Learn how to classify and manage pneumonia in today’s episode!

This episode was written by Dr. Tammy Yau and Dr. Lidia Park with content support from Dr. Natasha Nakra. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points:

• Pneumonia can be due to bacteria or viruses and there is no reliable way to distinguish the two
• Pneumonia can be diagnosed clinically based on exam or with a CXR. Lab work is not always necessary
• Treatment of bacterial pneumonia depends on if you think it is community acquired (first line amoxicillin), atypical (first line azithromycin), or nosocomial/hospital acquired (consider antibiotics for pseudomonal or MRSA coverage)

Sources:

• AAP 2023, Pinto: https://doi.org/10.1542/aap.ppcqr.396216
• Pediatrics in Review 2017, Messinger: https://doi.org/10.1542/pir.2016-0183
• Pediatric Care Online 2016, Light: https://publications.aap.org/pediatriccare/book/348/chapter/5785224/Pneumonia-Chapter-315
• IDSA 2013: https://doi.org/10.1093/cid/cir531

Prolonged viral upper respiratory symptoms or is it actually sinusitis in disguise? Join us as we discuss all things sinusitis in this episode!

This episode was written by Dr. Tammy Yau and Dr. Lidia Park with content support from Dr. Natasha Nakra. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points:

• Acute bacterial sinusitis can be clinically diagnosed based on persistent respiratory symptoms lasting more than 10 days without improvement, worsening or new respiratory symptoms after initial improvement, or severe symptoms at onset lasting more than 3 days.
• First line antibiotic treatment for acute bacterial sinusitis is with amoxicillin or amoxicillin-clavulanate
• Complications include orbital or intracranial spread of infection

Sources:

• Pediatrics in Review 2013, Demuri and Wald: https://doi.org/10.1542/pir.34-10-429
• AAP Pediatrics 2013, Wald et al: https://doi.org/10.1542/peds.2013-1071
• Pediatrics 2024, Conway et al: https://doi.org/10.1542/peds.2023-064244

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Lisa Rasmussen. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

• Vitamin K is important in preventing early and late onset bleeding in newborns (up to 6 months of age), most importantly, intracranial bleeding.
• Intramuscular vitamin K is most effective but oral vitamin K regimens are used outside of the US and are better than not giving any vitamin K

Sources/Supplemental Information:

• AAP Pediatrics 2022, Hand: https://doi.org/10.1542/peds.2021-056036

CDC Vitamin K Handout: https://www.cdc.gov/ncbddd/vitamink/vitamin-k-fact-sheet-general.html

Can someone with HIV breastfeed their child? You might be surprised at the answer!

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Laura Kair. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

• New guidelines from the CDC recommend allowing mothers with HIV on antiretroviral therapy (ART) with an undetectable viral load to breastfeed their child if they desire, whether or not they live in a developed or underdeveloped country. The risk for HIV transmission through breastmilk in these cases is 0.6%
• In the US, you can call the national perinatal HIV/AIDS hotline at 1-888-448-8765 for advice
• 

Sources

• CDC 2023 Infant Feeding for Individuals with HIV in the US: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/hiv.html

Stay up to date with new research on shortening antibiotic treatment duration for urinary tract infections (UTIs) with our episode today where we review a recently published randomized control trial (RCT). Learn how to critically analyze study data and what key points we take away.

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Michelle Hamline. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.



Key points:

• A single RCT found similar risk of UTI recurrence in children who received a 5 day course vs 10 day course of antibiotics within the first 30 days

Sources

• Pediatrics 2024, Montini et al: https://doi.org/10.1542/peds.2023-062598
• BMJ 2007, Montini et al: https://doi.org/10.1136/bmj.39244.692442.55
• Cochrane Rev 2012, Altamimi et al: https://doi.org/10.1002/14651858.CD004872.pub3
• JAMA Ped 2021, Pernica et al: https://doi.org/10.1001/jamapediatrics.2020.6735
• JAMA Ped, 2022, Williams et al: https://doi.org/10.1001/jamapediatrics.2021.5547

Ever seen a tuft of hair over the lower back or a sacral dimple? Learn how to recognize and manage normal vs abnormal back and spinal findings in our episode today.

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Laura Kair. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

• Spinal dysraphism is the incomplete fusion of the spine during development.
• Not all spinal dysphraphisms will have abnormal cutaneous manifestations that you can see on exam
• Diagnose spinal dysphraphisms with spinal ultrasound in young children and MRI in older children
• Sacral dimples can be normal but should be worked up if they are larger than 5 mm at the base, above 2.5cm from the anus, not midline, or if there are multiple dimples

Sources

• Pediatrics in Review 2019, Holmes and Li: https://doi.org/10.1542/pir.2018-0155
• Peds in Review 2011, Zywicke and Rozzelle: https://doi.org/10.1542/pir.32-3-109
• Hospital Pediatrics 2020, Aby et al: https://doi.org/10.1542/hpeds.2019-0264

Toxoplasmosis is a parasitic TORCH infection that is often associated with cats but did you know owning a cat is not associated with increased prevalence? Learn more on how the disease is actually acquired and how to prevent infection in this episode!

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Ritu Cheema. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

-Cats, undercooked meat, and raw seafood can lead to toxoplasmosis infection

-Findings of toxoplasmosis infection in utero include scattered intracranial calcifications and chorioretinitis

-Treat toxoplasmosis infection in neonates with pyrimethamine, sulfadiazine, and folinic acid

Sources:

AAP 2017 https://publications.aap.org/pediatrics/article/139/2/e20163860/59988/Diagnosis-Treatment-and-Prevention-of-Congenital?autologincheck=redirected

Learn about how the virus that causes cold sores can also cause serious complications in infants.

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Ritu Cheema. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

-First time HSV infection in pregnancy is higher risk to infants than reactivation of previous infection

-Symptoms of neonatal HSV infection include seizures, vesicles, and irritability

-Diagnose HSV with viral culture or PCR of bodily fluids

-Use acyclovir to treat infants and pregnant people with HSV infection

Sources:

AAFP 2022 https://www.aafp.org/pubs/afp/issues/2002/0315/p1138.html

Redbook 2021 https://publications.aap.org/redbook/book/347/chapter-abstract/5752755/Herpes-Simplex?redirectedFrom=fulltext

Neoreview 2018 https://publications.aap.org/neoreviews/article/19/2/e89/87448/Neonatal-Herpes-Simplex-Virus-Infection