Keywords: meningitis, neisseria meningitidis, streptococcus pneumoniae, haemophilus influenzae, child care, nursery (PubMed Search)
Meningitis Prophylaxis in Children
While H1N1 and garden-variety influenza have been taking the spotlight lately, we can't forget about other disease processes. Meningitis is still a severe, life-threatening/altering process which occurs in various social groups (e.g. military cadets, college students).
However, with more of our parents working out of the home, child care is more often the norm, and as such, you may find yourself dealing with cases of children who have been in proximity to another child or caregiver diagnosed with meningitis. What do you do?
The causative agent will often dictate your choice of management.
Neisseria meningitidis - nursery/child care contacts should receive chemoprophylaxis and the Menactra vaccine (if they have not already received it) within 7 days of onset; casual school or work contacts do NOT require prophylaxis
Streptococcus pneumoniae - no chemoprophylaxis or vaccination required (unless series was not continued)
Haemophilus influenzae - if only one case reported, no intervention; if 2 or more cases within a 60-day period, Hib vaccination and chemoprophylaxis with rifampin for BOTH children and caregivers (especially if the center cares for young children who have not completed their Hib series)
Pediatrics in Review, July 2009: "Infections in Child-Care Facilities and Schools"
Keywords: congenital heart disease, cyanosis, neonate, prostaglandin (PubMed Search)
Ductal-Dependent Cardiac Lesions in the Neonate
Keywords: conjunctivitis, pinkeye, gonococcal ophthalmia neonatorum (PubMed Search)
Conjunctivitis in Children:
HOWEVER... remember to consider other common etiologies of a red eye in a child!
Keywords: pollutant, breastfeeding, environment, contaminants (PubMed Search)
While breastfeeding is still the preferred source of infant nutrition by the AAP, a little-known fact is that breastfeeding may expose the nursing infant to environmental pollutants to which they might not normally be exposed. If you have a mother that appears ill due to exposure to any of these agents, don't forget to have the infant examined as well for signs of intoxication.
American Academy of Pediatrics Committee on Environmental Health. Chapter 3. In: Etzel RA, ed. Pediatric Environmental Health, 2nd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2003.
Keywords: infant, neonate, spasm (PubMed Search)
Infantile Spasms (West Syndrome):
Nelson's Essentials of Pediatrics, 5th Edition.
Keywords: Pertussis, Whooping Cough (PubMed Search)
Pertussis (Whooping Cough):
Nelson's Essentials of Pediatrics, 5th Edition