0071643192.pdf

(Barré) #1

PEDIATRICS
HEADLICE


Caused by head louse (Pediculosis humanus capitis)


SYMPTOMS/EXAM


Patients typically present with pruritis. Nits (eggs) are typically found close to
the scalp, firmly adherent to hair.


DIFFERENTIAL


Clinical diagnosis


DIAGNOSIS


Clinical diagnosis


TREATMENT


■ Initial therapy with over the counter 1% permethrin, applied to scalp and
hair for 10 minutes after washing and towel drying. Second application
1 week later is often recommended.
■ For treatment failure, malathion (0.5%) is recommended for children
≥6 years, applied to dry hair as 8- to 10-hour application; lindane 1%
shampoo can also be used in older children as second line but carries
risk of potential CNS toxicity that has occasionally led to seizures and
death


NEUROLOGY

Febrile Seizures


Febrile seizures may occur in the setting of fever, but are not due to a 1°
infection or disturbance of the brain (see Table 5.12).


■ Febrile seizures are common, with 2–4% of children affected between the
ages of 3 months to 5 years.
■ Peak incidence is 2 years of age.
■ Children who have very high fevers or who have a family history of febrile
seizures are at greatest risk for developing febrile seizures.
■ A careful, detailed history is essential, including a history of recent illness,
trauma, medication exposure, or immunizations.


TABLE 5.12. Types of Febrile Seizures


NUMBER OF
SEIZURES DURATION TYPE OFSEIZURE

Simple febrile seizure One <15 min Generalized tonic-clonic

Complex febrile seizure >1 in 24 hours >15 min Focal
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