Most Common Pediatric Diseases and Treatment
Dengue
Dengue is a viral disease that not only affects babies and children but is also responsible for deaths in many cases.
The good news is that it can be prevented by proper awareness, little cleanliness, and avoiding mosquito bites.
How do children get dengue?
Dengue is a viral disease that is transmitted by Aedes mosquitos.
When an Aedes mosquito carrying the dengue virus bites a healthy child, the child gets infected by dengue. The mosquito is the vector to spread dengue from a diseased person to a healthy person. Without mosquitoes, dengue cannot be transmitted by different mediums.
Usually, these mosquitos are very active in the early morning and early evening times. It has been observed that though they do not have the ability to fly high, through lift they might fly to higher apartments. Dengue virus is of four different types. But this is worth noting that although a child can get infected with one type of dengue virus there is a high chance of reinfection if other types of virus enter the healthy child. Immunity is usually built for the specific strain which has caused the dengue, immunity is not built for other strains.
The second episode of dengue is usually more dangerous with more complications than the first episode.
How does a pediatrician identify dengue?
Various symptoms can appear in children after 4 days to 2 weeks of the mosquito bite. It lasts up to 1 week.
Dengue usually comes with high fever, tremendous body pains, rashes all over the body, very intense headache, diarrhea & vomiting. There can be one or multiple symptoms along with fever. In case of a severe decrease in platelets, bleeding from the nose and gums is also observed. This disease is prevalent around the year but is more frequently seen during monsoons.
Parents noticing these symptoms must go to Pediatrician for confirmation and proper treatment.
Often complications have been seen once the fever subsided in two-three days. Based on the symptoms, the pediatrician, after a thorough physical examination, take a blood sample to confirm the disease. Though there is no cure for dengue, based on symptoms medicine is advised and more importantly, a pediatrician helps in saving the child from developing any complications due to dengue.
Complications in dengue
The most common complication which is deadly seen as a complication of dengue is a sudden fall in blood platelets. Though the fever subsides in many cases within 2-3 days or later complications may arise afterward and complications of dengue could be lethal. In dengue, blood vessels become leaky and loss of fluid happens. This affects blood circulation, due to which organs don’t get proper and sufficient nutrients and oxygen.
Due to low platelets count, dehydration and hemorrhage is also seen in many children. An alarming and life-threatening condition arises which is called dengue shock syndrome or dengue hemorrhagic fever. However, dengue shock syndrome and other complications can be avoided if dengue is diagnosed at the right time and the right treatment by a pediatrician is provided. With over a decade of experience, Dr. Vamsi Krishna is an expert in handling Dengue shock syndrome.
How Dengue can be prevented?
Dengue is a disease that has no cure and usually takes 1 week time to recover but, it may become serious and lethal in the general child population. As this spread through mosquitoes so by preventing kids & children from mosquito bite can help in preventing dengue. Parents should always make sure that in the surroundings there is no place left where mosquitos can breed. Any water logging should be checked properly and thoroughly.
As mosquitoes breed in clean water so all vessels should not have prolonged water stored and if it is there then the container should be properly covered. In balcony or kitchen garden, utmost care is required to prevent the breeding of mosquitos. In the home, all doors and windows should have mesh to block the entry of mosquitoes inside the home. Children should wear full clothing to have minimum uncovered areas. And Mosquito-repellent creams should be applied on exposed body parts. For babies, toddlers,s and children, it should be a habit for parents to use a mosquito net to protect kids from mosquito bites while sleeping.
Treatment in dengue
Treatment for dengue varies from patient to patient. Some kids may have mild symptoms which can be taken care of at home under a pediatrician’s supervision and guidance. In mild symptoms, kids usually require plenty of rest, sleep, and fluid at regular intervals. Based on the kid’s body weight, age, and condition, the pediatrician may consider prescribing medicine for body aches or other conditions. Sometimes there could be moderate to severe illness. Your pediatrician will ask you to admit your kid to the nearest children’s hospital to avoid any complications and treat them properly. During the hospital stay, the pediatrician monitors the fluid, and condition, and as per need fluid and medicines will be administered.
