flJ Blackwell Publishing 5amir Shah Blueprints Q&A Step and BLUEPRINTS Blue rints Q&A Step Pediatric Infectious Diseases Review Individual content areas as needed and be fully prepared for Steps & 31 Thoroughly reviewed by students who have recently taken the boards, these 10 books are also perfect for use during clerkships, board review, shelf or end-of-rotation exam review The second editions of the Blueprints Q&A Step and Blueprints Q&A Step � � v series feature brand new questions and " contain many other exciting enhancements - � many of which were suggested by our � readers o Double the questions 200 per book +' o " V Questions formatted to match the current USMLE Step and Step boards Full answer explanations for correct and incorrect answers Increased number of figures NEW! Abbreviations NEW! Normal lab values NEW! Shaded tabs for easy navigation between questions e x o g; e " I and answers NEW! Index NEW! Convenient pocket size In or Bookstores Now! :s: x '" '" tJ call: 1-800-216-2522 www.blackwellmedstudent.com CODE: QAstep2304 V Blueprints> for your pocket! In an effort to answer a need for high yield review books for the BLUEPRINTS elective rotations, Blackwell Publishing now brings you Blueprints> in pocket size These new Blueprints> provide the essential content needed during the shorter rotations They will also prOVide the basic content needed for USMLE Steps and 3, or if you were unable to fit in the rotation, these new pocket-sized Blueprints> are just what you need Each book will focus on the high yield essential content for the most commonly encountered problems of the specialty Pediatric Infectious Diseases Each book features these special appendices: • Career and residency opportunities • Commonly prescribed medications • Self-test Q&A section Ask for these at your medical bookstore or check them out online at www.blackwellmedstudent.com Blueprints Dermatology Blueprints Urology Blueprints Pediatric Infectious Diseases Blueprints Ophthalmology Blueprints Plastic Surgery Blueprints Orthopedics Blueprints Hematology and Oncology Blueprints Anesthesiology Blueprints Infectious Diseases Samir S Shah, MD Instructor, Department of Pediatrics ne University of Pennsylvania School of Medici General Pediatrics Fellow, Divisions of Infectious Diseases and The Children's Hospital of Philadelphia Philadelphia, PA fl) Blackwell Publishing © 2005 by Blackwell Publishing Blackwell Publishing, Inc., 350 Main Street, Malden, Massachusetts 02148-5018, USA Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Blackwell Publishing Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053, Australia All rights reserved No part of this publication may be reproduced in any form or by any electronic or mechanical means, including information stor age and retrieval systems, without permission in writing from the publisher except by a reviewer who may quote brief passages in a review " This book is dedicated to my grandparents- Shantilal and Savitaben Shah and Ramanlal and Savitaben Sheth 04 05 06 07 ISBN: 1-4051-0402-3 Library of Congress Cataloging-in-Publication Data Blueprints pediatric infectIous diseases / p.; cm - (Blueprints) '" I edited by] Samlr S Shah.-I st ed Includes index " I Communicable diseases in children-Outlines, syllabi, etc Communicable diseases in children-Handbooks, manuals, etc I Communicable Q) X v ISBN 1-4051-0402-3 lpbk.J [DNLM: � Diseases-Child-Handbooks CommunIcable Diseases-Child-Outlines CommunIcable Diseases Infant-Handbooks Communicable Diseases-Infant-Outlines Pediatrics-methods-Handbooks Pediatrics-methods-Outlines Q) , '" III 14 o , o CDC Centers for Disease Control and Prevention CFTR Cystic fibrosis transmembrane conductance regulator CGD Chronic granulomatous disease CHD Congenital heart disease CIN Cefsulodin-irgasan-novobiocin CLD Chronic lung disease CMV Cytomegalovirus CNS Central nervous system CoNS Coagulase-negative staphylococci CPE Cytopathic effect ,: x 0 " Chest radiograph DCF Dichlorohydrofluorescein DDS Dose dependent susceptible DFA Direct fluorescent antibody DHR Dihydroxyrhodamine 123 DIC Disseminated intravascular coagulation ds Double stranded DTP Oiphtheria-tetanus-pertussis (vaccine) EBV Epstein-Barr virus ECG Electrocardiogram EEE Eastern equine encephalitis virus EEG Electroencephalogram EIA Enzyme immunoassay ELISA Enzyme-linked immunosorbent assay EM Erythema migrans EMB Eosin-methylene blue ESR Erythrocyte sedimentation rate S-FC S-Fluorocytosine, flucytosine FISH Fluorescent in situ hybridization FMF Familial Mediterranean fever FTA-ABS Fluorescent treponemaI antibody absorption test FUO Fever of unknown origin GAS Group A Streptococcus GBS Group B Streptococcus GGT y-Glutamyltransferase GI Gastrointestinal GMS Gomori methenamine silver GNR Gram-negative rods GU Genitourinary HAV Hepatitis A virus Hb 55 Sickle cell disease BIG-IV Botulinum immune globulin HBIG Hepatitis B immune globulin HBV Hepatitis B virus � HCV Hepatitis C virus HDCV Human diploid cell vaccine '" :;: HDV Hepatitis virus HEV Hepatitis E virus HHV-6 Human herpes virus "l: u Q) III