By Russell W. Steele
Within the care of pediatric sufferers, infectious illnesses include over 50% of the scientific diagnoses. for that reason, it's necessary to have a easy figuring out of infectious approaches and to maintain abreast of recent advancements within the box. This reference stands as a handy and time-saving reference for clinicians at the prognosis, remedy, and prevention of pediatric infections illnesses and is totally up-to-date to incorporate the newest guidance from esteemed societies comparable to the Infectious ailment Society of the United States, the facilities for sickness regulate and Prevention, the yankee Thoracic Society, and the yankee Academy of Pediatrics.
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Extra info for Clinical Handbook of Pediatric Infectious Disease
For infection in otherwise stable neonates, fluconazole is the preferred antifungal therapy because of its low toxicity and excellent activity against the predominant species. Amphotericin B is the agent of choice for Candida invasive disease, although its toxicities have resulted in an ongoing search for alternative therapies. Many clinicians use combination amphotericin B plus fluconazole initially, discontinuing the amphotericin B when neonates are improved. O. medications. Liposomal forms of amphotericin B should be used in patients with impaired renal function.
Disease in infants is caused by the release of toxin from organisms that have gained entry to the gastrointestinal tract. Onset of illness is usually 8 to 11 weeks of age with a reported range of 1 week to 10 months. Constipation and poor feeding are the first indications of disease with more suggestive neurologic signs beginning a few days later (Table 4). Diagnosis is best confirmed by identification of botulinus toxin in the stool (Table 5). Culture of the stool for C. botulinum should also be attempted but, because the organism is ubiquitous, it is not unusual to find it as normal flora in an infant’s intestinal tract.
Larger purpura have a straked appearance as contrasted with the purpura with Henoch-Schonleion disease which are round. Severe infection with disseminated intravascular coagulation caused by many other bacterial pathogens may look identical to meningococcemia. TABLE 28 Laboratory Diagnosis for Meningococcemia Complete blood count characteristically shows leukocytosis and thrombocytopenia Cultures (blood, cerebrospinal fluid, skin lesion, nasopharynx) Cerebrospinal fluid analysis for evidence of meningitis Latex agglutination of blood, CSF and urine Clotting studies for evidence of DIC: low-prothrombin time, fibrinogen, and fibrin split products with disseminated intravascular coagulation TABLE 29 Treatment of Meningococcemia Ceftriaxone 80 mg/kg per day IV div.