Childhood Diseases and Disorders Pathophysiology Infectious Diseases Viruses

Childhood Diseases and Disorders Pathophysiology

Infectious Diseases § Viruses § Bacterial § Fungal § Parasitic

Viral Diseases

Measles, Mumps, and Rubella (MMR) § § § Measles (Rubeola) § Highly contagious (incubation period is 7 -14 days) § Symptoms include fever, inflammation of respiratory mucous membranes, rash, and spots in mouth called Koplik’s spots § Treatment is fluids, fever reducer, and rest § May cause encephalitis or meningitis or ear infections and conjunctivitis (pink eye) Mumps § Affects parotid glands (one of the three salivary glands) § Spread by saliva with incubation period 16 -18 but may be as long as 25 days § Blood test determines presence and symptoms are chills, swelling of glands, fever § Treatment is to treat symptoms § May cause orchitis (inflammation of testis) or nerve conduction deafness Rubella (German Measles or three day measles) § Incubation period of 14 -21 days § Symptoms like rubeola but lighter in color; also joint pain and lymph node involvement § Diagnosis through a blood test § May cause fetal problems or birth defects is pregnant women are exposed (80% chance in first 3 mos)

MMR

Varicella (Chicken Pox)/ Poliomyelitis § § Varicella § Incubation of 10 -21 days; caused by varicella-zoster § May have shingles as an adult § Symptoms include classic dew drop rose petal macular rash (vesicles) Poliomyelitis § Incubation of 3 -6 days for milder form, 7 -21 for severe form § Spread through oral fecal routes § Headache, sore throat and then paralysis § Stool sample or throat cultures confirms diagnosis § Treatment is only supportive; physical therapy or respiratory ventilation may be needed

Chicken Pox Polio

Influenza/ Common Cold § § Influenza § Symptoms are fever, headache, joint pain, runny nose, etc § No treatment except rest, hydration, nasal sprays Common Cold (rhinovirus) § Symptoms are rhinitis § No treatment except rest, hydration, nasal sprays

Mononucleosis § Caused by Epstein-Barr virus § Spread through saliva § Symptoms happen 4 -7 days after exposure § Diagnosis through blood test showing rise in WBC § Takes 3 -4 weeks to recover and sports should be avoided for one month after to protect the spleen

Acquired Immunodeficiency Syndrome (AIDS) § Caused by HIV virus § In 1980’s most children with the disease got it from infected blood because they were hemophiliacs and received transfusions. Today most get it from perinatal transmission § Some sexually active teens have the disease § 2. 1 million live with HIV § Time between HIV infection and AIDS is shorter in children and infants

Bacterial Diseases

Diphtheria / Pertussis § § Diphtheria § Once had a fatality rate of 20% in 1920’s § Caused by Corynebacterium diphtheriae § Produces a membranous coating of pharynx, nose, and sometimes tracheobronchial tree called exudate with proteins and WBC that seep from tissue § Diagnosis is gray membrane covering throat and positive culture § Treatment is antibiotic and diphtheria antitoxin Pertussis (whooping cough) § Caused by Bordetella pertussis § Incubation is 6 -10 days but can be as long as 21 days § Symptoms are § § Catarrhal- increase in inflammation of mucous membranes § Paroxysmal-spasm or convulsion with violent coughing, cyanosis, vomiting § Convalescent stage-gradually reduced coughing Treatment is with antibiotics and supportive therapy but pneumonia can be a problem

Tuberculosis (TB) § Affects respiratory system § Currently on the rise § Caused by Mycobacterium tuberculosis § Also found in GI system and the bones, brain, and lymph nodes § Incubation period is 4 -12 weeks § Symptoms include bloody sputum, fever, cough, lymph node enlargement § Disease in children often stays dormant § Diagnosis is by positive skin test, sputum culture and chest x-rays § Treatment is rest, drug therapy § There is a TB vaccine, bacille Calmette-Guesnn per year (BCG) for places with infection greater than 1%

