0071643192.pdf

PEDIATRICS

COMPLICATIONS

Rare, but include orchtis pancreatitis, encephalitis, meningitis

PINWORMS

■ Caused byEnterobius vermicularis(a nematode/roundworm)

■ Humans only natural hosts; passed on as fomites, eg, from inorganic material

such as clothing and fecal-oral route

SYMPTOMS/EXAM

Anal and/or vulvar pruritis

DIAGNOSIS

■ Tape test(application of transparent adhesive tape to perianal skin, exam

under microscope for eggs, highest yield with three consecutive specimens

taken on first awakening in the morning)

■ Occasionally direct visualization of worms, usually 2–3 hours after child

goes to sleep

TREATMENT

■ Children >2 years of age: Mebendazole single dose, repeated in 2 weeks

■ All family members and close contacts should be treated empirically.

SCABIES

Caused bySarcoptes scabieimite

SYMPTOMS/EXAM

■ Intense pruritis with erythematous, papular rash (especially in finger webs,

wrists, axillae) caused by burrowing of adult female mites in the upper lay-

ers of epidermis

■ Younger children and infants differ from older children and adults in that

the rash is often vesicular and can affect areas usually spared in older chil-

dren (eg, head, neck, palms, soles) due to a hypersensitivity reaction to the

parasite.

DIAGNOSIS

■ Clinical; mite is not visible to naked eye

■ Can be confirmed by microscopic identification of the mite or eggs

(mineral oil scrapings of burrows placed on a slide and examined under

low power)

TREATMENT

■ Topical 5% permethrin cream applied from neck down, washed off in

8–12 hours; reapplication in 7 days recommended

■ Decontamination of bedding, clothing, bath towels, and similar items is

needed as well.