Useful resources in preparation for this year’s expected RSV bronchiolitis surge in this month’s newsletter. Also, a bit on managing young people who are “tired all the time”, height and weight issues in non face-to-face consultations and a short article asking why do we give children 10 days of foul tasting pen-V qds for tonsillitis instead of 5 days of tds amoxicillin which, it transpires, is actually cheaper? Microbiologists and others are welcome to leave comments below!
An emphasis on children’s psychological support this month, particularly around bereavement during Covid. A couple of useful links to PIMS-TS information for GPs and families, a bit more on bites with a safeguarding slant and what to do with constipation when Movicol is not the answer.
Do leave comments below.
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.
With thanks to Dr David Gardiner, one of our current paediatric FY2 doctors at Homerton University Hospital, for updating us on HUS.
- Profuse diarrhoea that typically turns bloody after 1-3 days
- Abdominal pain (crampy)
- Fever (sometimes)
- 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
- 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
- Refer to secondary care urgently
- Strict input/output fluid monitoring
- Correction of anaemia
- Correction of electrolyte imbalances
- Antihypertensive therapy if required
- Furosemide to induce diuresis
- Report to PHE – can’t go back to school until 2 negative stool samples