Download Manual of Childhood Infection: The Blue Book

Manual of Childhood Infection PDF

Manual of Childhood Infection – Infectious diseases remain a leading cause of child morbidity and mortality worldwide. Now in its fourth edition, Manual of Childhood Infections is a simple-to-use, evidence-based, and practical handbook on how to recognize, investigate, and manage both common and rare infectious diseases in children and babies. Endorsed by the Royal College of Paediatrics and Child Health and the European Society for Paediatric Infectious Diseases, this fully updated version of the established ‘Blue Book’ complements the Pan European initiatives and UK diploma courses to harmonise patient management and training in Paediatric Infectious Diseases (PID), making it essential reading for UK and European paediatricians.

Manual of Childhood Infections is divided into two alphabetized sections for easy access to information, covering key diagnosis and management features of infections alongside crucial points of epidemiology and clinical features. This fourth edition forms practical reading for practising paediatricians, featuring updates to all key chapters based on a literature review alongside new chapters focusing on emerging problems for Europe.

Many new chapters in this new edition extend The Blue Book to include all common and rarer childhood infections, while an enhanced European and global focus reflects the changing world of international travel and imported infections.

Bibliographic Information

Publisher: Oxford University PressPrint Publication Date: Apr 2011Print ISBN-13: 9780199573585Published online: Oct 2011DOI: 10.1093/med/9780199573585.001.0001

Review – Manual of Childhood Infection


“I was very impressed by this book, the content is superb, and it is well written and is ideal for a number of health care professionals.”- Glycosmedia
“The clinical features, diagnosis, and management of childhood infectious diseases presented in this compact guide make it a practical tool for providers across the globe who care for children.” –Doodys Health Science

Content – Manual of Childhood Infection

Section editors xiv
Contributors xv
Abbreviations and symbols xxiv
Section 1 Clinical syndromes
1 Antibiotics and resistance 3
2 Antifungal drugs 10
3 Antiparasitics 20
4 Antivirals 25
5 Bone and joint infections 38
6 Cardiac infections: endocarditis 44
7 Cardiac infections: myocarditis and pericarditis 54
8 Central venous catheter infections 68
9 Chronic fatigue syndrome 73
10 Congenital infections 77
11 Conjunctivitis 90
12 Diarrhoea and vomiting 97

13 Emerging and re-emerging infections 102
14 Encephalitis 107
15 Enlarged lymph nodes 116
16 Haemolytic-uraemic syndrome 131
17 Healthcare-associated infections 137
18 Acute hepatitis 148
19 Human immunodefi ciency virus infection 153
20 Immunocompromised children with infection 163
21 Infection control in community settings 172
22 Intra-abdominal infections 178
23 Invasive fungal infection 193

24 Investigating the child with possible
immunodefi ciency 204
25 Kawasaki disease 214
26 Laboratory diagnosis of infection 220
27 Lower respiratory tract infection 230
28 Mastoiditis, quinsy, and brain abscess 240
29 Meningitis 247
30 Neonatal infection 262
31 Ocular infections 270
32 Periodic fever syndromes 282
33 Pyrexia of unknown origin 287
34 Rash: making a diagnosis 292
35 Refugees and internationally adopted children 303
36 Sepsis syndrome 308
37 Sexually transmitted infections 320
38 Skin and soft tissue infections 327

39 Toxic shock syndrome 334
40 Trauma, bites, and burns 344
41 Travelling abroad with children 350
42 The unwell child returning from abroad 357
43 Urinary tract infection 364
44 Upper respiratory tract infections 373
45 Zoonoses 383
Section 2 Specifi c infections
46 Adenovirus 394
47 Amoebiasis 401
48 Anaerobic infections 407

