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Chapter 20
Childhood Diseases and Disorders
Copyright © 2015 Cengage Learning®.
Infectious Diseases
• Four categories:
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Viral
Bacterial
Fungal
Parasitic
• Some infections can be prevented by
immunization
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Infectious Diseases
• Many have incubation period
• Symptoms:
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Fever
Malaise
Coughing
Anorexia
Nausea and vomiting
Rash
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Infectious Diseases
• Treatment varies with the disease
• Often consists of:
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Symptom relief
Good nutrition
Rest
Nonaspirin antipyretics
Good hand washing
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Viral Diseases
• Usually symptomatic treatment
• Invade host and can lay dormant
• Reactivated by certain triggers such as
stress
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Viral Diseases
• Measles
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Also known as rubeola
One of the most serious childhood diseases
Commonly spread by contaminated airborne droplets
Symptoms:
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Fever
Runny nose
Red maculopapular rash
Koplik’s spots
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Measles/Rubeola
Photo courtesy the Centers for Disease
Control and Prevention
Copyright © 2015 Cengage Learning®.
Koplik’s Spots
Photo courtesy the Centers for Disease
Control and Prevention
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Viral Diseases
• Rubella
– Type of measles
• Also known as German measles
• In pregnant women may lead to birth defects
• Less contagious than rubeola
– Symptoms:
• Lymph node enlargement, nasal discharge, joint pain, chills,
fever
– Children and women of childbearing age should be
immunized
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Rubella Rash
Photo courtesy the Centers for Disease
Control and Prevention
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Viral Diseases
• Mumps
– Inflammation of parotid glands
– Symptoms:
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Chills
Fever
Ear pain
Swelling of parotid glands
– Complication:
• Orchitis and nerve conduction deafness
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Mumps
Photo courtesy the Centers for Disease
Control and Prevention
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Viral Diseases
• Varicella
– Also known as chickenpox or herpes zoster
– Highly contagious
– Symptoms:
• Classic rash that develops into vesicles
• Rash on face, trunk, and extremities
• Poliomyelitis
– Causes:
• Polio virus
– Immunization has reduced threat of disease
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Varicella
Photo courtesy Robert A. Silverman, MD,
Pediatric Dermatology, Georgetown University
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Viral Diseases
• Influenza
– Acute infectious respiratory disease
– Occurs late fall through early spring
– Symptoms:
• Sudden high fever
• Dry, hacking cough
• Chills, headache, joint or muscle aches
– Prevention:
• Vaccination
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Viral Diseases
• Common cold
– Most frequently occurring disease
– Causes:
• Rhinovirus
– Prevention:
• Good hand washing
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Viral Diseases
• Mononucleosis
– Primarily affects children and young adults
– Causes:
• Epstein-Barr virus
– Symptoms:
• Fatigue, sore throat, fever, swollen lymph glands
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Viral Diseases
• AIDS
(covered in detail in Chapter 5)
• Has now affected thousands of children
• Cause:
– HIV
• Most cases result from maternal–fetal transfer
• Children suffer symptoms and often are orphaned
• Treatment:
– Treatment focuses on prevention
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Bacterial Diseases
• Causes:
– Pathogens
• E.g., Staphylococcus, Streptococcus, Haemophilus,
Clostridium
• Symptoms:
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Cough
Fever
Headache
Difficulty breathing
Sore throat
• Treatment based on causative agent
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Bacterial Diseases
• Pertussis
– Also known as whooping cough
– Symptoms:
• Catarrhal
• Paroxysmal spasm
• Violent whooping coughing
• Diphtheria
– Severe inflammation of respiratory system
– Was a leading cause of death in children
– Rarely seen now due to vaccination
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Bacterial Diseases
• Tuberculosis
– Most commonly affects the respiratory system
• But can be systemic to bone, brain, lymph nodes
– Increasing number of cases in children
• Tularemia
– Also known as rabbit fever
– Transmitted by bite of infected insect or direct contact
with infected animal
– Prevention is avoiding tick bites
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Bacterial Diseases
• Impetigo
– Contagious superficial pyoderma
– Causes:
• Staphylococcus
• Group A Streptococcus
– Prevention:
• Good hand washing
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Bacterial Diseases
• Acute tonsillitis
– Infection of palatine tonsils located on posterior wall
of nasopharynx
– Cause:
• Commonly group A beta-hemolytic streptococci
– Symptoms:
• Sore throat
• Enlarged tonsils
– Treatment:
• Antibiotics
• Tonsillectomy
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Bacterial Diseases
• Otitis media
– Acute bacterial infection of middle ear
– Untreated, chronic infection develops
– Symptoms:
• Pain, fever, ear drainage
– Treatment:
• Antibiotics
• Myringotomy with tympanoplasty
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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
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Fungal Diseases
• Candidiasis
– Also known as a yeast infection
• Common in infants’ mouths and called thrush
• In diaper area, called diaper rash
– Cause:
• Oral fungal infection
