Infectious arthritis in children can be caused by bacteria, viruses, or fungi. Pyogenic arthritis is characterized by a purulent inflammatory response, usually caused by a bacterial infection. Reactive (inflammatory) arthritis is inflammation of one or more joints that can result…
Osteomyelitis is inflammation of bone. It is usually caused by bacteria but occasionally by fungi. Osteomyelitis in children has a mainly hematogenous origin; less commonly, it occurs as a result of trauma, surgery, or spread from infected contiguous soft tissue.…
Skin and soft tissue infections (SSTIs) are common in children. They usually are recognized easily and treated with few residual long-term problems. However, myositis, pyomyositis, and necrotizing fasciitis are soft tissue infections that can be difficult to diagnose in their…
Acknowledgment The author acknowledges the use of substantial material from this chapter in the previous edition. Infection of soft tissues can involve the skin, subcutaneous tissues, fascia, and skeletal muscle or a combination of these structures. The subcutaneous compartment is…
Papules, nodules, and ulcers are primary lesions of the skin with a variety of infectious and noninfectious causes ( Tables 72.1 and 72.2 ). A papule is a raised superficial lesion that is less than 1 cm in diameter whose…
Urticaria and erythema multiforme (EM) are common cutaneous hypersensitivity reactions seen in children. They can be triggered by infection, although noninfectious causes also are prevalent. Although distinctly different entities, acute urticaria often is misdiagnosed as EM. Although urticaria usually is…
Purpura is a significant finding, especially because it has been associated with multiple infectious causes, some of which are life-threatening. Purpura results from trauma to blood vessels in the skin, causing hemorrhage into the surrounding tissue. Purpuric lesions do not…
Vesicles and bullae (i.e., blisters) result from a disturbance of epidermal or basement membrane connections, creating spaces that allow fluid collection. Blisters can be caused directly by bacterial, viral, and fungal infections or a reactive phenomenon to an infection. Diagnosis…
Approach Differentiating rashes due to infection from other common cutaneous eruptions, particularly adverse drug eruptions, can be difficult. Recognizing the differences in presentation and using proper terminology for erythematous exanthems are the initial steps. The commonly used (and often overused)…
The skin has a primary protective function, providing a permeability barrier that prevents the loss of water and electrolytes and protects against the invasion of pathogens. Intact skin is resistant to colonization and invasion of bacteria by several mechanisms. The…