Kawasaki disease
#
1. symptoms
1. >5days fever
2. non purulent conjunctivitis
3. oral erythema
4. strawberry tongue
5. submandibular lymphadenopathy
6. erythema multiform
2. Refer the pt
Archive
Influenza
#
1. Treatment
1. Cap oseltamivir 30 mg for 7 days
1. or syrup oseltamivir 60 mg/5/ml
2. or cap Flubivir 75 mg
3. or cap Tamiflu 30/45/75 mg
1. Symptom therapy only
1. Serum N/S 500-1000 cc IV infusion
2. Amp apotel 1gr (10-15mg/kg) INF
3. Amp ketorolac IV
4. Amp B-complex
2. Approach
1. if suspicious of pneumonia, take CXR
2. Vaccination in high risk group:
1. Vaccine Influvac #1
1. >3y/o 1 Amp
2. <1y/o 1/2 amp
3. <12y/o for first time, repeat 1 month later
4. for pregnancy, in 2nd and 3rd trimester
5. safe in breast feeding
6. contra indicated in dose who are sensitive to Egg’s protein
2. may cause GBS
3. use in
1. health care workers
2. old age
3. immunodeficient
4. chronic disease
Impetigo
#
1. Cause
1. staph
2. strep
2. Treatment
1. for wet lesions:
1. Oint tetracycline
2. For dry lesions
1. Cream mupirocin 2%
3. or more severe cases add:
1. Cap cefalexin 500 mg #30 qid for 7-10 days (25mg/kg/day)
1. or syrup cefalexin w/4 qid #1
3. Risk of PSGN ⇒ 2% in 1-2 month post infection
Hordeolum
1. Acute infection of tip of eyelids (گل مژه)
2. Always R/O cellulitis
3. Treatment
1. Baby shampoo #1 tds
2. Oint opht erythromycin 0.5% #1 qid
3. warm compress for 10 mins qid
Herpetic gingivostomatitis
1. symptoms:
1. 6m/o – 6y/o
2. oral vesicular lesions
3. pain on eating
4. halitosis due to bacterial growth
5. superficial wound after vesicle rupture
6. self-limited in 1-2 weeks
2. Treatment
1. Tab acyclovir 15mg/kg/dose qid (tab 200, 400mg)
2. Cocktail
1. Syrup diphenhydramine #1
2. Cap tetracycline #8
3. Amp lidocaine
4. mouth washing for 2 mins then spit out
Herpangina
#
1. Common viral infection in Autumn
2. Characteristic:
1. vesicular lesions only on
1. soft palate
2. tonsils
3. oropharynx
2. low grade fever
3. sore throat
3. Treatment
1. Syrup acetaminophen 120mg/5ml w/2cc qid
2. syrup diphenhydramine w/3cc bid
Hand/Foot/Mouth disease
1. symptoms
1. self-limiting
2. vesicle/papule with erythema
2. if pruritus:
1. Syrup diphenhydramine 12.5mg/5ml w/4cc qid
3.
H. pylori infection
1. Who to treat?
1. peptic ulcer
2. long term anti acid use
3. cancer risk factor
4. more than 1 year use of anti acid
2. Test:
1. Urea Breath Test (UBT)
2. or Fecal H. pylori Antigen (no use of Ab in last month and no use of anti acid in last 2 weeks)
3. or Serum H. pylori IgG
3. Triple therapy:
1. Cap esomeprazole 40 mg bid #28
2. tab clarithromycin 500 mg bid #28
3. Cap amoxicillin 500 mg 2tabs bid #60
1. or tab metronidazole 500 mg bid #28
4. Quadruple therapy:
1. Cap amoxicillin 500 mg 2tabs bid #60
2. Cap esomeprazole 40 mg bid #28
3. tab metronidazole 500 mg bid #28
1. tab clarithromycin 500 mg bid #28
4. tab bismuth sub citrate 2 tab bid #60
5. 2nd line treatment: for 2 weeks
1. Cap amoxicillin 500 mg 2 tab bid
2. Cap levofloxacin 500 mg bid
1. or cap rifampin 150 mg bid
2. or Tab furazolidone 100 mg bid
3. Cap esomeprazole 40 mg bid
6. Side effects:
1. clarithromycin: bitter taste, skin rash
2. Metronidazole: iron taste
3. Bismuth: dark stool
4. Amoxicillin: pseudomembranous colitis, diarrhea
5. tetracycline: skin rash, photosensitivity