UC Davis Health
Department of Pediatrics

Infectious-Disease | Pediagogy Podcast | Department of Pediatrics | UC Davis Health

Infectious Disease

  • Acute Otitis Media

    Get a real ear-full of information today when we talk about the 2nd most common diagnosis in the pediatric emergency department, acute otitis media (AOM)!

    This episode was written by Dr. Tammy Yau and Dr. Lidia Park with content support from Dr. Lena Van der list. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Ear pain with a red bulging tympanic membrane and decreased tympanic membrane mobility is our diagnosis for acute otitis media.
    • AOM can be due to bacteria (S. pneumoniae, H. influenza, and Moraxella) and viruses (influenza, adenovirus, human metapneumovirus)
    • Treat AOM with high dose amoxicillin (cephalexin or azithromycin if penicillin allergy) or amoxicillin-clavulanate. Avoid complications like mastoiditis or tympanic membrane perforation

    Sources:

  • Community Acquired Pneumonia

    Learn how to classify and manage pneumonia in today’s episode!

    This episode was written by Tammy Yau and Lidia Park with content support from Natasha Nakra. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Pneumonia can be due to bacteria or viruses and there is no reliable way to distinguish the two
    • Pneumonia can be diagnosed clinically based on exam or with a CXR. Lab work is not always necessary
    • Treatment of bacterial pneumonia depends on if you think it is community acquired (first line amoxicillin), atypical (first line azithromycin), or nosocomial/hospital acquired (consider antibiotics for pseudomonal or MRSA coverage)

    Sources:
    AAP 2023, Pinto: https://doi.org/10.1542/aap.ppcqr.396216
    Pediatrics in Review 2017, Messinger: https://doi.org/10.1542/pir.2016-0183
    Pediatric Care Online 2016, Light: https://publications.aap.org/pediatriccare/book/348/chapter/5785224/Pneumonia-Chapter-315
    IDSA 2013: https://doi.org/10.1093/cid/cir531

  • Congenital CMV

    Part 2 of our TORCH series discusses CMV, the most common infectious cause of hearing loss in the US.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

    This episode was written by Tammy Yau and Lidia Park, with content support from Dean Blumberg. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Findings include blueberry muffin rash, microcephaly, periventricular calcifications, sensorineural hearing loss, and jaundice.
    • Infection persists lifelong and treatment with valganciclovir is meant to prevent long term sequelae
    • Monitor for myelosuppression with treatment.
    • Frequent hearing screening is needed.

    Sources:

    • AAP Red Book CMV chapter
    • Fowler KB, Boppana SB. Congenital cytomegalovirus infection. Semin Perinatol. 2018 Apr;42(3):149-154. doi: 10.1053/j.semperi.2018.02.002. Epub 2018 Mar 2. PMID: 29503048.

  • Congenital HSV

    Learn about how the virus that causes cold sores can also cause serious complications in infants.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

    This episode was written by Tammy Yau and Lidia Park, with content support from Ritu Cheema. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • First time HSV infection in pregnancy is higher risk to infants than reactivation of previous infection
    • Symptoms of neonatal HSV infection include seizures, vesicles, and irritability
    • Diagnose HSV with viral culture or PCR of bodily fluids
    • Use acyclovir to treat infants and pregnant people with HSV infection

    Sources:
    AAFP 2022 https://www.aafp.org/pubs/afp/issues/2002/0315/p1138.html
    Redbook 2021 https://publications.aap.org/redbook/book/347/chapter-abstract/5752755/Herpes-Simplex?redirectedFrom=fulltext
    Neoreview 2018 https://publications.aap.org/neoreviews/article/19/2/e89/87448/Neonatal-Herpes-Simplex-Virus-Infection

  • Congenital Rubella

    We are starting our mini-series on TORCH infections with congenital rubella, a rare disease nowadays in the US but prevalent still worldwide.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

    This episode was written by Tammy Yau and Lidia Park, with content support from Dean Blumberg. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Think of this disease in infants of immigrant or under-immunized mothers.
    • Findings include cataracts, retinopathy, PDA, hearing loss, blueberry muffin rash
    • Treatment is supportive, with patients needing to isolate for at least several months.
    • There is little evidence for immunoglobulin to prevent disease

    Sources:

  • Congenital Syphilis

    This week on our series on TORCH infections, we are discussing syphilis, an increasingly prevalent disease in the pediatric population.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

    This episode was written by Tammy Yau and Lidia Park, with content support from Elizabeth Partridge. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Most congenital syphilis is asymptomatic. Less commonly will present with rash, snuffles, hepatosplenomegaly, anemia, and jaundice.
    • Untreated disease can cause neurosyphilis and bone defects
    • Compare mother's RPR titers to baby's and look for findings consistent with syphilis.
    • Workup is based on whether mother was adequately treated and includes CBC, LP, skeletal survey, and LFTs.
    • Treatment is with IV penicillin G for 10 days.