– Prevention:
• Thrush can be prevented by breast feeding; common in
infants
• Diaper rash treated by keeping the area clean and dry
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Fungal Diseases
• Tinea
(discussed in detail in Chapter 18)
– Also known as ringworm
– Group of diseases
• Tinea capitis
– Scalp
• Tinea pedis
– Feet
• Tinea cruris
– Groin and scrotum
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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
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Parasitic Diseases
• Giardiasis
– Infection by caused by protozoa called Giardia
lamblia
– Young children are most often affected
– Protozoa lodge in lining of the small intestine
– Symptoms:
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Diarrhea
Nausea
Cramping
Flatulence
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Parasitic Diseases
• Pediculosis
– Infestation with lice
– Transmitted human to human by direct contact
– Nits
• Lice eggs
– Epidemic among school children
– Treatment with permethrin (more information in
Chapter 18)
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Parasitic Diseases
• Pinworms
– Parasitic nematodes that infect intestines and rectum
– Transmitted by ingestion or inhalation of eggs
– Symptoms:
• Anal itching; worms appear as tiny white threads
• Roundworms
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Found in soil
Parasites lodge in intestines
Spread by hand-to-mouth activity
Absorb nutrients from host
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Respiratory Diseases
• Most common childhood diseases seen by
physicians
– Children very vulnerable due to continuous person-toperson contact
• Infants most susceptible
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Respiratory Diseases
• Sudden infant death syndrome (SIDS)
– Abrupt, unexplained death of infant under age 1
– Symptom:
• Only symptom is death of unknown cause in an infant
• Croup (laryngotracheobronchitis)
– Upper respiratory infection
– Affects children ages 3 months to 3 years
– Symptoms:
• Inspiratory stridor
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Respiratory Diseases
• Adenoid hyperplasia
– Enlargement of pharyngeal tonsils
– May require adenoidectomy
• Asthma
– Serious chronic respiratory disease in children
– Symptoms:
• Acute coughing, wheezing, shortness of breath
– Cause:
• Unknown
– Triggers: Stimuli that cause attack
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Respiratory Diseases
• Pneumonia
– Infection of lung parenchyma
– Symptoms:
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Cough
Fever
Wheezing
Malaise
– Treatment:
• Antibiotics if bacterial
• If viral, runs course in 5-7 days
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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
• May be caused by vomiting and diarrhea
• Colic is a common symptom of digestive problems
– Gastrointestinal pain, crying, irritability
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Digestive Diseases
• Fluid imbalances
– Vomiting or diarrhea can be serious
– Dehydration
• Life-threatening in children
• Food allergies
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Most often in children under age 1
Most common allergies are cow’s milk and eggs
Many disappear after age 5
If allergy develops after age 3, it usually continues
into adult life
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Digestive Diseases
• Eating disorders
– Major problem among children
• Especially adolescent females
– Most common types:
• Anorexia nervosa
• Bulimia
(discussed in detail in Chapter 21)
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Cardiovascular Diseases
• Most cardiovascular diseases in children
are related to genetic or developmental
disorders (discussed in detail in Chapter 19)
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Musculoskeletal Diseases
• Common in children due to high activity
level
• Range from soft tissue injuries and
fractures to joint and bone deformities or
degenerative muscle disorders
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Musculoskeletal Diseases
• Legg-Calvé-Perthes (LCP)
– Avascular necrosis of upper end of femur
– Causes changes in bone growth
– Untreated, it may lead to permanent deformity
• Ewing’s sarcoma
– Malignant neoplasm occurring before age 20
• Usually in long bones
– More common in males
– Quickly metastatic and highly malignant
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Blood Diseases
• Leukemia
– Malignancy of blood-forming cells in bone marrow
– Most common disorder of blood and blood-forming
organs in children
– Symptoms:
• Pallor, bleeding or bruising, fatigue, joint/bone/abdominal
pain
– Treatment:
• Among the most curable diseases of childhood cancers
• Chemotherapy
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Neurologic Diseases
• Reye’s syndrome
– Acute encephalopathy in children under age 15 who
have had viral infection
– Cause:
• Unknown, there is a relationship between the disease and
use of aspirin for febrile illnesses in children
– Symptoms:
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Nausea and vomiting
Liver enlargement
Lethargy
Seizures, coma, and in many cases death
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Eye and Ear Diseases
• Have profound effects on child’s ability to
learn and develop
• Strabismus
– Lazy or cross-eye
• Deafness
– Causes:
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Genes
Trauma
Infections
Exposure to ototoxic drugs
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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
• Suicide
– Third leading cause of death among young people
– Prevention
• Early intervention most important
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Trauma
• Drug abuse
– Illicit drug, alcohol, and tobacco use
– Epidemic problem among children
• Especially adolescents
• 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
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