Typhoid
How can I know if my child may have Typhoid?
How can I know if my child may have Typhoid?Symptoms of typhoid in children begin 1-3 weeks after exposure to the bacteria. Some signs and symptoms of Typhoid include:
- High fever (Step ladder fever is typical of Typhoid. Fever here starts low, and increases every day and temperature can go up to 104 degrees Fahrenheit)
- Headache
- Stomach pain
- Constipation or diarrhea
- Swollen stomach
- Loss of appetite
- Rash- Rose spots mainly on the neck and stomach region
- Dry cough
If Typhoid is untreated then it can lead to severe life-threatening complications. Children infected with Typhoid can become confused and extremely weak.
What causes Typhoid?
Faeco-Oral transmission
In developing countries, where typhoid fever is established, most people become infected by drinking contaminated water and eating contaminated food. The bacteria in the urine and feces of an infected person can get deposited in the food and water and thus spreads to the non-infected person when he/she consumes such food.
Transmission through Typhoid carriers
Even after an antibiotic treatment, a small number of people who recover from typhoid fever continue to harbor the typhoid bacteria. These people, known as chronic carriers, no longer have signs or symptoms of the disease themselves. However, they shed the bacteria in their feces and are capable of infecting others.
Measures to prevent Typhoid?
Safe drinking water, improved sanitation, and adequate medical care can help prevent and control typhoid fever. Here are a few measures you can take to keep your child safe:
Wash your hands:
Frequent hand-washing with soap water is the best way to control infection. Encourage your children to wash their hands thoroughly before eating and after using the toilet. Carry an alcohol-based hand sanitizer with you for times when water isn't available. When cooking at home all meals should be prepared after washing hands thoroughly.
Avoid drinking unsafe water from outside:
Contaminated drinking water is a major cause of the spread of Typhoid. Whenever possible encourage your children to carry their water bottle from home, or else prefer packaged drinking water from outside. When consuming any cold drinks or juices prefer a safe place and avoid ice in it.
Avoid raw fruits and vegetables:
Raw fruits and vegetables may have been washed in contaminated water and are better to be avoided if they can’t be peeled. To be safe, you may want to avoid raw foods entirely.
Choose hot foods:
Avoid food that is cold stored or served at room temperature. Steaming hot foods are the best. Also, it's best to avoid food from street vendors it has more chances to be infected.
Complications of Typhoid
Untreated Typhoid leads to serious complications. These can include:
Intestinal perforation:
This is a serious complication of typhoid. The bacteria that live in the digestive system can move to the abdominal cavity-peritoneum leading to a condition called peritonitis. The peritoneum is usually a sterile space and doesn’t have a defense mechanism like other parts of the body. It is thus a medical emergency. Infection from the peritoneum can spread to other organs via blood and thus require immediate medical attention.
Antibiotics and surgery for the correction of perforation are needed to cure this condition.Internal bleeding:
Internal bleeding may occur in untreated typhoid cases which can make your child feel very unwell. The child may develop excessive tiredness, breathlessness, pale skin, irregular heartbeat, blood in vomiting, and blood in stool in such a case.
Other complications:
of Typhoid include severe weight loss, severe diarrhea, persistent high fever, a state of delirium for the child, and the development of life-threatening septic shock.
Dr. Vamsi Krishna with over a decade of experience has expertise in treating complicated Typhoid. If your child has any symptoms that point toward this disease then visit a pediatrician near you.
Pneumonia
What causes pneumonia?
Pneumonia is most often caused by bacteria or viruses. Most of these bacteria and viruses can spread by direct contact when a healthy child comes in contact with an infected child.
