BR R B ed ook ® o e R B o d ed ook ® Atlas of Pediatric k ® Infectious Diseases IA Atlas of n t 4th Edition fl e a c Editor: Carol J. Baker, MD, FAAP s t Pediatric io o The fourth edition of this best-selling f u image companion to the Red Book P s aids in the diagnosis and treatment of Infectious more than 160 infectious diseases. Includes 1,300+ De d Streamline disease recognition and images—with clinical decision-making with more 400+ new! isia than 1,300 finely detailed color i mages e t Diseases (400 new images) adjacent to step-by- ar step recommendations. si c e A superefficient quick reference and learning tool s Concise text descriptions walk the reader through diagnosis, evaluation, and management essentials for each condition. • Clinical manifestations B 4TH EDITION • Etiology a • Epidemiology k • Diagnostic tests e r • Treatment Ten new chapters cover Zika virus, rhinovirus infections, c oagulase- Editor negative staphylococcal infections, and more. Carol J. Baker, MD, FAAP For other pediatric resources, visit the American Academy of Pediatrics at shop.aap.org. Image companion to Red Book® AAP Red Book ® Atlas of Pediatric Infectious Diseases 4TH EDITION Editor Carol J. Baker, MD, FAAP American Academy of Pediatrics Publishing Staff Mary Lou White, Chief Product and Services Officer/ SVP, Membership, Marketing, and Publishing Mark Grimes, Vice President, Publishing Heather Babiar, MS, Senior Editor, Professional/Clinical Publishing Theresa Weiner, Production Manager, Clinical and Professional Publications Jason Crase, Manager, Editorial Services Peg Mulcahy, Manager, Art Direction and Production Linda Smessaert, Senior Marketing Manager, Professional Resources Published by the American Academy of Pediatrics 345 Park Blvd Itasca, IL 60143 Telephone: 630/626-6000 Facsimile: 847/434-8000 www.aap.org The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults. The recommendations in this publication do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. Statements and opinions expressed are those of the authors and not necessarily those of the American Academy of Pediatrics. Any websites, brand names, products, or manufacturers are mentioned for informational and identification purposes only and do not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication. The publishers have made every effort to trace the copyright holders for borrowed materials. If they have inadvertently overlooked any, they will be pleased to make the necessary arrangements at the first opportunity. This publication has been developed by the American Academy of Pediatrics. The contributors are expert authorities in the field of pediatrics. No commercial involvement of any kind has been solicited or accepted in development of the content of this publication. Disclosures: Dr Baker disclosed no relevant financial relationships. Every effort is made to keep Red Book® Atlas of Pediatric Infectious Diseases consistent with the most recent advice and information available from the American Academy of Pediatrics. Special discounts are available for bulk purchases of this publication. Email Special Sales at [email protected] for more information. © 2020 American Academy of Pediatrics All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording, or otherwise—without prior permission from the publisher (locate title at http://ebooks.aappublications. org and click on © Get permissions; you may also fax the permissions editor at 847/434-8780 or email [email protected]). First edition published 2010; second, 2013; third, 2017. Printed in the United States of America 9-425/1019 1 2 3 4 5 6 7 8 9 10 MA0934 ISBN: 978-1-61002-350-4 eBook: 978-1-61002-351-1 Library of Congress Control Number: 2018966768 III Contents Preface ..............................................................................................................IX 1 Actinomycosis ............................................................................................1 2 Adenovirus Infections ................................................................................4 3 Amebiasis ..................................................................................................7 4 Amebic Meningoencephalitis and Keratitis ...............................................14 5 Anthrax ....................................................................................................18 6 Arboviruses ..............................................................................................25 7 Arcanobacterium haemolyticum Infections .........................................34 8 Ascaris lumbricoides Infections ............................................................36 9 Aspergillosis ............................................................................................39 10 Astrovirus Infections ................................................................................44 11 Babesiosis ................................................................................................46 12 Bacillus cereus Infections and Intoxications ..........................................51 13 Bacterial Vaginosis ...................................................................................53 14 Bacteroides, Prevotella, and Other Anaerobic Gram-Negative Bacilli Infections ......................................................................................56 15 Balantidium coli Infections ...................................................................58 16 Bartonella henselae (Cat-Scratch Disease) ...........................................60 17 Baylisascaris Infections .........................................................................65 18 Infections With Blastocystis hominis and Other Subtypes .....................69 19 Blastomycosis .........................................................................................71 20 Bocavirus .................................................................................................74 21 Borrelia Infections Other Than Lyme Disease ........................................75 22 Brucellosis ...............................................................................................78 23 Burkholderia Infections ........................................................................82 24 Campylobacter Infections ..........................................................................85 25 Candidiasis ..............................................................................................88 26 Chancroid and Cutaneous Ulcers .............................................................97 27 Chikungunya ..........................................................................................100 28 Chlamydia pneumoniae ...................................................................102 29 Chlamydia psittaci............................................................................104 30 Chlamydia trachomatis ....................................................................107 