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Chapter 20 Childhood Diseases and Disorders Copyright Copyright © 2010 © 2010 Delmar, Delmar, Cengage Cengage Learning. Learning. ALLALL RIGHTS RIGHTS RESERVED. RESERVED. Infectious Diseases • Four categories: – – – – Viral Bacterial Fungal Parasitic • Some infections can be prevented by immunization Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infectious Diseases • Many have incubation period • Symptoms: – – – – – – Fever Nausea and vomiting Malaise Cough Rash Anorexia nervosa Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Infectious Diseases • Varied treatment: – Good nutrition – Rest – Non-aspirin antipyretics Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Viral Diseases • Invade host and can lay dormant • Reactivated by certain triggers: – Stress – Illness – Trauma • Usually symptomatic treatment Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Viral Diseases • Measles – Also known as rubeola – Symptoms: • Koplik’s spots • Fever • Runny nose Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Viral Diseases • Rubella – Type of measles • Also known as German measles – Symptoms: • Rash – Mild in children – Serious in pregnant women Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Measles/Rubeola Photo courtesy Centers for Disease Control and Prevention Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Koplik’s Spots Photo courtesy Centers for Disease Control and Prevention Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Rubella Rash Photo courtesy Centers for Disease Control and Prevention Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Viral Diseases • Mumps – Inflammation of parotid glands – Symptoms: • • • • Chills Fever Ear pain Swelling of parotid glands Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Viral Diseases • Mumps – Complication: • Orchitis and nerve conduction deafness Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mumps Photo courtesy Centers for Disease Control and Prevention Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Viral Diseases • Varicella – Also known as chickenpox or herpes zoster – Symptoms: • Rash that develops into vesicles • Poliomyelitis – Causes: • Polio virus – Immunization has reduced threat of disease Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Varicella Photo courtesy Robert A. Silverman, MD, Pediatric Dermatology, Georgetown University Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Viral Diseases • Influenza – Acute infectious respiratory disease – Many types – Prevention: • Vaccination Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Viral Diseases • Common cold – Causes: • Rhinovirus – Prevention: • Good handwashing Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Viral Diseases • Mononucleosis – Also known as kissing disease – Causes: • Epstein-Barr virus • AIDS – Causes: • HIV • Most cases result from maternal-fetal transfer Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Bacterial Diseases • Causes: – Pathogens • E.g., staphylococcus, streptococcus, haemophilus, clostridium • Symptoms: – Fever – Cough Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Bacterial Diseases • Symptoms: – Headache – Difficulty breathing – Sore throat • Treatment based on causative agent Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Bacterial Diseases • Pertussis – Also known as whooping cough – Symptoms: • Paroxysmal • Violent coughing • Diphtheria – Severe inflammation of respiratory system – Rarely seen now due to vaccination Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Bacterial Diseases • Tuberculosis – Most commonly affects lungs • But can be systemic – Increasing number of cases in children • Tularemia – Also known as rabbit fever – Transmitted by bite of infected insect or direct contact with infected animal Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Bacterial Diseases • Impetigo – Dermatitis – Causes: • Staphylococcus • Group A streptococcus – Prevention: • Good handwashing Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Bacterial Diseases • Acute tonsillitis – Infection of palatine tonsils located on posterior wall of nasopharynx – Treatment: • Antibiotics • Tonsillectomy Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Impetigo Photo courtesy Robert A. Silverman, MD, Pediatric Dermatology, Georgetown University Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Bacterial Diseases • Otitis media – Acute bacterial infection of middle ear – Untreated, chronic infection develops – Symptoms: • Pain – Treatment: • Antibiotics • Myringotomy with tympanoplasty Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Fungal Diseases • Affect skin or mucous membranes in children – Sometimes more common in infants • Usually not severe – But irritating • May need medical attention to prevent spread Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Fungal Diseases • Candidiasis – Also known as thrush – Oral fungal infection – Common in infants Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Fungal Diseases • Tinea – Also known as ringworm – Group of diseases • Capitis – Scalp • Corporis – Body Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Fungal Diseases • Tinea – Group of diseases • Cruris – Groin and scrotum • Pedis – Feet Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parasitic