Infectious Diseases

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Pneumonia is one of the most common conditions encountered by primary care providers. Certain organisms cause pneumonia in particular age groups. For example, group B streptococci, Gram-negative bacilli Escherichia coli in particular) and, rarely, Listeria monocytogenes cause pneumonia in neonates. In infants younger than 3 months, group B streptococci and organisms encountered by older children occasionally cause pneumonia, as does Chlamydia trachomatis. Older infants and preschoolers are at risk for infection with Streptococcus pneumoniae and Haemophilus influenzae. In children older than 5 years, S pneumoniae and Mycoplasma pneumoniae are the key pathogens. Let the patient's age, history, clinical presentation, and radiographic findings guide your choice of therapy. Even though most patients with uncomplicated pneumonia can be treated as outpatients, close follow-up is important. Hospitalize patients younger than 6 months and those with complications.

The Centers for Disease Control and Prevention (CDC) announced that approximately 81% of the nation's toddlers are receiving all the vaccinations in the recommended series."These results are terrific news," said Dr. Julie Gerberding, director of the CDC. "They illustrate the tremendous progress we've made in preventing what were once common childhood diseases. Most importantly, these results show that parents have high levels of confidence in our vaccination recommendations. It's encouraging to see that parents recognize the importance of protecting their children against diseases that while relatively uncommon, can cause serious harm."

The incidence of community-based methicillin-resistant Staphylococcus aureus (MRSA) infection in healthy children is increasing. This review discusses possible reasons for that rise, reviews antibiotic susceptibility patterns, and presents management guidelines.

Concerned about the logistics of vaccinating patients this flu season, now that even healthy children younger than 2 years are to be immunized? Worried about reimbursement? For a practical approach to vaccinating against influenza--without putting a financial strain on your practice--read on.

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.