A Difficult Beast

A 14 year old girl was brought in by her family with lethargy, agitation, and confusion. Her past medical history includes depression and a recent viral upper respiratory tract infection.   Bottom Line: Encephalitis is caused by inflammation of the brain and is difficult to diagnose and manage. Up to 50% of patients experience short-term…

Kawasaki Disease – Beware the Incomplete!

  A four year old Japanese male was brought into Emergency with 5 days of fevers, non-exudative bilaterally injected sclerae, erythematous pharynx and irritability. Wondering about the possibility of Kawasaki Disease, I turned to check the 2017 update of the American Heart Association Scientific Statement, focusing on considering a diagnosis of Incomplete Kawasaki Disease.  …

Quadrivalent Meningococcal Vaccination: W(135)hat’s all the fuss about?

I’ll never forget the throbbing, pounding headache that heralded the onset of meningococcal meningitis and septicaemia as a 14 year old girl; the complete overwhelm of the horrifying physical sensation that is sepsis. Within two hours I was unconscious – but thanks to a vocal family member advocating their concern for how sick I was,…

A gentle nudge…

Children have a right to receive healthcare regardless of the decisions made by their parents. This week, the RACP released a further statement citing refusal to treat patients for non-vaccination as ‘unethical coercion’. Whilst the majority of paediatricians are clear on the benefits of vaccinations, parents can choose not to vaccinate their children. Under the…

CVADs – a survival guide

This guest post is from Amanda Ullman, Tricia Kleidon, Anna Dean and the Paediatric Vascular Assessment and Management Service, Lady Cilento Children’s Hospital, Brisbane. We all love reliability. Central venous access devices (CVADs) are everywhere – across disciplines and departments, and we just want them to work reliably, without complication. But every day, somewhere in your…

Big Picture Paediatrics : Adverse Childhood Experiences

So much of paediatrics, and medicine in general, is focussed on small experimental or observational studies. This series of posts takes the wider view; we’re talking here about some of the biggest and longest running studies that help us frame, measure and understand childhood through time and across the world. References: Felitti, VJ, Anda RF,…

A new approach to febrile infants

The fortnight has seen two hot off the press articles by a group from the Basque Country. They are challenging the existing paradigm in the investigation and management of febrile infants with their “Step by step” approach. The approach questions the relative supremacy of the Rochester criteria as a basis for investigating and managing infants under…

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