by Brad Sobolewski
PEM Currents is a Pediatric Emergency Medicine focused podcast hosted by Brad Sobolewski
Language
🇺🇲
Publishing Since
1/8/2013
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April 30, 2025
<br /> In this episode, we tackle the clinical mischief of Parvovirus B19, a common viral infection with a surprisingly wide range of manifestations—from the classic “slapped cheek” rash of erythema infectiosum to aplastic crises in children with hemolytic anemias and fetal hydrops in pregnant contacts. We’ll break down the virology, epidemiology, clinical presentation, and complications of Parvovirus B19. You’ll also learn how to manage exposures in the emergency department, especially when the child has a pregnant caregiver, and why isolation isn’t always necessary once the rash shows up.<br /> <br /> <br /> <br /> Learning Objectives<br /> <br /> <br /> <br /> <br /> * Describe the classic and atypical clinical presentations of Parvovirus B19 infection in pediatric patients, including erythema infectiosum, arthropathy, transient aplastic crisis, and chronic anemia in immunocompromised hosts.<br /> <br /> <br /> <br /> * Understand the epidemiology and transmission timeline of Parvovirus B19, especially its seasonal peaks and viral shedding period.<br /> <br /> <br /> <br /> * Recognize key diagnostic features that help differentiate Parvovirus B19 from other viral exanthems and systemic illnesses.<br /> <br /> <br /> <br /> * Formulate an evidence-based management plan for patients with suspected or confirmed Parvovirus B19, including those with underlying hemolytic disease or immunocompromise.<br /> <br /> <br /> <br /> * Counsel families and caregivers—including pregnant household contacts—on the risks, exposures, and infection control considerations related to Parvovirus B19.<br /> <br /> <br /> <br /> <br /> Connect with Brad Sobolewski<br /> <br /> <br /> <br /> <br /> * PEMBlog: <a href="https://www.pemblog.com/">PEMBlog.com</a><br /> <br /> <br /> <br /> * Blue Sky: <a href="https://bsky.app/profile/bradsobo.bsky.social">@bradsobo</a><br /> <br /> <br /> <br /> * X (Twitter): <a href="https://twitter.com/PEMTweets">@PEMTweets</a><br /> <br /> <br /> <br /> * Instagram: <a href="https://www.instagram.com/bradsobolewski/">Brad Sobolewski</a><br /> <br /> <br /> <br /> * Mastodon: <a href="https://med-mastodon.com/@bradsobo">@[email protected]</a><br /> <br /> <br /> <br /> <br /> References<br /> <br /> <br /> <br /> Jordan, Jeanne A. “Treatment and Prevention of Parvovirus B19 Infection.” UpToDate, Jun. 14, 2024. https://www.uptodate.com/contents/treatment-and-prevention-of-parvovirus-b19-infection<br /> <br /> <br /> <br /> Edwards, Morven S. “Clinical Manifestations and Diagnosis of Parvovirus B19 Infection.” UpToDate, Jun. 14, 2024. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-parvovirus-b19-infection<br /> <br /> <br /> <br /> Macri, Angela, and Crane, Jonathan S. “Parvoviruses.” StatPearls, NCBI Bookshelf, Jun. 28, 2023. https://www.ncbi.nlm.nih.gov/books/NBK482245/<br /> <br /> <br /> <br /> Kostolansky, Sean, and Waymack, James R. “Erythema Infectiosum.” StatPearls, NCBI Bookshelf, Jul. 31, 2023. https://www.ncbi.nlm.nih.gov/books/NBK513309/<br /> <br /> <br /> <br /> “Parvovirus B19 Infection and Pregnancy.” Centers for Disease Control and Prevention. https://www.cdc.gov/parvovirusb19/pregnancy.html<br /> <br /> <br /> <br /> Transcript<br /> <br /> <br /> <br /> Note: This transcript was partially completed with the use of the Descript AI and the Chat GPT 4o AI<br /> <br /> <br /> <br /> Welcome to PEMCurrents, the Pediatric Emergency Medicine Podcast. As always, I’m your host, Brad Sobolewski, and today we are covering Parvovirus B19—a common but clinically diverse viral infection that you will definitely encounter in pediatrics, and not just in the form of a rash. Parvovirus B19 is best known for causing fifth disease, but in certain patients it can lead to some serious complications like aplastic crises, fetal hydrops, or chronic anemia.<br /> <br /> <br /> <br /> So as you can see,
