Together, three types of bacteria account for over 90 percent of bacterial meningitis: H. influenza type b, meningococcus, and pneumococcus.
These bacteria are transmitted by person-to-person contact through respiratory secretions. Many people carry these bacteria with no serious consequence. (Pneumococcus, for instance, is the most common cause of ear infections.) A few people get very sick. Pneumococcus causes meningitis in about 3 per 100,000 people. (Textbook of Pediatric Infectious Disease, Saunders 1998)
Sudden onset meningitis features shock, internal bleeding, purple spots, and reduced consciousness at the very outset, with a rapidly progressive course often resulting in death within 24 hours.
More commonly, meningitis begins with several days of upper respiratory symptoms or gastrointestinal symptoms. Most children have high fevers, severe headaches, and poor feeding. They may also have muscle aches, nasal congestion, vomiting, neck stiffness, and seizures.
Children with meningitis become increasingly irritable and/or lethargic. The presence of petechiae (purple spots that indicate internal bleeding) is a sign that the infection may be raging out of control.
Pneumococcal meningitis is a devastating disease. Of all causes of meningitis, it is the most likely to have a negative outcome (Pediatric Infectious Disease Journal, May 1993). The overuse of antibiotics is resulting in increasingly resistant strains of pneumococcus every month.
In 1991, a vaccine against the H. influenzae Type b (HIB) bacteria was incorporated into the routine immunization schedule beginning at 2 months of age. The amount of meningitis plummeted. Arkansas Children's Hospital had about 27 cases of HIB meningitis per year in the 1980's before the vaccine was used. By 1993, the number had dropped to only 1.7 per year (Southern Medical Journal, Jan 1994). During the same period the number of cases dropped by 95 percent in the United States as a whole (Textbook of Pediatric Infectious Diseases, Saunders 1998).
The new pneumococcal vaccine for infants is now FDA approved and recommended by the American Academy of Pediatrics for all children less than 2 years of age. Vaccination of children between 2 and 5 years of age may also be considered on an individual basis. In large clinical studies, the vaccine has been shown to decrease the risk of invasive pneumococcal infection (i.e. meningitis and blood infections) by more than 93%. It has also been shown to decrease the risk of pneumonia and otitis media (ear infections). More information about the vaccine can be found at www.cdc.gov/.
Our eyes are constantly making a protective film of tears to bathe the eyeball. Simple in appearance, tears have a marvelously complex structure. The tear film is composed of three layers. The thin outer layer, produced by the inside of the eyelids, is an oily film. The largest part of the tear structure is a middle layer of salty water, produced in the lacrimal gland. The innermost layer, produced by the conjunctiva on the front of the eye, is composed mostly of mucus. This wonderfully designed film is ideal to protect, cleanse, and lubricate the eye.
Tears normally drain though a pinpoint opening at the inside corner of the eye. They then flow through the nasolacrimal duct into the nose.
What is blocked tear duct?
In many babies, the nasolacrimal duct is not fully developed at the time of birth. Signs of this usually appear in the first weeks of life. The duct may be plugged by a membrane left from birth, or by swelling or mucus. This is called nasolacrimal duct obstruction (NLDO) or a blocked tear duct. A child who has an unusually narrow duct has dacrostenosis.
Who gets blocked tear duct?
This condition occurs in infants and is quite common.
What are the symptoms of blocked tear duct?
The tears back up, causing wetness or pooling. As the watery layer evaporates, a soft mucoid discharge accumulates, which can then dry and become crusty.
Children with blocked tear ducts are also more prone to conjunctivitis.
Is blocked tear duct contagious?
No
How long does blocked tear duct last?
Blocked tear ducts usually disappear on their own by the time a child is a year old.
How is blocked tear duct diagnosed?
The diagnosis is based on the history and physical exam.
How is blocked tear duct treated?
The primary treatment is gentle cleansing of the lids with a warm wet washcloth. Use a clean portion of the washcloth with each pass. This may be accompanied by a regimen of gentle nasolacrimal duct massage, usually 2 or 3 times a day. With a clean finger, simply rub the area between the inside corner of the eye and the bridge of the nose. Occasionally symptoms persist beyond one year of age. If they do, probing of the duct by a pediatric ophthalmologist is indicated.
Sometimes eye drops are needed if an infection is beginning.
How can blocked tear duct be prevented?
Gentle nasolacrimal duct massage can prevent some episodes of obstruction in a baby who is prone.
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