Tularemia (Rabbit fever or deer fly fever) § Caused by Francisella tularensis § Symptoms include headaches, lymph node swelling, chills, vomiting § Diagnosis is with blood test or chest x-ray to rule our pneumonia § Treatment is with antibiotics § Prevention is protection from ticks

Impetigo / Acute Tonsillitis / Otitis Media § § § Impetigo § Caused by pyoderma commonly found on face and hands of children § Caused by Staphylococcus aureus Acute Tonsillitis § Infection of palatine tonsils caused by beta-hemolytic streptococci § Symptoms are sore throat, cough, fever, trouble swallowing § Diagnosis with throat culture § Treatment is tonsillectomy Otitis Media § Bacterial infection of middle ear § If persistent, myringotomy with tympanopathy tubes might be treatment

Fungal Diseases

Candidiasis/ Tinea § § Candidiasis § Also known as thrush, oral fungal infection § Caused by Candida albicans § White plaques on mucous membranes and tongue § Treatment of choice is usually swabbing mouth with oral nystatin Tinea § Also known as ringworm § Usually affect scalp and between toes § Males also get it in the groin area

Parasitic Diseases

Giardiasis / Pediculosis § Giardiasis § § § § Infection with protozoa called giardia Caused by the Giardia lamblia and affects the digestive system Symptoms include watery diarrhea , nausea, flatulence Stool will float and be shiny May take many samples to identify parasite Treatment is furazolidone or similar drugs; clear fluids to prevent dehydration Pediculosis Lice acceptance § Adult females produce 6 eggs/ 24 hours § Nits (eggs) can be seen in hair § Treated with permethrin 1% crème rinse §

Pinworms/ Roundworms § Pinworms (seatworms or threadworms) are nematodes that infect intestines and rectum § § § § No harmful, just itchy Caused by Enterobius vermicularis Eggs can survive for 2 -3 weeks; females lay 10, 000 -20, 000 eggs at anus Symptoms are anal itching and look like white threads Diagnosis is by microscopic exam of stool Treatment is OTC or prescription drug therapy; may need to repeat in 2 weeks Roundworms § Ascaris lumbricoides found in soil Symptoms are abdominal pain, excessive gas, weight loss, vomiting § Diagnosis is through stool sample § Treatment is same as for pinworms §

Respiratory Diseases § SIDS § Croup § Adenopid Hyperplasia § Asthma § Pneumonia

Respiratory Illness

Sudden Infant Death Syndrome (SIDS) / Croup § § SIDS § Unexplainable death of an infant under age one; also known as crib death § Cause unknown but suggested that infants be put in supine rather than prone position § Only diagnosis is autopsy Croup § Also known as laryngotracheobronchitis (URI) § Caused by parainfluenza 1 and 2 viruses in children from 3 mos- 3 yrs old § Symptoms are inspiratory stridor, difficulty breathing at night § Diagnosis is physical exam § Treatment is usually high humidity, fluids, rest, racemic epinephrine § https: //www. youtube. com/watch? v=Qbn 1 Zw 5 CTb. A

Adenoid Hyperplasia/ Asthma § § Adenoid Hyperplasia § Enlargement of the pharyngeal tonsils § Symptoms are blockage of Eustachian tubes causing otitis media; difficulty breathing § Diagnosis is exam/ throat culture § Treatment is antibiotic therapy or adenoidectomy Asthma § More than 5 million children under age 18 diagnosed (I out of every 4) § #1 reason for school absences § Cause unknown § Symptoms are respiratory distress § Diagnosis is by chest x-rays, allergy test, pulmonary function tests, physical exam § Treatment is with medications like a bronchodilator and anti-inflammatory drugs § Monitored with peak flow meter § Prevention is knowing triggers § https: //www. youtube. com/watch? v=VA 9 C_a. CH 7 F 0

