Discover and read the best of Twitter Threads about #PedsID
Most recents (12)
1/
In the newest Febrile Digest, we chat about SCORTCH as a framework for congenital infections. Check out our guest's overview: pubmed.ncbi.nlm.nih.gov/32586930/
Some nice figs below fr the paper 👇
But where did "TORCH" come fr? I tried to take a look in this 🧵
#IDTwitter #IDMedEd
In the newest Febrile Digest, we chat about SCORTCH as a framework for congenital infections. Check out our guest's overview: pubmed.ncbi.nlm.nih.gov/32586930/
Some nice figs below fr the paper 👇
But where did "TORCH" come fr? I tried to take a look in this 🧵
#IDTwitter #IDMedEd
2/ From what I could tell, the ToRCH acronym originated in the 1970s and has been attributed to Dr. Nahmias: nature.com/articles/pr197…
3/
There was a proposal from Harold Fuerst for "STORCH" in 1975, to include the omitted syphilis
publications.aap.org/pediatrics/art…
There was a proposal from Harold Fuerst for "STORCH" in 1975, to include the omitted syphilis
publications.aap.org/pediatrics/art…
#LongCOVID
We reviewed 14 studies of persisting symptoms following #COVID19 in #children & #adolescents
Most had major limitations and should be interpreted with caution.
True risk is likely to be nearer 1 in 100 than often quoted 1 in 7.
#medpeds #IDTwitter
(Long) 🧵1/n
We reviewed 14 studies of persisting symptoms following #COVID19 in #children & #adolescents
Most had major limitations and should be interpreted with caution.
True risk is likely to be nearer 1 in 100 than often quoted 1 in 7.
#medpeds #IDTwitter
(Long) 🧵1/n
@Dr_Petzi @PittetLaure @MCRI_for_kids @RCHMelbourne @UniMelbMDHS @ASIDANZ @ESPIDsociety @ESPR_EBN @WSPID @PIDSociety @DFTBubbles @PIDJournal
#medpeds #IDTwitter #tweetiatrician #paediatrics #pediatrics #PaedsID #PedsID #PedID #PID
#medpeds #IDTwitter #tweetiatrician #paediatrics #pediatrics #PaedsID #PedsID #PedID #PID
The 14 studies involved 19,426 children & adolescents.
Common persistent symptoms reported 4-12 weeks after acute #COVID19 were:
•headache
•fatigue
•sleep disturbance
•concentration difficulties
•abdominal pain.
Symptoms rarely lasted more than 12 weeks.
Common persistent symptoms reported 4-12 weeks after acute #COVID19 were:
•headache
•fatigue
•sleep disturbance
•concentration difficulties
•abdominal pain.
Symptoms rarely lasted more than 12 weeks.
To reassure parents, a reminder of some key facts about #COVID in #children:
#SARSCoV2 infection remains asymptomatic or mild in the vast majority of children, even with the #DeltaVariant. Hospitalisation and deaths from COVID are still rare in this age group.
1/n 🧵
#SARSCoV2 infection remains asymptomatic or mild in the vast majority of children, even with the #DeltaVariant. Hospitalisation and deaths from COVID are still rare in this age group.
1/n 🧵
However, the greater transmissibility of the Delta variant means there is more COVID in *all* age groups, including children, so we will see more paediatric cases.
As a large number of older people are now vaccinated, the increase is blunted in the elderly so, compared with earlier in the pandemic, a higher *proportion* of current cases will be in children: this can give the mistaken impression that the Delta variant is targeting children.
1/
Have you ever been confused about the BCG vaccine?
Check out this graphic that @LeaGoren @AliceCLehman @thie0149 created and the following thread!
#IDTwitter #IDMedEd #MedTwitter #MedPedsID #PedsID
Have you ever been confused about the BCG vaccine?
Check out this graphic that @LeaGoren @AliceCLehman @thie0149 created and the following thread!
#IDTwitter #IDMedEd #MedTwitter #MedPedsID #PedsID
2/💉Bacille-Calmette-Guerin (BCG) immuniz. against TB is a group of related live vaccines derived from attenuated M.bovis.
