Treatments for Leptospirosis
Treatments for Leptospirosis
The list of treatments mentioned in various sources
for Leptospirosis
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Leptospirosis: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Leptospirosis may include:
Latest treatments for Leptospirosis:
The following are some of the latest treatments for Leptospirosis:
Hospital statistics for Leptospirosis:
These medical statistics relate to hospitals, hospitalization and Leptospirosis:
- 0.0004% (54) of hospital consultant episodes were for leptospirosis in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 70% of hospital consultant episodes for leptospirosis required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 96% of hospital consultant episodes for leptospirosis were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 4% of hospital consultant episodes for leptospirosis were for lwomen in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 79% of hospital consultant episodes for leptospirosis required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Discussion of treatments for Leptospirosis:
Leptospirosis (General): DBMD (Excerpt)
Leptospirosis is treated with antibiotics, such as doxycycline
or penicillin, which should be given early in the course of the
disease. Intravenous antibiotics may be required for persons with
more severe symptoms. Persons with symptoms suggestive of leptospirosis
should contact a (Source: excerpt from Leptospirosis (General): DBMD)
Leptospirosis and Your Pet: DBMD (Excerpt)
Is there a
treatment for leptospirosis in pet animals?
Yes, leptospirosis is treatable with antibiotics. If an animal
is treated early, it may recover more rapidly and any organ damage
may be less severe. Other treatment methods, such as dialysis
and hydration therapy may be required. (Source: excerpt from Leptospirosis and Your Pet: DBMD)
Buy Products Related to Treatments for Leptospirosis
Book Excerpts: Treatment of Leptospirosis
Treatments of Leptospirosis: Online Medical Books
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Review excerpts from medical books online, free, without registration,
for more information about the treatments of Leptospirosis.
Fever:
Treatment
(In a Page: Signs and Symptoms)
-
Initial treatment of fever includes antipyretics (e.g., acetaminophen, NSAIDs)
-
Infection should be treated with appropriate antimicrobial therapy and tailored as antibiotic sensitivities are identified
–Many cases of deep-seated infection or abscess require percutaneous or surgical drainage
-
Fever due to malignancy will usually regress with surgical debulking, chemotherapy, and/or radiation directed at the primary tumor
-
Rheumatologic disorders may require NSAIDs, steroids, methotrexate, hydroxychloroquine, or other cytotoxic agents
-
Dantrolene for malignant hypothermia
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Rash with Fever:
Treatment
(In a Page: Signs and Symptoms)
-
Supportive management and thorough evaluation for multisystem disease is imperative in this patient subset.
-
Doxycycline is the treatment of choice for RMSF, while ceftriaxone is commonly used for meningococcal therapy; because these two diseases can present similarly and rapidly evolve, many clinicians empirically treat with both of these antibiotics until the diagnosis is confirmed
-
Unfortunately, a complete discussion of fever and rash is far beyond the scope of this brief excerpt; the importance of rapid and accurate assessment of every patient presenting with this complaint cannot be overemphasized; rule out the most serious diagnoses first, then “a watch and wait” approach may be considered
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Jaundice:
Treatment
(In a Page: Signs and Symptoms)
-
Discontinue and avoid potentially hepatotoxic medications
-
Supportive care for viral hepatitis
-
Rehydrate/refeed for Gilbert's syndrome
-
Consider steroids in fulminant alcoholic hepatitis
-
Cholecystectomy or ERCP with stone removal for obstructing gallstones
-
Treat underlying causes of hemolysis or other disorders
-
Antibiotics for cholangitis, sepsis
-
Hydroxyurea and folate for sickle cell disease, prevent crises by adequate hydration, vaccinating against diseases, and try to prevent other infections
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Fever – Acute:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treating febrile episodes is common despite substantial evidence that fever is more beneficial than harmful; exception is patient with history of febrile seizures
-
Antipyretics are relatively safe drugs that inhibit prostaglandin synthesis and reduce hypothalamic set point to normal
-
Acetaminophen is safest antipyretic for young children
-
Aspirin must be avoided (risk of Reye syndrome)
-
NSAIDs are potent antipyretics and have antiinflammatory effects
-
Physical methods (cooling blankets, lukewarm baths) may be counterproductive if not combined with an antipyretic; alcohol baths are not recommended
-
Most viral syndromes are self-limited, requiring only antipyretics and increased fluid intake for risk of dehydration
-
Empiric treatment with antibiotics and hospitalization recommended only in neonates and critically ill patients
>>>>
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Fever – Cyclic:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
PFAPA
–Single dose prednisone with the onset of symptoms
–Prophylactic cimetidine and tonsillectomy have been
tried to prevent recurrences
-
Cyclic neutropenia
–Life-long therapy with GCSF decreases risk of infection
-
Familial Mediterranean fever
–Daily colchicine to prevent attacks and amyloidosis
-
Hyper-IgD
–Prednisone and colchicine have been used
–Even without treatment, attacks decrease with age
-
TRAPS