31 Botulism and Infant Botulism .................................................................113 32 Clostridial Myonecrosis ..........................................................................119 33 Clostridium difficile ..........................................................................121 34 Clostridium perfringens Food Poisoning ............................................125 35 Coccidioidomycosis ...............................................................................127 IV CONTENTS 36 Coronaviruses, Including SARS and MERS .............................................134 37 Cryptococcus neoformans and Cryptococcus gattii Infections ..........139 38 Cryptosporidiosis ..................................................................................142 39 Cutaneous Larva Migrans ......................................................................147 40 Cyclosporiasis ........................................................................................149 41 Cystoisosporiasis ..................................................................................151 42 Cytomegalovirus Infection .....................................................................154 43 Dengue .................................................................................................162 44 Diphtheria..............................................................................................167 45 Ehrlichia, Anaplasma, and Related Infections ....................................173 46 Serious Bacterial Infections Caused by Enterobacteriaceae ...............182 47 Enterovirus (Nonpoliovirus) .................................................................189 48 Epstein-Barr Virus Infections .................................................................194 49 Escherichia coli Diarrhea ....................................................................199 50 Other Fungal Diseases ..........................................................................205 51 Fusobacterium Infections ...................................................................214 52 Giardia intestinalis (formerly Giardia lamblia and Giardia duodenalis) Infections ..........................................................................217 53 Gonococcal Infections ...........................................................................222 54 Granuloma Inguinale .............................................................................232 55 Haemophilus influenzae Infections ....................................................234 56 Hantavirus Pulmonary Syndrome ...........................................................244 57 Helicobacter pylori Infections .............................................................247 58 Hemorrhagic Fevers Caused by Arenaviruses ........................................250 59 Hemorrhagic Fevers Caused by Bunyaviruses ........................................252 60 Hemorrhagic Fevers Caused by Filoviruses: Ebola and Marburg............256 61 Hepatitis A .............................................................................................262 62 Hepatitis B .............................................................................................266 63 Hepatitis C .............................................................................................275 64 Hepatitis D ............................................................................................280 65 Hepatitis E .............................................................................................282 66 Herpes Simplex .....................................................................................284 67 Histoplasmosis ......................................................................................298 68 Hookworm Infections ............................................................................303 69 Human Herpesvirus 6 (Including Roseola) and 7 ...................................308 70 Human Herpesvirus 8 ............................................................................312 71 Human Immunodeficiency Virus Infection ...............................................314 72 Influenza ................................................................................................334 73 Kawasaki Disease ..................................................................................347 CONTENTS V 74 Kingella kingae Infections ...................................................................354 75 Legionella pneumophila Infections ....................................................356 76 Leishmaniasis ........................................................................................361 77 Leprosy ..................................................................................................368 78 Leptospirosis .........................................................................................373 79 Listeria monocytogenes Infections .....................................................378 80 Lyme Disease .........................................................................................382 81 Lymphatic Filariasis ...............................................................................394 82 Lymphocytic Choriomeningitis ..............................................................399 83 Malaria...................................................................................................401 84 Measles ..................................................................................................412 85 Meningococcal Infections ......................................................................420 86 Human Metapneumovirus ......................................................................429 87 Microsporidia Infections ........................................................................431 88 Molluscum Contagiosum ........................................................................435 89 Moraxella catarrhalis Infections ........................................................438 90 Mumps ...................................................................................................440 91 Mycoplasma pneumoniae and Other Mycoplasma Species Infections ..................................................445 92 Nocardiosis ............................................................................................450 93 Norovirus and Sapovirus Infections ......................................................454 94 Onchocerciasis ......................................................................................457 95 Human Papillomaviruses ........................................................................460 96 Paracoccidioidomycosis .........................................................................465 97 Paragonimiasis .......................................................................................468 98 Parainfluenza Infections .........................................................................472 