Pediatrics(2)

HIV : Human Immunodeficiency Virus HR : Heart Rate

HSV : Herpes Simplex Virus HT : Hematocrite

HTN : Hypertension

HZV : Herpes Zoster Virus

ICU : Intensive Care Unit

IE : Infective Endocarditis IM : Intra-muscular

IR : Intrarectal

INH : Isoniazide

INR : International Normalized Ratio

ITP : Idiopathic Thrombocytopenic Purpura IU : International Units

IV : Intravenous

JVP : Jugular Venous Pressure KD : Kidney disease

KOH : Potassium Hydroxide LBW : Low Birth Weight LDH : Lactate dehydrogenase LE : Lupus Erythematosis

LGS : Lennox-Gastaut Syndrome LFM : Life Style Modification LFT : Liver Function Tests

LGIB : Lower Gastro-Intestinal Bleeding LMWH : Low Molecular Weight Heparin LP : Lumbar Puncture

LV : Left Ventricle

MAP : Mean Arterial Pressure MCV : Mean Cell Volume

MRI : Magnetic Resonance Imaging

NHL : Non-Hodgkin’s Lymphoma NGT : Naso Gastric Tube

NPO : Nil Per Os (Nil By Mouth)

NSAID : Non Steroidal Anti Inflammatory drugs NVE : Native Valve Endocarditis

OD : Once per day

ORS : Oral Rehydration Salts PA : Postero-Anterior

PaO2 : Partial Pressure Oxygen

PCP : Pneumo Cystis Pneumonia PDA : Patent ducus Arterousus PE : Pulmonary Embolus

PEF : Peak Expiratory Flow

PEEP : Positive End Expiratory Pressure PO : Per Os (Take orally)

PPI : Proton Pump Inhibitor PT : Prothrombin Time

PTT : Partial Thromboplastin Time QID : Four times a day

PUD : Peptic Ulcer disease RBC : Red Blood Cell RNA : Ribonucleic Acid

RHD : Rheumatic Heart diseases RSV : Respiratory Syncytial Virus RR : Respiratory Rate

RV : Right Ventricle

SBP : Systolic Blood Pressure SL : Sublingual

SLE : Systemic Lupus Erythematosis

SSSS : Staphylococcal Scaled skin Syndrome SMEI : Severe Myoclonic Epilepsy of Infancy T4 : Thyroxine

TB : Tuberculosis

TDS, TID : Three times per day TORCH : Toxoplasmosis Other Rubella Cytomegalovirus Herpes

TSH : Thyroid Stimulating Hormone UGIB : Upper Gastro-Intestinal Bleeding ULN : Upper Limit of Normal

UTI : Urinary Tract Infection VLBW : Very Low Birth Weight VSD : Ventricular Septal defect VZV : Varicella-Zona Virus WAS : Wiskott Aldrich Syndrome WBC : White Blood Count

WHO : World Health Organization DIDACTION

This book is especially didacted to my parents who gave me the most precious thing in life(the life itself)

1. Respiratory Diseases

1.1. Rhinitis and Rhinopharyngitis

Definition: Rhinitis and rhinopharyngitis are very common viral

infections of the nasal or pharyngeal mucosa, which occur with seasonal variations in children under 5 years old (more frequent in cold and rainy seasons)

Causes

-Most common virus : Rhinoviruses

-Other viruses: Coronaviruses, respiratory syncytial viruses, human metapneumovirus, influenza viruses, para influenza viruses, adenoviruses, enteroviruses rarely

-Other causes include allergies (in case of recurrence), iron deficiency, passive tobacco smoke

Signs and Symptoms

-Nasal congestion

-Sore throat

-Sneezing

-Productive cough

-Fever sometimes

-Watery red eyes

-Headache

Note: Suspect allergic rhinitis in case of recurrent signs of rhinitis

with itching of nose, eyes, ears and palate. Complications

-Otitis media

-Sinusitis (in children over 6 years old)

-Tonsillitis

-Exacerbation of asthma

Management

- No specific treatment

-Nasal irrigation with 0.9% Sodium chloride, 4 to 6 times/ day to clear the airway.

-In patients with fever give Paracetamol as follows:

• 15 mg/kg/dose maximum 4 times a day (maximum dose 60mg/kg/day)

-Air humidification using nebulisation with 0.9% Sodium chloride once a day to clear the airway

-Postural drainage

-For allergic rhinitis only, give an Antihistamine (chlorpheniramine) for 3 to 5 days as follows:

•From 6 to 12 years: 2 mg, to be repeated 4 to 6 times without exceeding 12mg/day

•Avoiding the allergen

Recommendation

- Antibiotics are not indicated in viral rhinitis and rhinopharyngitis except in cases of evident superinfection

1.2. Pneumonia

Definition: Pneumonia is an inflammation of the parenchyma of the lungs classified according to the infecting organism.

Causes

-Bacterial: Streptococcus pneumonia is the most common at all ages followed by Chlamydia pneumonia and Mycoplasma pneumonia (over 5 year old age), Chlamydia trachomatis

(infant) Staphylococcus aureus, Haemophilus influenza (in case of no vaccination), Pseudomonas aeruginosa (In immunocompromised patients), Klebsiella pneumonia

-Viral: Respiratory Synctitial Virus, Adenovirus, Influenzae A and B, Parainfluenzae types 1 and 3, Metapneumovirus

-Fungal: Cryptococcus neoformans, Aspergillus spp

-Mycobacterial: Mycobacterium tuberculosis, Mycobacterium avium, Mycobacterium intracellulare,

-Parasites: Pneumocystis jiroveci

Signs and Symptoms

-Fever

-Tachypnea

-Respiratory distress (inter-costal, sub-costal recession)

-Nasal flaring

-Use of accessory muscles

-Cyanosis and respiratory fatigue (in severe case especially for infant)

-Crackles and wheezing in auscultation

-bronchial breathing

Findings suggestive of viral and bacterial pneumonia

Note: It is often not possible to distinguish viral pneumonia from disease caused by bacterial pathogens.

Complications

-Empyema

-Pleural effusion

-Pneumothorax

-Sepsis/ Meningitis / Arthritis Investigations

-FBC

-Chest x-ray