Some bacteria and viruses that may cause pneumonia include the following:
- Streptococcus pneumonia
- Mycoplasma pneumonia
- Group B Streptococcus
- Staphylococcus aureus
- Respiratory syncytial virus (RSV)Parainfluenza virus
- Influenza virus
- Adenovirus
- Risk factors for pneumonia
The following can make a child more prone to developing pneumonia:
Weak immune system
- If the child has any other ongoing chronic illness
- If the child has any lung disease
- Children are also at a greater risk of developing pneumonia if they are passively exposed to tobacco smoke.
- Symptoms of pneumonia
Pneumonia may produce varied symptoms, and not all symptoms may be present in all children.
Some common symptoms include:
- Fever
- Cough with mucus
- Chills
- Fast breathing
- Breathing with grunting or wheezing sounds
- Forced breathing
- Vomiting
- Chest pain
- Pain in abdomen
- Being less active
- Loss of appetite in an older child and poorly feeding an infant
Early symptoms of viral pneumonia are the same as those of bacterial pneumonia. But with viral pneumonia, breathing problems happen slowly. Your child may wheeze and the cough may get worse. Viral pneumonia may make a child more at risk for bacterial pneumonia.
In case of any doubtful symptoms contact a pediatrician near you at the earliest.
How is pneumonia diagnosed in a child?
Your pediatrician will take a detailed history of disease from you and perform a physical examination for your child, including listening to chest sounds using a stethoscope. Additionally, to confirm the diagnosis your doctor may also advise for a chest x-ray, sputum culture, blood tests, pulse oximetry test, or even a CT scan in case of severe infection. Very rarely a bronchoscopy or pleural fluid culture may be done by an expert.
Treatment of pneumonia
Treatment of pneumonia usually depends on the cause and severity of the disease. Your doctor will prescribe antibiotics to your child or administer them through the intravenous route depending on the need. Antibiotics are most-effective against proven bacterial pneumonia.
Other treatments can ease symptoms. They include:
- Plenty of rest
- Getting more fluids
- Cool mist humidifier in your child’s room
- Acetaminophen for fever and discomfort
- Medicine for cough
- IV fluids if your child is unable to drink well
- Oxygen therapy
- Frequent suctioning of your child’s nose and mouth to help get rid of thick mucus
- Breathing treatments as advised by your healthcare provider
At times a child may even need admission to a PICU for more pneumonia.
When untreated pneumonia can lead to infection in the blood and severe breathing distress.
Prevention of Pneumonia in children
Some types of pneumonia can be prevented by vaccines.
Children usually get routine vaccines against Haemophilus influenzae, pneumococcus, and whooping cough beginning at 2 months of age.
Flu vaccine: All children from age of 6 months to 19 years are recommended to get the flu vaccine. These are more important in children with chronic illnesses.
Covid vaccine: All children from ages 12 years and above are recommended to take their covid vaccine.
As a precaution children should be kept away from anyone with symptoms of a cold or respiratory infection. During the pandemic, masks have been very helpful in preventing the spread of viruses and bacteria that cause pneumonia. With over a decade of experience, Dr. Vamsi Krishna specializes in treating severe pneumonia in children.
Cerebral Malaria
What is Malaria?
What is Malaria?Malaria is a disease caused by the parasite Plasmodium in humans. This can be transmitted by infected female mosquitoes. In addition to being transferred by mosquitoes, blood-borne transmission through the transfusion of blood products, transplantation, or needle-sharing, as well as congenital transmission of malaria can also occur. Once infected, malaria can either evolve into simple or severe forms.
Initially, malaria causes nonspecific flu-like symptoms including tiredness, loss of appetite, dizziness, headache, body aches, nausea, vomiting, and chills. The progression of malaria into more severe symptoms will often depend upon the variant of infecting parasite. Most of the severe complications of malaria occur in individuals who have been infected with P. falciparum. Severe malaria is the presence of Plasmodium in peripheral blood. Some of the complications of severe malaria can involve the central nervous system, which is otherwise referred to as cerebral malaria.
What is cerebral malaria?
Severe malaria which leads to cerebral manifestations is referred to as cerebral malaria. Older children are more likely to develop this disease when compared to younger ones.