49 Arboviruses 416
50 Ascariasis 425
51 Aspergillosis 434
52 Botulism 448
53 Brucellosis 452
54 Campylobacter 456
55 Candidiasis 460
56 Cat scratch disease 464
57 Chicken pox—varicella zoster 467
58 Chlamydia 475
59 Cholera 483
60 Clostridium diffi cile infection 487
61 Cryptosporidiosis 496
62 Cytomegalovirus 499
63 Diphtheria 505
64 Enteroviruses and parechoviruses 508
65 Epstein–Barr virus 517

66 Escherichia coli diarrhoea 521
67 Giardiasis 523
68 Gonococcal infection 527
69 Gram-negative bacteria 531
70 Haemophilus infl uenzae 537
71 Hand, foot, and mouth disease 542
72 Head lice (pediculosis) 544
73 Helicobacter pylori 548
74 Helminthiases 553
75 Hepatitis B 564
76 Hepatitis C 571

77 Herpes simplex virus 1 and 2 576
78 Human herpesviruses 6 and 7 583
79 Human papillomavirus 587
80 Infl uenza and parainfl uenza 595
81 Legionella 600
82 Leishmaniasis 603
83 Listeriosis 609
84 Lyme disease 613
85 Malaria 616
86 Measles 624
87 Meningococcal disease 628
88 Molluscum contagiosum and other poxviruses 637
89 Mumps 640
90 Mycoplasma 644
91 Non-tuberculous mycobacterial infection 649

92 Norovirus 655
93 Parvovirus 659
94 Pertussis 664
95 Plague 670
96 Pneumocystis pneumonia (PcP) 674
97 Polio 678
98 Rabies 683
99 Respiratory syncytial virus 687
100 Rotavirus 692
101 Rubella 696
102 Scabies 701
103 Schistosomiasis 705
104 Shigellosis 710

105 Staphylococcal infections including MRSA 713
106 Streptococcal infections 721
107 Syphilis 730
108 Tetanus 735
109 Threadworm 738
110 Tinea 741
111 Toxocariasis 747
112 Toxoplasmosis 749
113 Tuberculosis 753
114 Typhoid and paratyphoid—enteric fever 759
115 Typhus 764
116 Viral haemorrhagic fevers 771
117 Yellow fever 778
118 Yersiniosis 783

Appendices
Appendix 1 The contribution of infectious diseases
to neonatal and childhood deaths in
England and Wales 786
Appendix 2 Guidance on infection control in
school and other childcare settings 792
Appendix 3 Immunization of the normal and
immunocompromised child 797
Appendix 4 Notifi cation and surveillance of
infectious diseases 803
Appendix 5 Blue Book Formulary 810
Index 863


Basic principles in the use of antibiotics

• Antimicrobial agents target sites or pathways that are unique to the bacterium in order to achieve maximum toxicity for the microorganisms and minimal toxicity to humans. • All antibiotics produce human toxicity to varying degrees and the therapeutic index (maximal tolerated dose divided by the minimum effective dose) provides a numerical expression of this. Some antibiotics, such as penicillins, are very safe and thus have a very high therapeutic index. Others, e.g. gentamicin, have a low maximum tolerated dose and thus a therapeutic index that is low. • Antimicrobials alter the host’s normal fl ora (e.g. ampicillin or amoxicillin/clavulanate are re-excreted into the gastrointestinal tract) and affect the predominantly anaerobic fl ora of the large bowel resulting in antibiotic-associated diarrhoea or promoting colonization by Clostridium diffi cile. • ‘Use it and lose it!’ Use and misuse of antibiotics contribute to development of antimicrobial resistance. There is reasonably good evidence that rational use of antibiotics can prevent or decrease the development of resistance.

Choosing the right antibiotic for therapy of a given infection is more challenging than ever and following the key steps listed below will allow for a systematic approach to antibiotic selection: • What is (are) the most likely causative pathogen(s) for the diagnosed clinical syndrome? • What is the probable susceptibility of the isolated (or suspected) pathogen based on lab results or local epidemiological parameters? • What is the appropriate dose and duration of therapy according to the host and the site of infection? • Presumptive and empirical therapy: • Initial choice of antibiotic is usually based on a clinical syndrome and anatomical site of infection. The initial antibiotic choice can often later be changed to the most narrow-spectrum, yet effective, antibiotic with activity against the identifi ed organism. • For suspected (unproven) infections presumptive therapy may be considered.

