pediatric infectious diseases

Question 1

Pertussis preferred treatment?

Answer 1

macrolide: azithromycin

erythromycin and clarithromycin not recommended

Question 2

pertussis S&S

Answer 2

paroxysymal cough, diff breathing, high pitched whooping cough,

1-3 weeks before symptomatic

common cold, runny nose, congestion, sneezing, milk fever, mild cough. worsen as thick mucus accumulates and then uncontrollable cough.

Question 3

pertussis diagnostics

Answer 3

Gold standard: positive culture
PCR test: not standard, but faster
DFA of nasopharyngeal specimens - sensitibity low

CDC recommends: culture + PCR test if cough > 3 weeks

Question 4

CAP bacterial

Answer 4

amoxicillin oral 90mg/kg/day in 2 doses

alter: amox-caluv same dosage

Question 5

CAP atypical

Answer 5

oral azithromycin 10mg/kg/ day 1, 5mg/kg/day once daily days 2-5

alter: clarithromycin 15 mg/kg/day in 2 doses 7-14 days OR erythrmoycin 40 mg/kg/day in 4 doses

Question 6

CAP bacterial >/5 years tx?

Answer 6

oral amoxicillin (if can’t distinguish) can add macrolide to amoxocillin

alter: amox-caluv same dose.

Question 7

CAP atypical > /5 years tx?

Answer 7

oral azithromycin 10mg/kg/ day 1, 5mg/kg/day once daily days 2-5 (max 500 mg on day 1 and 250 max 2-5)

alter: clarithromycin 15 mg/kg/day in 2 doses 7-14 days (max 1 g/day) OR erythrmoycin, doxyxcyline > 7 years