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Recent advances in pediatric infectious diseases and their impact on dermatology
1Boston University School of Medicine, Massachusetts.
Abstract:
The past five years have seen numerous advances in the field of pediatric infectious diseases, and many of these have a substantial impact on the practice of dermatology. We review some of these advances and discuss their implications on etiology, diagnosis, therapy and complications of some relatively common conditions. The etiologic agent of exanthum subitum (roseola infantum) has been clearly implicated as a herpesvirus-6. Although in the classically described situation high fever in a young child is followed by defervescence and rash, two new scenarios have been described associated with this virus. The first is fever without rash and the second is rash without fever. The etiologic agent of erythema infectiosum ("slapped cheek") has been shown to be a human parvovirus B19. The virus has also been associated with aplastic crises (in hemoglobinopathies), hydrops fetalis, and a syndrome of subacute arthralgias in women. The etiologic agent in cat-scratch disease has recently been shown to be a small pleomorphic bacillus that also can produce pyogenic granuloma-like lesions in patients with acquired immunodeficiency syndrome. The number of cases of congenital syphilis, particularly in large cities, is increasing tremendously. Many of these infants have received no prenatal care because of drug abuse problems in their parents. Finally, we describe the changing etiology of impetigo that is predominantly associated with Staphylococcus aureus. We further describe the growing resistance to erythromycin and several new erythromycin drug-drug interactions.
Insights
Recent advances in pediatric infectious diseases impact dermatology. Key findings include new herpesvirus-6 presentations, parvovirus B19 associations, cat-scratch disease etiology, rising congenital syphilis, and changing impetigo patterns with antibiotic resistance.
Area of Science:
- Pediatric Infectious Diseases
- Dermatology
Background:
- Advances in pediatric infectious diseases significantly influence dermatological practice.
- Common pediatric conditions are reviewed for their evolving etiology, diagnosis, therapy, and complications.
Purpose of the Study:
- To review recent advances in pediatric infectious diseases.
- To discuss the implications of these advances on common dermatological conditions.
Main Methods:
- Literature review of recent advances in pediatric infectious diseases.
- Discussion of the impact on etiology, diagnosis, therapy, and complications of specific conditions.
Main Results:
- Herpesvirus-6 implicated in exanthum subitum (roseola infantum), presenting with fever and/or rash.
- Human parvovirus B19 identified as the cause of erythema infectiosum, linked to aplastic crises and arthralgias.
- Cat-scratch disease etiology identified as a bacillus, potentially causing pyogenic granuloma-like lesions in immunocompromised individuals.
- Increasing congenital syphilis cases noted, often associated with parental drug abuse and lack of prenatal care.
- Impetigo etiology shifting to Staphylococcus aureus, with growing erythromycin resistance and drug interactions.
Conclusions:
- Understanding evolving etiologies and resistance patterns is crucial for managing pediatric skin conditions.
- New insights into viral and bacterial infections necessitate updated diagnostic and therapeutic approaches in pediatric dermatology.
- Public health issues like congenital syphilis require attention due to rising incidence.