Control of resistance – Manual of Childhood Infection

Antibiotic prescribing habits of clinicians and general practitioners are largely responsible for the emergence of resistant pathogens. The unnecessary use of antibiotics acts as a strong selective tool for the emergence of resistant microorganisms, and restriction of use should lead to the opposite effect (although this is more diffi cult to demonstrate outside controlled environments) Reducing antibiotic prescribing is far from easy and a combined effort is mandatory. Adherence to prescribing guidelines (for hospital and community prescribing) and restriction policies that reduce use of certain antibiotics (for hospital prescribing) may lead to the reduction in antibiotic overuse and resistance. All children’s hospitals should develop an antimicrobial stewardship programme.

New agents and conservation of old drugs

There is a marked shortage of new antibiotics under development by pharmaceutical companies, especially for multidrug-resistant Gramnegative infections. Clinicians should generally reserve new antibiotics for third line use. Improved incentives to invest in new antimicrobial agents are underway in both the European Union and the USA. Improved stewardship of current agents should be based on a better understanding of current resistance rates in children across Europe. Point prevalence surveys can be standardized to produce comparative prescribing data between and within countries.

About the author (2011) – Manual of Childhood Infection

Mike Sharland has been a consultant in the Paediatric Infectious Diseases Unit at St George’s Hospital for 15 years. He is a recognised expert in optimising antimicrobial use in children. He is a board member of ESPID, Chair of ESPID Research Committee, Previous Chair of ESPID Training Committee, and Chair of RCPCH Standing Committee on Infection and Immunisation and Chair of the UK Medicines for Children Research Network Allergy, Infection and Immunity Clinical Study Group. He is also the Joint Chair of the Pediatric European Network for Trials in Infection.

Andrew Cant has served on the European Society for Paediatric Infectious Diseases (ESPID) education and training committees since 1999, representing ESPID at the Confederation Europeenne des Specialistes en Pediatrie (CESP), developing Europe wide training programmes in paediatric infectious diseases and immunology that were recently ratified by the European Medical Union. He was elected President of ESPID, taking up office in May 2006. From 2000 to 2004 he was chairman of the bone marrow transplant working party of the European Society for Immunodeficiencies (ESID); collating and presenting data on our Europe wide results of BMT for immunodeficiency. He is currently chairman of the ESID educational working party.

Graham Davies trained in medicine at Cambridge University and University College Hospital, London. His training in paediatrics, immunology and infectious diseases included an Action Research Training Fellowship at the Institute of Child Health. After a consultant appointment in paediatrics and infectious diseases at St Georges University of London, he took up his current position at Great Ormond Street Hospital/ Institute of Child Health in 1997. His research interests are in the diagnosis and management of immunodeficiency disorders. He leads a programme developing thymus transplantation and has chaired an intercollegiate working party on mother-to-child transmission of HIV. Until recently, he chaired the specialist advisory committee for training in paediatric immunology and infectious diseases.

David Elliman has had a major interest in immunisation and infection control in the community for over 30 years. He has written and lectured widely on the topic, as well as spending time talking to parents. Some years ago he was co-author of a review of the characteristics of spread of a number of infectious diseases. More recently he was involved in a European Communicable Diseases Centre project to provide factsheets on infectious diseases for healthcare professionals and the public.

Susanna Esposito is Director of the Pediatric Infectious Diseases Unit at the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Universita degli Studi di Milano, Italy, where she is also Vice-Director of the Pediatric Department and Chief of the outpatient clinic for travel medicine. Her research has focused on respiratory tract infections, vaccines and preventive pediatrics. She is also chief of one of the pediatric HIV clinics at Regione Lombardia, and an associate professor in pediatrics at the Department of Maternal and Pediatric Sciences, Universita degli Studi di Milano.

