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Complications of Acute Bronchiolitis

1-Dehydration o due to tachypnea & anorexia.
2-Lung collapse or pneumothorax and sudden deterioration.
3-Respiratory failure.
4- Heart failure.

#Pediatrics
-There is higher incidence of wheezing and asthma in children with a history of bronchiolitis.

#Pediatrics
-Staphylococcus aureus is the commonest cause of Bacterial Tracheitis.
-Often follows viral laryngotracheobronchitis.


#Pediatrics
Congenital rickets:


Onset: Neonatal period
Predisposing factor:
-Maternal osteomalacia
• Clinical features:
Skeletal deformities with tetany.
Investigations:
-Radiological features suggestive of metaphyseal lesion, widening, cupping, fraying of ribs and long bones can be seen in utero (or) at birth.

Treatment:
-IV calcium gluconate (or) oral calcium chloride with vitamin D 1000 ID/ day should be given for 4-6 weeks.
-Calcium and phosphate supplement should be given.

Prevention:
-Detect and treat osteomalacia during pregnancy.


#Pediatrics
Remember:


-Infective stage is promastigote.
-Diagnostic stage is amastigote.

#Infections
Causes of Short Stature:

-Familial
-Constitutional
-Chromosomal disorders such as Down's syndrome and Turner's syndrome
-Endocrine disorders such as hypopituitarism and hypothyroidism
-Undernutrition
-Chronic systemic disorders
-Psychosocial conditions
-Skeletal dysplasias such as achondroplasia
-Children born small for gestational age.

#Pediatrics
What is Normal Stature?

-The height or length is between 3rd and 97th percentile for age, sex, region and race .

#Pediatrics
What is Short Stature?

-The height or length is below third percentile or less than two standard deviations below the mean for the age, sex, region and race.

#Pediatrics
What is Tall Stature?

-The length or height is above 97th percentile or two standard deviations above the mean for normal population of same age, sex, region and race.

#Pediatrics
Causes for tall stature:

-Constitutional
-Cerebral gigantism
-Marfan's syndrome
-Sexual precocity
-Beckwith-Wiedemann syndrome.

#Pediatrics
Remember:

-Primary microcephaly is present since birth and the causes are inherited.


-Secondary microcephaly occurs due to an insult to the growing brain, which results in deceleration or arrest of brain growth.

#Pediatrics
Brachycephaly is seen in:

• Apert's syndrome
• Carpenter's syndrome
• Crouzon's syndrome
• Down's syndrome.

#Pediatrics
Investigations of choice.

#Surgery
Severe perinatal asphyxia criteria according to American academy:

1. Apgar score <4 for 5minutes
2. Umblical artery PH<7
3. Neurological disorder as seizures
4. Multiorgan disorders.

#Pediatrics
Glasgow coma scale in children and infants.

#Pediatrics
Causes of death in Marasmus:

1-Severe hypoglycemia
2-Shock "septic or dehydration"
3-Dehydration and electrolytes disturbance
4-Heart failure
5-Hypothermia
6-DIC
7-Infections especially pneumonia.


#Pediatrics
-The most common viruses causing meningitis are enteroviruses and parechoviruses.

#Pediatrics
-The term aseptic meningitis principally refers to viral meningitis, but meningitis with negative cerebrospinal fluid (CSF) bacterial cultures may be seen with other infectious organisms (Lyme disease, syphilis, tuberculosis).

#Pediatrics
Remember:

-In older children, S. pneumoniae and N. meningitidis remain the most common causes of bacterial meningitis.

-Staphylococcal meningitis primarily occurs after neurosurgery or penetrating head trauma.

#Pediatrics
-Rapid onset is typical of infections with S. pneumoniae and N. meningitidis.

#Pediatrics
Partially treated bacterial meningitis:

Pressure:
Normal or elevated1-10,000;
Cells:
PMNs usual but mononuclear cells may predominate if pretreated for extended period
Protein:
>100 mg/dl
Glucose:
Depressed or normal

Organisms may be seen; pre treatment may render CSF sterile but bacteria may be detected by PCR.


#Pediatrics