x '" CRMO Chronic recurrent multifocal osteomyelitis CRP C-reactive protein CSF Cerebrospinal fluid CT Computed tomography CVA Cerebrovascular accident CVC Central venous catheter '" '" CVID Common variable immune deficiency v xxii CXR I Q '" '" '" Q) "l: :;: x u • HHV-7 Human herpesvirus HHV-8 Human herpes virus HIB Haemophilus influenzae type b HIV Human immunodeficiency virus HPV Human papilloma virus HSM Hepatosplenomegaly HSV Herpes simplex virus HTLV Human T-ceil lymphotropic virus IFA Indirect fluorescent antibody xxiii 220 • Blueprints Pediatric Infectious Diseases Appendix D ;CHAPTER • 221 Rarnnath RR, Heller RM, Ben-Ami T, et a1 Implications of early sonographic evaluation of parapneumonic effusions in children Auletta JJ, Chandy Cc Spinal epidural abscesses in children: a IS-year experience and review of the literature with pneumonia Clin Infect Dis Pediatrics 1998; 101: 68-71 Shah SS, Alpern ER, Zwerling L, McGowan KL, Bell LM Risk of 2001;3 2: 9-16 bacteremia in young children with pneumonia treated as out Mathisen GE, Johnson JP Brain abscess Clin Infect Dis 1997;25: A patients Arch Pediatr Adolesc M ed 2003 ; 157:3 89-392 763 -779 Saez-Lorenz X, McCracken GH, Jr Bacterial meningitis in chil dren Lancet 2003 ;3 61:213 9-2]48 CHAPTER 10 Whitley RJ, Gnann JW Viral encephalitis: familiar infections and emerging pathogens Lancet 2003 ;3 59:507-513 Q) x V A CHAPTER S Q) American Academy of Pediatrics, Subcommittee on Management III of Sinusitis and Committee on Quality Improvement Clinical o Practice Guideline: Management of sinusitis Pediatrics 200 I; 108:798-808 Ausejo M, Saenz A, Pham B, et a1 The effectiveness of glucocor ticoids in treating croup: meta-analysis +> g v Baltimore RS Infective endocarditis In: Jenson HB, Baltimore RS, eds Pediatric infectious diseases: principles and practice, 2nd ed Philadelphia, WB Saunders, 2002 Drucker NA, Newberger JW Viral myocarditis: diagnosis and management Adv Pediatr 1997;44: 141-171 Feldman WE Bacterial etiology and mortality of purulent peri carditis in pediatric patients: a review of 162 cases Ferrieri P, Gewitz MH, Gerber MA, et a1 Unique features of infective endocarditis in childhood BM] 1999;319: Am ] Dis Child 1979: 133 :641 Pediatrics 2002: 109; 931-943 595-600 Bisno AL, Gerber MA, Gwaltney JM, et a1 Diagnosis and man agement of group A streptococcal pharyngitis: a practice guideline CHAPTER 11 Ciin Infect Dis ]997;25:574-583 Bojrab D, Bruderly T, Abdulrazzak Y Otitis externa Otolaryngol Altschuler S, Liacouras C, eds Ciin North Am 1996;29: 761-782 tions in children Suchy F, Sokol R, Balistreri W, ed Pediatr Infect Dis] 1992;11: 14-18 Ghaffar FA, Wordemann M, McCracken GH Acute mastoiditis in children: a seventeen-year experience in Dallas, Texas Pediatr Infect Dis] 2001;20:376-3 80 x o g; ., Hughes E, Lee JH Otitis externa Pediatr Rev 2001; 22:19]-197 Malhotra A, Krilov LR Viral croup Pediatr Rev 2001;22:5-12 Clinical pediatric gastroenterology New York: Churchill Livingstone, 1998 Broughton RA Non-surgical management of deep neck infec Liver disease in children, 2nd ed Philadelphia: Lippincott Williams & Wilkins, 2001 C, Suchy F Biliary tract disease in children Pediatr Clin North Am 1996;43: 75 McEvoy Narkewicz M Biliary atresia; an update on our understanding of Curr Opin Pediatr 2001; 13:435-440 Red Book 2003 Report of the Committee on Infectious Diseases, 26th ed Elk Grove Village, the disorder Committee on Infectious Diseases IL: American Academy of PediatriCS, 2003 CHAPTER Schaefer F Management of peritonitis in children receiving Freij BJ, Kusmiesz H, Nelson JD, McCracken GH Jr Para chronic peritoneal dialysis Paediatr Drugs 2003 ;5:3 15-325 pneumonic effusions and empyema in hospitalized children: a retrospective review of 227 cases Pediatr lnfect Dis] 1984;3 : 578-591 CHAPTER 12 Garrison MM, Christakis DA, Harvey E, Cummings P, Davis RL Systemic corticosteroids in infant bronchiolitis: a meta-analysis Pediatrics 2000;105:e44 American Academy of Pediatrics Guidelines for the evaluation of sexual abuse of children Pediatrics 1999; 103 : 186-191 222 Blueprints Pediatric Infectious Diseases Appendix D • 223 Klein Jo Management of the febrile child without a focus of American Academy of Pediatrics Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in infection in the era of universal pneumococcal immunization febrile infants and young children Pediatrics 1999; 103:843-852 Pediatr Infect Dis J 2002;21:584-588 Mermel LA, Farr BM, Sherertz RJ, Raad II, O'Grady N, Harris JS Hoberman A, Wald ER, Hickey RW, et a1 Oral versus initial intra Guidelines for the management of intravascular catheter-related venous therapy for urinary tract infections in young febrile chil dren Pediatrics 1999;104:79-86 1\ infections Clin Infect Dis 2001;32:1249-1272 Lohr JA, O'Hara SM Renal (intrarenal and perinephric) abscess In: Long SS, Pickering LK, Prober CG, eds Principles and prac tice of pediatric infectious diseases, 2nd edition New York: Churchill Livingstone: 2003:329-333 Seigel RM, Schubert CJ, Meyers PA, Shapiro RA Prevalence of sexually transmitted diseases in children and adolescents evalu ated for sexual abuse in Cincinnati: rationale for limited STD testing in prepubertal girls Pediatrics 19 , CHAPTER 16 Appelgren P, Bjomhagen V, Bragderyd K, Jonsson CE, Ransjo U A prospective study of infections in burn patients Bums 2002;28:39-46 Bell LM, Baker MD, Beatty D, Taylor L Infections in severely traumatized children J Pediatr Surg 1992;27:1394-1398 Cummings P Antibiotics to prevent infection in patients with dog bite wounds: a meta-analysis of randomized trials CHAPTER 13 Ann Emerg Med 1994;23:535-540 Bhumbra N, McCullough S Skin and subcutaneous infections Primary Care: Clin Office Pract 2003;30:1-24 Primary Care: Clin Office Pract 2000;27:459-473 Rhody C Bacterial infections of the skin Stulberg DL, Penrod MA, Blatny RA Caring for common skin Am Fam Phys 2002;66:119-124 Valeriano-Marcet J, Carter J, Vasey E Soft tissue disease Rheum Dis Clin North Am 2003;29: 77 -88 Hollander JE Singer Al Laceration management Ann Emerg Med 1999;34:356-367 Talan DA, Citron DM, Abrahamian FM, Moran GJ, Goldstein EI Bacteriologic analysis of infected dog and cat bites N Eng/ J Med 1999;340:85-92 conditions: common bacterial skin infection CHAPTER 17 Arav-Boger R, Pass RE Diagnosis and management of cytomegalo Pediatr Ann 2002;31:719-724 JS, Klein JO, eds Infectious diseases of the fetus and newborn infant, 5th ed Philadelphia: WB Saunders, 2001:347-388 virus infection in the newborn Cooper LZ, Alford CA Jr Rubella In: Remington "CHAPTER 14 Fernandez M, Carrol CL, Baker CI Discitis and vertebral osteo myelitis in children: an 18- year review Pediatrics 2000;105: 1299-1304 Correa AG Congenital syphilis: evaluation, diagnosis, and treat ment Semin Pediatr Infect Dis 1994;4:30-34 Kimberlin DW, Lin C-Y, Jacobs RF, et a1 Natural history of Orthopedic Clin N neonatal herpes simplex virus infections in the acyclovir era Sonnen GM, Henry NK Pediatric bone and joint infections Remington JS, McLeod R, Thulliez P, Desmonts G Toxoplas Glazer P, Hu SS Pediatric spinal infections Am 1996;27:111-123 Pediatr Clin N Am 1996;43:933-947 CHAPTER 15 Giroir BT Recominant human activated protein C for the treat ment of severe sepsis: is there a role in pediatrics? Pediatr 2003;15:92-96 Curr Opin Pediatrics 2001;108:223-229 mosis In: Remington JS, Klein JO, eds Infectious diseases of the fetus and newborn infant, 5th ed Philadelphia: WB Saunders, 200l:205-346 CHAPTER 18 Alpern ER, Alessandrini EA, Bell LM, Shaw KN, McGowan KL Occult bacteremia from a pediatric emergency department: 224 Blueprints Pediatric Infectious Diseases Appendix D current prevalence, time to detection, and outcome Pediatrics compromised pediatric cancer patient Baker MD, Bell LM, Avner JR Outpatient management without fever in selected infants 225 Neville K, Renbarger J, Dreyer Z Pneumonia in the immuno 2000;106: 505-511 antibiotics of • Semin Respir Infect 2002;17:21-32 N Engl J Med Shenep JL, Flynn PM, Baker DK, et al Oral cefixime is similar to 1993;329: 1437-144l continued intravenous antibiotics in the empirical treatment of Baker MD, Bell LM Unpredictability of serious bacterial illness 1\ month of age Arch Pediatr Adolesc Med 1999;153:508-511 in febrile infants from birth to febrile neutropenic children with cancer Clin Infect Dis 2001;32:36-43 Gorelick MH, Shaw KN Clinical decision rule to identifY young febrile children at risk for UTI Arch Pediatr Adolesc Med CHAPTER 21 2000;154:386-390 Mason W H, Takashahi M Kawasaki syndrome Clin Infect Dis American Academy of Pediatrics, Committee on Pediatric AIDS 199928:169-187 Evaluation and medical treatment of the HIV-exposed infant Ryan ET, Wilson ME, Kain KC Illness after international travel N Engl J Med 2002;347:505-516 Shah SS, Zaoutis TE Fever following international travel: what's bugging this child? Pediatr Case Rev 2003;3:44-46 OJ , '" III 14 o , o s:: CHAPTER 19 v Jacobs RF, Schutze GE Ehrlichiosis in children J Pediatr Pediatrics 1997;99:909-917 Centers for Disease Control and Prevention Public Health Service Task Force recommendations for the use of antiretroviral drugs in pregnant women infected with HIV- l for maternal health and for reducing perinatal HIV-l transmission in the United States MMWR Morb Mortal Wkly Rep 1998:47 (RR-02) (regular revi sions available on line: http://aidsinfo.nih.gov/) Havens PL, and the Committee on Pediatric AIDS Postexposure 1997;131:184-192 prophylaxis in children and adolescents for nonoccupational and infections in children: agents of roseola and other syndromes Curr Opinion Pediatr 2000;12:269-274 exposure to Human Immunodeficiency Virus Leach CT Human herpesvirus Mandl KD, Stack AM, Fleisher GR Incidence of bacteremia in infants and children with fever and petechiae J Pediatr 1997; 131:398-404 Pediatrics 2003; 111:1475-1489 Working Group on Antiretroviral Therapy and Medical Manage ment of HIV-Infected Children Guidelines for the use of anti retroviral agents in pediatric HIV infection Updated and avail able on line: http://aidsinfo.nih.gov/ (revised June 25, 2003) Maslers EJ, Olson GS, Weiner SJ, Paddock CD