April 3, 2025
<br /> This episode of PEM Currents: The Pediatric Emergency Medicine Podcast focuses on the approach to unvaccinated or undervaccinated children aged 3–36 months presenting to the ED with fever. Host Brad Sobolewski reviews differences in immune response, risk for serious and invasive bacterial infections, and outlines evaluation strategies including labs, imaging, and empiric antibiotics. He highlights data showing increased interventions in this population and calls for local guideline development. The episode emphasizes thoughtful, individualized care in the context of rising vaccine hesitancy and declining immunization rates.<br /> <br /> <br /> <br /> Learning Objectives<br /> <br /> <br /> <br /> <br /> * Compare the clinical presentation of bacterial infections in unvaccinated and undervaccinated children versus fully immunized children in the Emergency Department<br /> <br /> <br /> <br /> * Assess the need for empiric antibiotics and diagnostic testing in an unvaccinated or undervaccinated child presenting with fever without source<br /> <br /> <br /> <br /> * <br /> <br /> <br /> <br /> <br /> Connect with Brad Sobolewski<br /> <br /> <br /> <br /> PEMBlog: <a href="https://pemblog.com/">PEMBlog.com</a><br /> <br /> <br /> <br /> Blue Sky: <a href="https://bsky.app/profile/bradsobo.bsky.social">@bradsobo</a><br /> <br /> <br /> <br /> X (Twitter): <a href="https://x.com/PEMTweets">@PEMTweets</a><br /> <br /> <br /> <br /> Instagram: <a href="https://www.instagram.com/bradsobolewski">Brad Sobolewski</a><br /> <br /> <br /> <br /> Mastodon: <a href="https://mastodon.social/@bradsobo">@bradsobo</a><br /> <br /> <br /> <br /> References<br /> <br /> <br /> <br /> Curtis M, Kanis J, Wagers B, et al. Immunization status and the management of febrile children in the pediatric emergency department: what are we doing? Pediatr Emerg Care. 2023;39(1):1-5. doi:10.1097/PEC.0000000000002864<br /> <br /> <br /> <br /> Finkel L, Ospina-Jimenez C, Byers M, Eilbert W. Fever without source in unvaccinated children aged 3 to 24 months: what workup is recommended? Pediatr Emerg Care. 2021;37(12):e882-e885. doi:10.1097/PEC.0000000000002249<br /> <br /> <br /> <br /> Herz AM, Greenhow TL, Alcantara J, et al. Changing epidemiology of outpatient bacteremia in 3- to 36-month-old children after the introduction of the heptavalent-conjugated pneumococcal vaccine. Pediatr Infect Dis J. 2006;25(4):293-300. doi:10.1097/01.inf.0000207485.39112.bf<br /> <br /> <br /> <br /> Kaufman J, Fitzpatrick P, Tosif S, et al. Faster clean catch urine collection (Quick-Wee method) from infants: randomised controlled trial. BMJ. 2017;357:j1341. doi:10.1136/bmj.j1341<br /> <br /> <br /> <br /> Kuppermann N, Fleisher GR, Jaffe DM. Predictors of occult pneumococcal bacteremia in young febrile children. Ann Emerg Med. 1998;31(6):679-687. doi:10.1016/S0196-0644(98)70225-2<br /> <br /> <br /> <br /> Rutman MS, Bachur R, Harper MB. Radiographic pneumonia in young, highly febrile children with leukocytosis before and after universal conjugate pneumococcal vaccination. Pediatr Emerg Care. 2009;25(1):1-7. doi:10.1097/PEC.0b013e318191dab2<br /> <br /> <br /> <br /> Trippella G, Galli L, De Martino M, Lisi C, Chiappini E. Procalcitonin performance in detecting serious and invasive bacterial infections in children with fever without apparent source: a systematic review and meta-analysis. Expert Rev Anti Infect Ther. 2017;15(11):1041-1057. doi:10.1080/14787210.2017.1400907<br /> <br /> <br /> <br /> Van den Bruel A, Thompson MJ, Haj-Hassan T, et al. Diagnostic value of laboratory tests in identifying serious infections in febrile children: systematic review. BMJ. 2011;342:d3082. doi:10.1136/bmj.d3082<br /> <br /> <br /> <br /> Transcript<br /> <br /> <br /> <br /> Note: This transcript was partially completed with the use of the Descript AI<br /> <br /> <br /> <br /> Welcome to PEM Currents: The Pediatric Emergency Medicine P odcast. As always,
