Measles
History:
- 3Cs (conjunctivitis, cough, coryza)
- Rash behind ears → face → toes
- Koplik spot
- measles immunisation history
- contact with suspicious case
immediate action
- notify the local health department /community disease centre
- isolation of the child
- take blood for measles serology
- discuss nasal swab for Measles PCR with department of health
- paracetamol fever
Osgood Schlatter disorder
C/F:
Pain on ant lower knee
Worse when active
limping
O/E
Pain when flex knee against resistance
Tender on tubercle tuberosity
Mx: Self limiting ICE pack NSAIDs (can cause harm) Paracetamol Quadriceps strengthening exercise + modified activity (not full rest)
croup (laryngotracheobronchitis)
Parainfluenza virus but rarely RSV, influenza A and B
Epidemiology:
3 months - 6 years of age
C/F
Barking cough
Inspiratory stridor (in acute epiglottitis → expiratory stridor)
Fever 38-39
Sing of severity (stridor at rest, tracheal tug)
Chest X-ray: (not needed)
Steeple sign: subglottic narrowing
Mx: Coal, warm steam Minimal handling (limited examination) Prednisolone PO 1mg/Kg repeat in 12 or 24 hours Adrenaline nebuliser (5 ml of 1:1000)
Kawasaki disease (muco-cutaneous- LN)
C/F
- Age < 5 years + fever > 5 days +
- Bilateral conjunctivitis
- Intra-oral erythema
- Skin rash
- LAP
- Swelling of hands and feet
Complication
- Myocarditis/pericarditis
- Coronary a. Aneurysm
- meningitis
Ix:
- High ESR, CRP
- Thrombocytosis (platelet high)
- Echo
Treatment
1. IVIg within 1st 10 days
2. Prednisolone 2mg/Kg for 5/7: until CRP is normal
3. Aspirin 5mg/Kg for 6/52: until normal Echo
Complication: Reye syndrome
(the only condition to use ASPIRIN in children)
Follow up
- Echo every 5 years
Transient lactose intolerance
C/F
Profuse, explosive diarrhoea after drinking milk
usually happens after gastroenteritis
Treatment:
- Lactose-free diet for 2-4 weeks (milk formula, cheese, yoghurt, ice-cream)
- Then introduce lactose gradually
- Soy milk (lactose-free) is the best to be given
