngol Clin North Am 2008; 41:551.

Richards AM. Pediatric Respiratory Emergencies. Emerg Med Clin North Am. 2016 Feb;34(1):77-96. PMID: 26614243.

Faden H. The dramatic change in the epidemiology of pediatric epiglottitis. Pediatr Emerg Care. 2006 Jun;22(6):443-4. PMID: 16801849

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Tags epiglottitis, supraglottitis

Infectious Diseases

Norovirus

Norovirus is the leading cause of viral gastroenteritis worldwide and is also a major cause of food borne illness. It spreads rapidly and causes vomiting and diarrhea that lead to many ED visits. Hopefully this brief episode will enrich the discussions that you have with patients and their families when making the diagnosis of viral gastroenteritis.

PEMBlog

My Mastodon account @bradsobo

References

O’Ryan ML, Peña A, Vergara R, Díaz J, Mamani N, Cortés H, Lucero Y, Vidal R, Osorio G, Santolaya ME, Hermosilla G, Prado VJ. Prospective characterization of norovirus compared with rotavirus acute diarrhea episodes in chilean children. Pediatr Infect Dis J. 2010 Sep;29(9):855-9. doi: 10.1097/INF.0b013e3181e8b346. PMID: 20581736.

King CK, Glass R, Bresee JS, et al. Managing acute gastroenteritis among children: oral rehydration, maintenance, and nutritional therapy. MMWR Recomm Rep 2003; 52:1.

Wilhelmi I, Roman E, Sánchez-Fauquier A. Viruses causing gastroenteritis. Clin Microbiol Infect 2003; 9:247.

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Tags gastroenteritis, norovirus

Infectious Diseases

Periorbital Cellulitis

Perioribital cellulitis (AKA Preseptal cellulitis)is a soft tissue infection of the eyelids and skin anterior to the orbit. It must be differentiated from the more invasive and dangerous orbital cellulitis. Treatment varies depending on the original source (sinusitis, local trauma, stye etc,.). Learn all about periorbital cellulitis in this brief episode of PEM Currents: The Pediatric Emergency Medicine Podcast.

The companion blog post is right here!

References

Fox S. Periorbital cellultiis. Pediatric EM Morsels. March 29, 2013. https://pedemmorsels.com/periorbital-cellulitis/. Accessed October 20, 2022.

Andrea Hauser, Simone Fogarasi; Periorbital and Orbital Cellulitis. Pediatr Rev June 2010; 31 (6): 242–249. https://doi.org/10.1542/pir.31-6-242

Murphy, D.C., Meghji, S., Alfiky, M. and Bath, A.P. (2021), Paediatric periorbital cellulitis: A 10-year retrospective case series review. J Paediatr Child Health, 57: 227-233. https://doi.org/10.1111/jpc.15179

Podcast: Play in new window | Download (Duration: 5:52 — 8.1MB)

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Tags orbital cellulitis, periorbital cellulitis, preseptal cellulitis

Infectious Diseases Surgery

Neutropenic enterocolitis

Post author By bradsobo
Post date September 28, 2022
No Comments on Neutropenic enterocolitis

Bad things happen when you don’t have enough neutrophils. After getting cytotoxic chemotherapy you tend to have even fewer neutrophils. This can put you at risk for neutropenic enterocolitis which should be suspected in an immunocompromised child with fever and abdominal symptoms. Treatment is broad spectrum antibiotics and the imaging test of choice is CT with contrast. Learn all about this potentially catastrophic condition in this brief podcast episode.

References

Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, Raad II, Rolston KV, Young JA, Wingard JR. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011 Feb 15;52(4):e56-93. doi: 10.1093/cid/cir073. PubMed PMID: 21258094.

McQueen A, et al. Oncologic Emergencies. In: Shaw KN, et al. Fleisher & Ludwig’s Textbook of Pediatric Emergency Medicine. 8th ed. 2021:901-935.

Moran H, Yaniv I, Ashkenazi S, Schwartz M, Fisher S, Levy I. Risk factors for typhlitis in pediatric patients with cancer. J Pediatr Hematol Oncol. 2009 Sep;31(9):630-4. doi: 10.1097/MPH.0b013e3181b1ee28. PMID: 19644402.

Kirkpatrick ID, Greenberg HM. Gastrointestinal complications in the neutropenic patient: characterization and differentiation with abdominal CT. Radiology. 2003 Mar;226(3):668-74. doi: 10.1148/radiol.2263011932. Epub 2003 Jan 24. PMID: 12601214.

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Infectious Diseases

Chicken Pox

Dewdrops on a rose petal. You’ve all heard the description, right? But how many of you have actually seen chicken pox in the wild. And what about monkey pox – does it look the same? How can I tell them apart? I wish there was a brief podcast episode focused on varicella that would help answer some of these questions…

References

CDC for Healthcare Professionals: Chicken Pox (Varicella). https://www.cdc.gov/chickenpox/hcp/index.html. Accessed 8/11/2022.

Freer G, Pistello M. Varicella-zoster virus infection: natural history, clinical manifestations, immunity and current and future vaccination strategies. New Microbiol. 2018 Apr;41(2):95-105. PMID: 29498740.

Sauerbrei A. Diagnosis, antiviral therapy, and prophylaxis of varicella-zoster virus infections. Eur J Clin Microbiol Infect Dis. 2016 May;35(5):723-34. PMID: 26873382.