Adam Finn is Head of the Academic Unit of Child Health at Bristol Medical School, Department of Clinical Science, South Bristol and an honorary consultant in paediatric infectious diseases and immunology at Bristol Royal Hospital for Children. He is director of the South West Medicines for Children Research Network and heads the Bristol Children’s Vaccine Centre. His main research interests include mucosal immunology relating to bacterial vaccines, in particular pneumococcus and clinical trials of vaccines and medicines in children.

Jim Gray has been a consultant medical microbiologist at Birmingham Children’s and Women’s Hospitals since 1985, where he has had a significant role in developing specialist paediatric and neonatal microbiology and infection control. His clinical interests include antibiotic prescribing, infection control and neonatal infections, while his research interests include Staphylococcus aureus (including MRSA) infections, group B streptococci, healthcare associated infections, diagnostic test accuracy studies and point of care testing. He has contributed to several national and international committees on microbiology and infection control.

Paul Heath is Reader/ Honorary Consultant in Paediatric Infectious Diseases at St George’s, University of London and Vaccine Institute in London. His training in paediatrics and infectious diseases was at the Royal Children’s Hospital, Melbourne, the John Radcliffe Hospital, Oxford and St George’s Hospital, London. His particular research interests are in the epidemiology of vaccine preventable diseases, in clinical vaccine trials, particularly in at-risk groups, and in perinatal and neonatal infections.

As an infectious diseases paediatrician, Hermione Lyall is particularly interested in viral infections and their interactions with their hosts. Prevention of transmission of HIV from mother to infant, and the management of HIV infected children and young people is her main area of interest. She is a member of the steering committee of PENTA (Paediatric European Network for the Treatment of AIDS) and participates in international treatment trials for HIV infected children. She is the chair of training for PENTA, and leads the [email protected] course.

Andrew Pollard obtained his medical degree at St Bartholomew’s Hospital Medical School, University of London in 1989 and trained in paediatrics and infectious disease in Birmingham, London and Vancouver, Canada. He obtained his PhD at St Mary’s in 1999 studying immunity to Neisseria meningitidis in children and worked on anti-bacterial innate immune responses in children in Canada before returning to his current position as Professor of Paediatric Infection and Immunity at the University of Oxford in 2001. Current research activities include design, development, clinical trials and evaluation of vaccines for children in the UK and Nepal. His publications include over 200 manuscripts and he chaired the UK’s NICE meningitis guidelines development group.

Mary Ramsay is a consultant epidemiologist who leads on national surveillance for a range of vaccine preventable diseases and hepatitis at the HPA Centre for Infections. The Centre’s outputs are used to inform national vaccine policy and strategies to control viral hepatitis in England. She contributes to a range of national guidance documents and is joint chief editor for the UK’s Immunisation Against Infectious Disease. Internationally, she coordinated the EU surveillance of invasive bacterial infections for 8 years and regularly acts as a temporary advisor to the WHO on immunisation policy.

Andrew Riordan is Consultant in Paediatric Infectious Diseases and Immunology at Alder Hey Children’s NHS Foundation Trust, Liverpool, UK. He was Johanne Holly Research Fellow at the University of Liverpool and wrote his Doctoral Thesis on Meningococcal Disease. He has helped produce NICE guidance, standards for the care of children with HIV and advice to the Joint Committee on Vaccination and Immunisation.

Delane Shingadia is a consultant in Paediatric Infectious Disease at Great Ormond Street Hospital NHS Trust. Over the past 20 years, he has developed his interest in Infectious Diseases, particularly in TB, tropical infections and HIV infection. He presently works as part of a team delivering tertiary care for children with infectious diseases. He has been the paediatric representative on various guidelines, such as the NICE TB guidelines, and national committees, such as the Joint Tuberculosis Committee of the British Thoracic Society and the Advisory Committee for Malaria Prevention. His research interests including infectious diseases epidemiology and infection in immunocompromised children.

Share this:

Comment