Rocky Mountain spotted fever: a clinician's dilemma Arch Intern Med 2003;163:769-774 Nelson B, Jill S, Stone MS Update on selected viral exanthems Curr Opin Pediatr 2000; 12:359-364 Rosenstein NE, Perkins BA, Stephens DS, Popovic T, Huges JM Engl J Med 2001;344:1378-1388 Steele A C Medical progress: Lyme disease N Engl J Med 2001;345:115-125 Meningococcal disease N Wells LC, Smith JC, Weston V, Collier J, Rutter N The child with a non-blanching rash: how likely is meningococcal disease? Arch Dis Child 2001;85:218-222 CHAPTER 23 Burnett MW, Bass Jw, Cook BA Etiology of osteomyelitis com plicating sickle cell disease Pediatrics 1998;101:296-297 Davis PB, Drumm M, Konstan MW Cystic fibrosis State of the art Am J Respir Crit Care Med 1996;154;1229-1256 Fishman JA, Rubin RH Infection in organ-transplant recipients N Engl1 Med 1998;338:1741-1751 Green M, Michaels MG Infections in solid organ transplant recipients In: Long SS, Pickering LK, Prober CG, eds Principles and practice of pediatric infectious diseases, 2nd ed New York: Churchill Livingstone, 2003:554-561 CHAPTER 20 Ho M, Miller G, Atchison W, et al Epstein-Barr virus infections 2002 Guidelines for and DNA hybridization studies in post transplantation lym the use of antimicrobial agents in neutropenic patients with phoma and lymphoproliferative lesions: the role of primary Hughes WT, Armstrong D, Bodey GP, et al cancer Clin Infect Dis 2002;34:730-51 infection J Infect Dis 1985;152:876-886 226 • Blueprints Pediatric Infectious Diseases Norris CF, Smith-Whitley K, McGowan KL Positive blood cul tures in sickle cell disease: time to positivity and clinical out come ] Pediatr Hematol Onml Z003;Z5:390-395 Schaffner A Pretransplant evaluation for infections in donors and recipients of solid organs Clin Infect Dis ZOO I ;33(Suppl 1):S9-S14 1\ Wong WY, Overturf GD, Pwars DR Infection caused by Strepto coccus pneumoniae in children with sickle cell disease: epidemi ology, immunologic mechanisms, prophylaxis and vaccination Note: Page numbers followed by t indicate tables; those followed by Clin Infect Dis 199Z;14: 1Z4-1136 marerial � CHAPTER 24 V Henretig FM, Cieslak TJ, Eitzen EM Biological and chemical ter rorism ] Pediatr ZOOZ; 41:311 -3Z6 Patt HA, Feigin RD Diagnosis and management of suspected cases of bioterrorism: a pediatric perspective Pediatrics ZOOZ; 09:685-69Z Swartz MN Recognition and management of anthrax: an update Abbreviations, xxi-xxv Abscess 1\ brain, 45-46 OJ epidural, 43-44 OIl '" o , o " v hepatic, with cancer, 60t peritonsillar and retropharyngeal, 49-52 renal, 93-94 Absidia, Absolute lymphocyte count N Engl] Med Z001; 345:16Z1-16Z6 (ALC), in severe combined immunodeficiency, 75 Absolute neutrophil count CHAPTER 25 (ANe) 54, 156 Acid-fast bacillus (AFB) stain , Bolyard EA, Tablan OC, Williams WW, et al Guideline for infec tion control in healthcare personnel modified, Infect Control Hosp EpidemioI1998;19:407-463 Committee on Infectious Diseases 2003 Red Book Report of the Committee on Infectious Diseases, Z6th ed Elk Grove Village, Exposure to Human Immunodeficiency Virus Pediatrics 53-55 Z003; Acyclovir, for encephalitis, 43 for neonatal herpes simplex virus infection, 134 for ophthalmia neonatorum, 32t resistance to, 29 :s: x OIl '" , Microscopy of bacteria, antibiotics for, /-221 '-' for Blastocystis hominis, 82 t Microbiology, diagnostic, 49 Moraxella, antibiotics for, 21 1-22t �tt � II I, 21 of fungi, of parasites, 1O-1 l Microsporum spp, vaccine, adverse events with, viruses, 4t, enteroviral, 38, 40t MBC (minimal bactericidal Measles, 152, 521 Molecular amplification, of parameningeal, 38, 401 Microsporidia, 9t Measles-mumps-rubella (MMR) against, 26t cryptococcal, 40t Mastoiditis, 56-57 concentration), spectrum of antifungal activity Minimal bactericidal concentration (MBC), Minimal inhibitory concentration (MIC), MMR (measles-mumps-rubella) vaccine, adverse events with, 95 Modified acid-fast bacillus stain, Molds defined, S identification methods for, : :c 0 -eo E< (') � '" " 0 Q) III :c cervical lymphadenitis due to, 60, identification methods for, Mycobacterium avium, disseminated, with HIV infection, 68 Mycobacterium tuberculosis cervical lymphadenitis due to, 60, pneumonia due to, 66 Mycoplasma pneumoniae, pneumonia due to, 65, 66 " Mycoses See Fungi '" Myeloperoxidase deficiency, 76t "t Myocarditis, 77-78 :t Myringotomy, for mastoiditis, I Q co � " '" " v NBT (nitroblue tetrazolium) test, for neutrophil disorders, 76 Nebulized epinephrine, for croup, 53 Necator americanus, intestinal infection with, 821 Necrotizing fasciitis, 02- 104 Needle aspiration, for septic arthritis, 06, 107 Neisseria gonorrhoeae arthritis due to, lOS, 06, 107 ophthalmia neonatorum due to, 30, , /, 321 pharyngitis due to, 49 Neisseria meningitidis fever and petechiae due to, 146 meningitis due to, 1 Nematodes, Nephrectomy, for urinary tract infection, 94 Neutropenia with cancer, 54-156 cyclic, 761 Neutrophil chemotaxis assay, 177 Neutrophil count, absolute, 54, 56 Neutrophil disorders, 75-177, 76t Neutrophil expression of CD l lb/l8, 7 Niclosamide, for