Childhood Infectious Diseases: Prevention, Symptoms, and Treatment

1. Chapter 20 Childhood Diseases and Disorders

2. Infectious Diseases • Four categories: • Viral • Bacterial • Fungal • Parasitic • Some infections can be prevented by immunization

3. Infectious Diseases • Many have incubation period • Symptoms: • Fever • Malaise • Coughing • Anorexia • Nausea and vomiting • Rash

4. Infectious Diseases • Treatment varies with the disease • Often consists of: • Symptom relief • Good nutrition • Rest • Nonaspirin antipyretics • Good hand washing

5. Viral Diseases • Usually symptomatic treatment • Invade host and can lay dormant • Reactivated by certain triggers such as stress

6. Viral Diseases • Measles • Also known as rubeola • One of the most serious childhood diseases • Commonly spread by contaminated airborne droplets • Symptoms: • Fever • Runny nose • Red maculopapular rash • Koplik’s spots

7. Measles/Rubeola Photo courtesy the Centers for Disease Control and Prevention

8. Koplik’s Spots Photo courtesy the Centers for Disease Control and Prevention

9. Viral Diseases • Rubella • Type of measles • Also known as German measles • In pregnant women may lead to birth defects • Less contagious than rubeola • Symptoms: • Lymph node enlargement, nasal discharge, joint pain, chills, fever • Children and women of childbearing age should be immunized

10. Rubella Rash Photo courtesy the Centers for Disease Control and Prevention

11. Viral Diseases • Mumps • Inflammation of parotid glands • Symptoms: • Chills • Fever • Ear pain • Swelling of parotid glands • Complication: • Orchitis and nerve conduction deafness

12. Mumps Photo courtesy the Centers for Disease Control and Prevention

13. Viral Diseases • Varicella • Also known as chickenpox or herpes zoster • Highly contagious • Symptoms: • Classic rash that develops into vesicles • Rash on face, trunk, and extremities • Poliomyelitis • Causes: • Polio virus • Immunization has reduced threat of disease

14. Varicella Photo courtesy Robert A. Silverman, MD, Pediatric Dermatology, Georgetown University

15. Viral Diseases • Influenza • Acute infectious respiratory disease • Occurs late fall through early spring • Symptoms: • Sudden high fever • Dry, hacking cough • Chills, headache, joint or muscle aches • Prevention: • Vaccination

16. Viral Diseases • Common cold • Most frequently occurring disease • Causes: • Rhinovirus • Prevention: • Good hand washing

17. Viral Diseases • Mononucleosis • Primarily affects children and young adults • Causes: • Epstein-Barr virus • Symptoms: • Fatigue, sore throat, fever, swollen lymph glands

18. Viral Diseases • AIDS (covered in detail in Chapter 5) • Has now affected thousands of children • Cause: • HIV • Most cases result from maternal–fetal transfer • Children suffer symptoms and often are orphaned • Treatment: • Treatment focuses on prevention

19. Bacterial Diseases • Causes: • Pathogens • E.g., Staphylococcus, Streptococcus, Haemophilus, Clostridium • Symptoms: • Cough • Fever • Headache • Difficulty breathing • Sore throat • Treatment based on causative agent

20. Bacterial Diseases • Pertussis • Also known as whooping cough • Symptoms: • Catarrhal • Paroxysmal spasm • Violent whooping coughing • Diphtheria • Severe inflammation of respiratory system • Was a leading cause of death in children • Rarely seen now due to vaccination

21. Bacterial Diseases • Tuberculosis • Most commonly affects the respiratory system • But can be systemic to bone, brain, lymph nodes • Increasing number of cases in children • Tularemia • Also known as rabbit fever • Transmitted by bite of infected insect or direct contact with infected animal • Prevention is avoiding tick bites

22. Bacterial Diseases • Impetigo • Contagious superficial pyoderma • Causes: • Staphylococcus • Group A Streptococcus • Prevention: • Good hand washing

23. Bacterial Diseases • Acute tonsillitis • Infection of palatine tonsils located on posterior wall of nasopharynx • Cause: • Commonly group A beta-hemolytic streptococci • Symptoms: • Sore throat • Enlarged tonsils • Treatment: • Antibiotics • Tonsillectomy

24. Bacterial Diseases • Otitis media • Acute bacterial infection of middle ear • Untreated, chronic infection develops • Symptoms: • Pain, fever, ear drainage • Treatment: • Antibiotics • Myringotomy with tympanoplasty

25. Fungal Diseases • Affect skin or mucous membranes in children • Sometimes more common in infants • Usually not severe • But irritating • May need medical attention to prevent spread

26. Fungal Diseases • Candidiasis • Also known as a yeast infection • Common in infants’ mouths and called thrush • In diaper area, called diaper rash • Cause: • Oral fungal infection • Prevention: • Thrush can be prevented by breast feeding; common in infants • Diaper rash treated by keeping the area clean and dry

