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8. Viral diseases
Treatment of complications
S evere p neum o nia ceftriaxone IV o r IM + cloxacillin IV then change to amoxicillin/clavulanic
acid P O (see p ages 6 8 -6 9 )
+ oxygen if cy ano sis o r O 2 saturatio n < 9 0 %
+ salbutamol if exp irato ry wheez ing and sibilant rales o n auscultatio n
In all cases, clo se m o nito ring.
P neum o nia witho ut amoxicillin P O fo r 5 d ay s
severe signs
C ro up I np atient m o nito ring ( risk o f w o rsening) . K eep th e ch ild calm .
A gitatio n and cry ing exacerbate the sy m p to m s.
F o r severe cro up :
dexamethasone IM : 0 .6 m g/ k g single d o se
+ nebuliz ed epinephrine ( ad renaline, 1 m g/ m l am p o ule) : 0 .5 m l/ k g
(m ax. 5 m l)
+ oxygen if cy ano sis o r O 2 saturatio n < 9 0 %
Intensive m o nito ring until sy m p to m s reso lve.
A cute o titis m ed ia S ee p age 5 7
D ehy d ratio n R ehy d ratio n acco rd ing to W H O P lan B o r C .
O ral cand id iasis S ee p age 9 2
P urulent S ee p age 1 2 3
co njunctivitis
K eratitis/ tetracycline 1% eye ointment 2 tim es d aily fo r 7 d ay s
k erato co njunctivitis + retinol P O o ne d o se o n D 1 , D 2 and D 8 (see p age 1 2 1 )
+ ey e p ro tectio n and tramadol P O fro m 6 m o nths o f age (see p age
3 2 ).
N o to p ical co rtico stero id s.
Xero p hthalm ia S ee p age 1 2 1
F ebrile seiz ures S ee p age 2 3
8
Prevention
– N o chem o p ro p hy laxis fo r co ntacts.
– V accinatio n:
• The first d o se is ad m inistered at 9 m o nths o f age. In situatio ns where there is high
risk o f infectio n (o vercro wd ing, ep id em ics, m alnutritio n, infants bo rn to a m o ther
with H IV infectio n, etc.): ad m inister o ne d o se at 6 m o nths o f age (between 6 and
8 m o nths) and o ne d o se at 9 m o nths o f age, with an interval o f at least 4 week s
between injectio ns.
• C hild ren m ust receive a seco nd d o se befo re they are 5 y ears o ld in o rd er to co ver
unvaccinated child ren o r child ren who d id no t resp o nd to the first d o se.
191
Treatment of complications
S evere p neum o nia ceftriaxone IV o r IM + cloxacillin IV then change to amoxicillin/clavulanic
acid P O (see p ages 6 8 -6 9 )
+ oxygen if cy ano sis o r O 2 saturatio n < 9 0 %
+ salbutamol if exp irato ry wheez ing and sibilant rales o n auscultatio n
In all cases, clo se m o nito ring.
P neum o nia witho ut amoxicillin P O fo r 5 d ay s
severe signs
C ro up I np atient m o nito ring ( risk o f w o rsening) . K eep th e ch ild calm .
A gitatio n and cry ing exacerbate the sy m p to m s.
F o r severe cro up :
dexamethasone IM : 0 .6 m g/ k g single d o se
+ nebuliz ed epinephrine ( ad renaline, 1 m g/ m l am p o ule) : 0 .5 m l/ k g
(m ax. 5 m l)
+ oxygen if cy ano sis o r O 2 saturatio n < 9 0 %
Intensive m o nito ring until sy m p to m s reso lve.
A cute o titis m ed ia S ee p age 5 7
D ehy d ratio n R ehy d ratio n acco rd ing to W H O P lan B o r C .
O ral cand id iasis S ee p age 9 2
P urulent S ee p age 1 2 3
co njunctivitis
K eratitis/ tetracycline 1% eye ointment 2 tim es d aily fo r 7 d ay s
k erato co njunctivitis + retinol P O o ne d o se o n D 1 , D 2 and D 8 (see p age 1 2 1 )
+ ey e p ro tectio n and tramadol P O fro m 6 m o nths o f age (see p age
3 2 ).
N o to p ical co rtico stero id s.
Xero p hthalm ia S ee p age 1 2 1
F ebrile seiz ures S ee p age 2 3
8
Prevention
– N o chem o p ro p hy laxis fo r co ntacts.
– V accinatio n:
• The first d o se is ad m inistered at 9 m o nths o f age. In situatio ns where there is high
risk o f infectio n (o vercro wd ing, ep id em ics, m alnutritio n, infants bo rn to a m o ther
with H IV infectio n, etc.): ad m inister o ne d o se at 6 m o nths o f age (between 6 and
8 m o nths) and o ne d o se at 9 m o nths o f age, with an interval o f at least 4 week s
between injectio ns.
• C hild ren m ust receive a seco nd d o se befo re they are 5 y ears o ld in o rd er to co ver
unvaccinated child ren o r child ren who d id no t resp o nd to the first d o se.
191