Pneumonia § Infection of the lung parenchyma § Can be viral or bacterial; alveolar air spaces become filled with fluid § Symptoms are wheezing, coughing, fever, malaise § Diagnosis is by chest x-ray and auscultation of the chest § Treatment varies (antibiotics if bacterial)

Digestive Diseases / Cardiovascular Diseases § § Digestive § Colic- in babies § Fluid Imbalances § Food Allergies § Eating Disorders Cardiovascular § Most are related to genetic or developmental disorders

Fluid Imbalances / Food Allergies/ Eating Disorders § § § Fluid Imbalance § Children have higher exchange of fluids so diarrhea or vomiting can be serious § Dehydration serious § Treatment includes rehydration and electrolyte replacement Food Allergies § Overreaction of immune system to a particular food § Reaction may take seconds or even hours § More common in children especially under age 1 § After age three, if one develops it stays for adult life § Testing can be done § http: //health. usnews. com/health-news/health-wellness/articles/2014/04/17/how-to-cope-with-food-allergies Eating Disorders § Problem during adolescence § Anorexia and bulimia most common

Musculoskeletal Diseases / Blood Diseases § § Musculoskeletal § Legg-Calve-Perthes (LCP) § Ewing’s Sarcoma Blood Diseases § Leukemia

Musculoskeletal diseases § § Legg-Calve-Perthes (LCP) § Avascular necrosis of the upper end of the femur § Blood flow is reduced to the head of the femur § Most common in boys age 4 -8 § Only symptom is pain when walking § Cause unknown § Diagnosis with x-ray § Treatment is maintain position of femur, rest, ROM exercises, traction, etc. Ewing’s Sarcoma § More common in males; found in long bones like femur § Cause unknown § Diagnosis with x-ray, CT scan, MRI § Treatment is chemotherapy or amputation

Neurologic Diseases / Eye and Ear Diseases § Neurologic § § Reye’s Syndrome Eye and Ear § Strabismus § Deafness

Neurologic Diseases § Reyes Syndrome § Acute encephalopathy seen in children under age 15 § Cause unknown but relationship with use of aspirin § Symptoms are nausea and vomiting, liver enlargement, seizures § Diagnosis should be suspected in a child who had a recent viral illness; blood testing of liver enzymes and lumbar puncture (spinal tap) § Treatment is in ICU

Eye and Ear Diseases § § Strabismus § Lazy eye or crossed § Should not be present after age 4 mos Deafness § Ranges from mild to complete § Cause unknown but may be from trauma, infections, or exposure to ototoxic drugs § Audiometric testing is needed for accurate diagnosis § Treatment depends on extent of deafness § Cochlear implants are now inserted surgically to stimulate 8 th cranial nerve

Blood Diseases § Leukemia § Malignancy of the blood-forming cells located in bone marrow § Most common cancer in children § Cause is unknown § Most common type in children is ALL (Acute Lymphoblastic Leukemia) § Symptoms are pale skin, easy bleeding, bruising, abdominal pain, fever § Diagnosed with blood tests and bone marrow biopsy § Treatment is chemotherapy or radiation in some cases

Trauma § Child Abuse § Suicide § Drug Abuse § Poisoning

Child Abuse § More common than any other pediatric illness § Neglect vs. abuse § Neglect is failing to provide basic needs § Abuse is causing harm § Diagnosed with physical exam and interview of child and care providers § Cigarette and hands most common items of abuse § Shaking Baby Syndrome common § Types of abuse § Sexual § Physical § Emotional § Verbal

Suicide § 3 rd leading cause of death (15 -24 years) § Firearms used in 57% of male suicides § Depression, alcohol and drug use are contributing factors § Highest in incarcerated youths, gay or bisexual, and sexually abused § Girls attempt more but males are more successful in suicide attempts

Poisoning § Among top five causes of death under age 10; 75% under age 6 § Household items and medications are common forms of poisoning § Lead poisoning is chronic and blood can be tested to diagnose; caused neurological disorders § Treatment MAY be medication to induce vomiting