UMEM Educational Pearls - By Rose Chasm

Category: Pediatrics

Title: Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM)

Keywords: Epstien Barr Virus, Mononucleosis (PubMed Search)

Posted: 2/6/2009 by Rose Chasm, MD (Updated: 8/17/2022)
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Epstein-Barr virus (EBV)-associated infectious mononucleosis (IM) 

Most commonly presenting clinical findings: fever, fatigue, exudative pharyngitis, lymphadenopathy, and hepatosplenomegaly. 

Self-limited illness that lasts an average of 2 - 3 weeks. 

Treatment is primarily supportive.  Use of ampicillin, amoxicillin, or penicillin during the acute phase not indicated and may result in the development of a morbilliform rash, which studies have suggested may occur in more than 50% of the cases.  Antiviral therapy is not recommended. Splenic rupture occurs in about 1 - 2:1000 cases.  Therefore, avoidance of activities that increase the risk for injury is recommended until splenomegaly has resolved. 

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Category: Pediatrics

Title: Tinea Capitis

Posted: 3/9/2013 by Rose Chasm, MD (Emailed: 8/17/2022) (Updated: 8/17/2022)
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  • Tinea capitis (ringworm of the scalp) is caused by dermatophytic fungi
  • Trichophyton tonsurans is the most common species in the US, and does NOT flouresce under Wood's lamp
  • Griseofulvin (20-25mg/kg/ day orally) is the standard first-line therapy in children older than 2 years, and has a good safety profile
  • Both tablet and suspension formulations are available, and it should be taken with food that are high in fat to increase drug concentrations
  • NO laboratory assessment of hepatic enzymes is required during the 8-week therapy course in children who have no history or clinical examination findings concerning for liver disease.
  • Topical antifungal agents are ineffective because they do not penetrate sufficiently into the hair shaft.

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