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Case Based Reviews in Pediatric Pulmonology

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Muhammad Rizal Adriyansyah
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796 views8 pages

Case Based Reviews in Pediatric Pulmonology

Uploaded by

Muhammad Rizal Adriyansyah
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF or read online on Scribd
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z oe e =i = S 6 4 Editors Case Based Reviews in Pediatric Pulmonology ma ara Kana Ram Jat Jhuma Sankar Rakesh Lodha Sushil K Kabra Case Based Reviews in Pediatric Pulmonology Editors Kana Ram Jat MoFcce MAMS Assistant Professor Department of Pediatrics Alina institute of Medical Sciences ‘New Delhi, India Jhuma Sankar Mo. Asustant Professor Department of Pediatrics AllIndia institute of Medical Sciences ‘New Delhi, India Rakesh Lodha mo Additional Professor Departmant of Pediatrics Allindia institute of Medical Sciences ‘New Delhi India Sushil K Kabra Moons Professor Department of Pediatrics Alllndie Institute of Medical Sciences "New Delhi India The Health Sciences Publisher ‘New Deth | London | Panama x Pre HEE scion Several bacteria and viruses cause tonsil- lopharrgt Acie nt Mi epmnosin 4 tee Gatneneet ext ce import cre pathogen Other sepooce tiyroupCandGArcabacerianfue motu, I promi ameratic tose et can feuse tnallopharyegis."Corynebacerirs diphtheriae causing membranous _pharyn- gitis can be life-threatening but thankfully fas becuca rare dus 6 ciphers peru fd teats seks (DP) immniaton Wrsse ae by me oe cece co uw See Wee Tied chica recoprable hms of Pinot eg. herpanginn and. hand fo Thou duce cased by Conecte nts pharegnceeaoctl lve by adonortun eed cl grghesomae by hepa soplot Ti. moiiee | ol stewiveaes count for apprsimacly 20% cach o al al Dharyngtis. Va tnsllopharghs sel Tinting aad eke spontaneous aly Tending ompoatons Disorders of Upper Respiratory Tract CASE2 AN eyaacold boy presented with tc of fever ‘host pin fr nt 4 cays. He bad generated ash, Speprana and deceased food ise for 2 <3 ‘On exrrination he ha titel esl erlsge rent th esudites and congested phar and “nteorcerdcllymphrodeserlagerene The child ac mecutr rash ecarberform) 6 2 ‘igure 2 Seaatnform ash after pata improvement (Foran vesion se Pla 1) ‘0: Whats the likely diagnosis? [As mentioned above, absence of symptoms of ‘coryza and presence of exudates and enlarged anterior cervical Iymplt nodes make the diag wosis of bacterial tonsils very likely, Ahough sxantematons rash penal its the diagnos {owatda Viral etiology, typical rash ofscatet ever is the hallmark of GABHS ‘The ash appears 2-4 days alter the onset of fever ‘and has rough “sandpaper” like feel and fades ‘with characteristic desquamation, especially in the palms and around the fingers. ‘Q: Whats the importance of distin- ‘guishing GABHS from other etiologies? Group A p-hemolstic streptococcus tonsilitis js associated with seute rheumatic fever and rheumatic heart disease as well as acute pox streptococeal glomerulonephritis These poten: tially le-threatening complications can be voided by adequate treatment and elimination ofstreptococcalthronteartige.Inadditon, acute suppurative complications, like periconsillar abscess and systemic infections, make adequate treatment of GABHS infection essential CASES | shyear old ge beer and thot pa 0 ys ‘rate, Se had mil brkna te oF cough Tate darn 2 hinerhas andra wratering oe, (On examine, piste tris wer ented and jphayrs ma corgesties but hee were no excites fad petechae aver the False. Tongue was teri conde! hmph nodes were ey tnd ‘utrax mated staged Q:To treat or not to treat with antibiotics? Im clinical practice, there is 2 of symptoms and signs, and it is sometimes tunclear whether we are dealing with GABHS tonsilliis or not. When in doubt, it would be pprilent to wat and watch for a day or two, for ‘more features to evolve aver time, No harm is

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