Infectious Diseases

This 13-year-old boy plays basketball for his school team. His mother brings him to your office and asks you about her son's toenail that has changed appearance and now looks like his father's great toenail. The father has psoriasis.

Most cases of HSV-2 infection are spread through sexual transmission. An infected person can have virus in his or her saliva, semen, or vaginal secretions. When a seronegative partner comes in sexual contact with these secretions, the virus can enter the body through mucosal surfaces (such as the vagina, anus, or mouth) or micro-abrasions on the skin (eg, the penile shaft, scrotum, thighs, or perineum).

This 7-year-old boy was recently brought to my office having received a diagnosis of pemphigus foliaceus. His parents were seeking a second opinion.

How did I get herpes? Is there a cure? What causes an outbreak-- and what can I do to prevent another one? My friend got herpes and had to stay in the hospital; will that happen to me? Can I still have children?

Until very recently, when it came to chronic cough, children were to be treated like little adults. In its 1998 guidelines on cough, the American College of Chest Physicians (ACCP) stated that "the approach to managing chronic cough in children is similar to the approach in adults."

Poisons have been a threat to the health and well-being of humankind for millennia. Given the ubiquitous nature of potential poisons, exposure to a toxin should be included in the differential diagnosis of patients with unexplained illnesses or unusual presentations.

Gonorrhea (aka "the clap," or "the drip") is caused by sexually transmitted Neisseria gonorrhoeae--a Gram-negative diplococcus. One of the most common reportable diseases in the United States, gonorrhea frequently affects sexually active adolescents. Approximately 30% of the 350,000 annual cases involve 15- to 19-year-olds. (That percentage is thought to be an underestimate!) Those most often infected are young women 15 to 24 years old. Recent data suggest that infection rates are higher among teens who are homeless or pregnant, and in those from a minority group or an economically disadvantaged background.

Seven-year-old girl with generalized rash that started as a single isolated oval lesion on the lower abdomen. Six days later, diffuse papulosquamous lesions appeared mainly on the trunk, sparing the scalp, face, and extremities. Intense itching despite 3 days of diphenhydramine therapy.

According to a study by investigators at the University of California, San Francisco School of Dentistry, fluoride varnish reduces the incidence of early childhood tooth decay in combination with dental health counseling for parents.

An 8-year-old boy is assessed on the same day that he passed red-colored urine. The boy first noted the abnormal-colored urine when he voided on awakening.

Photo Finish: Acute Dx: What Cause of Sudden Illness?

Every day, children are served up a barrage of television commercials telling them what to eat. According to J. Michael McGinnis, senior scholar at the Institute of Medicine (IOM), that's a problem: "Current food and beverage marketing practices put kids' long-term health at risk." McGinnis's findings appear in a report, Food Marketing to Children and Youth: Threat or Opportunity?, issued recently by the IOM's committee on food marketing and the diets of children and youth.

The US Food and Drug Administration in December approved the use of Tamiflu (oseltamivir phosphate) for preventing seasonal influenza in children 1 to 12 years old. Tamiflu's labeled use had previously been for prevention and treatment of flu in children 13 years and older, as well as in adults.

Initial clinical studies of a tool that measures impedance in the esophagus provide new insight into acid reflux disease.

Among children, rotavirus remains a leading cause of gastroenteritis and, globally, of death. Here's the latest on treatment and prevention, including vaccines in the offing.

Among children, rotavirus remains a leading cause of gastroenteritis and, globally, of death. Here's the latest on treatment and prevention, including vaccines in the offing.

"There is some drama associated with influenza every year," said George Kent, MD, associate director of the Center for Education in Family and Community Medicine at the Stanford University School of Medicine. "In 2004, it was the surprise vaccine shortage and the surge in demand, followed by a very ordinary year in terms of disease. This year, we appear to have plenty of vaccine, except for avian influenza, for which we have no vaccine at all."

ABSTRACT: Hypothermia is not limited to the northern states: people also die of hypothermia in other areas with milder climates. Infants, young adolescent boys, and inadequately dressed teens who abuse alcohol or illicit drugs are at highest risk for death secondary to hypothermia. The mildly hypothermic patient may appear fatigued and display persistent shivering, ataxia, clumsiness, confusion, tachypnea, and tachycardia. The child with moderate hypothermia will not be shivering; declining mental status may cause the freezing patient to remove clothing. An irregular heartbeat is likely at this stage. Severe hypothermia is marked by apnea, stupor, and coma. In a frostbitten patient, rapid rewarming of the affected area in warm water for 15 to 30 minutes is the first step. Potent analgesia is often necessary. After thawing, the frostbitten part is kept dry, warm, and loosely covered. With an adequate dose of common sense, the vast majority of deaths from cold injury can be prevented.

In the aftermath of Hurricane Katrina's devastation in the Gulf Coast region, it is important for physicians in the United States to consider the infectious disease risks for children who have been displaced or who are still living in affected areas. These risks include infections acquired through ingestion of waterborne organisms; wound infections; lack of immunization continuity; and overcrowding, which increases the risk of respiratory or GI infections. In addition, problems will arise from disruption of therapy for select populations of children, such as those who are HIV-infected; those receiving immunosuppressive treatment; and those in need of continuous antibiotic prophylaxis, such as those who have sickle cell disease.

For 2 days, a 4-year-old girl had complained of discomfort and a yellow discharge from the left eye. The left conjunctiva was hyperemic, but there was no preauricular lymphadenopathy.