🌏Used in >100 countries, most widely administered vaccine in world
🧠Given to ⬇️incidence of TB meningitis + miliary dz in children
who.int/immunization/s…
🌏Used in >100 countries, most widely administered vaccine in world
🧠Given to ⬇️incidence of TB meningitis + miliary dz in children
who.int/immunization/s…
3/
Bookmark the BCG World Atlas to quickly see BCG vaccination policies by country as well as other information such as TB incidence
bcgatlas.org
While use in the US is uncommon, there are a few select individuals who might be considered for BCG vacc 👇
Bookmark the BCG World Atlas to quickly see BCG vaccination policies by country as well as other information such as TB incidence
bcgatlas.org
While use in the US is uncommon, there are a few select individuals who might be considered for BCG vacc 👇
1/ A great part of our newest ep. is the discussion about immigrant & refugee health assessments. Check out the great image from our guests @AliceCLehman @LeaGoren @thie0149 ! 👇
Keep scrolling for more resources/links
#IDMedEd #IDTwitter #MedPedsID
Keep scrolling for more resources/links
#IDMedEd #IDTwitter #MedPedsID
2/
Children born outside of the US are vulnerable to increased morbidity due to the lack of awareness of their migration journey and indications for screening/tx. @AliceCLehman outlined some of the definitions that are often used
Children born outside of the US are vulnerable to increased morbidity due to the lack of awareness of their migration journey and indications for screening/tx. @AliceCLehman outlined some of the definitions that are often used
3/
A key point from @AliceCLehman: refugee children are provided predeparture screening/treatment, which is coordinated with the International Office of Migration -- but immigrant/migrant children do not always undergo the same screens; may have variable predeparture environments
A key point from @AliceCLehman: refugee children are provided predeparture screening/treatment, which is coordinated with the International Office of Migration -- but immigrant/migrant children do not always undergo the same screens; may have variable predeparture environments
1/
In the newest episode, @JillWeather spoke about eosinophilia!
#1 step: calculate your absolute eosinophil count (AEC).
You can then grade eosinophilia based on AEC (mild/mod/severe)👉although this doesn't exactly predict organ damage
What else?
In the newest episode, @JillWeather spoke about eosinophilia!
#1 step: calculate your absolute eosinophil count (AEC).
You can then grade eosinophilia based on AEC (mild/mod/severe)👉although this doesn't exactly predict organ damage
What else?
2/
The ddx for eosinophilia is broad! It can help to think of different causes in groups.
Here is a nice mnemonic and graphic from @HawraAllawati on how she remembers: iPa3d!
I nfection
P arasite
A3 atopy, autoimmune, adrenal insufficiency
D rug rxn
The ddx for eosinophilia is broad! It can help to think of different causes in groups.
Here is a nice mnemonic and graphic from @HawraAllawati on how she remembers: iPa3d!
I nfection
P arasite
A3 atopy, autoimmune, adrenal insufficiency
D rug rxn
3/
Another memory tool is 3 Ws:
🪱Worms: helminth infections
🫁Wheezes: allergic/atopic, adverse drug reactions
🤪Weird diseases: hypereos syndromes, rare immunodef
Here is a nice review on a practical approach to pt with hypereosinophilia: pubmed.ncbi.nlm.nih.gov/20538328/
Another memory tool is 3 Ws:
🪱Worms: helminth infections
🫁Wheezes: allergic/atopic, adverse drug reactions
🤪Weird diseases: hypereos syndromes, rare immunodef
Here is a nice review on a practical approach to pt with hypereosinophilia: pubmed.ncbi.nlm.nih.gov/20538328/
1/
Liver abscess is estimated to occur in about 1/3 of patients with CGD. In the episode, we discussed how a liver abscess may have distinct characteristics in the setting of CGD
#IDTwitter #IDMedED #PedsID @ID_fellows
PLA = pyogenic liver abscess
Liver abscess is estimated to occur in about 1/3 of patients with CGD. In the episode, we discussed how a liver abscess may have distinct characteristics in the setting of CGD
#IDTwitter #IDMedED #PedsID @ID_fellows
PLA = pyogenic liver abscess
2/
PLA in CGD:
📌septate mass surrounded by a thick pseudocapsule
📌Inside=dense inspissated fluid.
📌Can be homogenously enhancing on imaging while small, but then develop mult locules separated by thick enhancing septations with intense halo/rim of enhancement around abscess
PLA in CGD:
📌septate mass surrounded by a thick pseudocapsule
📌Inside=dense inspissated fluid.
📌Can be homogenously enhancing on imaging while small, but then develop mult locules separated by thick enhancing septations with intense halo/rim of enhancement around abscess
3/
Read more here about hepatic abscess in pts with CGD:
pubmed.ncbi.nlm.nih.gov/11882760/
pubmed.ncbi.nlm.nih.gov/16861554/ ➡️ look at Fig 3!
Read more here about hepatic abscess in pts with CGD:
pubmed.ncbi.nlm.nih.gov/11882760/
pubmed.ncbi.nlm.nih.gov/16861554/ ➡️ look at Fig 3!
#IDWeek2020
Session: Challenging Cases #PedsID
Cerebral toxoplasmosis in alloHCT pt
CSF cytology actually noted tachyzoites - great image!
Session: Challenging Cases #PedsID
Cerebral toxoplasmosis in alloHCT pt
CSF cytology actually noted tachyzoites - great image!
