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Learn to recognize the symptoms of periorbital cellulitis in your baby or older child and what the treatment is for this serious eye condition. Preseptal cellulitis (sometimes called periorbital cellulitis) is an infection of the anterior portion of the eyelid, not involving the orbit or other ocular structures. Cellulitis is an infection of the skin and deep underlying tissues group a strep (streptococcal) bacteria are the most common cause the bacteria enter. The content on the uptodate website is not intended nor recommended as a substitute for medical advice diagnosis or treatment. The content on the uptodate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment always seek the advice of your own. In june 2013 the american academy of pediatrics published updated guidelines on the diagnosis and management of acute bacterial sinusitis in children and. Above you can read article and ebook that discuss about Periorbital Cellulitis Treatment Uptodate.
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Community-acquired pneumonia (CAP) is defined as the presence of signs and symptoms of pneumonia in a previously immunised healthy child due to an infection acquired outside the hospital. Etiology of infection in CAP varies for different age groups; group B Streptococcus and Gram-negative enteric bacteria are the most common pathogens in neonates. Children with CAP usually present with fever and signs of respiratory distress such as dyspnea, productive cough, tachypnea, rales, nasal flaring, grunting, retractions, use of accessory muscles, wheezing, and decreased breath sounds.
Not every child suspected to have pneumonia requires laboratory or radiographic evaluation. Chest Radiograph is not necessary for the confirmation of suspected CAP in patients well enough to be treated in the outpatient setting because CXRs do not reliably distinguish bacterial from viral CAP or among the various bacterial pathogens. CXR, however, is beneficial in patients with suspected or documented hypoxia or significant respiratory distress and in patients failing initial antibiotic therapy to verify the presence or absence of complications of pneumonia, including parapneumonic effusion, necrotising pneumonia, and pneumothorax.
FBC (Full Blood Count) is not necessary in all children with suspected CAP managed in outpatient, but for those with more serious disease, results may provide useful information for clinical management.
Blood culture should be obtained in children who fail to demonstrate clinical improvement and in those who have progressive pneumonia.
ESR, CRP or Procalcitonin cana€™t be used as the sole determinant to distinguish between viral and bacterial causes of CAP.
Sensitive and specific tests for the rapid diagnosis of influenza and other respiratory viruses should be used to evaluate children with CAP. Any child with pneumonia is at risk for hypoxemia and should have pulse oximetry to determine oxygen saturation. Antibiotic may be withheld in preschool-aged children if close monitoring can be ensured since viral pathogens are responsible for the great majority of clinical disease. Amoxicillin should be used as first-line therapy for previously healthy, appropriately immunised infants and preschool-aged children with mild to moderate CAP suspected to be of bacterial origin and school-aged children and adolescent with mild to moderate CAP due to S.

For patients with more severe disease, amoxicillin (or another beta-lactam antibiotic) may be combined with a macrolide.
Treatment courses of 10 days have been best studied, although shorter courses may be just as effective, particularly for more mild diseases managed on an outpatient basis.
The decision to admit a child with pneumonia should be made on an individual basis and should be based on multiple clinical and social factors. Dr Ratna Sridjaja graduated magna cum laude from the University of Southern California, USA.
According to the Instituto Nacional de Salud in Colombia, there were more than 400 suspected meningitis cases reported in week 34 (Aug. The territorial communities of origin with the largest number of reported cases are Antioquia, Bogota, Valle del Cauca, Bolivar and Cartagena.
Meningitis infection may show up in a person by a sudden onset of fever, headache, and stiff neck.
If meningitis is suspected, samples of blood or cerebrospinal fluid (near the spinal cord) are collected and sent to the laboratory for testing. The most effective way to protect you and your child against certain types of bacterial meningitis is to complete the recommended vaccine schedule.
Each year, more than two million children younger than five years of age die from pneumonia, representing approximately 20% of all deaths in children within this age group.
