Little evidence for efficacy 120 children aged 1-5y given prednisolone or placebo No effect on parental reported respiratory symptom score at 7 days 700 preschool children given prednisolone or placebo No effect on duration of hospitalisation No effect on respiratory symptom score in first 24 hours Steroids in preschool VIW
Short burst therapy probably should be reserved for clinical features suggestive of atopic asthma History of multi-trigger wheeze Severe eczema Family history of atopy Steroids in preschool VIW
Do nothing? Investigations? Oral antibiotics? Intravenous antibiotics? Plan of action?
“Reactive” Infection Bacterial Atypical mycobacterium TB Other Causes of acute cervical lymphadenopathy
Fluctuant node Incision & drainage/excision Well Oral antibiotics for 7-10 days – review in 48-72h Unwell IV antibiotics Investigations probably only indicated for persistent adenitis (>2 weeks) Plan(s) of action
Acute adenitis If collection suspected, needs I&D Oral antibiotics & review appropriate for the majority of well children Questions? Take home points