Lots about diarrhoea this month. Also ADHD and no need any more for an ECG prior to starting medication. Obesity in A&E; can we at least start the journey towards a more healthy future in the Emergency department?
Tag Archives: infectious disease
August 2021 PDF
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!
February 2021 newsletter
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.
Happy Christmas and best wishes for the new decade from the Paediatric Pearls team, December 2019
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.
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: