Pediatric emergency medicine trisk 2304 2304
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Cutaneous larval
migrans
Dengue
Diphtheria
E. coli (0157:H7)
Filariasis
Giardia
Hantavirus
(use of formalin ethyl
oocysts
acetate stool
concentration method is
recommended and at least
three stool specimens
collected on separate days
are required because
shedding can be
intermittent
Clinical diagnosis
Clinical diagnosis
Nitazoxanide bid x 3 days (100 mg for 1
11 yo; 500 mg for ≥12 yo)
PCR is best modality for all
stages
Ancillary:
Stage 1: Thrombocytopenia,
leukopenia, elevated
hepatic transaminases
Stage 2: DIC,
hypoalbuminemia, severe
thrombocytopenia
Stage 3: No specific
laboratory findings
Clinical diagnosis
confirmed by
nasopharyngeal or
cutaneous lesion cultures
(positive cultures should
be sent to CDC)
Conventional Stool culture
Stage 1: PCR or
ELISA
Stage 2: PCR
Serologic tests crossreact with other
flaviviral infections
or flaviviral
vaccines (e.g.,
yellow fever,
Japanese
encephalitis virus)
Supportive care, fluid resuscitation
Nasopharyngeal or
cutaneous lesion
cultures
IV equine antitoxin
Erythromycin (oral or parenteral)
Penicillin G IM or IV for 14 days
Stool culture
Supportive care
Microscopic detection of
microfilaria on blood
smears obtained at night
PCR and immunologic
testing also available
Stool culture (sensitivity is
higher for diarrheal stool
specimens)
PCR
Serology, PCR
Ancillary:
thrombocytopenia,
metabolic acidosis,
elevated creatinine,
elevated hepatic
transaminases
Culture not recommended
due to risk to laboratory
personnel
Microscopic detection Microfilaria of W. bancrofti: Diethylcarb
of microfilaria on
(DEC) 2 mg/kg × 1 dose, or 50 mg DE
blood smears
old × 1 dose
obtained at night
Hemorrhagic fever Serology
viruses (other
Ancillary:
than dengue)
thrombocytopenia,
Albendazole 15 mg/kg daily for 3 days (
mg/day) or ivermectin 200 µg/kg once
Stool culture
Metronidazole 5–7 days; tinidazole (for
(sensitivity is higher
mg/kg (max: 2 g) as a single dose, or
for diarrheal stool
days (100 mg for 1–3 yo; 200 mg for
specimens)
≥12 yo)
Serology (should be
sent to CDC)
Supportive care
Serology (subject to
cross-reaction with
Supportive
Lassa: ribavirin highly effective if given
illness