Taenia saginata, 82t Nitazoxanide, for Crypwsporidium parvum, 821 Nitroblue tetrazolium (NBD test, for neutrophil disorders, 76 Nontuberculous mycobacteria (NTM), cervical lymphadenitis due to, 60, Nucleic acid hybridization assays, for viruses, 14t-15t Nucleic acid probes, for mycobacteria, 240 • Index Index Nucleic acid synthesis, inhibitors of 19 Perinatal infections See Paracoccidioides brasiliensis, CongenitalJperinatal infections Parainfluenza, antiviral agents for; Perinephric abscess, 93-94 281 Occult bacteremia (OB), 136-137 O&P (ova and parasites) examination, 10 Ophthalmia neonatorum, 30-32, l t, 321 Ophthalmologic infections, Parasites, 8-1 classification of, 8-10, 9t intestinal, -84, 821 laboratory methods to identify, 0-1 Parasitic endophthalmitis, 34, 35 conjunctivitis in older child, Paromomycin, endophthalmitis, 33-35 ophthalmia neonatorum, 30-32, t, 321 orbital and periorbital cellulitis, 35-37 Opportunistic fungi, 6-7 Oral medications, 7-2 Orbital cellulitis, 35-37 Organ transplant recipients, infections in, 80-183, b Orthomyxoviridae, 3t Oseltamivir, spectrum of activity of, 28t OsteochondritiS, Pseudomonas, 109, 1091 Osteomyelitis, 8b, 9t, 107-1 with sickle cell disease, 791 Otitis media (OM), 53-55 Ova and parasites (O&P) examination, Oxacillin, spectrum of activity of, 211 Oxazolidinone, spectrum of activity of, 221 Parvoviridae, 2/ Parvovirus B 9, 52, 52t Passive immunization, 195-197, 196t PCR (polymerase chain reaction), for HIV infection, 164, 165 P E (progressive encephalopathy), Papovaviridae, 121 Papular acrodermatitis, 521 Papular purpuric gloves and socks syndrome, 521 ParacenteSiS, for peritonitiS, 87 1\ :s: � C! ') 0c '" � Q) :c v 1\ Qi '" " , c v 2lt Penicillin-binding proteins (PBPs), Penicillin resistance, 9-20 Penicillin V potassium, Penicillium marneffei, 197-198, 971 for HIV, 168-169, 1691 Percutaneous aspiration, for urinary tract infection, 94 Perianal cellulitis, with cancer, 60t Pericardiocentesis, 76 Pericarditis, 74-77, 75b Peritonitis, 87-88 with cancer, 60/ Peritonsillar abscess, 49-5 Pertussis adverse events with vaccine for, 94-195 postexposure prophylaxiS for, 71 Petechiae, fever and, 146-147, 47t 175-177, 761 Pelvic inflammatory disease Penicillin, spectrum of activity of, Periorbital cellulitis, 35-37 Phagocyte disorders, /, Pediatric subspecialty training, 200 of, 281 139- , 1401 141 Pediatric residency training, 200 Penciclovir, spectrum of activity Periodic fever syndromes, cervical adenitis), 40, 401, career opportunities in, 201 Pelvic osteomyelitis, 08 140, 1401, stomatitis, pharyngitis, and Pediatric infectious diseases, (PIO), 94-96 cervical adenitis (PFAPA), PFAPA (periodic fever, aphthous with HIV infection, 167 PEP (postexposure prophylaxis), Palivizumab, for bronchiolitis, 64 stomatitis, pharyngitis, and Paramyxoviridae, 131 30-37 32-33 Periodic fever, aphthous Parameningeal meningitis, 38, 40t Pharyngitis, 48-49 1\ PhenotypiC assays, for viruses, 51 >, 0- Picornaviridae, 31 : PIO (pelvic inflammatory :c 0 "" " I '" :s: 0Q) III :c disease), 94-96 Pityriasis rosea, 521 Plague, 87-189 Pleconaril, spectrum of activity of 281 Pleura) effusion, 67-69, 68b, 681 " Pleural fluid assessment, 68, 681 '" Pneumococcal vaccine (prevnar), I Q co � "t '" :c '" " v 64 Pneumocystis carinii pneumonia, 67 Pneumonia acute, 64-67, 65/, 661 with cancer, 241 Pneumocystis carinii, 67 with sickle cell disease, 791 Pneumonic plague, 188 Pneumonic tularemia, 189 Pneumonitis, lymphocytic interstitial, 167 Polyenes, 23 Polymerase chain reaction (PCR), for HIV infection, 164, 65 Postexposure prophylaxis (PEP), 97-198, 971 for f-ilV, 168-169, 691 Postinfectious encephalitis 42 Potassium hydroxide (KOH) stain, Poxviridae, 2/ PPO (purified protein derivative) test, for pulmonary lymphadenopathy, Praziquantel, for Taenia saginaw, 821 Precautions, 98t, 99t Prednisone, for bronchiolitis, 63 Preseptal cellulitis, 35-37 Prevention, of infection, 194-199 by active immunization, 194-195 by chemoprophylaxis, 197-1 98, 1971 Piperacillin (PIPTAZ05), spectrum of activity of, 221 • by infection control, 198-199, 98/, 1991 by passive immunization, 195-197, 1961 Prevnar (pneumococcal vaccme), 64 Progressive encephalopathy (PE), with HIV infection, ) 67 Prophylaxis chemo-, 97-198, 1971 postexposure, 197-198, 971 for HIV; 68-1 69, 691 for sickle cell disease, 80 for trauma, 120, 20/ 242 • Index Protease inhibitors, for HIV infection, 66b Index · 243 Recombinant activated protein C (rhAPC), for sepsis, 1 Protein C, for sepsis, 1 Rectal swab, for sexual abuse, 97 Protein synthesis, inhibitors of, Renal abscess, 93-94 Retropharyngeal mass, VS retropharyngeal abscess, Retroviridae, 3t Saprophytic protozoa, SBE (subacute bacterial endocarditis), blood cultures for, S SBI (serious bacterial infections), fever due to, 135-136 Protozoa, 8-9, 9t Renal cortical scintigraphy, 92t for urinary tract infection, 92 " Reverse transcriptase inhibitors (RTI), for HIV infection, 66b Rhabdoviridae, 3t Pseudohyphae, Reoviridae, 13t :;: Rhagades, in congenital syphilis, 128 Pseudomonas aerugirwsa, Reporting, of communicable diseases, 199 ophthalmia neonatorum due to, 30, 32 Pseudomonas osteochondritis, 09, 109t Pulmonary infections See Respiratory tract infections Pulmonary lymphadenopathy, 69-71 , 70b Purified protein derivative (PPD) test, for pulmonary lymphadenopathy, Pyelonephritis, 90-92, 91b, 92t Pyrimethamine, for Isospora belli, 82t Q fever, 42t, 147 Quinolones, spectrum of activity of, 22t Quinsy, 49-5 Rabbit fever, 189-190 Rabies, l , 22 Rabies immune globulin (RIG) 22 Racemic epinephrine, for bronchiolitis, 63 Rash with cancer, fever and, 46-1 53 due to Lyme disease, 149-1 due to major childhood exanthems, 1-153, 52t due to rickettsial infections, 147-149 �C! 0c '" Residency training, in pediatrics, 200 � Q) x rhAPC (recombinant activated protein q, for sepsis, 13 Rhizopus, Ribavirin aerosolized, for bronchiolitis, 63 spectrum of activity of, 28t Resistance antibiotic, I9-20 to antifungal agents, 23-24 to antiviral agents, 27-29 m Rickettsia, Respiratory syncytial virus (RSV) antiviral agents for, 28t bronchiolitis due to, 62-64 " Rickettsia akari, 147 Rickettsial pox, 147 Respiratory syncytial virus intravenous immunoglobulin (RSV IVIG, RespiGam), for bronchiolitis, 63-64, 96t v " I/) 0 c v fever due to, 42t with rash, 47-149 Rickettsia prowazekii, Rickettsia typhi, gastroenteritis due to, t osteomyelitis due to, l 09t SBP (spontaneous bacterial peritonitis), 87-88 Scarlatiniform lesions, lSI Scarlet fever, 52t Schistosomiasis fever due to, 142t hepatitis due to, 84 Schlicter test, 147 47 Rifampin, RIG (rabies immune globulin), 122 Schwachman-Diamond syndrome, 76t SCID (severe combined immunodeficiency), 74-1 75 Scrub typhus, 147 Sepsis, 1 1-1 3, 1 2b Respiratory syncytial virus (RSV) monoclonal antibody, 96t Rimantadine, spectrum of activity of, 28t Respiratory tract infections with cancer, 7-1 59 lower, 62-71 acute pneumonia, 64-67, 65t, 66t bronchiolitis, 62-64 pleural effusion, 67-69, 68b, 68t pulmonary lymphadenopathy, 69-71 , 70b upper, 48-61 cervical lymphadenitis, 59-61 croup, 52-53 mastoiditis, 56-57 otitis media, 53-55 peritonsillar and retropharyngeal abscess, 49-52 pharyngitis, 48-49 sinUSitis, 57-59 "Ringworm," Septicemic plague, 88 RNA quantitative assay, for HIV infection, 164 Septic shock, I I I Retropharyngeal abscess, 49-52 " :> 0- ,: x 0- E< , I't Serologic tests, for hepatitis, 86t Roseola infantum, 152t Serology, of viruses, St Roundworms, intestinal infection with, 82t Serum cidal test, � '" :;: RTI (reverse transcriptase inhibitors), for HIV infection, 66b u 0- Q) III x '" I Q '" '" Q) I't Serious bacterial infections (SBI), fever due to, 135-136 Rocky Mountain spotted fever (RMSF), 47-148 RSV See Respiratory syncytial virus (RSV) � Septic arthritis, 05-107, l 06t Rubella, 52, 52t congenital, 29-130 Severe combined immunodeficiency (SCID), 74-1 75 Sexually abused child, infectious diseases in, 96-97 Sexually transmitted diseases (STDs), 96-97 Shah, Suresh and Meena, 5/1 Shell vial, for viruses, 4t " '" '" Saber shins, in congenital syphilis, 28 Shigella spp, gastroenteritis Sai, 5/2 v Salmonella spp Shock septic, I I I toxic, 16-1 u antibiotics for, 21 t-22t to, l t due 244 • Index Sickle cell disease, infections Index · 245 central venous catheter-related Sickle trait, 78 Silver nitrate chemical conjunctivitis, 30, l t, 32t Sinus aspiration, for sinusitis, 59 Sinusitis, 57-59 SIRS (systemic inflammatory response syndrome), I I I Skin and soft tissue infections' 98-104 with cancer, 56-1 57, 57t cellulitis, 100-10I folliculitis, furuncles, and carbuncles, 101-102 impetigo, 98-99 necrotizing fasciitis, 02-104 toxic shock syndrome due to' 117 STDs (sexually transmitted diseases), 96-97 for bronchiolitis' 63 for croup, 53 Stool sample for gastroenteritis, 80 for intestinal parasites, 83 Streptococcus pneumoniae (SPN) antibiotics for, 21 t-22t necrotizing fasciitis due to, 103 pharyngitis due to, 48, 49 scarlet fever due to, 52t group B antibiotics for, 21 t-22t meningitis due to, 41 t osteomyelitis due to, l 09t Streptococcus pneumoniae (SPN) antibiotics for, t-22t macrolide resistance by, 20 penicillin resistance by, Spontaneous bacterial peritonitis (SBP), 87-88 Sporothrix schenkii, antifungal agents for, 26t 9-20 pneumonia due to, 64 with sickle cell disease, 78 Streptococcus pyogenes Sporotrichosis, impetigo due to, 98 Sporozoa, 9t toxic shock syndrome due to, Spotted fever, 147 Stains for bacteria, I, 2t for fungi, Standard precautions, 198t, 99t Staphylococci, coagulase negative, central venous catheter-related infection due to, I I 6t Staphylococcus aureus antibiotics for, t-22t " Surveillance, 199 Susceptibility testing antifungal, Swabs, for virus specimen collection, Syphilis, congenital, 27-129 Systemic inflammatory response syndrome (SIRS), I I I Systemic mycoses, group A SPACE, antibiotics for, l t-22t SPN See Streptococcus Suprapubic aspirate, 92t antimicrobial, SterOids Solid organ transplant recipients, handling, for viruses, 6-1 Superficial fungi, 5-6 pneumonia due to, 65 and soft tissue infections Specimen collecting and pediatrics, 200 osteomyelitis