–Prednisone and etanercept have been reported to be effective
>
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Fever – Recurrent:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Repeated viral illnesses
–Reassurance of the parents
–Advice on antipyretics
–Encourage fluid intake
–Limit of sick exposure if possible
-
UTI
–Antibiotics based on bacteria and sensitivity
–Prophylactic antibiotics if underlying cause is present
-
-
-
Bacterial infections: Bacteria-specific antibiotic
-
JRA, Behçet, or IBD
–Prednisone or immunosuppressive medications
-
TRAPS
–Prednisone and etanercept
-
Familial cold urticaria and Muckle-Wells syndrome
–Prednisone may be used
–If amyloidosis is present, colchicine may be required
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Fever – Unknown Origin:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Specific treatment once diagnosis is made
-
Empiric treatment with antibiotics is to be considered only for critically ill patients
-
Empiric steroids may be justified only if Still disease is suspected
-
Anti-inflammatory agents are sometimes used for a limited period of time and subsequently the patient is observed for recurrence of the fever
-
Cessation of offending drugs
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Jaundice in Infants – Direct:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Varies by specific disorder
-
General medication principles of cholestasis include
–Promoting bile flow with ursodeoxycholic acid
–Consider phenobarbital (increases bile excretion)
–Fat-soluble vitamins including K, D, E
–Vitamin A is a relative contraindication given hepatotoxicity at high levels
Consider formula with medium chain triglycerides as fat source (does not require bile acids to be absorbed)
Treat underlying disorder
–Kasai portoenterostomy for biliary atresia
–Surgical repair of choledochal cyst
–Special formulas for tyrosinemia
–Lactose free formula for galactosemia (e.g., soy based)
–Remove toxic exposures
–Treat infections
–Treat hypothyroidism
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Jaundice in Infants – Indirect:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treatment options vary based on level of bilirubin, age of presentation, and cause
–Goal is prevent levels high enough to cause kernicterus
-
Phototherapy involves the use of photon energy to change the structure of bilirubin and permit excretion without glucuronidation
–Decisions for use are age-based
–Considered when serum level above 14 mg/dL
-
Exchange transfusion should be considered with serum levels above 25 mg/dL
-
IVF or breast-feed more frequently to increase volume
-
-
-
Correct endocrine abnormality
-
Improve perfusion if cardiac problem
-
Correct anatomic abnormality
-
Consider enteral binding agents
–Cholestyramine, charcoal, calcium phosphate
-
Crigler-Najjar: Phenobarbital, may need liver transplantation
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Fever:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If you detect a fever higher than 106° F, take the patient’s other vital signs and determine his level of consciousness (LOC). Administer an antipyretic and begin rapid cooling measures: Apply ice packs to the axillae and groin, give tepid sponge baths, or apply a cooling blanket. These methods may evoke a cooling response; to prevent this, constantly monitor the patient’s rectal temperature.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Colorado tick fever:
Treatment
(Professional Guide to Diseases (Eighth Edition))
After correct removal of the tick, supportive treatment focuses on relieving symptoms, combating secondary infection, and maintaining fluid balance. Colorado tick fever needs to be differentiated from Rocky Mountain spotted fever and tularemia.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Lassa fever:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of Lassa fever includes I.V. ribavirin, I.V. colloids for shock, analgesics for pain, and antipyretics for fever. Infusion of immune plasma from patients who have recovered from Lassa fever may be useful, but test results on the benefit of this type of therapy are inconclusive.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Relapsing fever:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Doxycycline or erythromycin is the treatment of choice and should continue for 4 to 5 days. In cases of drug allergy or resistance, penicillin G may be administered as an alternative. However, neither drug should be given at the height of a severe febrile attack because it may cause Jarisch-Herxheimer reaction, resulting in malaise, rigors, leukopenia, flushing, fever, tachycardia, rising respiration rate, and hypotension. This reaction, which is caused by toxic by-products from massive spirochete destruction, can mimic septic shock and may prove fatal. Antimicrobial therapy should be postponed until the fever subsides. Until then, supportive therapy (consisting of parenteral fluids and electrolytes) should be given.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Rheumatic fever and rheumatic heart disease:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Effective management eradicates the streptococcal infection, relieves symptoms, and prevents recurrence, reducing the chance of permanent cardiac damage. During the acute phase, treatment includes penicillin, sulfadiazine, or erythromycin. Salicylates such as aspirin relieve fever and minimize joint swelling and pain; if carditis is present or salicylates fail to relieve pain and inflammation, corticosteroids may be used. Supportive treatment requires strict bed rest for about 5 weeks during the acute phase with active carditis, followed by a progressive increase in physical activity, depending on clinical and laboratory findings and the response to treatment.
