Infectious Diseases

Most infectious disease researchers believe that a pandemic of influenza--like the Spanish flu pandemic of 1918 and 1919 that killed 50 million people--is inevitable. That fear has gained new urgency with the resurgence in Asia of avian influenza.

It has been difficult to determine the impact of influenza infection on infants and young children, because annual outbreaks of respiratory syncytial virus infection often overlap influenza outbreaks. But careful epidemiologic tests, combined with accurate, simple-to-perform viral diagnostic studies, have now clearly demonstrated that young children--particularly those younger than 2 years--are hospitalized because of influenza at a rate that equals or exceeds the influenza hospitalization rate for the elderly.

A 6-year-old girl and an 11-year-old boy each presented for evaluation of an erythematous, pruritic, papular rash that developed after swimming in a Wisconsin lake.

2004 immunization schedule for January to June 2004

Herpes simplex infection is often misdiagnosed. Here is a look at distinguishing features of type 1 infections and a review of associated disorders, diagnostic tools, and treatment options.

Prophylactic antibiotics have long provided asplenic children with a measure of protection against bacteremia and sepsis. Recent progress in vaccines promises to strengthen the defense.

Wheeler D et al: Arch Dis Child 2003;88:688

I've been on service this month caring for hospitalized patients and, once again, I'm reminded that managing illness in children isn't as straightforward as it used to be.

A toddler was brought to the emergency department with a 3-day history of a rash on her neck and irritability and fever (temperature, 38.3°C [101°F]) of 1 day's duration. The child's mother noticed a red, purulent bump on the girl's hand 2 days before the rash developed.

Complaints of pain in an ear prompted the mother of a 4-year-old boy to seek medical consultation for her son. The external ear was red, swollen, and warm. This appearance is typical of erysipelas caused by group A β-hemolytic streptococci.

After several days of suffering fever, headache, and malaise, a 17-year-old boy noticed a rash developing over much of his body. He sought medical attention and was admitted to the hospital.