Respiratory syncytial virus (RSV) is consistently the most frequently detected virus, representing up to 40% of identified pathogens. The widespread use of pneumococcal immunisation has reduced the incidence of invasive disease. In febrile children, the absence of tachypnea has a high negative predictive value (97.4%) for pneumonia. A well-appearing child with cough and rales may be diagnosed clinically and treated as an outpatient. CXR findings have also not been shown to improve clinical outcomes or significantly change treatment.
Pleural effusion on chest radiography is the most significant predictor of bacterial pneumonia.
Treatment of suspected bacterial pneumonia is based on the presumptive cause and the age and clinical appearance of the child. Guidelines of therapy for previously healthy, appropriately immunised infants and preschool-aged children with mild to moderate CAP suspected to be of bacterial origin and school-aged children and adolescent with mild to moderate CAP due to S.
Macrolides are the treatment of choice for children five to 16 years of age because of their activity against M. Children with an adequate therapy should demonstrate clinical and laboratory signs of improvement within 48 to 72 hours. Most infants younger than four months should be admitted initially unless a viral etiology is suspected, or unless the infant is relatively asymptomatic and close follow-up can be ensured.
Routine childhood immunisation with the pneumococcal conjugate vaccine significantly reduces the incidence of invasive pneumococcal disease in children. She then continued to pursue her medical degree at the University of Pennsylvania School of Medicine, USA, in 1995.
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23-29); however, after discarding and ruling out cases, 245 laboratory confirmed (59%) and probable (41%) cases remained. It will often have other symptoms, such as nausea, vomiting, increased sensitivity to light (photophobia), and altered mental status (confusion). It is important to know the specific cause of meningitis because that helps doctors understand how to treat the disease, and possibly how bad it will get.
Antibiotics may also be recommended for the entire family if a family member develops severe Hib infection and there’s a high-risk person in the house. But in this post i will explain The content on the uptodate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment.
Other frequently detected viruses are influenza A and B, parainfluenza types 1 through 3, adenovirus, rhinovirus, human metapneumovirus and enteroviruses.
Children with underlying conditions and those who attend childcare are at higher risk of invasive pneumococcal disease. Conversely, the presence of tachypnea in febrile children has a low positive predictive value (20.1%). Alveolar infiltrate is more suggestive of bacterial than viral infection, especially if the infiltrate is lobar. Clindamycin may be used if the patient is stable without bacteraemia, and if the local resistance rate to clindamycin is less than 10 %. Ineffective empiric therapy may be the result of inappropriate drug selection, resistance to the initial agents, or development of complications. Children should also be immunised against other potential causes of pneumonia including Hemophilus Influenza Type B, Pertussis, Influenza and Varicella. Dr Ratna completed her paediatrics specialty training at Thomas Jefferson University Hospital in 1999. This compares with the number of meningitis fatalities reported during the 4 previous weeks: Week 33 (29 deaths), week 32 (31 deaths), week 31 (31 deaths) and week 30 (30 deaths).
Fortunately the US Centers for Disease Control and Prevention (CDC) notes, most of the bacteria that cause meningitis are not as contagious as viruses that cause the common cold or the flu. Appropriate antibiotic treatment of the most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk remains higher among young infants and the elderly. A  4 The Management of Community-Acquired Pneumonia in Infants and Children Older Than 3 Months of Age: Clinical Practice Guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America.
She is American Board Certified in Paediatrics and a Fellow of American Academy of Pediatrics.
Also, the bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been. In febrile children with tachypnea, findings of chest retractions, grunting, nasal flaring, and crepitation increase the likelihood of pneumonia.
She was also with the Emergency Department at Dupont Hospital for Children before coming to Singapore in 2008 where she worked at the National University Hospital Childrena€™s Emergency Department. With her global experience, Dr Ratna is multi-lingual a€“ she is able to communicate in English, Mandarin, Malay, Hokkien and Indonesian.

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