Symptoms of cerebral malaria
Coma is the hallmark symptom of cerebral malaria; this can occur suddenly or gradually. Other symptoms of cerebral malaria include:
- Deconjugate gaze: Both eyes looking in different directions
- Inability to see despite open eyes
- Nystagmus- rapid and involuntary movement of eyes
- Rigidity of the neck
- Seizures
- EEG abnormalities
- Teeth grinding
Non-neurological symptoms such as enlargement of the liver and spleen, jaundice, renal dysfunction, bleeding, etc may also occur in cerebral malaria.
Prevention of cerebral malaria
Cerebral malaria is a deadly complication and it's thus recommended to identify malaria at an early stage and seek treatment for it. To prevent malaria in any form utmost care has to be taken to protect the child from any harmful mosquito bite and also, you have to make sure that your surroundings are not responsible for the breeding of such mosquitoes. The following can be remembered when it comes to prevention:
- Usage of mesh in all doors and windows to block the mosquitoes from entering the house.
- Usage of mosquito net for babies and children to prevent any mosquito bites while they are asleep.
- Usage of mosquito repellent creams on the exposed body parts whenever the child goes out to play.
- Make children wear full sleeves shirts and t-shirts and full pants especially when they go out.
- Any water accumulation should be prevented in and around the house. It is important to make sure that utmost hygiene is maintained in and around the house.
Treatment of cerebral malaria
Antimalarial drugs for the treatment of malaria along with additional interventions to treat neurological complications are needed in cerebral malaria. Patients with this complication may need intubation and ventilation. Since seizures are also a complication of this malaria, anti-convulsant medication may also be prescribed by your doctors for its control.
Early detection and treatment of malaria help prevent its complication. If your child shows any symptoms of malaria or its complication visit a pediatrician near you at the earliest.
With over a decade of experience, Dr. Vamsi Krishna has managed multiple cases of cerebral malaria.
Empyema
What are the symptoms of empyema?
Some symptoms that may point towards empyema include:
- Chest pain that worsens on breathing
- Weak breathing sounds
- Troubled breathing
- Shortness of breath
- Dry cough
- Unexplained weight loss
- Fever
- Reduced appetite
What causes empyema in children?
In most cases, empyema develops after a child has had pneumonia. What increases the risk of children developing empyema after pneumonia is if the child has conditions like Chronic obstructive pulmonary disease (COPD), Diabetes, compromised immune system, lung abscess, rheumatoid arthritis, etc. At times complicated tuberculosis of the chest can also lead to the development of empyema.
How is empyema diagnosed?
Your doctor will take a detailed history and perform a physical examination of the child if empyema is suspected. To confirm the diagnosis of empyema the following tests may also be advised by your doctor:
- Chest x-ray to confirm that empyema is present and estimate the amount of pus in the chest
- Ultrasound of the chest to determine the thickness and amount of pus
- A computed tomography study may be advised in some cases to examine in detail
- Blood tests to check for changes due to the empyema
- A culture of the pus from the chest is the best way to identify the bacteria causing empyema
Treatment of empyema
The following measures may be used by the doctor to manage empyema in your child:
- Pain killer is used to keeping your child comfortable
- Depending on the bacteria causing the infection, antibiotics are given to your child to control it
- A chest tube (a small tube inserted between the ribs through the chest wall) is placed to drain the pus from the inside of the chest in your child
- The chest tube stays in place for 3 to 5 days
- At times your doctor may administer medicines through the chest tube to dissolve pus
In rare cases, surgery may be needed to help drain the pus from the chest. Pus and blood are removed from the chest through a surgical procedure following which a chest tube is placed to collect any remaining pus. This chest tube stays in place for 3 to 5 days. Pain medications are given to keep your child comfortable.
Early detection and treatment of empyema leads to better resolution of the disease and prevents any further complications. If you suspect any empyema-like symptoms in your child then visit a pediatric intensivist near you today.
With over a decade of experience, Dr. Vamsi Krishna has managed multiple cases of empyema.