Pediatrics Lecture Notes

Neonatal Infections

• Age 0-3 months: Common infections are Group B Strep, E. Coli, and Listeria (mnemonic: BEL).
  • Suspect pneumonia or meningitis.
  • Treatment: Ampicillin or Gentamicin.
• Older than 3 months: Common causes switch to Strep Pneumo, H. flu, and Moraxella.
  • Treatment: Vancomycin and Ceftriaxone.
• Fever in less than 28 days old: Hospitalization is mandatory.

CSF Findings

• Bacterial: Elevated protein, decreased glucose, neutrophil predominance.
• Viral: Normal glucose, elevated protein, lymphocyte predominance.
• Fungal: Low glucose, lymphocyte predominance (TB also shows similar pattern).

Meningitis

• Fungal Meningitis: Common in immunocompromised, e.g., AIDS patients with Cryptococcus neoformans.
• Bacterial Meningitis: TB has basilar enhancement; HSV affects temporal lobes and causes seizures.

Sinusitis

• Viral: Most common; treat with supportive care.
• Bacterial: If symptoms persist over a week, with purulent discharge.
  • Common bugs: Strep pneumo, H. flu, Moraxella.
  • Treatment: Amoxicillin.

Otitis Media

• Acute Otitis Media: Common in pediatrics; diagnosed with otoscopy.
  • Treatment: Amoxicillin.
• Otitis Externa: Ear canal infection; painful with ear pulling.
  • Treatment: Antibiotic ear drops.

Other Infections

• Diphtheria: Pharyngitis with gray plaque in unvaccinated children.
  • Treatment: Diphtheria antitoxin.
• Impetigo: Honey-crusted lesions. First-line treatment: Mupirocin.
• Cellulitis/Erysipelas: Rapid onset and sharp borders in erysipelas; both treated with cephalosporin or penicillin.

Gastrointestinal Infections

• Diarrhea:
  • Non-inflammatory: Rotavirus and Norwalk virus.
  • Inflammatory: Campylobacter, E. coli, Salmonella, Shigella, Yersinia.
  • C. difficile: Treated with oral Vancomycin.

Respiratory Conditions

• Croup: Caused by parainfluenza virus, treatment depends on severity.
• Bronchiolitis: Most commonly caused by RSV, treated supportively.
• Asthma: Managed based on frequency of symptoms.

Cardiology

• Congenital Heart Defects: ASD, Coarctation of the aorta, Tetralogy of Fallot.
• Tetralogy of Fallot: Characterized by VSD, pulmonic stenosis, overriding aorta, RV hypertrophy.

Rare Conditions

• Kawasaki Disease: Fever, rash, and possibly coronary artery aneurysms.
• Wiskott-Aldrich Syndrome: Thrombocytopenia, Eczema, Recurrent infections.
• Chronic Granulomatous Disease: Prone to infections with catalase-positive organisms.

Miscellaneous

• Duchenne’s Muscular Dystrophy: Early childhood onset, Gower's sign.
• Cystic Fibrosis: Recurrent lung infections, pancreatic insufficiency.

These notes summarize the key points from today's lecture on pediatrics, including common infections, treatments, and characteristics of various conditions. Study these key points to ensure a solid understanding of pediatric concepts.