A bit of a viral soup this month with articles on ‘flu vaccines, how long should children have off school when unwell, NAFLD, and dermatomyositis. Do leave comments below.
Tag Archives: infectious disease
August 2019 Paediatric Pearls newsletter uploaded
More on the coca-cola urine story this month, NF type I, cerebellar ataxia and restless legs syndrome. Do leave comments below.
July 2019 PDF
July 2019: Honing in on coca cola coloured urine this month and a closer look at armpits. Links to suitable child safeguarding CPD on harmful sexual behaviour and a look at the ANA test. Do leave comments below.
January 2019 newsletter
Genetics this month and an explanation of the microarray test. Managing measles contacts in the “lessons from the front line” section, use of a smartphone app for recording palpitations and the start of a new dermatology series – skin manifestations of systemic disease. Do leave comments below.
December 2018 PDF
Christmas disease this month, acute psychosis in children, an Emoji guide to the workings of the facial nerve, sleep hygiene and the start of a 2 part series on measles. Happy New Year and do leave comments below!
Haemolytic Uraemic Syndrome (HUS)
With thanks to Dr David Gardiner, one of our current paediatric FY2 doctors at Homerton University Hospital, for updating us on HUS.
Presentation:
- Profuse diarrhoea that typically turns bloody after 1-3 days
- Abdominal pain (crampy)
- Vomiting
- Fever (sometimes)
- Oedema
- Reduced urine output (abrupt onset) but also polyuria/normal urine output (rarer)
- Neurological complications: seizure, coma, cranial nerve palsies, confusion, hallucinations
- Classic triad – anaemia, uraemia and thrombocytopaenia
- Most common in children under the age of 5
Investigations:
- B/P – hypertension
- Blood film: Fragmentation and signs of haemolysis (Coombs test negative)
- Raised WCC and neutrophils, low platelets, low Hb
- Raised LDH
- Clotting screen typically normal (cf DIC)
- Raised bilirubin, low albumin
- Urea and creatinine raised
- Stool for PCR E.Coli
Management:
- Refer to secondary care urgently
- Strict input/output fluid monitoring
- Correction of anaemia
- Correction of electrolyte imbalances
- Antihypertensive therapy if required
- Dialysis
- Furosemide to induce diuresis
- Report to PHE – can’t go back to school until 2 negative stool samples
More resources:
Kidney Research website on HUS
https://patient.info/doctor/haemolytic-uraemic-syndrome-pro#ref-8
September 2018 PDF content
September’s newsletter reminds us of the CPD requirements for child safeguarding for all of us, warns us of the dangers of missing Kawasaki Disease, talks about PHE’s #askaboutasthma campaign and describes the differences between fever and sepsis. Do leave comments below:
July 2018 newsletter published
July 2018 brings HEADSSS as a communication tool in adolescent medicine this month, vaccine hesitancy, chikungunya, empyemas, a good headache course coming to London and appropriate use of the EEG. Please do leave comments below.
June 2018 PDF published
June 2018 features include the rotavirus immunisation, febrile myoclonus, investigating normochromic anaemia, complications of sinusitis and the first in our adolescence series. Please do leave comments below:
April 2018 newsletter uploaded
NICE on Lyme disease this month – just in time for the weather to pick up and the tics to start biting. Also a reminder on the risk factors for SIDS, what to do in a terrorist attack, how to manage a child with a non-blanching rash and a discussion on the use of the antistreptolysin O titre. Do leave comments below: