Download STATE MEDICAL AND PHARMACEUTICAL UNIVERSITY

MINISTRY OF HEALTH
STATE UNIVERSITY OF MEDICINE AND PHARMACY
«NICOLAE TESTEMIŢANU»
Approved
by the Council of Medicine Faculty No. 2
Meeting Protocol No.__ from _________
Dean of Medicine Faculty No.2
Professor, PhD_________ M. Gavriliuc
Approved
at the meeting of Infectious diseases CEMPh
Meeting Protocol No.__ from _________
Head of Infectious diseases CEMPh
Professor, PhD_________ V.Pântea
ANALYTICAL PROGRAM // Syllabus
Name of the course: Infectious diseases of children
Code of the course: S.11.O.098
Type of the course: mandatory
Total number of academic hours – 70 hours
Inclusively courses - 20, practical seminars – 50
Number of credits offered for course completion: 3
Names of lectures authors:
Associated professor Tatiana Alexeev
Assistant professor Tatiana Juravliov
Chişinău 2011
Explanatory note
Infectious diseases have a great importance in the structure of the general
morbidity and children mortality.
Nowadays the majority of children with acute infectious diseases may be treated at
home and the doctor is obliged to establish as soon as possible the write diagnosis, to
prescribe a correct treatment regimen, to assure if necessary the emergency medical
assistance, to organize prevention measures in the epidemic place, etc.
The aim of the Department Children’s Infectious Diseases activity is the training
of doctors in order to assure good knowledge in the field of modern diagnosis, therapy
and prevention procedures for infectious diseases at children.
The training process will cover and epidemiological aspects of these diseases.
This program will cover also a series of important problems within this field that
are faced by students of VI year, after their familiarization with infectious diseases of
adults, and our department will specify particular clinical and evolution features of
infectious diseases in children according to the age and differential diagnosis.
The student must have following knowledge:
1. Early diagnosis of infectious diseases of children
2. Clinical features, disease evolution, complications and particularities
according to the age. Infectious diseases consequences at children.
3. Clinical symptoms of the cranial nerves affection.
4. Indications for hospitalization and rules for patient’s transportation in
case of infectious diseases.
5. Laboratory diagnosis and treatment of infectious disease in home
conditions (isolation, therapy regimen, diet, prescription’s fill in).
6. Clinical symptoms and laboratory tests of cerebral spinal fluid in
viral and bacterial meningitis.
7. To perform a treatment plan for children with infectious diseases.
8. To perform a plan of emergency medical measures at the prehospital
level of medical assistance in case of:
 Meningococcal infection;
 Meningitis, meningoencephalitis;
 Toxic scarlet fever.
9. To give medical emergent help to children with:
 Toxic-infectious shock;
 Acute cerebral edema.
10. Diet and hygienic regimen of patients with infectious diseases.
11. Criteria for admission to the institutions for children
(kindergartens, schools).
12. The survey in dynamics of children with infectious diseases and
their follow-up.
13. Immunization and prophylaxis of infectious diseases at children
(national schedule of immunization).
The student must possess following practical skills:
1. To perform an examination of a child with infectious diseases;
2. To establish and motivate the early diagnosis of infectious diseases at
children;
3. To perform a plan of medical care at home in case of a patient with
infectious disease;
4. To interpret the blood analysis at children with infectious diseases
according to the age;
5. Organization of a correct transportation to the hospital of the child
with infectious disease;
6. Isolation and treatment at home of a patient with infectious disease;
7. To perform a plan of laboratory examination of children infectious
diseases and to mention basic (specific) diagnostic methods;
8. To characterize the rush in different infectious exanthematous
diseases;
9. To characterize changes in the pharynx in different infectious
diseases with angina syndrome;
10. To collect emetic masses, fecal material, urine and blood for
bacteriological exam;
11. The gastric lavage method at children;
12. To appreciate the presence and the degree of dehydration at infants
and small children in acute infectious gastroenteritis;
13. The stool characteristics at patients with acute infectious
gastroenteritis and viral hepatitis;
14. Treatment and oral rehydration (plan A, B, C);
15. Qualitative laboratory test to exam biliary pigments in urine;
16. The appreciation of jaundice degree in viral hepatitis;
17. The examination of the abdomen, liver and spleen;
18. Meningeal symptoms at children;
19. To interpret correct the results of laboratory exams, CSF,
bacteriological and virusological test of the blood, serological tests
(complement fixation – CF, hemagglutination inhibition – HI,
enzyme-linked immunosorbent assay – ELISA, polymerization
chain reaction – PCR, neutralization reaction - NR) of
nasopharyngeal eliminations, exam of intestinal bacterial colonies.
The student must know following:
1.
2.
3.
4.
5.
Specific features of infectious diseases agents at children;
Morbidity by infectious diseases at children;
Pathogenesis and pathology of infectious diseases;
Principles and modern methods of infectious diseases diagnosis;
Principles of specific therapy of infectious diseases (therapy with
serums, immunotherapy);
6. Principles of antibiotic therapy in infectious diseases;
7. Principles of prevention and control of infectious diseases.
Epidemiologic methods in the place of epidemic eruption;
8. Rules of behavior in patient’s room;
9. Principles to fill in clinical files of patients with infectious diseases;
10.Structure, functions, anatomic and physiological features of SNC,
respirator and digestive tract, and other systems at infants and small
children;
11.Specific features of infectious diseases at adults;
12.Indications, techniques and clinical interpreting of lumbar puncture.
13.Treat the child’s with acute intestinal infections and acute respiratory
viral infections
14.Complications in infectious diseases at children
15.Criteria of hospitalizations in infectious diseases at children
16.Laboratory findings in infectious diseases at children
STATE MEDICAL AND PHARMACEUTICAL UNIVERSITY
“Nicolae Testemitanu”
DEPARTMENT CHILDREN’S INFECTIOUS DISEASES
The Plan
of Lectures for students of VIth university year
Faculty of General Medicine (XIth half-year)
2011-2012
THE NAME OF THE SUBJECT
Number of
hours
1.
Streptococcal infection in children. Scarlet
fever.
2
2.
Diphtheria.
2
3.
Measles (rubeola). Rubella.
2
4.
Specific features of influenza and acute
respiratory infections at children.
2
5.
Mumps (epidemic parotitis).
2
6.
Meningococcal infection at children.
2
7.
Pertussis (whooping cough). Parapertussis.
1
№
8.
9.
10.
Herpesvirus infections (Chickenpox,
Herpes Zoster, Herpes simplex).
Acute Intestinal Infections in children.
Salmonellosis, Shigellosis, Escherichiosis.
Differential diagnosis. Treatment in Acute
Intestinal Infections in children. Syndrome
of dehydration.
Acute viral hepatitis at children.
Fulminating hepatitis.
TOTAL
Chief of the Department,
Professor PhD
2
2
2
Lecturer
T.Alexeev
T.Juravliov
T.Alexeev
T.Juravliov
T.Alexeev
T.Juravliov
T.Alexeev
T.Juravliov
T. Alexeev
T. Juravliov
T. Alexeev
T. Juravliov
T. Alexeev
T. Juravliov
T. Alexeev
T. Juravliov
T.Alexeev
T.Juravliov
T.Alexeev
T.Juravliov
20
V.Pântea
STATE MEDICAL AND PHARMACEUTICAL UNIVERSITY
“Nicolae Testemitanu”
DEPARTMENT CHILDREN’S INFECTIOUS DISEASES
The Plan
of subjects for Practical work-sessions for students of VIth university year
Faculty of General Medicine (XIth half-year)
2011-2012
№
Number
of hours
THE NAME OF THE SUBJECT
Rules of admission to the hospital, distribution to the rooms and discharge
1. of children with infectious diseases. Files and documentation.
Case presentation.
Acute Intestinal Infections at children. Salmonellosis, Shigellosis,
2. Escherichiosis.
Treatment of acute gastroenteritis at children. Syndrome of dehydration,
3. pathogenesis, clinical manifestations, diagnosis and treatment. Oral
rehydration.
Acute viral hepatitis A at children. Peculiarities of evolution. Clinical
4. forms. Diagnosis. Differential diagnosis. Treatment.
Enteroviral infections (non-poliomyelitis).
3
2
6
4
2
5. Poliomyelitis.
4
6. Diphtheria. Mumps.
5
7. Meningococcal infection at children.
5
8. Influenza and acute respiratory infections.
5
Herpesvirus infections (Chickenpox, Herpes Zoster, Herpes simplex).
9. Pertussis (whooping cough).
Scarlet fever.
4
10. Measles . Rubeolla.
5
11. Practical skills.
5
TOTAL
Chief of the Department,
Professor PhD
50
V.Pântea
UNFOLDED DISCIPLINE PROGRAM
1. Streptococcal infection.
Scarlet fever. Etiology. Specific epidemiology features. Clinical forms. Erysipelas
at children. Evolution. Complications. Atypical forms. Differential diagnosis.
Treatment at home and at the hospital. Indications for hospitalization. Prevention.
Finding and treatment of patients with angina. Prevention and measures necessary
to be taken in the epidemic area.
2. Diphtheria.
Disease history, successes achieved in the research, prevention and treatment of
this disease. Specific epidemiology features of diphtheria nowadays. Etiology.