due to, l 09t Soft tissue infections See Skin Specific granule deficiency, 76t Subspecialty training, in impetigo due to, 98 Smallpox, 90-1 91 infections in, 80-1 83, b Subdural empyema, 43-44 infection due to, 1 6t with, 78-1 80, 79t 117 Streptogramin, spectrum of activity of, 22t Stridor, vs peritonsillar or retropharyngeal abscess, 51 Strongyloides stercoralis, intestinal infection with, 82t Subacute bacterial endocarditis (SBE), blood cultures for, Subcutaneous fungi, "Tache noir," in rickettsial infections, 48 Tachypnea, due to pneumonia, 64 Taenia saginata, intestinal infection with, 82t Tapeworms, TB (tuberculosis) fever due to, 142t postexposure prophylaxis for, 197t T cell and B cell deficiency, l t, 74-1 75 T cell deficiency, t, 73, 74-1 75 T cell subsets, in HIV infection' 164 Technetium bone scan, of osteomyelitis, 09 Teeth, Hutchinson, in congenital syphilis, 28 Tetanus, adverse events with vaccine for, 194-195 Tetanus immune globulin (TIG), 96t fur lacerations, 20 Tetanus immunization, for lacerations, 20 Tetracyclines, spectrum of activity of, 22t Thiabendazole, for Strongyloides stercoralis, 82t Ticarcillinipotassium clavulanate (TICAR-CLAV), spectrum of activity of, 22t TIG (tetanus immune globulin), 96t for lacerations, 120 Tinea nigra, Tinea versicolor, TMP-SMX See Trirnethoprirn sulfamethoxazole (TMP SMX, Bactrirn) Togaviridae, 13t "Tolerance," TORCHES, 25 Torticollis, vs peritonsillar or retropharyngeal abscess, Toxic shock syndrome (TSS), I I 6-I I Toxoplasma gondii, 26 in organ transplant recipient, 82 Toxoplasmosis, congenital, 26-1 27 Transesophageal echocardiography, for endocarditis, 74 Transient hypogarnmaglobulinemia of infancy, 73 Transplant recipients, infections in, 80-1 83, b Transudate, pleural effusion as' 67, 68t Transurethral catheterization, 92t TRAPS (tumor necrosis factor receptor-associated periodic syndrome), 4Ot, 141 Trauma-related infections' I I 9-1 20, I I 9t, 20t Traveler, fever in returning, 1-143, 142t 246 • Index · 247 Index Trematodes, Treponema pallidum, 7, 28 intestinal infection with, 82t Trichinella spiralis, Trichophyton spp, Trifluorothymidine, for ophthalmia neonatorum, 32t Trimethoprim-sulfamethoxazole (TMP-SMX, Bactrim), for Isospora belli, 82t for Pneumocystis carinii pneumonia, 167 spectrum of activity of 22t Unilateral laterothoracic exanthem of childhood, 52t Ventricular shunt infections, 46-47 Upper respiratory tract infections (URls), 48-61 cervical lymphadenitis, 59-61 croup, 52-53 mastoiditis, 56-57 otitis media, 53-55 peritonSillar and retropharyngeal abscess, 49-52 pharyngitis, 4�9 sinusitis, 57-59 Vertebral osteomyelitis, Trophozoite, Urinary tract infection (UTI), 90-92, 91b, 92t Trypanosomiasis, fever due to, 142t Urine culture, 91 , 92t TSS (toxic shock syndrome), I l 6-1 Vaccine(s), 194-195 botulinum, 93 pneumococcal, 64 with sickle cell disease, 80 smallpox, 191 Tsutsugamushi, 147 Tuberculin skin testing (PPD), for pulmonary lymphadenopathy, 71 Tuberculosis (TE) fever due to, 142t postexposure prophylaxis for, 97t Tuberculous meningitis, 39, 40t Tuberculous pericarditis, 76 Tularemia, 89-1 90 Tumor necrosis factor receptor associated periodic syndrome (T�), 40� 141 Vaccinia immune globulin, 191 Vaginal swab, for sexual abuse, 97 Valacyclovir, spectrum of activity of 28t Vancomycin, spectrum of activity of l t 22ql l deletion syndrome, 75 Tympanocentesis, for otitis media, 54 Varicella vaccine, adverse events with, 195 Tympanostomy tubes, for otitis media, 55 Varicella zoster immune globulin (VZlG), I 96t Typhlitis, with cancer, 6Ot, 161 Varicella zoster virus (VZV) antiviral agents for; 28t with cancer, Typhoid fever, 142t Typhus, 147 Ultrasound, for urinary tract infection, 92 A Variola, 190-191 VCUG (voiding cystourethrogram), 92t Velocardiofacial syndrome, 75 Vesicoureteral reflux (VUR), and pyelonephritis, 90 Vibrio cholerae, gastroenteritis due to, t Vidarabine, for ophthalmia neonatorum, 32t Viral conjunctivitis, 32-33 Q) x Viral encephalitis, 42 V Viral hemorrhagic fever (VHF), 142t, 191-192 A Q) -< I/) Varicella with conjunctivitis, 33 postexposure prophylaxis for, 197t Typhoidal tularemia, 89 09 Vaccine Adverse Event Reporting System (VAERS), 94-195 VZV (varicella zoster virus) antiviral agents for, 28t with cancer, B '"' o C v Viral load (VL), for HlV infection, 65 Water-borne illness, gastroenteritis due to, 80 Western blot, for HlV infection, 64 Wiskott-Aldrich syndrome, 75 Worms, 9-10 Wound infections due to bites, -1 22 due to bums, 22-1 24 due to trauma, 1 9-120, 1 9t, 20t Virology, diagnostic, 2-1 7, 2t-1 t Xigris (drotrecogin alfa), for sepsis, 13 Virus(es) choosing tests for detection of 5-1 classification and properties of 2, 2t, 3t DNA, 2t laboratory methods to identify, 2, 14t- 5t RNA, 3t specimen collecting and handling for, 6-1 X-linked agammaglobulinemia, 73-1 74 VL (viral load), for HIV infection, 65 Voiding cystourethrogram (VCUG), 92t Yale School of Medicine, 998 Yeasts defined, S identification methods for, 7-8 spectrum of antifungal activity against, 25t Yersinia enterocolitica, gastroenteritis due to, t Yersinia pestis, 187-189 Voriconazole, spectrum of activity for, 25t, 26t Zanamivir, spectrum of activity of 28t VUR (vesicoureteral reflux), and pyelonephritis, 90 Ziehl-Neelsen stain, I VZIG (varicella-zoster immune globulin), 96t Zygomycetes, antifungal agents for; 26t - �-!I- I = =' ;m 1i = • • • information about • • • - - , • ISBN - 4051 - 02 - I 78 40 04029 I t [...]