Diseases • Caused by organism that feeds on another organism • Mostly found in places of poor nutrition, contaminated water, and low socioeconomic conditions • Only a few common in United States Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parasitic Diseases • Giardiasis – Infection by caused by protozoa – Symptoms: • • • • Diarrhea Nausea Cramping Flatulence Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parasitic Diseases • Giardiasis – Symptoms: • Fever • Anorexia nervosa Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parasitic Diseases • Pediculosis – Also known as lice – Nits • Lice eggs – Epidemic among school children Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parasitic Diseases • Pinworms – Parasitic nematodes that infect intestines and rectum – Transmitted by ingestion or inhalation of eggs • Roundworms – Parasites that lodge in intestines – Absorb nutrients from host Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Respiratory Diseases • Most common childhood diseases seen by physicians – Children very vulnerable due to continuous person-toperson contact • Infants most susceptible Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Respiratory Diseases • Sudden infant death syndrome (SIDS) – Abrupt, unexplained death of infant under age 1 – Prevention: • Place infants supine rather than prone in bed • Croup (laryngotracheobronchitis) – Affects children ages 3 months to 3 years – Symptoms: • Inspiratory stridor Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Respiratory Diseases • Adenoid hyperplasia – Enlargement of pharyngeal tonsils – May require adenoidectomy • Asthma – Serious chronic respiratory disease in children – Triggers: • Stimuli that cause attack Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Respiratory Diseases • Pneumonia – Inflammation of lung parenchyma – Symptoms: • • • • Cough Fever Wheezing Malaise Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Respiratory Diseases • Pneumonia – Treatment: • Antibiotics if bacterial Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Digestive Diseases • Children may experience serious development problems due to lack of appropriate ingestion, digestion, absorption, or elimination • Fluid and electrolyte imbalance frequently more severe in children Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Digestive Diseases • Fluid imbalances – Vomiting or diarrhea can be serious – Dehydration • Life-threatening in children • Food allergies – Many disappear after age 5 – Peanut allergies rising Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Digestive Diseases • Eating disorders – Major problem among children • Especially adolescent females – Most common types: • Anorexia nervosa • Bulimia Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Musculoskeletal Diseases • Common in children due to high activity level • Ranges from soft tissue injuries and fractures to joint and bone deformities or degenerative muscle disorders Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Musculoskeletal Diseases • Legg-Calvé-Perthes (LCP) – Avascular necrosis of upper end of femur – Causes changes in bone growth • Ewing’s sarcoma – Malignant neoplasm occurring before age 20 • Usually in long bones – More common in males Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Blood Diseases • Leukemia – Malignancy of blood-forming cells in bone marrow – Most common disorder of blood and blood-forming organs in children – Treatment: • Chemotherapy – Often curable in children Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Neurologic Diseases • Reye’s syndrome – Acute encephalopathy in children under age 15 who have had viral infection – Symptoms: • Nausea and vomiting • Liver enlargement • Lethargy Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Neurologic Diseases • Reye’s syndrome – Symptoms: • Seizures • Coma – Important prevention: • Avoid giving aspirin and products containing aspirin to children Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Eye and Ear Diseases • Have profound effects on child’s ability to learn and develop • Strabismus – Lazy or cross-eye Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Eye and Ear Diseases • Deafness – Causes: • • • • Genes Trauma Infections Exposure to ototoxic drugs Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma • Child abuse – Serious problem in United States – Often fatal – Emotional, physical, or sexual harm or neglect • Emotional abuse harder to diagnose than physical abuse • Sexual abuse occurring in epidemic proportions Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma • Suicide – Third leading cause of death among young people – Early intervention most important • Drug abuse – Illicit drug, alcohol, and tobacco use – Epidemic problem among children • Especially adolescents Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Trauma • Poisoning – Among top five causes of accidental death under age 10 – Most poisonings due to common substances found at home • E.g., cleaning products, medicines, plants Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Animation Click Here to Play Asthma in Child Animation Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Animation Click Here to Play Croup & Epiglottitis Animation Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.