Pathogenesis. Clinical forms. Clinical manifestations of angina in diphtheria, nasal
diphtheria, croup in diphtheria, etc. Classification of pharyngeal diphtheria and
characteristics of local forms, toxic forms. Evolution. Complications. Diagnosis.
Differential diagnosis. Treatment (specific and non-specific). Specific prevention.
Measures necessary to be taken in the epidemic area.
3. Measles (rubella). Rubella.
Measles (rubella) at the stage of infection liquidation. Etiology. Pathogenesis.
Specific epidemiology features. Clinical manifestations in typical forms, mitigate
at children and adults and vaccinated people. Complications. Diagnosis.
Differential diagnosis with scarlet fever, rubella, acute respiratory viral infections,
allergic statements, etc. Treatment. Specific prevention. Measures necessary to be
taken in the epidemic area. Rubella. Etiology. Pathogenesis. Clinical
manifestations. Acquired rubella. Diagnosis. Prevention. Congenital rubella
(embriopathy).
4. Mumps (epidemic parotitis).
Etiology. Pathogenesis. Specific epidemiology features. Clinical forms. Clinical
manifestations, diagnosis in different clinical forms (parotitis, submaxilitis,
meningitis, meningoencephalitis, orchitis, pancreatitis). Specific features in adults.
Evolution. Complications, outcomes. Differential diagnosis and treatment
according to clinical forms. Prevention. Measures necessary to be taken in the
epidemic area.
5. Pertussis (whooping cough).
Etiology. Pathogenesis. Specific epidemiology features. Clinical manifestations in
different stages of the disease. Clinical forms. Criteria of disease severity. Specific
features at new-borns and infants, vaccinated children and adults. Parapertussis.
Clinical manifestations. Complications. Diagnosis. Differential diagnosis.
Treatment. Prevention.
6. Meningococcal infection at children.
Etiology. Pathogenesis. Clinical forms. Clinical manifestations in local and
generalized forms (meningitis, meningococcemia). Evolution. Emergency
statements: toxic-infectious shock of I, II, III degree of severity, cerebral edema,
intracranial hypotension. Evolution. Complications, outcomes. Treatment.
Emergency medical assistance at home. Measures necessary to be taken in the
epidemic area.
7. Influenza and acute respiratory viral infections at children.
The role of viral infections in pediatric morbidity. Etiology and pathogenesis in
different viral infections. Diagnosis. Treatment.
a) Influenza. Specific clinical manifestations at children. Clinical syndromes.
Criteria of severity. Evolution, complications. Influenza at new-borns and
infants. Pathogenesis. Clinical manifestations. Diagnosis. Treatment.
b) Parainfluenza. Clinical manifestations. Croup syndrome in influenza and
Parainfluenza. Diagnosis. Treatment of the croup according to the stenosis
degree at home. Complications.
c) Adenoviral infections. Specific epidemiology features. Clinical forms. Clinical
manifestations in pharyngeal-conjunctival fever and other forms. Evolution.
Complications. Specific clinical and evolution features at infants. Diagnosis.
d) Specific features of the infection with respiratory syncytial virus. Obstruction
syndrome. RS-infection at premature and new-borns.
8. Herpesvirus infections.
Etiology, pathogenesis and clinical manifestations of primary, latent and relapsing
herpesvirus infection. Varicella. Etiology and pathogenesis. Clinical forms,
clinical manifestations and evolution. Herpes Zoster, Herpes simplex. Specific
clinical and evolution features at new-borns and infants. Diagnosis. Treatment at
home and hospital. Prevention.
9. Acute gastroenteritis at children.
The role of intestinal infections in children morbidity at different age. Bacterial
dysentery. Etiology and pathogenesis. Clinical manifestations. Clinical forms,
criteria of severity. Evolution. Specific clinical features at new-borns and infants.
Diagnosis. Treatment at home and hospital. Prevention.
Acute diarrhea with Escherichia coli.
Etiology and pathogenesis. Clinical forms. Evolution of acute diarrhea caused by
ECEP. Diarrheic and toxic syndromes. Dehydration. Diagnosis. Specific features
at new-borns. Treatment of acute diarrhea according to WHO recommendations.
Acute diarrhea with Salmonella.
Etiology and pathogenesis. Clinical forms. Epidemiology. Clinical manifestations,
evolution according to the age and ways of contamination. Specific features at
new-borns and infants. Nosocomial infection. Generalized salmonellosis.
Diagnosis. Treatment. Prevention.
10.Acute gastroenteritis caused by conditional pathogen bacteria and viruses.
Intestinal dysbiosis.
Characterization and classification of enterobacteria and other conditional
pathogen agents. Definition of intestinal dysbiosis as disease, physiologic norms.
Etiology and pathogenesis. Clinical manifestations in acute diarrhea caused by
Proteus, Klebsiella, Staphylococcus, Campylobacter, Yersinia and Rotaviruses.