After the acute phase subsides, low-dose antibiotics may be used to prevent recurrence. Such preventive treatment usually continues for 5 years or until age 21 (whichever is longer). Heart failure necessitates continued bed rest and diuretics. Severe mitral or aortic valve dysfunction that causes persistent heart failure requires corrective valvular surgery, including commissurotomy (separation of the adherent, thickened leaflets of the mitral valve), valvuloplasty (inflation of a balloon within a valve), or valve replacement (with prosthetic valve). Such surgery is seldom necessary before late adolescence.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Rocky Mountain spotted fever:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment requires careful removal of the tick and administration of antibiotics, such as chloramphenicol or tetracycline (preferably doxycycline), until 3 days after the fever subsides. Treatment also includes symptomatic measures and, in DIC, heparin and platelet transfusion.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
GI hemorrhage:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Blood transfusions, I.V. fluid replacement, endotracheal intubation and mechanical ventilation, Minnesota or Sengstaken-Blakemore tube, surgery, vasopressin, cauterization
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Fever [Pyrexia]:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If you detect a fever higher than 106° F (41.1° C), take the patient’s other vital signs and determine his level of consciousness (LOC). Administer an antipyretic and begin rapid cooling measures: Apply ice packs to the axillae and groin, give tepid sponge baths, or apply a cooling blanket. These methods may evoke a cooling response; to prevent this, constantly monitor the patient’s rectal temperature.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Jaundice [Icterus]:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Encourage the patient with a hepatic disorder to decrease his protein intake sharply and increase his intake of carbohydrates. If he has obstructive jaundice, encourage a nutritious, balanced diet (avoiding high-fat foods) and frequent small meals.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Rheumatic fever and rheumatic heart disease:
Treatment
(Handbook of Diseases)
Effective management eradicates the streptococcal infection, relieves symptoms, and prevents recurrence, reducing the chance of permanent cardiac damage.
Treatment in acute phase
During the acute phase, treatment includes low doses of antibiotics, such as penicillin, sulfadiazine, or erythro-mycin. Salicylates, such as aspirin, can help relieve fever and minimize joint swelling and pain; if carditis is present or the salicylate fails to relieve pain and inflammation, corticosteroids may be used.
Supportive treatment requires strict bed rest for about 5 weeks during the acute phase with active carditis, followed by a progressive increase in physical activity, depending on clinical and laboratory findings and the patient’s response to treatment.
Preventive treatment
After the acute phase subsides, the patient is maintained on low-dose antibiotic therapy, especially during the first 3 to 5 years after the initial episode of rheumatic fever, to prevent recurrence. Such preventive treatment usually continues for 5 to 10 years.
Surgery and other measures
Heart failure necessitates continued bed rest and diuretic therapy. Severe mitral or aortic valvular dysfunction causing persistent heart failure requires corrective valvular surgery, including commissurotomy (separation of the adherent, thickened leaflets of the mitral valve), valvuloplasty (inflation of a balloon within a valve), or valve replacement (with a prosthetic valve). Corrective valvular surgery is rarely necessary before late adolescence.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Fever:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Regularly monitor the patient’s temperature, and record it on a chart for easy follow-up of the temperature curve. Provide increased fluid and nutritional intake. When administering a prescribed antipyretic, minimize resultant chills and diaphoresis by following a regular dosage schedule. Promote patient comfort by maintaining a stable room temperature and providing frequent changes of bedding and clothing. Prepare the patient for laboratory tests, such as complete blood count and cultures of blood, urine, sputum, and wound drainage.