    Sources:

    • AAP Red Book Syphilis chapter
    • Sankaran D, Partridge E, Lakshminrusimha S. Congenital Syphilis-An Illustrative Review. Children (Basel). 2023 Jul 29;10(8):1310. doi: 10.3390/children10081310. PMID: 37628309; PMCID: PMC10453258.
    • Fang J, Partridge E, Bautista GM, Sankaran D. Congenital Syphilis Epidemiology, Prevention, and Management in the United States: A 2022 Update. Cureus. 2022 Dec 27;14(12):e33009. doi: 10.7759/cureus.33009. PMID: 36712768; PMCID: PMC9879571.
    • https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf

  • Congenital Toxoplasmosis

    Toxoplasmosis is a parasitic TORCH infection that is often associated with cats but did you know owning a cat is not associated with increased prevalence? Learn more on how the disease is actually acquired and how to prevent infection in this episode!

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

    This episode was written by Tammy Yau and Lidia Park, with content support from Ritu Cheema. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

  • Congenital Varicella

    Despite widespread vaccination, there are still breakthroughs of varicella (commonly known as chicken pox). Let's dive into this episode of our TORCH series.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

    This episode was written by Tammy Yau and Lidia Park, with content support from Ritu Cheema. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Transplacental varicella transmission can lead to congenital varicella syndrome which includes dermatomal rash, cicatrix, limb hypoplasia, microcephaly, and cataracts
    • Use Acyclovir to treat neonates and pregnant people with active varicella infection. Congenital varicella syndrome does not require treatment.
    • Varicella immunoglobulin can be used to prevent infection in certain cases including exposed neonates 5 days before delivery and 2 days after delivery.

    Sources:
    VZV in Newborns: Neoreviews (2016) 17 (9): e507–e514. https://doi.org/10.1542/neo.17-9-e507
    TORCH infections: Pediatr Rev (2011) 32 (12): 537–542. https://doi.org/10.1542/pir.32-12-537

  • Croup

    Does your child have a barking seal like cough? You better be thinking of croup! Join us on this resident-led episode today.

    This episode was written by pediatric resident Anjali Doshi and pediatricians Lidia Park and Tammy Yau with content support from Alexis Toney (UC Davis pediatric hospitalist). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • Croup, acute laryngotracheitis, a viral infection causing respiratory inflammation, bark like cough, and inspiratory stridor
    • Westley score can be used to determine severity of croup
    • Treatment for mild symptoms is humidified air and supportive care
    • Treatment for moderate/severe symptoms is racemic epinephrine breathing treatment and IV dexamethasone
    • Imaging can be considered to rule out bacterial tracheitis or epiglottitis if history and physical exam cannot narrow down the differential to croup
    • Antibacterials not normally given unless concurrent infection

    Reference:

    • AAP Point of Care Quick Reference, Retzke, 2021. https://doi.org/10.1542/aap.ppcqr.396247
    • Russell KF, Liang Y, O'Gorman K, Johnson DW, Klassen TP. Glucocorticoids for croup. Cochrane Database Syst Rev. 2011;(1):CD001955. Published 2011 Jan 19. doi:10.1002/14651858.CD001955.pub3
    • Cochrane Database Syst Rev. 2018;10:CD006822. Epub 2018 Oct 29.
    • Juliette Anderson. “Baby with Croup Stridor Barking Cough Visual & Audio Sound - When to Hospitalize.” YouTube, 14 Apr. 2011, www.youtube.com/watch?v=Qbn1Zw5CTbA. Accessed 3 Oct. 2024.

  • Febrile Infants

    Listen up! Today we talk about the management of well-appearing febrile infants aged 8-60 days old including work-up algorithms and treatment. It's a lot of information so pay close attention and you might even want to pull up the AAP guideline diagrams to follow along!

