Discover and read the best of Twitter Threads about #PedsID

Most recents (12)

In the newest Febrile Digest, we chat about SCORTCH as a framework for congenital infections. Check out our guest's overview:

Some nice figs below fr the paper 👇

But where did "TORCH" come fr? I tried to take a look in this 🧵

#IDTwitter #IDMedEd ImageImage
2/ From what I could tell, the ToRCH acronym originated in the 1970s and has been attributed to Dr. Nahmias:… Image
There was a proposal from Harold Fuerst for "STORCH" in 1975, to include the omitted syphilis… Image
Read 6 tweets

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
The 14 studies involved 19,426 children & adolescents.

Common persistent symptoms reported 4-12 weeks after acute #COVID19 were:

•sleep disturbance
•concentration difficulties
•abdominal pain.

Symptoms rarely lasted more than 12 weeks.
Read 13 tweets
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 🧵
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.
Read 7 tweets
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…
Bookmark the BCG World Atlas to quickly see BCG vaccination policies by country as well as other information such as TB incidence

While use in the US is uncommon, there are a few select individuals who might be considered for BCG vacc 👇
Read 8 tweets
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 Image
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 Image
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 Image
Read 8 tweets
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?
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 Image
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:
Read 8 tweets
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
📌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
Read more here about hepatic abscess in pts with CGD: ➡️ look at Fig 3!
Read 9 tweets
Session: Challenging Cases #PedsID

Some case thinking in a "COVID-free zone"
Session: Challenging Cases #PedsID

Cerebral toxoplasmosis in alloHCT pt

CSF cytology actually noted tachyzoites - great image!
Session: Challenging Cases #PedsID

Fusobacterium necrophorum causing liver and renal abscess

Anonymous vampire pic appreciated 🧛
Read 7 tweets
Now to watch Mano a Mano, always a great session!! @PIDSociety
#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
#IDWeek2020 #PedsID
Session: Mano a Mano
Should we tx + tracheal cultures?

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
Read 10 tweets
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

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


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…

US CDC data has 2% of admissions in PICU (limited data)…

Read 12 tweets
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
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
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.
Read 15 tweets
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 👇🏻
- I-Perfuse: great tool for anything cardiovascular including #ECMO cannula sizes, equations, a calculator... very useful for #PedsCICU
- Heartpedia: awesome 3D models of heart anatomy. Also great for teaching at the #PedsCICU. And it was created by the great @pccm_doc
Apps continued:
- The Sanford Guide: it costs 25€/year. I’d pay 250€ since I use it everyday in the #PedsICU. Basically everything you need to now about antibiotics and bugs #PedsID.
Read 14 tweets

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