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The individual type of bacteria that causes bacterial URTI in a previously healthy child depends on: a. Immunization history.b. Previous antimicrobial therapy. AbstractUpper Respiratory Tract Infection (URTI) or acute nasopharyngitis is the most common disease in pediatrics. However, it is not always simple and transient as its causative pathogens are changing and challenging. Local and Systemic Septic complications of bacterial URTI are common and systemic aseptic complications of streptococcal nasopharyngitis are not uncommon. However, there is a great debate about the management plan because of two facts: It is the most common cause of antibiotic use and misuse [1] and all septic and aseptic complications are actually preventable if bacterial URTI was properly treated with antibiotics [2]. The aim of this article is to summarize facts about septic and aseptic complications of URTI and to illustrate the best management plan including wise use of antibiotics to save pediatric patients not only from overtreatment, but also from under treatment.

Crying baby is one of the most common causes of Emergency Room visits during infancy and is associated with adverse outcomes for some mothers and babies. 20% of parents report problems with their Infant crying in the first 3 months. 5% of crying babies have organic causes that could be serious or life threatening if not diagnosed early. The aim of this article is to illustrate the organic and non-organic causes of crying baby and to outline a professional approach and management plan.

Second wave of the new coronavirus (SARS-CoV-2) has been declared throughout the world. It has been always thought that children are the least affected group. A new childhood disease, referred to as MIS-C (Multisystem Inflammation Syndrome) or PIMS-TS (Pediatric Inflammatory Multiorgan Syndrome Temporally related to SARS-CoV-2) was first recognized in April 2020. Shock and multiorgan failure affected some of those children that required intensive care; others were clinically similar to Kawasaki disease or toxic shock. The clinical evidence suggests that this inflammatory multisystem syndrome is temporally associated with severe acute respiratory syndrome corona virus 2. Many clinical uncertainties regarding this new disease rapidly became apparent in prevalence, clinical phenotypes, variable severity, clinical course, and optimal management. We aim to increase awareness of this syndrome regarding the diagnosis and management of children with suspected PIMS-TS by presenting two clinical cases and illustrating the available medical literature in regards to establishing the diagnosis and the appropriate therapeutic interventions. SARS-Cov-2 related medical impacts on children seem not well clarified yet. When a PIMS-TS case is suspected then full investigations should be done, children who have persistent fever associated with abdominal pain, diarrhea ,vomiting ,cough, neurologic symptoms should have primary blood tests to identify PIMS-TS: full blood count, CRP: C-reactive protein,  BUN: Blood Urea Nitrogen, Cr: Creatinine, Electrolytes and liver function. Multidisciplinary team approach seems mandatory from the very beginning. Despite the use of IVIG in the treatment of all diagnosed cases, steroids in regular doses could be a good alternative and requires further investigative evaluations.

Fever in early infancy may indicate the presence of an invasive bacterial infection [IBI]. Viral infection is the most common cause of fever in young infants, with Rhinovirus being the most common. Rectal temperature 38°C should be considered as fever. Bacterial infection may be the cause of fever in this age group even in the presence of a clear viral etiology. Evaluation and treatment of febrile infants during the first 3 months of life requires a balanced and cautious approach. After the introduction of vaccines in early infancy, there have been considerable changes in the bacterial pathogens and consecutive changes in the evaluation and empiric treatment of febrile young infants. While full septic screen seems necessary in the evaluation of many febrile young infants, partial septic screen without Lumbar puncture could be better in selected cases. It is the responsibility of the pediatrician to recognize the risk of invasive bacterial infection and to avoid unnecessary investigations at the same time. In this study, we suggest a simple approach that avoids the weak points of the available approach plans. Using clinical examples, we try to simplify this practical challenge.