    Follow us on Twitter @Pediagogypod.

    This episode was written by Tammy Yau and Lidia Park with content support from Nathan Kuppermann, Lena van der List, and Su-Ting Li. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • New strategies for management of febrile infants depending on age (1-3 weeks, 3-4 weeks, or 4-8 weeks)
    • Inflammatory markers like CRP and procalcitonin help to determine if LP is needed in older patients
    • Learn about common bugs that cause infection in infants and the antibiotics we use to treat them
    • Observation of febrile infants is now reduced from 48 hours to 24-36 hours

    Supplemental information:

  • Hepatitis C Screening

    Learn how research continues to change our ability to detect and treat pediatric patients with hepatitis C in today’s episode.

    This episode was written by Lidia Park and Tammy Yau with content support from Daniel Dodson. Lidia and Tammy take full responsibility for any errors or misinformation.

    Key Points:

    • Perinatal hepatitis C exposure is the most common cause of pediatric hepatitis C infection
    • NAT testing for hepatitis C RNA can be done as early as 2 months of life to detect hepatitis C infection in pediatric patients rather than waiting until 18 months of life when hepatitis C antibody testing can be done
    • Hepatitis C positive moms can still breastfeed but should halt breastfeeding temporarily if breasts are cracked or bleeding

    Sources:

  • Influenza Treatment

    Plan ahead for the flu season with our episode today where we talk about how to treat the common flu, also known as influenza.

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

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

    Key Points:

    • The influenza vaccine is important every flu season!
    • Anti-viral neuraminidase inhibitors like oseltamivir/Tamiflu (oral), zanamivir (inhaled), and peramivir (IV) prevent the flu virus from fusing with infected cell membranes, preventing the release of the virus.
    • Baloxavir is an endonuclease inhibitor that inhibits mRNA synthesis, which can be given as a one-time dose to treat influenza infections.
    • Otitis media, PNA, retropharyngeal abscesses, Pott puffy tumors, empyema, meningitis, encephalitis, GBS, acute cerebella ataxia, transverse myelitis, myositis, pericarditis, and myocarditis are all serious complications that can occur with influenza infections.

    Sources:

    • O’Leary ST, et al. Recommendations for Prevention and Control of Influenza in Children, 2024–2025: Technical Report. Pediatrics. 2024 Oct 1;154(4). doi: 10.1542/peds.2024-068508
    • AAP Red Book, 2023. doi:10.1542/9781610025782-S3_068
    • Moscona, A. Neuraminidase Inhibitors for Influenza. N Engl J Med 2005;353:1363-1373. 2025 Sept 9. doi: 10.1056/NEJMra05074

  • Journal Club: Febrile UTI

    Stay up to date with new research on shortening antibiotic treatment duration for urinary tract infections (UTIs) with our episode today where we review a recently published randomized control trial (RCT). Learn how to critically analyze study data and what key points we take away.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

    This episode was written by Tammy Yau and Lidia Park, with content support from Michelle Hamline. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • A single RCT found similar risk of UTI recurrence in children who received a 5 day course vs 10 day course of antibiotics within the first 30 days

    Sources
    Pediatrics 2024, Montini et al: https://doi.org/10.1542/peds.2023-062598
    BMJ 2007, Montini et al: https://doi.org/10.1136/bmj.39244.692442.55
    Cochrane Rev 2012, Altamimi et al: https://doi.org/10.1002/14651858.CD004872.pub3
    JAMA Ped 2021, Pernica et al: https://doi.org/10.1001/jamapediatrics.2020.6735
    JAMA Ped, 2022, Williams et al: https://doi.org/10.1001/jamapediatrics.2021.5547

  • Otitis Externa

    Don’t miss this "ear"-resistible episode on outer ear infections, also known as otitis externa or swimmer’s ear!

    This episode was written by Dr. Tammy Yau and Dr. Lidia Park with content support from Dr. Lena van Der List. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Think otitis externa when your patient has ear pain, ear drainage, decreased hearing, and swelling or debris in the ear canal.
    • Treat otitis externa with otic aminoglycosides (neomycin, polymyxin B, trimethoprim-sulfate) when you have an intact tympanic membrane or fluoroquinolone (ciprofloxacin, ofloxacin) if you can’t visualize the tympanic membrane or there is a perforation

    Sources:
    Pediatrics in Review 2013, https://doi.org/10.1542/pir.34-3-143

  • Phoenix Sepsis Score

    Did you know that if you exercise while you have a fever, you probably meet SIRS criteria? The new Phoenix sepsis scoring systems aims to better categorize sepsis through specific categories based on the patient’s vitals, labs, and medications. Learn with us as we walk through this new scoring system in today’s episode.

