RE: infectious disease questions, fruthter info

The dog was diagnosed at Cornell University Vet. Hospital (He was
transported several hundred miles to get there) and he was diagnosed
by cultures. Children are too young for tetracyclines. Father says
they all may have cleaned up the urine using rags. He had no idea
whether anyone, including himself, had abrasions or sores.

------------------ Reply Separator --------------------
Originally From: "Wayne Fellmeth, MD"
Subject: RE: infectious disease questions
Date: 11/06/1999 05:45pm

#1 - I would treat with Albuterol immediately as well as starting a
macrolide antibiotic (I've used clarithromycin rather than
erythromycin for
GI upset and compliance reasons). It may be adenovirus or even asthma
but I
think you have to think about pertussis with that kind of cough.

#2. No, I would wait until I got the cultures/testing back on the
first
child. You do have some incubation time.

#3. Same as for #2

#4. Are they symptomatic? How was the dog's diagnosis made/confirmed?
So,
maybe with more info.

Wayne G. Fellmeth, MD, FAAP phone: 908-788-6468
Hunterdon Pediatric Assoc. fax: 908-788-7477
1100 Wescott Drive, Suite G-3 hidden@email-address
Flemington, NJ 08822

-----Original Message-----
From: hidden@email-address [mailto:hidden@email-address]On Behalf Of
David Tinkelman
Sent: Saturday, November 06, 1999 12:10 PM
To: hidden@email-address
Subject: infectious diseas questions

I have had some interesting scenarios come up and am interested in how
others would handle them.
#1 first patient of the day is a three year old, booked as a cold with
cough, but history shows the cough is in paroxysms leading to color
changes and vomiting. He has history of contacts with other children
with bad coughs that is consistent with pertussis. Cultures are sent.
When do you start treatment?
#2 The next patient of the day is a 2 month old in for routine care.
Do you treat with prophylactic antibiotics?
#3 the third patient of the day is also a two month and comes in
immediately after the index case leaves. Has there been an exposure
and should this one be treated?
PS The next day the slide test is reported as positive for pertussis
#4 A father calls and says his dog is dying of leptospirosis. The dog
while ill was often incontinent of urine in the house. He wants his
well children treated with penicillin. Should you comply? David
Tinkelman, MD

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This message is from PEDTALK - a Pediatric Focused email discussion
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Admin questions: "hidden@email-address" or
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