... media: Burdetella spp., Legionella spp., Escherichia coli 0157:H7, Campylobacter spp , and Yersinia spp 2 • Ch 1: Diagnostic M icro biology Blueprint!? Pediatric Infectious Diseases Diagnostic Testing Catalase-pOSitive, gram-positive Possible Organisms Infectious Agent Comments Staphylococcus,Micrococcus,Aerococcus Bartonella hense/ae IFA; sensitivity 95%, specificity 95% BordeteJla pertussis peR (new... I'vI tuberculosis and M al'iulll complex (M allium, M intracellulare) DNA sequencing: Generally used for other species (i.e., M kansasii, M gordonae) 4 • Ch 1: Diagnostic Microbiology Blueprints Pediatric Infectious Diseases • 5 • Taking multiple specimens increases sensitivity Specific Susceptibility Tests • Disc diffusion (Kirby-Bauer): Commercially prepared filter paper disks impregnated with a... discontinue antibiotics for "negative" cultures Cutaneous/Superficial • Candida spp.: Cutaneous, mucocutaneous, and nail infections; normal skin flora 6 • Ch 1: Diagnostic Microbiology Blueprints Pediatric Infectious Diseases Subcutaneous 7 • • Malassezia furfur (tinea versicolor): Normal skin flora in fat rich areas; causes pityriasis versicolor and seborrheic dermatitis when density becomes too high... stain of surface lesions or aspirated fluids or GMS stain of biopsy specimens suggests C albicans Microscopically, examine yeast for presence of capsule by India ink (C neoformans) _ 8 • Blueprints Pediatric Infectious Diseases - Candida spp appear as pearly white colonies with a sharply demarcated border on blood or Sabouraud dextrose agar - CHROMagar Candida differentiates Candida albicans, Candida... dilllinuta), pork (Taenia solium), or beef (T sagi nata) Tissue infection in humans after ingestions of eggs from infected human (T solium) or sheep (Echinococcus granulo sus) stool 10 • Blueprints Pediatric Infectious Diseases Ch 1: Diagnostic Microbio logy • Trematodes (flukes): come in intestinal, liver, lung, and blood forms Intestinal: Fasciolopsis buski, Echinostoma ilocanum, Hetero phyes heterophyes,... required for detection of viruses in culture; detect only one or a few viruses at a time and are normally less sensitive than conventional culture systems 14 • Ch 2: Diagno st i c Vi ro lo gy Blueprints Pediatric Infectious Diseases Test Format Se nsit ivity Time to Result Inoculation of specimens High- Days- into culture tubes containing moderate weeks Test Org a ni sm Detected Cell Culture Systems Conventional... assays have limited u utility Tests are slow, relatively insensitive, cumbersome to v perform, and expensive However, assay format is well suited for detecting human papillomaviruses 16 • • Blueprints Pediatric Infectious Diseases Ch 2: Diagnostic Virology envelopes, are quite labile outside their natural host When im Molecular amplification methods (e.g., PCR) are extremely mediate transport is not possible,... alterations in cell wall proteins called penicillin binding proteins (PBPs) PBP: Cross-links peptidoglycan frag ments; number of changes in PBPs determines the level of resistance 20 Blueprints Pediatric Infectious Diseases - Solution: Compensate for inefficient drug binding by in creasing amount of drug available Best example is use of high-dose amoxicillin for otitis media in children at risk for... azoles to characterize isolates with intermediate resistance that can be inhibited hy higher doses of drug DDS isolates may be treated successfully with 12 mglkg/d of fluconazole 23 24 • • Blueprints Pediatric Infectious Diseases Available agents: Imidazoles (topical only; ketoconazole, miconazole, clotrimazole); triazoles (fluconazole, itraconazole, voriconazole, posaconazole, * ravuconazole*) Flucytosine... of the rapid development of resistance S, susceptible; I, intermediate; DDS, dose dependent susceptible; R, resistant n :::J'" � J> ::J � ::J 1.0 !lL J> 1.0 ('1) ::J (it i'J U1 26 • I Blueprints Pediatric Infectious Diseases TABLE 4-2 Spectrum of Antifungal Activity Against Dimorphic Fungi Drug of Choke Alternative Histoplasma capsulatum Amphotericin B, itra(onazole Fluconazole Coccidioides immitis ... www.blackwellmedstudent.com Blueprints Dermatology Blueprints Urology Blueprints Pediatric Infectious Diseases Blueprints Ophthalmology Blueprints Plastic Surgery Blueprints Orthopedics Blueprints Hematology... practice of pediatric infectious diseases is challenging and rewarding every day It has the structure of a puzzle and the richness of human interaction Blueprints Pediatric Infectious Diseases gets... Cataloging-in-Publication Data Blueprints pediatric infectIous diseases / p.; cm - (Blueprints) '" I edited by] Samlr S Shah.-I st ed Includes index " I Communicable diseases in children-Outlines,