    This episode was written by Lidia Park and Tammy Yau with content support from Alexis Toney. Lidia and Tammy take full responsibility for any errors or misinformation.

    Key Points:

    • The Phoenix sepsis score is based out of 13 points. 2 or more points meets sepsis criteria. The score is based on 4 categories: respiratory, cardiovascular, coagulation, and neurologic.
    • The Phoenix sepsis score is better at predicting mortality than SIRS criteria but does not predict morbidity

  • Sepsis

    In this *shocking​* episode, we discuss identifying and managing sepsis and septic shock in the pediatric population. This episode features two of our 2nd year pediatric residents, Victoria and Kat. We are so excited to have them join us and teach us about this very common chief complaint, especially for patients getting admitted to the hospital.

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

    This episode was written by Victoria Tran, Katrina Marks, Tammy Yau, and Lidia Park, with content support from Moonjoo Han. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points

    • Defining and differentiating SIRS, sepsis, and septic shock. Identifying the symptoms of sepsis is important for appropriate patient triage.
    • SIRS comprises of constellation of symptoms. For SIRS criteria, 2 or more criteria must be met, which include hyper/hypothermia, leukocytosis/leukopenia, tachycardia/bradycardia, tachypnea.
    • SIRS + infectious source = sepsis
    • Initial management of sepsis includes broad-spectrum antibiotics and fluid resuscitation with isotonic fluids (typically 10-20 cc/kg)

    Sources:

    • Weiss, Scott L. MD, MSCE, FCCM (Co-Vice Chair) et al. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatric Critical Care Medicine 21(2):p e52-e106, February 2020. | DOI: 10.1097/PCC.0000000000002198
    • Link: https://journals.lww.com/pccmjournal/Fulltext/2020/02000/Surviving_Sepsis_Campaign_International_Guidelines.20.aspx
    • Menon, Kusum et al. “A Prospective Multicenter Study of Adrenal Function in Critically Ill Children.” American journal of respiratory and critical care medicine: an official journal of the American Thoracic Society, medical section of the American Lung Association. 182.2 (2010): 246–251. Web.

  • Sinusitis

    Prolonged viral upper respiratory symptoms or is it actually sinusitis in disguise? Join us as we discuss all things sinusitis in this episode!

    This episode was written by Tammy Yau and Lidia Park with content support from Natasha Nakra. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key Points:

    • Acute bacterial sinusitis can be clinically diagnosed based on persistent respiratory symptoms lasting more than 10 days without improvement, worsening or new respiratory symptoms after initial improvement, or severe symptoms at onset lasting more than 3 days.
    • First line antibiotic treatment for acute bacterial sinusitis is with amoxicillin or amoxicillin-clavulanate
    • Complications include orbital or intracranial spread of infection

    Sources:
    Pediatrics in Review 2013, Demuri and Wald: https://doi.org/10.1542/pir.34-10-429
    AAP Pediatrics 2013, Wald et al: https://doi.org/10.1542/peds.2013-1071
    Pediatrics 2024, Conway et al: https://doi.org/10.1542/peds.2023-064244

  • UTI and Pyelonephritis

    Help my kid has a UTI! Does cranberry juice have any benefit for UTIs? Find out with us in today’s episode about urinary tract infections (UTIs)!

    Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

    This episode was written by Tammy Yau and Lidia Park, with content support from Natasha Nakra. Tammy and Lidia take full responsibility for any errors or misinformation.

    Key points:

    • A fever may be your only symptom in a young child with a UTI
    • If you think it’s a UTI, get a clean specimen for culture. A positive culture has more than 50k CFUs/ml on a catheter sample and more than 100k CFUs/ml on a clean catch/void sample.
    • Most common bacteria causing UTIs are E. coli, Klebsiella, Proteus, Enterococcus, and Enterobacter
    • Simple cystitis may only need 3-10 days of treatment depending on age, whereas pyelonephritis needs 10-14 days.

    Sources