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Overview of Bacterial Infections in Childhood

by Geoffrey A. Weinberg, MD

Bacteria are microscopic, single-celled organisms (see Overview of Bacteria). Only some bacteria cause disease in people. The most common bacterial infections among children are skin infections (including impetigo), ear infections, and throat infections (strep throat). These and many other less common bacterial disorders are treated similarly in adults and children and are discussed elsewhere in the book. Other infections occur at all ages but have specific considerations in children. Several severe bacterial infections are preventable by routine immunization early in childhood.

Certain children are at particular risk of bacterial infections. These children include infants younger than 2 months, children who have no spleen or who have an immune system disorder, and children who have sickle cell disease.

Sometimes doctors diagnose bacterial infections by the typical symptoms they cause. Usually, however, bacteria must be identified in samples of tissue or body fluids, such as blood, urine, pus, or cerebrospinal fluid. Sometimes bacteria from these samples can be recognized under a microscope or identified with a rapid detection test. Usually, however, they are too few or too small to see, so doctors must try to grow (culture) them in the laboratory. It typically takes 24 to 48 hours to culture the bacteria. Cultures can also be used to test the susceptibility of particular bacteria to various antibiotics. The results can help a doctor determine which drug to use in treating an infected child. Doctors may treat certain potentially serious childhood infections with antibiotics before they have the culture results. When results are obtained, the antibiotics are continued or changed as needed. If no bacteria are found, antibiotics may be stopped.

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