27. Fungal Diseases • Tinea (discussed in detail in Chapter 18) • Also known as ringworm • Group of diseases • Tinea capitis • Scalp • Tinea pedis • Feet • Tinea cruris • Groin and scrotum

28. Parasitic Diseases • Caused by organism that feeds on another organism • Mostly found in places of poor nutrition, contaminated water, and low socioeconomic conditions • Only a few common in United States

29. Parasitic Diseases • Giardiasis • Infection by caused by protozoa called Giardia lamblia • Young children are most often affected • Protozoa lodge in lining of the small intestine • Symptoms: • Diarrhea • Nausea • Cramping • Flatulence

30. Parasitic Diseases • Pediculosis • Infestation with lice • Transmitted human to human by direct contact • Nits • Lice eggs • Epidemic among school children • Treatment with permethrin (more information in Chapter 18)

31. Parasitic Diseases • Pinworms • Parasitic nematodes that infect intestines and rectum • Transmitted by ingestion or inhalation of eggs • Symptoms: • Anal itching; worms appear as tiny white threads • Roundworms • Found in soil • Parasites lodge in intestines • Spread by hand-to-mouth activity • Absorb nutrients from host

32. Respiratory Diseases • Most common childhood diseases seen by physicians • Children very vulnerable due to continuous person-to-person contact • Infants most susceptible

33. Respiratory Diseases • Sudden infant death syndrome (SIDS) • Abrupt, unexplained death of infant under age 1 • Symptom: • Only symptom is death of unknown cause in an infant • Croup (laryngotracheobronchitis) • Upper respiratory infection • Affects children ages 3 months to 3 years • Symptoms: • Inspiratory stridor

34. Respiratory Diseases • Adenoid hyperplasia • Enlargement of pharyngeal tonsils • May require adenoidectomy • Asthma • Serious chronic respiratory disease in children • Symptoms: • Acute coughing, wheezing, shortness of breath • Cause: • Unknown • Triggers: Stimuli that cause attack

35. Respiratory Diseases • Pneumonia • Infection of lung parenchyma • Symptoms: • Cough • Fever • Wheezing • Malaise • Treatment: • Antibiotics if bacterial • If viral, runs course in 5-7 days

36. Digestive Diseases • Children may experience serious development problems due to lack of appropriate ingestion, digestion, absorption, or elimination • Fluid and electrolyte imbalance frequently more severe in children • May be caused by vomiting and diarrhea • Colic is a common symptom of digestive problems • Gastrointestinal pain, crying, irritability

37. Digestive Diseases • Fluid imbalances • Vomiting or diarrhea can be serious • Dehydration • Life-threatening in children • Food allergies • Most often in children under age 1 • Most common allergies are cow’s milk and eggs • Many disappear after age 5 • If allergy develops after age 3, it usually continues into adult life

38. Digestive Diseases • Eating disorders • Major problem among children • Especially adolescent females • Most common types: • Anorexia nervosa • Bulimia (discussed in detail in Chapter 21)

39. Cardiovascular Diseases • Most cardiovascular diseases in children are related to genetic or developmental disorders (discussed in detail in Chapter 19)

40. Musculoskeletal Diseases • Common in children due to high activity level • Range from soft tissue injuries and fractures to joint and bone deformities or degenerative muscle disorders

41. Musculoskeletal Diseases • Legg-Calvé-Perthes (LCP) • Avascular necrosis of upper end of femur • Causes changes in bone growth • Untreated, it may lead to permanent deformity • Ewing’s sarcoma • Malignant neoplasm occurring before age 20 • Usually in long bones • More common in males • Quickly metastatic and highly malignant

42. Blood Diseases • Leukemia • Malignancy of blood-forming cells in bone marrow • Most common disorder of blood and blood-forming organs in children • Symptoms: • Pallor, bleeding or bruising, fatigue, joint/bone/abdominal pain • Treatment: • Among the most curable diseases of childhood cancers • Chemotherapy

43. Neurologic Diseases • Reye’s syndrome • Acute encephalopathy in children under age 15 who have had viral infection • Cause: • Unknown, there is a relationship between the disease and use of aspirin for febrile illnesses in children • Symptoms: • Nausea and vomiting • Liver enlargement • Lethargy • Seizures, coma, and in many cases death

44. Eye and Ear Diseases • Have profound effects on child’s ability to learn and develop • Strabismus • Lazy or cross-eye • Deafness • Causes: • Genes • Trauma • Infections • Exposure to ototoxic drugs

45. Trauma • Child abuse • Serious problem in United States • Often fatal • Emotional, physical, or sexual harm or neglect • Emotional abuse harder to diagnose than physical abuse • Sexual abuse occurring in epidemic proportions • Suicide • Third leading cause of death among young people • Prevention • Early intervention most important

46. Trauma • Drug abuse • Illicit drug, alcohol, and tobacco use • Epidemic problem among children • Especially adolescents • Poisoning • Among top five causes of accidental death under age 10 • Most poisonings due to common substances found at home • E.g., cleaning products, medicines, plants