#IDWeek2020
Session: Challenging Cases #PedsID
Fusobacterium necrophorum causing liver and renal abscess
Anonymous vampire pic appreciated 🧛
Session: Challenging Cases #PedsID
Fusobacterium necrophorum causing liver and renal abscess
Anonymous vampire pic appreciated 🧛
#IDWeek2020 #PedsID
Session: Mano a Mano
Should we tx + tracheal cultures?
Con: @asicksamuels
3 Reasons not to treat:
1. Positive cxs do not equal infection
2. Trach cxs are unreliable
3. Treated positive trach cxs do not equal improved outcomes
+
Risk patient harm from over-tx
Session: Mano a Mano
Should we tx + tracheal cultures?
Con: @asicksamuels
3 Reasons not to treat:
1. Positive cxs do not equal infection
2. Trach cxs are unreliable
3. Treated positive trach cxs do not equal improved outcomes
+
Risk patient harm from over-tx
#IDWeek2020 #PedsID
Session: Mano a Mano
Should we tx + tracheal cultures?
Pro:
VAT assoc'd w/⬆️duration of mech vent, ICU LOS, mortality
Tx of VAT can prevent progression to VAP and perhaps mortality
Treating VAT w/impaired oxygenation is really tx'ing VAP, which is warranted
Session: Mano a Mano
Should we tx + tracheal cultures?
Pro:
VAT assoc'd w/⬆️duration of mech vent, ICU LOS, mortality
Tx of VAT can prevent progression to VAP and perhaps mortality
Treating VAT w/impaired oxygenation is really tx'ing VAP, which is warranted
Ok a few things have been moving in the world of paediatric #COVIDー19 literature
Time for an updated #tweetorial on SARS-CoV-2 infection in children!
#FOAMped #FOAMed #PedsICU #PedsID #IDtwitter
1/12
Time for an updated #tweetorial on SARS-CoV-2 infection in children!
#FOAMped #FOAMed #PedsICU #PedsID #IDtwitter
1/12
So there are fewer cases in children. How much fewer?
Children consistently make up <2% of confirmed COVID-19 cases. These are usually ascertained by testing sick people in hospital
US: dx.doi.org/10.15585/mmwr.…
Italy: jamanetwork.com/journals/jama/…
Madrid: jamanetwork.com/journals/jamap…
2/12
Children consistently make up <2% of confirmed COVID-19 cases. These are usually ascertained by testing sick people in hospital
US: dx.doi.org/10.15585/mmwr.…
Italy: jamanetwork.com/journals/jama/…
Madrid: jamanetwork.com/journals/jamap…
2/12
COVID-19 is less severe in children, but often is it severe?
From a Chinese cohort 0.6% needed PICU but lots of community testing involved
pediatrics.aappublications.org/content/early/…
US CDC data has 2% of admissions in PICU (limited data)
dx.doi.org/10.15585/mmwr.…
3/12
From a Chinese cohort 0.6% needed PICU but lots of community testing involved
pediatrics.aappublications.org/content/early/…
US CDC data has 2% of admissions in PICU (limited data)
dx.doi.org/10.15585/mmwr.…
3/12
1/15 #Fever #tweetorial
Parents and paediatricians alike are obsessed with fever
We've all got fever fever 🔥 But it is SO misunderstood
Let's take a look at what fever actually is, and finish off with some myth busting!
#FOAMPed #FOAMed #IDTwitter #PedsICU #PedsID
Parents and paediatricians alike are obsessed with fever
We've all got fever fever 🔥 But it is SO misunderstood
Let's take a look at what fever actually is, and finish off with some myth busting!
#FOAMPed #FOAMed #IDTwitter #PedsICU #PedsID
2/15
Fever (pyrexia) is an elevated core body temperature as part of a physiological response to infection controlled by the hypothalamus
This is opposed to hyperthermia, a pathological elevated temperature
This is important, as your body is IN CONTROL. Fever happens on purpose
Fever (pyrexia) is an elevated core body temperature as part of a physiological response to infection controlled by the hypothalamus
This is opposed to hyperthermia, a pathological elevated temperature
This is important, as your body is IN CONTROL. Fever happens on purpose
3/15
What temperature counts as a fever?
There's no strict definition (there's no really good data on what a "normal" temperature is...), but an arbitrary cut of off 38C is often used.
Its better taken in context; 37.8C following temps >38.5C is probably still a fever.
What temperature counts as a fever?
There's no strict definition (there's no really good data on what a "normal" temperature is...), but an arbitrary cut of off 38C is often used.
Its better taken in context; 37.8C following temps >38.5C is probably still a fever.
With the help of @PICJournalWatch @harrykchris we though we could put together a collaborative thread with useful #PedsICU resources like apps, websites, blogs and accounts. This thread is open so please don’t hesitate to add yours. Here are mine 👇🏻