99 Parasitic Diseases ..................................................................................475 100 Human Parechovirus Infections .............................................................486 101 Parvovirus B19 ......................................................................................487 102 Pasteurella Infections ..........................................................................492 103 Pediculosis Capitis .................................................................................494 104 Pediculosis Corporis ..............................................................................499 105 Pediculosis Pubis ...................................................................................501 106 Pelvic Inflammatory Disease ..................................................................503 107 Pertussis (Whooping Cough) .................................................................508 108 Pinworm Infection .................................................................................514 109 Pityriasis Versicolor ...............................................................................517 110 Plague ....................................................................................................520 111 Pneumococcal Infections .......................................................................526 VI CONTENTS 112 Pneumocystis jiroveci Infections .........................................................537 113 Poliovirus Infections ..............................................................................541 114 Polyomaviruses .....................................................................................546 115 Prion Diseases: Transmissible Spongiform Encephalopathies ................548 116 Q Fever (Coxiella burnetii Infection) ..................................................552 117 Rabies ....................................................................................................555 118 Rat-Bite Fever ........................................................................................561 119 Respiratory Syncytial Virus ...................................................................564 120 Rhinovirus Infections .............................................................................569 121 Rickettsial Diseases ...............................................................................570 122 Rickettsialpox ........................................................................................572 123 Rocky Mountain Spotted Fever ..............................................................574 124 Rotavirus Infections ...............................................................................580 125 Rubella ..................................................................................................582 126 Salmonella Infections ..........................................................................588 127 Scabies ..................................................................................................597 128 Schistosomiasis......................................................................................602 129 Shigella Infections ................................................................................608 130 Smallpox (Variola) .................................................................................612 131 Sporotrichosis .......................................................................................619 132 Staphylococcal Food Poisoning ..............................................................623 133 Staphylococcus aureus ........................................................................624 134 Coagulase-Negative Staphylococcal Infections .......................................641 135 Group A Streptococcal Infections ..........................................................643 136 Group B Streptococcal Infections ..........................................................656 137 Non-Group A or B Streptococcal and Enterococcal Infections ...............661 138 Strongyloidiasis .....................................................................................666 139 Syphilis ..................................................................................................669 140 Tapeworm Diseases ...............................................................................689 141 Other Tapeworm Infections ...................................................................695 142 Tetanus ..................................................................................................700 143 Tinea Capitis ..........................................................................................704 144 Tinea Corporis ......................................................................................708 145 Tinea Cruris ...........................................................................................712 146 Tinea Pedis and Tinea Unguium (Onychomycosis) .................................714 147 Toxocariasis ...........................................................................................717 148 Toxoplasma gondii Infections .............................................................720 149 Trichinellosis .........................................................................................729 CONTENTS VII 150 Trichomonas vaginalis Infections ......................................................733 151 Trichuriasis ............................................................................................738 152 African Trypanosomiasis ........................................................................741 153 American Trypanosomiasis ....................................................................744 154 Tuberculosis ..........................................................................................749 155 Nontuberculous Mycobacteria................................................................772 156 Tularemia ...............................................................................................781 157 Endemic Typhus ....................................................................................788 158 Epidemic Typhus ...................................................................................790 159 Ureaplasma urealyticum and Ureaplasma parvum Infections ........793 160 Varicella-Zoster Virus Infections .............................................................795 161 Cholera ..................................................................................................805 162 Other Vibrio Infections .........................................................................809 163 West Nile Virus ......................................................................................811 164 Yersinia enterocolitica and Yersinia pseudotuberculosis Infections .............................................................817 165 Zika Virus ..............................................................................................821 Index ..............................................................................................................829 IX Preface The American Academy of Pediatrics (AAP) Red Book® Atlas of Pediatric Infectious Diseases, 4th Edition, is a summary of key disease information from the AAP Red Book®: 2018–2021 Report of the Committee on Infectious Diseases. It is intended to be a study guide for students, residents, and practicing physicians. The images of common and unusual features of children with infectious diseases can provide diagnostic clues not found in the print version of Red Book. The juxtaposition of these images against text summarizing the clinical manifestations, epidemiology, diagnostic methods, and treatment information will be, I hope, effective as a training tool and a quick reference. The Red Book Atlas is not planned to provide detailed information on treatment and manage- ment but, rather, a big-picture approach that can be refined, as desired, by reference to authoritative textbooks, original articles, or infectious disease specialists. Complete disease and treatment information from the AAP can be found in the electronic version of the Red Book at https://redbook.solutions.aap.org. The Red Book Atlas would not exist without the assistance of Heather Babiar, Jason Crase, and Theresa Wiener at the AAP and of those physicians who photographed disease manifestations in their patients and shared these with the AAP. Some diseases have disappeared (ie, smallpox), and others are rare (eg, diphtheria, tetanus, congenital rubella syndrome) because of effective prevention strategies, especially immunization. While photographs cannot replace hands-on familiarity, they helped me to consider the likelihood of alternative diagnoses, and I hope that this will be so for the reader. I also want to thank the many individuals at the Centers for Disease Control and Prevention who generously provided many images of etiologic agents, vectors, and life cycles of parasites and protozoa relevant to some of these infections. The study of pediatric infectious diseases has been a challenging and ever-changing professional life for me that has brought me enormous joy. To gather data with my ears, eyes, nose, and hands (the growingly obsolete history and physical examination), and to select the least-needed diagnos- tic tests to solve the mystery for the patient, is still exciting. Putting these pieces together to make a clear picture is akin to solving a crime. On many occasions, just seeing the clue (a characteristic rash, an asymmetry, a barely visible scar where a foreign body is hidden unnoticed) has solved the medical puzzle for me, thereby—with proper management—leading to complete recovery of the child. This can bring satisfaction that almost nothing else replaces. It is my hope that readers might catch a bit of this enthusiasm after reading the fourth edition of Red Book Atlas. Carol J. Baker, MD, FAAP Editor ACTINOMYCOSIS 1 CHAPTER 1 bacilli. They can be part of normal oral, gastro- intestinal tract, or vaginal flora. Actinomyces Actinomycosis species frequently are copathogens in tissues CLINICAL MANIFESTATIONS harboring multiple other anaerobic and/or aero- bic species. Isolation of Aggregatibacter Actinomycosis results from pathogen introduc- (Actinobacillus) actinomycetemcomitans, tion following a breakdown in mucocutaneous frequently detected with Actinomyces species, protective barriers. Spread within the host is by may predict the presence of actinomycosis. direct invasion of adjacent tissues, typically EPIDEMIOLOGY forming sinus tracts that cross tissue planes. Actinomyces species occur worldwide, being There are 3 common anatomic sites of infec- components of endogenous oral and gastroin- tion. Cervicofacial is most common, often testinal tract flora. Actinomyces species are occurring after tooth extraction, oral surgery, opportunistic pathogens (reported in patients or other oral/facial trauma or even from cari- with human immunodeficiency virus [HIV] and ous teeth. Localized pain and induration may with chronic granulomatous disease), with dis- progress to cervical abscess and “woody hard” ease usually following penetrating (including nodular lesions (“lumpy jaw”), which can human bite wounds) and nonpenetrating develop draining sinus tracts, usually at the trauma. Infection is uncommon in infants and angle of the jaw or in the submandibular children, with 80% of cases occurring in region. Thoracic disease most commonly is adults. The male-to-female ratio in children is secondary to aspiration of oropharyngeal 1.5:1. Overt, microbiologically confirmed, secretions but may be an extension of cervico- monomicrobial disease caused by Actinomyces facial infection. It occurs rarely after esopha- species has become rare in the era of antimi- geal disruption secondary to surgery or crobial agents. nonpenetrating trauma. Thoracic presentation includes pneumonia, which can be complicated The incubation period varies from several days by abscesses, empyema, and rarely, pleuroder- to several years. mal sinuses. Focal or multifocal mediastinal DIAGNOSTIC TESTS and pulmonary masses may be mistaken for tumors. Abdominal actinomycosis usually is Only specimens from normally sterile sites attributable to penetrating trauma or intestinal should be submitted for culture. Microscopic perforation. The appendix and cecum are the demonstration of beaded, branched, gram- most common sites; symptoms are similar to positive bacilli in purulent material or tissue appendicitis. Slowly developing masses specimens suggests the diagnosis. Acid-fast may simulate abdominal or retroperitoneal testing can distinguish Actinomyces species, neoplasms. Intra-abdominal abscesses and which are acid-fast negative, from Nocardia peritoneal-dermal draining sinuses occur even- species, which are variably acid-fast positive tually. Chronic localized disease often forms staining. Yellow “sulfur granules” visualized draining sinus tracts with purulent discharge. microscopically or macroscopically in drainage Other sites of infection include the liver, pel- or loculations of purulent material suggest the vis (which, in some cases, has been linked to diagnosis. A Gram stain of “sulfur granules” use of intrauterine devices), heart, testicles, discloses a dense aggregate of bacterial fila- and brain (which usually is associated with a ments mixed with inflammatory debris. A primary pulmonary focus). Noninvasive pri- israelii forms “spiderlike” microcolonies on mary cutaneous actinomycosis has occurred. culture medium after 48 hours. Actinomyces species can be identified in tissue specimens ETIOLOGY using polymerase chain reaction assay and A israelii and at least 5 other Actinomyces sequencing of the 16s rRNA. species cause human disease. All are slow- growing, microaerophilic or facultative anaero- bic, gram-positive, filamentous branching