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Travel-Related Illnesses in Children

Pediatric EM Morsels

Hospitalization for travel-related illness are around 10% for both VFR and tourists (Leuthard 2015) Multiple studies have reported the most common travel infections in various countries. A “Syndromic” Approach for Diagnosing and Managing Travel-Related Infectious Diseases in Children. Glob Pediatr Health. 2021 May; 8:1-16.

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2023 Critical Care Year in Review (Part 1)

PulmCCM

Sepsis, infectious disease Managing septic shock with a restrictive-fluids approach (preferentially using vasopressors after a single liter crystalloid bolus) led to similar outcomes as the usual practice of bolusing large volumes of fluids first. Either approach in severe sepsis with shock seems reasonable.

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Professional Medical Societies Call for Elimination of SEP-1

PulmCCM

The Infectious Diseases Society of America (IDSA), along with societies for emergency medicine physicians and hospitalists, are again speaking up about the ongoing policy experiment known as the Centers for Medicare and Medicaid Severe Sepsis/Septic Shock Management Bundle (SEP-1). The stakes are going up.

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The Latest in Critical Care, 2/5/24 (Issue #28)

PulmCCM

Fever in the ICU: Guideline Update The Society of Critical Care Medicine (SCCM) and the Infectious Diseases Society of America (IDSA) issued an interim update to their 2008 recommendations for the management of fever in the ICU. PulmCCM is not affiliated with SCCM or IDSA. You can read the document here. What’s a Fever?

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Diagnostics and Therapeutics: The Who, What, Where, When and Why of Lumbar Punctures

Taming the SRU

2018) Epidemiology of lumbar punctures in hospitalized patients in the United States. Scandinavian journal of infectious diseases , 45 (9), 657–663. The UK joint specialist societies guideline on the diagnosis and management of acute meningitis and meningococcal sepsis in immunocompetent adults. PLOS ONE 13(12): e0208622.

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Diagnostics: Inflammatory Markers

Taming the SRU

In a small study involving 79 hospitalized children, PCT was found to be elevated in bacterial infections, with a decrease after appropriate antibiotic therapy, and decreased in viral infections [24]. Sepsis PCT may have some utility in guiding posttest probability for sepsis when the diagnosis is unclear.

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PEMPix 2023 Online Case 3: The Only Thing We Have to Fear

PEMBlog

rectally, prompting a sepsis workup given his age. This patient was hospitalized for 4 days where he remained well-appearing. The patient was ultimately discharged on a seven-day total course of cephalexin per Pediatric Infectious Disease recommendations. His rash is pictured here: He subsequently developed a fever to 38.2C