Yuck! Did someone say kissing bug? Ok we don't mean an actual insect but we are going to talk about mononucleosis or Epstein Barr virus (EBV) and explain where the term "kissing bug" came from.

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Dean Blumberg (pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

Key points:

• EBV is human herpesvirus 4 affecting B-cells and spreads through saliva or blood transfusions. About 90% of US adults are infected with it!
• Symptoms of EBV are typical mild upper respiratory symptoms including fever, cough, rhinorrhea, and sore throat that can look like palatal petechiae and tonsillar exudate on exam. EBV can appear similar to strep which is why testing is important to differentiate
• Because EBV is a virus, treatment is usually supportive but severe disease or immunocompromised patients may be given antivirals, immunomodulators, and/or steroids

Sources

• Red Book Epstein-Barr Virus Infections (Infectious Mononucleosis)
• “Epstein-Barr Virus”. Pediatr Rev (2011) 32 (9): 375–384. https://doi.org/10.1542/pir.32-9-375
• “Cytomegalovirus and Epstein-Barr Virus Infections”. Pediatr Rev (2016) 37 (6):223–234. https://doi.org/10.1542/pir.2015-0072
• Luzuriaga K, Sullivan JL. Infectious mononucleosis. N Engl J Med. 2010;362(21):1993-2000. doi:10.1056/NEJMcp1001116

Sore throats can be one of the most difficult symptoms to deal with you have a cold. But what if it's not just from a virus and it's group A strep instead? Learn about this common bacterial throat infection in our episode today!

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Dean Blumberg (pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

Key points:

• Group A streptococcal (GAS) pharyngitis (commonly referred to as "strep throat") is a bacterial infection of the tonsils and pharynx.
• Scarlet fever refers to GAS infection causing a sandpaper like rash on the body due to exotoxins.
• Diagnose with a throat swab (rapid antigen, culture, and/or PCR or NAAAT) and treat with penicillin or amoxicillin for a full 10 day course. Use Keflex or clindamycin for those with penicillin allergy

Sources

• “Group A Streptococcal Infections”. Red Book. https://doi.org/10.1542/9781610027373-S3_018_010
• “Dr. William Douglas' Description of Scarlet Fever in 1736—An American Medical Classic” Pediatrics (1978) 61 (6): 888. https://doi.org/10.1542/peds.61.6.888
• “Blindness in Walnut Grove: How did Mary Ingalls Lose her Sight?” Pediatrics (2013) 131 (3): 404–406. https://doi.org/10.1542/peds.2012-1438

Cute baby movements or is it infantile spasms in disguise? Learn what to look out for in today's episode!

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Joanna Galindo (pediatric neurology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

Key points:

• Infantile spasms are characterized by flexion of the trunk or neck and adduction or abduction of the arms, usually bilateral and symmetric in clusters and occuring in babies less than 1 years old
• Hypsarrhythmia on EEG is classic for infantile spasms and can help differentiate it from benign spasms of infancy or myoclonic epilepsy of infancy
• Treatment is with ACTH or high dose steroids and/or vigabatrin.

Sources:

• Pavone P, Polizzi A, Marino SD, et al. West syndrome: a comprehensive review. Neurol Sci. 2020;41(12):3547-3562. doi:10.1007/s10072-020-04600-5
• Go CY, Mackay MT, Weiss SK, et al. Evidence-based guideline update: medical treatment of infantile spasms [RETIRED]. Report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2012;78(24):1974-1980. doi:10.1212/WNL.0b013e318259e2cf
• Riikonen R. Biochemical mechanisms in pathogenesis of infantile epileptic spasm syndrome. Seizure. 2023;105:1-9. doi:10.1016/j.seizure.2023.01.004