February 28, 2025
<br /> In this episode we dive into the resurgence of Mycoplasma pneumoniae—an atypical bacterial cause of community-acquired pneumonia that’s making waves in pediatric emergency medicine. We’ll cover its clinical presentation, epidemiology, diagnostic approach, and management, including why standard beta-lactam antibiotics won’t work. Plus, we’ll discuss whether M. pneumoniae even needs to be treated in the first place!<br /> <br /> <br /> <br /> Learning Objectives<br /> <br /> <br /> <br /> <br /> * Describe the clinical presentation, epidemiology, and complications of Mycoplasma pneumoniae infections in pediatric patients, including its atypical manifestations.<br /> <br /> <br /> <br /> * Differentiate Mycoplasma pneumoniae pneumonia from typical bacterial and viral pneumonia based on history, physical exam findings, and diagnostic testing.<br /> <br /> <br /> <br /> * Assess the current evidence for antibiotic treatment of Mycoplasma pneumoniae and justify treatment decisions based on patient presentation, severity, and potential complications.<br /> <br /> <br /> <br /> <br /> Connect with Brad Sobolewski<br /> <br /> <br /> <br /> PEMBlog: <a href="https://pemblog.com/">PEMBlog.com</a><br /> <br /> <br /> <br /> Blue Sky: <a href="https://bsky.app/profile/bradsobo.bsky.social">@bradsobo</a><br /> <br /> <br /> <br /> X (Twitter): <a href="https://x.com/PEMTweets">@PEMTweets</a><br /> <br /> <br /> <br /> Instagram: <a href="https://www.instagram.com/bradsobolewski">Brad Sobolewski</a><br /> <br /> <br /> <br /> Mastodon: <a href="https://mastodon.social/@bradsobo">@bradsobo</a><br /> <br /> <br /> <br /> References<br /> <br /> <br /> <br /> Vallejo, Jesus G. “Mycoplasma Pneumoniae Infection in Children.” UpToDate, 1 Nov. 2024, www.uptodate.com/contents/mycoplasma-pneumoniae-infection-in-children.<br /> <br /> <br /> <br /> Garcia T, Florin TA, Leonard J, Shah SS, Ruddy RM, Wallihan R, Desai AP, Alter S, El-Assal O, Marzec S, Keaton M, Yun KW, Leber AL, Mejias A, Cohen DM, Ramilo O, Ambroggio L; Children’s Hospitals Initiative for Research in Pneumonia (CHIRP). Clinical Features and Management Strategies in Children With Mycoplasma Pneumoniae. Pediatr Emerg Care. 2025 Feb 17. doi: 10.1097/PEC.0000000000003338. Epub ahead of print. PMID: 39960098.<br /> <br /> <br /> <br /> Gao L, Sun Y. Laboratory diagnosis and treatment of Mycoplasma pneumoniae infection in children: a review. Ann Med. 2024 Dec;56(1):2386636. doi: 10.1080/07853890.2024.2386636. Epub 2024 Aug 3. PMID: 39097794; PMCID: PMC11299444.<br /> <br /> <br /> <br /> Shah SS. Mycoplasma pneumoniae as a Cause of Community-Acquired Pneumonia in Children. Clin Infect Dis 2019; 68:13.<br /> <br /> <br /> <br /> “Mycoplasma Pneumoniae Infections Have Been Increasing.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 18 Oct. 2024, www.cdc.gov/ncird/whats-new/mycoplasma-pneumoniae-infections-have-been-increasing.html.<br /> <br /> <br /> <br /> Transcript<br /> <br /> <br /> <br /> Note: This transcript was partially completed with the use of the Descript AI<br /> <br /> <br /> <br /> Welcome to PEMCurrents, the Pediatric Emergency Medicine Podcast. As always, I’m your host, Brad Sobolewski, and today we’re focusing on a pathogen that has been making waves in pediatric emergency departments across the country. Mycoplasma pneumoniae. Whether you know it or not, you’ve likely seen a surge where you work.<br /> <br /> <br /> <br /> Patients are presenting with community acquired pneumonia that isn’t responding to standard beta lactam antibiotics, or with parents who are just concerned that their child has walking pneumonia. That’s because mycoplasma pneumonia is just a little bit different than most of the pathogens that we deal with in children.<br /> <br /> <br /> <br /> So let’s dive in. So,
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