Patient teaching
If the patient hasn’t been admitted to the facility, ask him to measure his oral temperature at home and record the time and value. Explain that fever is a response to an underlying condition that plays an important role in fighting infection. For this reason, advise him not to take an antipyretic until his body temperature reaches 101° F (38.3° C). Discuss signs and symptoms related to dehydration and when to notify the physician.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Fever:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If you detect a fever higher than 106° F (41.1° C), take the patient’s other vital signs and determine his level of consciousness (LOC). Administer an antipyretic and begin rapid cooling measures: Apply ice packs to the axillae and groin, give tepid sponge baths, or apply a hypothermia blanket. These methods may evoke a cooling response; to prevent this, constantly monitor the patient’s rectal temperature.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Jaundice:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Encourage the patient with a hepatic disorder to decrease his protein intake sharply and increase his intake of carbohydrates. If he has obstructive jaundice, encourage a nutritious, balanced diet (avoiding high-fat foods) and frequent small meals. Teach the patient ways to reduce pruritus.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Fever [Pyrexia]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Regularly monitor and record the patient's temperature.
▪ Provide increased fluid and nutritional intake.
▪ When administering a prescribed antipyretic, minimize chills and diaphoresis by following a regular dosage schedule.
▪ Promote patient comfort by maintaining a stable room temperature and providing frequent changes of bedding and clothing.
▪ For high fevers, initiate treatment with a hypothermia blanket.
▪ Prepare the patient for laboratory tests, such as complete blood count and cultures of blood, urine, sputum, and wound drainage.
Patient teaching
▪ Instruct the patient about the proper way to take an oral temperature at home.
▪ Emphasize the importance of increased fluid intake.
▪ Discuss the proper use of antipyretics and antibiotics.
▪ Teach signs and symptoms that require immediate medical attention.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Jaundice [Icterus]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ To decrease pruritus, frequently bathe the patient; apply an antipruritic lotion, such as calamine; and administer diphenhydramine or hydroxyzine.
▪ Prepare the patient for diagnostic tests to evaluate biliary and hepatic function, including laboratory studies (such as urine and fecal urobilinogen, serum bilirubin, liver enzyme, and cholesterol levels; prothrombin time; and a complete blood count), computed tomography, ultrasonography, cholangiography, liver biopsy, and exploratory laparotomy.
Patient teaching
▪ Teach the patient appropriate dietary changes.
▪ Discuss ways to reduce pruritis.
▪ Review with the patient prescribed medications and their possible adverse effects.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Fever - Case 11-1: 18-Month-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
No specific therapy is currently available. In the future, targeted therapies
for NF1-associated tumors may be designed to inhibit growth-promoting pathways
activated in the absence of neurofibromin. Other potential therapies focus on
blockade of angiogenic factors that could potentially decrease tumor growth.
Routine office visits should focus on detection and management of complications,
as discussed previously. Annual ophthalmologic examinations are important to
detect optic nerve lesions. Interval history should focus on subtle sensory or
motor symptoms such as paresthesia or muscle atrophy. Pediatricians should also
inquire about incontinence, given the risk of spinal cord neurofibromas.
Consultation with specific surgical specialists is warranted based on the
location of neurofibromas. Laser treatment has not yet proved successful in
permanently removing caf
é-au-lait spots.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Fever - Case 11-4: 7-Month-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Most patients require only appropriate antibiotic therapy to treat bacterial
infections as they occur. Prophylactic antibiotics are not routinely used,
because the efficacy of such prophylaxis is unclear. Some patients benefit from
antibacterial mouthwashes for occasional mouth sores and gingivitis. G-CSF,
corticosteroids, and intravenous gammaglobulin administration are not routinely
required but have been used to increase neutrophil counts in patients with
serious or recurrent infections (15% of patients with AIN in infancy). In such cases, approximately
50% of children respond to corticosteroids and 75% respond to gammaglobulin.
G-CSF is effective in almost all patients. The neutropenia resolves
spontaneously in 95% of patients, usually within 7 to 24 months. Disappearance
of autoantibodies precedes spontaneous normalization of the neutrophil count.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Jaundice - Case 15-1: 14-Day-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
The removal of galactose from the diet remains the first principle of therapy
for galactosemia. The exclusion of milk (including breast milk) and dairy
products is necessary for the patient
's lifetime.