Podcast: Play in new window | Download (Duration: 8:25 — 11.6MB)

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Tags chicken pox, varicella

Infectious Diseases

Hand, Foot, & Mouth Disease

Post author By bradsobo
Post date July 19, 2022
No Comments on Hand, Foot, & Mouth Disease

Hand, Foot, and Mouth (and Butt) disease is incredibly popular in the summer/warm weather months in the Northern Hemisphere (August through October). It is so popular that I guarantee you will see it many times. This brief episode will teach you how to make the diagnosis and review strategies for management – which are largely supportive.

References

Guerra AM, Orille E, Waseem M. Hand Foot And Mouth Disease. [Updated 2022 May 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431082/

Woodland DL. Hand, Foot, and Mouth Disease. Viral Immunol. 2019 May;32(4):159.

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Tags coxsackie virus, enterovirus, hand foot and mouth

Infectious Diseases

Lyme Disease

Update 6/6/22 – there is ongoing work to determine the optimal treatment for meningitis in Lyme between doxy and ceftriaxone. The original episode recording did not make this clear – my apologies. The 2021 IDSA guideline suggests that you could use either agent. This episode was edited to reflect this change.

Lyme disease prevalence continues to rise – especially in places where we didn’t see it before (like Ohio!). this podcast episode focuses on making the diagnosis, the different stages of disease, as well as when to prophylaxis, treat, and how testing works – all in under 15 minutes.

CDC Lyme Disease Resource

Helpful Diagnostic Resources

CDC Tick ID – which tick bit me?

References

Shapiro ED. Lyme disease. N Engl J Med 2014; 371:684.

Lantos PM, Rumbaugh J, Bockenstedt LK, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis, and Treatment of Lyme Disease. Arthritis Rheumatol 2021; 73:12.

American Academy of Pediatrics. Lyme disease. In: Red Book, 31, Kimberlin DW, Brady MT, Jackson MA, Long SS (Eds), 2018. p. 515.

Nigrovic LE, Bennett JE, Balamuth F, Levas MN, Chenard RL, Maulden AB, Garro AC; for Pedi Lyme Net. Accuracy of Clinician Suspicion of Lyme Disease in the Emergency Department. Pediatrics. 2017 Dec;140(6):e20171975. doi: 10.1542/peds.2017-1975. PMID: 29175973; PMCID: PMC5703778.

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Tags Lyme diease, tick bite

Infectious Diseases

Toxic Shock Syndrome

Toxic Shock Syndrome can be hard to recognize and differentiate from clinical entities such as Kawasaki, MIS-C, and DRESS. This brief podcast episode will raise awareness of situations in which TSS can occur and drive home important management pearls – like why you need to add Clindamycin.

References

Gaensbauer JT et al. Epidemiology and Clinical Relevance of Toxic Shock Syndrome in US Children. Pediatr Infect Dis J. 2018 Dec;37(12):1223-1226. PMID: 29601458.

Javouhey et al. Similarities and Differences Between Staphylococcal and Streptococcal Toxic Shock Syndromes in Children: Results From a 30-Case Cohort. Front Pediatr. 2018 Nov 28;6:360. PMID: 30547021

Rodríguez-Nuñez et al. Streptococcal Toxic Shock Syndrome collaborative group of Spanish Society of Pediatric Intensive Care. Clinical characteristics of children with group A streptococcal toxic shock syndrome admitted to pediatric intensive care units. Eur J Pediatr. 2011 May;170(5):639-44. PMID: 20981441.

Podcast: Play in new window | Download (Duration: 6:55 — 9.5MB)

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Infectious Diseases

Mastoiditis

Post author By bradsobo
Post date July 14, 2020

Does mastoiditis always present with the classic triad of swelling behind the ear, otalgia, and protrusion of the auricle? Do you need to get a CT to make the diagnosis? What is the exact relationship with acute otitis media? Can swimmer’s ear turn into mastoiditis? These questions and more are why I recorded this episode of PEM Currents: The Pediatric Emergency Medicine Podcast.

The Facebook page

References

Geva et al. Conservative management of acute mastoiditis in children. Int J Pediatr Otorhinolaryngol. 2008;72(5):629.

Groth et al. Acute mastoiditis in children aged 0-16 years–a national study of 678 cases in Sweden comparing different age groups. Int J Pediatr Otorhinolaryngol. 2012;76(10):1494.

Leskinen et al. Complications of acute otitis media in children. Curr Allergy Asthma Rep. 2005;5(4):308.

Thompson et al. Effect of antibiotics for otitis media on mastoiditis in children: a retrospective cohort study using the United kingdom general practice research database. Pediatrics. 2009;123(2):424.

van den Aardweg et al. A systematic review of diagnostic criteria for acute mastoiditis in children. Otol Neurotol. 2008;29(6):751.

Podcast: Play in new window | Download (Duration: 15:12 — 20.9MB)

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Tags external otitis, mastoiditis, otitis media

Infectious Diseases

Multisystem Inflammatory Syndrome in Children

Post author By bradsobo
Post date May 21, 2020
No Comments on Multisystem Inflammatory Syndrome in Children

Multisystem Inflammatory Syndrome in Children (MIS-C) is an evolving clinical entity that is occurring, possibly in association with or following a COVID-19 infection. This episode of PEM Currents expands upon a recent PEMBlog post, as well as includes information from two studies published in The Lancet as well as included in a recent CDC webinar. This episode also provides recommendations on lab workup and the evolving criteria for diagnosis and the current case definition from the CDC.

PEMBlog