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Pyrexia of Unknown Origin
Pyrexia of unknown origin (PUO) is a condition that has long put physicians' diagnostic skills to the test. Patients with this illness will, by definition, be more challenging to identify because they resisted categorization during initial studies. Additionally, researching PUO necessitates familiarity with a wide range of illnesses from various clinical specialities as well as specialized investigative techniques. The etiology and epidemiology of the illnesses that cause PUO vary as society and medicine both continue to evolve. These factors make it crucial for doctors to address PUO logically and for the causes and treatment of PUO to be regularly examined.
About the Speaker
Dr Vineet Kwatra
Senior Consultant Department of Paediatrics and Neonatology Medanta Hospital
Clinical approach to Cough in Pediatrics
When assessing and managing cough in pediatric patients, a systematic clinical approach is essential to identify the underlying cause and provide appropriate care. Begin by obtaining a detailed history, including the onset, duration, and characteristics of the cough, as well as associated symptoms. Recognize that the causes and management of cough can vary significantly with the child's age. Evaluate the severity of the cough and its impact on the child's daily activities, sleep, and feeding. Inquire about environmental factors such as exposure to tobacco smoke, allergens, or irritants. Verify the child's immunization status, as some vaccine-preventable diseases can cause cough. Review the child's medical history, including any previous respiratory conditions, allergies, or chronic diseases.
Neurological Disorders in Children
Neurological disorders in children encompass a wide range of conditions affecting the developing nervous system. Common disorders include epilepsy, characterized by recurrent seizures that can impact a child's daily life and development. Cerebral palsy, a non-progressive disorder, affects movement, posture, and muscle coordination due to brain damage during early life. Autism spectrum disorders, marked by difficulties in social interaction and communication, fall within the neurological realm. Attention-deficit/hyperactivity disorder (ADHD) leads to challenges in sustaining attention, impulse control, and hyperactive behavior. Genetic conditions like Down syndrome affect both cognitive and neurological functions, leading to varying degrees of intellectual and developmental disabilities. Pediatric migraines can be debilitating, causing severe headaches, sensitivity to light, and nausea. Tourette syndrome manifests as involuntary movements and vocalizations, known as tics, that often appear during childhood. Developmental coordination disorder (DCD) affects motor skills, causing difficulties in activities like writing, tying shoelaces, and using utensils
Transposition of Great Arteries : Clues on prenatal Diagnosis
Transposition of the Great Arteries (TGA) is a congenital heart defect in which the two main arteries, the aorta, and the pulmonary artery, are switched in their positions. Prenatal diagnosis of TGA is crucial as it allows for early intervention after birth. Routine fetal ultrasounds can provide the first clues. Suspicion arises when the normal cross over between the great arteries is not visualized. Blood flow patterns can be assessed with Doppler ultrasound. Other cardiac abnormalities might be detected during prenatal ultrasounds, such as a ventricular septal defect (VSD) often associated with TGA.
Clinical approach : Acute Myocarditis & Cardiomyopathy in Children
Acute myocarditis and cardiomyopathy are serious heart conditions affecting children. Myocarditis involves inflammation of the heart muscle, often triggered by viral infections. Cardiomyopathy encompasses various heart muscle diseases, including hypertrophic cardiomyopathy, the most common type in children. Symptoms may include chest pain, rapid heartbeat, fatigue, and swelling. Diagnosis involves tests like echocardiograms, and treatment varies based on the cause and severity, including medications, supportive care, and in some cases, heart transplantation. Early medical attention is crucial for better outcomes. Pediatric cardiologists play a vital role in managing these conditions in children.
Approach to Fever in Pediatrics
Fever in pediatric patients is a common presenting symptom, and its evaluation requires a systematic approach. The first step in assessing a child with fever is to obtain a detailed history, including the onset, duration, associated symptoms, recent travel, immunization status, and exposure to sick contacts. Physical examination is crucial, focusing on vital signs, general appearance, skin rashes, lymph nodes, and signs of specific infections. Depending on the child's age and clinical presentation, different etiologies should be considered, including viral, bacterial, fungal, parasitic, or noninfectious causes. A complete blood count (CBC) with differential and a C-reactive protein (CRP) test can provide valuable information about the severity and inflammatory response. Urinalysis and urine culture are essential when evaluating fever, especially in infants, to rule out urinary tract infections. Lumbar puncture should be considered in febrile infants under two months of age to rule out meningitis. Blood cultures may be necessary in cases of high fever or severe illness, especially when there are signs of bacterial infections.