Pediatric emergency care
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Pediatric emergency care · Jan 2009
Comparative StudyRadiographic pneumonia in young, highly febrile children with leukocytosis before and after universal conjugate pneumococcal vaccination.
Studies before the introduction of conjugate pneumococcal vaccine demonstrated a high rate of radiographic pneumonia among highly febrile young children with leukocytosis and no other identified source of infection. We sought to evaluate the impact of universal vaccination with Prevnar (pneumococcal conjugate vaccine [PCV]) on the incidence and characteristics of occult and nonoccult radiographic pneumonia among these children. ⋯ Clinicians should continue to consider chest radiography in young highly febrile children with leukocytosis and no other identified source of infection.
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Pediatric emergency care · Jan 2009
Case ReportsFacial edema as the initial presentation of Henoch-Schonlein purpura in a 5-year-old boy.
The appearance of nonthrombocytic purpura is an important clue for the diagnosis of Henoch-Schonlein purpura (HSP). However, this classic skin lesion may be preceded by other symptoms such as abdominal pain and arthralgia, and the diagnosis may be delayed. Facial edema as a manifestation of HSP is typically observed in children younger than 2 years. We report a 5-year-old boy with facial edema at presentation; until 3 days later, the boy returned because of abdominal complication (intussusception) and developed purpura, the diagnosis of HSP was established.
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Pediatric emergency care · Jan 2009
ReviewUltrasound soft-tissue applications in the pediatric emergency department: to drain or not to drain?
Soft tissue infections frequently prompt visits to the pediatric emergency department. The incidence of these infections has increased markedly in recent years. ⋯ Ultrasound is an efficient, noninvasive diagnostic tool which can augment the physician's clinical examination. Ultrasound has been shown to be superior to clinical judgment alone in determining the presence or the absence of occult abscess formation, ensuring appropriate management and limiting unnecessary invasive procedures.
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Acute gastroenteritis is a common reason for children to seek health care. Among the potential complications of acute gastroenteritis, the most common is dehydration. ⋯ Some authorities have suggested that the early administration of dextrose to patients receiving intravenous rehydration may help terminate vomiting and result in fewer outpatient treatment failures. The purpose of this report was to review the evidence supporting the effectiveness of early intravenous dextrose administration in the outpatient management of dehydration in children with acute gastroenteritis.