Gastroesophageal Reflux
Gastroesophageal reflux (GER) refers to the process by which gastric contents flow backward into the esophagus. It is a common physiological phenomenon in infants and children. However, when reflux leads to symptoms or complications, it is classified as gastroesophageal reflux disease (GERD). GERD is a significant cause of morbidity in pediatric populations, with potential implications […]
Basic Fluid and Electrolyte Management
The first step to understanding how to manage fluid and electrolytes in children is to understand their needs, which of course like so many other things in pediatric care, depend on a child’s age. How much free water does a child need? How much sodium? How much potassium? How much sugar (glucose)? While a detailed […]
Fever of Unknown Origin
Fever of unknown origin (FUO) refers to a prolonged fever (>3 weeks) that remains unexplained after an initial evaluation, including a thorough history, physical examination, and basic laboratory tests. In pediatric patients, FUO presents a diagnostic challenge, as it may be caused by a wide variety of infections, inflammatory disorders, malignancies, or other rare conditions. […]
Fever in Neonates
Neonatal sepsis is a critical condition that is most often seen in infants 56 days of life or younger. Newborns with neonatal sepsis can show systemic signs, such as fever, poor feeding, poor perfusion, but often have more subtle clinical findings that make a high index of suspicion important. The specific types of infections of […]
Febrile Seizures
Febrile seizures are one of the most common types of seizures in children, typically occurring between the ages of 6 months and 5 years. These seizures are associated with fever (100.4°F or higher) anytime within the prior 24 hours and can be a source of significant anxiety for parents. Understanding febrile seizures is crucial for […]
Distributive shock
Distributive shock is a critical condition characterized by inadequate blood flow that leads to poor tissue perfusion, and thus, inadequate oxygen delivery. It is an umbrella term that includes common pediatric conditions, including sepsis and anaphylaxis, and requires prompt recognition and intervention to prevent morbidity and mortality. This article provides an overview of the epidemiology, […]
Diabetic Ketoacidosis
Ketoacidosis is responsible for the initial presentation of insulin dependent diabetes (IDDM) in up to 25% of children. It is the triad of hyperglycemia (above 200mg/dL), systemic ketosis (with ketones present in the urine or a beta-hydroxybutyrate (BOHB) over 3mmol/L), and acidosis (pH of <7.3 or bicarb <15mmol/L). It can be classified as either mild, […]
Dehydration
Dehydration is a common and potentially serious condition encountered in hospitalized pediatric patients. It occurs when there is an imbalance between fluid intake and loss, leading to a deficit in body water. Recognizing and managing dehydration effectively is crucial to prevent significant morbidity and even mortality in children. This guide will cover the common causes, […]
Community-acquired pneumonia
There are >100,000 hospitalizations of patients < 18 years old that can be attributed to community-acquired pneumonia (CAP). There is great variation in the care of these patients based on where they present (children’s hospital versus community hospital), with a common issue being over-utilization of antibiotics but also overuse of broad-spectrum antibiotics. Note This guideline […]
Cardiogenic shock
Cardiogenic shock is a critical condition characterized by the heart’s inability to pump sufficient blood to meet the body’s needs, leading to inadequate tissue perfusion and oxygenation. This article provides an overview of the epidemiology, etiology, pathogenesis, pathophysiology, clinical features, differential diagnosis, diagnosis, and treatment of cardiogenic shock in infants and children, tailored for pediatric […]