Depending on the degree of illness at the time of presentation, galactosemic
neonates often require supportive care measures such as intravenous fluids and
antibiotics. Liver synthetic function may be compromised, and the sick infant
may require supplemental vitamin K or even transfusion of fresh-frozen plasma.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Jaundice - Case 15-3: 2-Month-Old Boy:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Replacement of the hormones produced by the pituitary's target organs is the cornerstone of hypopituitarism therapy. Thyroid hormone
replacement should begin as soon as confirmatory testing is completed; delays
in therapy can result in increased risk of cognitive impairment. Jaundice
improves as the underlying endocrine disorder is treated.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Jaundice - Case 15-4: 6-Week-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
The hepatic portoenterostomy (Kasai procedure) for biliary atresia involves the
anastomosis of a limb of small intestine to hepatic ducts in the region of the
porta hepatis (where the portal vein and hepatic artery enter the liver and the
hepatic ducts exit). It relies on the patency of tiny duct remnants to allow
for bile drainage from the liver. Cholangitis is among the most worrisome of
the postoperative complications of hepatic portoenterostomy; its signs and
symptoms include fever, diminished bile flow, and the return of
hyperbilirubinemia. Over time, survivors of hepatic portoenterostomy are also
at risk for liver dysfunction, portal hypertension, esophageal varices,
hypersplenism, and hepatopulmonary syndrome, in which arteriovenous shunts form
within the lung. Liver transplantation is often required for patients who have
undergone portoenterostomy for EHBA, and it is sometimes necessary as a primary
operation if liver disease is far advanced at the time of diagnosis. Estimates
of 10-year survival for patients with EHBA range from 40% to 70%. Approximately
25% to 40% of patients survive 10 years without requiring transplantation.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Jaundice - Case 15-6: 5-Week-Old Girl:
VI. Treatment
(Pediatric Complaints and Diagnostic Dilemmas)
Treatment of Alagille syndrome focuses on the medical management of cholestasis,
promotion of growth and development, and treatment of any comorbidities (e.g.,
congenital heart disease). Children with Alagille syndrome suffer from
malabsorption and require supplementation of fat-soluble vitamins and provision
of sufficient calories for growth, which may necessitate tube feeding. Infants
should receive formulas containing medium-chain triglycerides, which are
absorbable without bile salts. Medications that may benefit Alagille patients
(for example, by promoting bile flow or reducing pruritus) include
phenobarbital, cholestyramine, ursodeoxycholic acid, and antihistamines.
Long-term follow-up of patients with Alagille syndrome includes monitoring for
the development of cirrhosis, portal hypertension, ascites, and liver failure.
The 20-year life expectancy for patients with Alagille syndrome is about 75%
overall, although rates are lower for those patients who require liver
transplantation and for those with severe associated abnormalities (e.g.,
congenital heart disease).
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Complaints and Diagnostic Dilemmas, 2003
Jaundice:
Jaundice - TREATMENT
(The 5-Minute Pediatric Consult)
Clinical pearls:
- Treat Crigler-Najjar syndrome promptly with phototherapy and phenobarbital to prevent kernicterus.
- Older children with Wilson disease may present with profound hemolysis and may have predominantly unconjugated hyperbilirubinemia with severe parenchymal liver disease and fulminant liver failure.
» READ BOOK EXCERPT ONLINE »
Source: The 5-Minute Pediatric Consult, 2008
Fever and Neutropenia:
Management
(Pediatric Infectious Disease)
The management of the patient with neutropenia and fever can be divided into
three major pathogen groups, discussed in the following sections.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Infectious Disease, 2004
Outpatient Evaluation of Fever:
Management
(Pediatric Infectious Disease)
Two regimens are accepted for empiric treatment of neonatal fever. Ampicillin is
usually given to address the possibility of
Listeria monocytogenes infection. The second agent given is usually a third-generation cephalosporin or
gentamycin to cover gram-negative organisms.
Standard practice continues to be a full evaluation and admission for
intravenous antibiotics pending results of blood, urine, and cerebrospinal
fluid (CSF) cultures.
» READ BOOK EXCERPT ONLINE »
Source: Pediatric Infectious Disease, 2004
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