Intestinal dysbiosis, diagnosis. Treatment. Prevention.
11.Treatment of acute gastroenteritis at children.
Dehydration syndrome, pathogenesis, clinical manifestations, diagnosis.
Treatment. Oral rehydration. Indications and basic principles of infusion therapy.
12.Acute viral hepatitis (A, B, C, D) at children.
Etiology and pathogenesis. Epidemiology. Clinical manifestations. Evolution.
Primary viral hepatitis (A,B,C,D) at children. Clinical forms. Criteria of the
severity degree. Complications. Specific features at new-borns and infants.
Congenital hepatitis. Fulminating hepatitis, evolution. Diagnosis, differential
diagnosis. Treatment. Prevention.
13.Enteroviral infections and poliomyelitis at children.
Etiology. The role of scientific research in study and prevention of poliomyelitis.
Pathogenesis. Clinical manifestations of paralytic and non-paralytic forms in
poliomyelitis. Diagnosis. Prognosis. Outcomes. Treatment. Prevention. Enteroviral
infections with ECHO and Coxsackie viruses. Etiology and pathogenesis. Clinical
forms. Clinical manifestations. Specific features of CSF in enteroviral meningitis.
Diagnosis. Differential diagnosis of different forms of enteroviral infections.
Treatment. Prevention.
Optional subjects
1. Infectious mononucleosis.
Etiology, pathogenesis, epidemiology. Clinical forms. Criteria of severity.
Evolution, complications, outcomes. Specific features at infants. Diagnosis.
Differential diagnosis. Treatment. Prevention.
2. Cytomegalovirus infection.
Etiology, pathogenesis, epidemiology. The way of spread of disease (by
direct contact, transplacentar, by injections, by food). Clinical
manifestations. Clinical forms. Specific features in acquired and congenital
cytomegalovirus infection. Early diagnosis at new-borns and infants.
Diagnosis. Differential diagnosis. Evolution. Treatment. Prevention.
DEPARTMENT CHILDREN’S INFECTIOUS DISEASES
Practical skills for students of VIth university year
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Bacteriological test in Diphtheria, Pertussis, Meningococcal Infection.
Bacteriological test in Salmonellosis, Shigellosis, Escherichiosis.
Immunofluorescent test in respiratory viral infections, acute diarrhea (technique,
importance).
Blood cultures in infectious diseases. Technique, indications, clinical
interpretation.
Technique of “thick drop” of the blood. Indications.
Lumbar puncture. Indications. Technique. Clinical interpretation of CSF.
Coprological test, clinical interpretation.
Serological tests in infectious diseases at children.
Gastric lavage. Indications, technique, bacteriological test results.
Examination of the patient in acute infectious disease (viral hepatitis, rubella,
mumps, etc.)
Interpretation the results of the blood tests in infectious diseases in children.
Endovenous perfusions, indications, technique, fluids, complications.
Criteria of hospitalizations in infectious diseases in children.
Indications for discharge for patients with acute gastroenteritis, air ways
infections, viral hepatitis.
Diet and hygienic regimen for patient with infectious diseases (meningitis,
mumps, diphtheria, viral hepatitis).
Treatment of acute infectious diseases (medical prescriptions, regimen, diet).
Follow-up of children after infectious diseases (hepatitis, salmonellosis,
meningitis). Documentation.
Immunization and prophylaxis of infectious diseases at children (national
schedule of immunization).
Rehydration of children with acute diarrhea (indications, technique).
Emergency medical assistance in case of acute cerebral edema, toxic-infectious
shock, seizures, hyperthermia, food toxic-infection.
LITERATURE
1. Richard E., Behrman M.D., Robert Kliegman, M.D. Essentials of pediatrics.
2. Swapan K. Nath, Sanjay G. Revankar. Problem-Based Microbiology.2006.
3. Red Book.Report of the Coomittee on Infectious Diseases. American Academy of
Pediatrics. 26th Edition, 2003.
4. A.M.Mikhailova, I.P.Mincov, A.I.Savchuk “Infectious Diseases in Children”,
Odessa, 2003.
5. HIV Infection. A Clinical Overview of HIV Disease and, Related Diagnosis,
Treatment, and Prevention. A Training Manual for HIV/AIDS Elective Course
for International Medical Students. Moscow, 2010.
6. Integrated Management of Childhood Illness (IMCI). Handbook. World Health
Organization, 2000.
7. Integrated Management of Childhood Illness (IMCI). Technical seminars.
World Health Organization, 2000.
8. Nick Y.Beeching F.Y.Nye Mosby-Volfo Diagnostic picture tests in Clinical
Infectious Disease, 2000.
9. Harison's Infectious diseases, 2010