{
 "topic": "Parasitic Infection",
 "slug": "parasitic-infection",
 "category_id": 14950,
 "passage_count": 14,
 "source_chars": 12573,
 "enough_material": true,
 "references": [
  {
   "title": "CURRENT Diagnosis and Treatment Pediatrics, Twenty-Fourth Edition",
   "author": "Hay, William W., Levin, Myron J., Deterding, Robin R., Abzug, Mark J.",
   "pages": [
    1344,
    1354
   ]
  },
  {
   "title": "Netters Pediatrics (Florin \u0422., Ludwig St.)",
   "author": null,
   "pages": [
    646
   ]
  },
  {
   "title": "Cover",
   "author": "Vitalsource Download",
   "pages": [
    4181,
    4467,
    4483
   ]
  },
  {
   "title": "Illustrated Textbook of Paediatrics (Tom Lissauer, Will Carroll)",
   "author": "Lissauer, Tom,Carroll, Will",
   "pages": [
    269
   ]
  },
  {
   "title": "Textbook of Pediatric Gastroenterology, Hepatology and Nutrition (Stefano Guandalini, Anil Dhawan)",
   "author": null,
   "pages": [
    231
   ]
  },
  {
   "title": "Pediatrics for Practitioner (Sharad Thora)",
   "author": null,
   "pages": [
    389
   ]
  },
  {
   "title": "Kliegman R. Nelson Textbook of Pediatrics 2-Volume Set 22ed 2024",
   "author": null,
   "pages": [
    1928,
    2242
   ]
  },
  {
   "title": "Algorithms in Pediatrics",
   "author": null,
   "pages": [
    302
   ]
  }
 ],
 "passages": [
  {
   "source": "CURRENT Diagnosis and Treatment Pediatrics, Twenty-Fourth Edition, p. 1344",
   "text": "## ~~\u00ba~~ ~~**PARASITIC INFECTIONS**~~ The parasites that cause human disease represent a diverse, highly evolved and complex group of organisms. Parasitic diseases are a major cause of global pediatric morbidity and mortality, with the heaviest disease burden occurring in low- and middle-income countries. Though less common in industrialized nations, parasites represent an important class of pathogens to recognize in this setting, as both endemic and imported cases are frequently encountered in pediatric practice. Given the complexity of this category of pathogens, a framework to organize human parasites according to their major biologic classification and predominant site (intestinal vs blood/tissue) of human interaction can be useful to the learner (Table 43\u20131). Additionally, understanding organisms associated with potential clinical presentations of parasitic diseases can help focus the diagnostic process (Table 43\u20132). ## **Selection of Patients for Evaluation**"
  },
  {
   "source": "Netters Pediatrics (Florin \u0422., Ludwig St.), p. 646",
   "text": "_P_ arasitic disease causes extensive morbidity and mortality worldwide in children, particularly _Plasmodium falciparum_ , which causes 1 to 2.7 million deaths annually. The morbidity of parasitic disease disproportionately affects the developing world with an estimated 39 million disability-adjusted life years attributable to infections with parasitic worms. Children in the United States are still at risk for parasitic infection. More common infections include giardiasis, pinworm infections, and head lice. Contaminated water and pets can serve as exposures to particular parasites including _Giardia lamblia_ , _Cryptosporidium parvum_ , _Toxoplasma gondii_ , and _Toxocara canis_ . Although covered in Chapter 89, it should be kept in mind that infection with _Trichomonas_ spp. is the most common parasitic infection in the United States with 7.4 million infections each year. A comprehensive review of all parasitic infections in children would exceed the scope of the chapter, so an overview discussion of the"
  },
  {
   "source": "Cover, p. 4181",
   "text": "_Candida_ species are the third or fourth most common cause of healthcareassociated bloodstream infections in children in the United States. In recent pediatric studies, _C albicans_ accounted for approximately 45% of cases. _C parapsilosis_ is the second most common pathogen in pediatrics, accounting for 20% to 25% of bloodstream infections, in both neonates and older children. ## **CLINICAL MANIFESTATIONS** Candidiasis may be broadly divided into 2 categories: mucocutaneous infections and invasive disease. Mucocutaneous infection includes involvement of the oropharynx, gastrointestinal tract, female genital tract, skin, and nails. Invasive disease includes candidemia and deep-seated infection due to hematogenous spread or direct inoculation. ## **Oropharyngeal and Gastrointestinal Tract Candidiasis**"
  },
  {
   "source": "Illustrated Textbook of Paediatrics (Tom Lissauer, Will Carroll), p. 269",
   "text": "255 ![](/tmp/pdf-images/pdf-0269-00.png) ## **Infection and immunity** |**The febrile child**|**256**|**Tuberculosis**|**275**| |---|---|---|---| |**Serious life-threatening infections**|**259**|**Tropical infections**|**277**| |**Specifc bacterial infections**|**263**|**HIV infection**|**279**| |**Common viral infections**|**265**|**Lyme disease**|**281**| |**Uncommon viral infections**|**271**|**Immunization**|**281**| |**Prolonged fever**|**273**|**Immunodefciency**|**284**| Infections are the most common cause of acute illness in children. Features of infection and immunity in children are: - [ worldwide, acute respiratory infections, diarrhoea, ] neonatal infection, malaria, measles, and HIV infection, often accompanied by undernutrition, are responsible for the deaths of more than 2.3 million children under 5 years of age annually (Fig. 15.1)"
  },
  {
   "source": "Netters Pediatrics (Florin \u0422., Ludwig St.), p. 646",
   "text": "## INTESTINAL PARASITES ## **ETIOLOGY AND PATHOGENESIS** Intestinal parasites infect millions worldwide, particularly in developing countries with poor access to potable water and in patients with comorbidities. Intestinal parasites that are the most common in children in the United States include: _G. lamblia_ , _Entamoeba histolytica_ , and _C. parvum_ . Table 99-1 reviews additional causes of intestinal parasitic infections (Figures 99-1 and 99-2). _G. lamblia_ is a flagellated protozoon and the most common cause of parasitic enteritis in the United States. Outbreaks can occur from contaminated water supplies, including pools, because it is resistant to chlorination as well as person to person in daycare centers. The mode of transmission is often fecal\u2013oral or direct person-to-person contact (Figure 99-3)."
  },
  {
   "source": "Textbook of Pediatric Gastroenterology, Hepatology and Nutrition (Stefano Guandalini, Anil Dhawan), p. 231",
   "text": "**Table 16.1** Entamoeba and its characteristic ## **Introduction** Diarrhoeal diseases are the second leading cause of mortality in children under 5 years globally and kill approximately 525,000 children under the age of 5 annually [1]. A significant proportion of diarrhoeal disease in children is caused by parasitic infections, principally amoebae, flagellates and coccidia. Helminth infections, when heavy, can cause specific clinical syndromes. Parasitic infections can contribute to impaired growth and development in children which in turn has implications for cognitive function, education and economic productivity in later life [2]. ## **Protozoa** ## **Amoebae**"
  },
  {
   "source": "Cover, p. 4483",
   "text": "## **SUGGESTED READINGS** American Academy of Pediatrics. Drugs for parasitic infections. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. _Red Book: 2015 Report of the Committee on Infectious Diseases_ . 30th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2015:927-956. - American Academy of Pediatrics. Preferred therapy for specific parasitic pathogens. In: Bradley JS, Nelson JD, Barnett ED, et al, eds. _2017 Nelson\u2019s Pediatric Antimicrobial Therapy_ . 23rd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2017:171-187. - Bern C, Montgomery SP, Herwaldt BL, et al. Evaluation and treatment of Chagas disease in the United States. A systematic review. _JAMA_ . 2007;298:2171-2181. - Centers for Disease Control and Prevention. Laboratory identification of parasitic diseases of public health concern. Available at http://www.cdc.gov/dpdx/az.html. Accessed May 22, 2017."
  },
  {
   "source": "CURRENT Diagnosis and Treatment Pediatrics, Twenty-Fourth Edition, p. 1344",
   "text": "The incidence of parasitic infections varies greatly with geographic area. Children who have traveled or lived in areas where parasitic infections are endemic are at risk for infection with a variety of intestinal and tissue parasites. Children who have resided only in developed countries are usually free of tissue parasites (with few exceptions, eg, _Toxocara, Toxoplasma_ ). Searching for intestinal parasites is expensive for the patient and time-consuming for the laboratory, and more than 90% of ova and parasite (O&P) examinations performed in the United States are negative. A frequent misperception is that intestinal helminths are common causes of diarrhea; with rare exception (eg, Trichuris dysentery syndrome) they are not. Parasitic diarrhea is almost exclusively caused by protozoa ( _Giardia, Cryptosporidium, Entamoeba_ ) which are now commonly diagnosed with molecular methods. Thus an O&P for a patient with diarrhea is rarely the correct test. It may also"
  },
  {
   "source": "Pediatrics for Practitioner (Sharad Thora), p. 389",
   "text": "- _Infection_ : The infections commonly seen in children with nephrotic syndrome are peritonitis, urinary tract infection, pneumonia and cellulitis. Presence of infection can trigger an episode of relapse very commonly. The commonest organisms suspected are _Streptococcus pyogenes, Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus_ and occasionally fungal infections. The antibiotics most commonly recommended are injectable ceftriaxone or cefotaxime (and cloxacillin in case of **370** Pediatrics for Practitioner ![](/tmp/pdf-images/pdf-0390-02.png) **----- Start of picture text -----**<br> Section 3<br>**----- End of picture text -----**<br> suspected staphylococcus infection) for duration of 7\u201310 days. In case of local or systemic fungal infection, fluconazole or amphotericin B is used respectively."
  },
  {
   "source": "Cover, p. 4467",
   "text": "Parasitic infections are an important cause of morbidity and mortality worldwide. Parasitic infections occur primarily in the tropical and subtropical areas; nevertheless, due to international travel and immigration, they are becoming important for healthcare practitioners all over the globe. The world of antiparasitic medications can be confusing. Some of the antiparasitic agents are not approved by the US Food and Drug Administration (FDA), and others are approved only for specific indications in children. A few antiparasitic drugs are only available through the Centers for Diseases Control and Prevention (CDC). Several new antiparasitic drugs have become available, and their effectiveness has been determined by their use in countries with endemic infections. Cooperation among governmental and private institutions has made a big impact in helping eradicate or diminish the incidence of parasitic infections in areas with extremely limited resources. Antiparasitic therapy for specific pathogens still could be"
  },
  {
   "source": "CURRENT Diagnosis and Treatment Pediatrics, Twenty-Fourth Edition, p. 1354",
   "text": "Giardiasis, caused by _Giardia intestinalis_ , is the most common intestinal protozoal infection in children in the United States and in most of the world. The infection is classically associated with drinking contaminated water, either in rural areas or in areas with faulty purification systems. Even ostensibly clean urban water supplies and pristine mountain streams can be contaminated intermittently, and infection has been acquired in swimming pools. Fecal-oral contamination allows person-to-person spread. Day care centers are a major source of infection. No symptoms occur in 25% of infected persons, facilitating spread to household contacts. Food-borne outbreaks also occur. Giardiasis may occur at any age, although infection is rare in neonates. High rates of transmission occur among men who have sex with men. Domestic animals are rarely sources of human infection due to strain differences between humans and pets. ## \u00bb **Clinical Findings** ## **A. Symptoms and Signs**"
  },
  {
   "source": "Kliegman R. Nelson Textbook of Pediatrics 2-Volume Set 22ed 2024, p. 2242",
   "text": "INFANT CHILD ADOLESCENT<br>ACUTE<br>Common<br>Gastroenteritis (viral > bacterial > protozoal) Gastroenteritis (viral > bacterial > protozoal) Gastroenteritis (viral > bacterial > protozoal)<br>Systemic infection Food poisoning Food poisoning<br>Antibiotic associated Systemic infection Antibiotic associated<br>Overfeeding Antibiotic associated<br>Rare<br>Primary disaccharidase deficiency Toxic ingestion Hyperthyroidism<br>Hirschsprung toxic colitis Hemolytic uremic syndrome Appendicitis<br>Adrenogenital syndrome Intussusception<br>Neonatal opiate withdrawal<br>CHRONIC<br>Common<br>Postinfectious secondary lactase deficiency Postinfectious secondary lactase deficiency Irritable bowel syndrome<br>Cow\u2019s milk or soy protein intolerance (allergy) Irritable bowel syndrome Inflammatory bowel disease<br>Chronic nonspecific diarrhea of infancy Celiac disease Lactose intolerance<br>Excessive fruit juice (sorbitol) ingestion Cystic fibrosis Giardiasis<br>Celiac disease Lactose intolerance Laxative abuse (anorexia"
  },
  {
   "source": "Algorithms in Pediatrics, p. 302",
   "text": "## **DEFINITIONS** medications should be checked as the child may be on steroids or other immune-suppressants. Occasionally, the recurrent infection can lead to the diagnosis of unsuspected condition like cystic fibrosis or a previously missed congenital heart disease, etc. Most common infections in children are viral, of short duration, and do not compromise growth. Children with inherited conditions like Down syndrome, DiGeorge syndrome, etc. are also more susceptible to infections. Family history of other family members prone to infections (siblings, parents), history of human immunodeficiency virus (HIV) needs to be taken. If none of the above then a primary immunodeficiency disorder may be the cause of the condition. In neutropenic patients, there are frequent bacterial and fungal infections. Though they present with fever, the classic signs of infection are often less marked due to neutropenia, hence a high index of suspicion is needed. ## **Recurrent or Repeated Infections: Common Causes**"
  },
  {
   "source": "Kliegman R. Nelson Textbook of Pediatrics 2-Volume Set 22ed 2024, p. 1928",
   "text": "## **280.1** Neonatal Infections _Jessica E. Ericson and Daniel K. Benjamin Jr._ _Candida_ is a common cause of oral mucous membrane infections **(thrush)** and perineal skin infections **(** _**Candida**_ **diaper dermatitis)** in young infants. Rare presentations include **congenital cutaneous candidiasis** , caused by an ascending infection into the uterus during gestation, and **invasive fungal dermatitis** , a postnatal skin infection resulting in positive blood cultures. Invasive candidiasis is a common infectious complication in the neonatal intensive care unit (NICU) because of improved survival of extremely preterm infants. ## **EPIDEMIOLOGY**"
  }
 ]
}