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ACUTE PEDIATRIC INFECTION PATIENTS AT CENTRAL HOSPITAL

ACUTE PEDIATRIC INFECTION PATIENTS AT CENTRAL HOSPITAL. Helena Ruotsalainen. FEVER AND SEIZURES. anticonvulsants: per rectum diatzepam 0.5mg/kg ad 10mg;to buccal mucus midatzolamin 0.25mg/kg ad 10mg;iv loratzepam 0.1mg/kg ad 2mg Parasetamol 15mg/kgx1-4/d po, p.rect.,iv

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ACUTE PEDIATRIC INFECTION PATIENTS AT CENTRAL HOSPITAL

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  1. ACUTE PEDIATRIC INFECTION PATIENTS AT CENTRAL HOSPITAL Helena Ruotsalainen

  2. FEVER AND SEIZURES • anticonvulsants:per rectum diatzepam 0.5mg/kg ad 10mg;to buccal mucus midatzolamin 0.25mg/kg ad 10mg;iv loratzepam 0.1mg/kg ad 2mg • Parasetamol 15mg/kgx1-4/d po, p.rect.,iv • Lab:WBC,CRP,blood culture (glu, Ca)urine specimen, spinal tap, x-ray • Iv-connection : fluids, drugs

  3. F E V E R • Consciousness, reacts to speech, open eyes, movements? • Hypotension, saturation, pulse • Neck stiffness / floppy • Dislike of being handled • Respiration: tachypnea • Skin: purpura/ petecchia

  4. MENINGITIS Meningococcus ad 1/10 dies, pneumococcus Purpura, restlessness, head extension Spinal tap:white cell count, protein high, glu low, bacteria Th: iv-cephalosporin; iv penicillin+ gentamycin Dexametason 0,15mg/kg:4, furesis (?) Herpes encephalitis: iv-aciclovir

  5. FLUIDS (braininfection, septichemia) • Reduced fluids (75-80%) for avoiding brain odema but take also care of extra losses:fever, vomiting, diarrhea. • Follow up blood pressure, urine excretion (least 1ml/kg/h – 2-3ml/kg/h), weight • Viral meningitis: symptomatic care (fluids, pain killers for headache)

  6. RESPIRATORY INFECTIONS • Laryngitis: inspiratorystridor, barkingcough.Th:metylprednisolonpo/im, adrenalinim/inhalation • Bronchiolitis,bronchitis:wheezing,retractions.Th:symphatomimetic-inhalations, mucussuction • Whoopingcough(pertussis):apnoe, paroxysmalcough.4-6weeks.Th:eythromycin • Tonsillitis: penicillin, iv-fluids(difficulties to eat)

  7. P N E U M O N I A • Fever, cough, pain when breathing • Tachypnea 40-60 /min, low saturation • Auscultation:rales, silent • Lab: WBC, CRP, blood culture • Thx-x-ray: lobar, pleuritis, emphyema, tbx( upper lobes, hilar nodes) • Th:iv-penicillin, po ampicillin,azithromycin, cephalosporin,+gentamycin, iv-fluids

  8. G A S T R O E N T E R I T I S • Bacterial: salmonella, shigella (tourism), yersinia,campylobacter(soil,meat); enterohaemorrhagice.coli=EHEC (cattle, milk,water).Blood in stools, oligouria. Kidneyproblem. Intensiveward, dialysis. Butsometimesneeds no therapy.-Fluids (iv-ORS) • Viral:rota, adeno, entero, noro. Th: ORS 50-60 ml/kg 4-6t, then5ml/kg/everystool

  9. URINARY TRACT INFECTIONS Pyelonephritis ac: fever, nausea, vomitis, pain in kidneys, abdominal pain urine culture, microscopia, WBC, crp, krea th: cephalosporin, TMP-SMZ, iv-fluids? Lower urinary tract infections: dysuria, low fever th: po at primary ward

  10. SKIN, SOFT TISSUE, BONEINFECTIONS • Pemphigus (infants), impetigo,erysipelas • Lympadenitis, abscesses, cellulitis • Osteomyelitis, arthritis • cause: fromskininjuries / dryatopicskin;fromrespiratorytractbacteries • Th:cephalosporin,kloxacillin,klindamycin,penic localtherapy;insomecasessurgery

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