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Pediatric Pearls - Pediatric Rheumatology

Caroline Chang, MD, Ilene Claudius, MD, and Solomon Behar, MD
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20:34
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Nurses Edition Commentary

Mizuho Spangler, DO
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01:22

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EMRAP 2016 January Summary 874 KB - PDF

Do you know your JIA from your macrophage activation syndrome? Pediatric rheumatologist Caroline Change sheads some light on the subject.

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Richard H. -

You mentioned otitis media as a source for fever. Thought current belief is that, like any simple abscess, OM should not be blamed for fever. No?

ilene c. -

Sorry for the delayed response- tried taking the kids to AAEM with me to speak- that was an adventure! That's a great question. I do agree that typically, when I see an OM and URI, I feel it likely that the URI is responsible for the fever, not the OM. The AAP guidelines of treating for a high fever certainly indicate that they believe a fever could be due to OM. There isn't literature definitively answering the question. My practice is the following: if I am really worried the fever is from a significant alternate pathology (kid looks terrible, has neutropenia, is <60 days, etc), I still work it up, even with an OM. If it is a kid that I'm not really worried about, I usually let it go with treatment and careful precautions. In that middle group, like the s/p biologics kid Caroline discusses, I'm sort of on the fence and base it on how high the fever is and how the kid looks. So, in a nutshell, while I agree with you, I don't care too much about fever in the majority of pediatric patients.

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Cracking The Chest Full episode audio for MD edition 254:13 min - 354 MB - M4AEMRAP 2016 January Aussie Edition Australian 27:57 min - 38 MB - MP3EMRAP 2016 January Canadian Edition Canadian 15:02 min - 21 MB - MP3EMRAP 2016 Janiver Résumé en Francais Français 63:14 min - 87 MB - MP3EMRAP 2016 Enero Resumen Español Español 83:06 min - 114 MB - MP3EMRAP 2016 January Board Review Answers 120 KB - PDFEMRAP 2016 January Board Review Questions 422 KB - PDFEMRAP 2016 January MP3 314 MB - ZIPEMRAP 2016 January Summary 874 KB - PDF

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