Herpes Simplex

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HERPES SIMPLEX
 Definition of Herpes Simplex
 Herpes simplex refers to a group of viruses that infect humans. H. Virus infection simplex is characterized by vesicles clustered in the mucocutaneous with reddened skin. The disorder can occur in both primary and secondary. Herpes simplex causes painful wounds on the skin.








Cause  of Herpes Simplex
 Herpes simplex virus type 1 (HSV-1) is a common cause for injuries fever (cold sores) around the mouth. HSV-2 usually causes herpes sex. However, HSV-1 can cause genital infections, and HSV-2 can infect the mouth area through sex.

Clinical- Infection with this virus is characterized local primary lesions, latency and the tendency of local recurrence- 2 agents cause, HSV types 1 and 2, generally cause the clinical syndrome clear, depending on the entryHSV type 1:- Primary infection may be mild and usually occurs in childhood Early before the age of 5 years.- Approximately 10% of primary infections cause a more severe form of the disease manifesting fever and malaise.- It can last for a week or more, and is associated with vesicular lesions in the mouth, eye infection or a generalized skin eruption that aggravate chronic eczema.- Reactivation of latent infection results in cold sores that appear as clear vesicles on an erythematous base, usually on the face and lips, which berkrusta and recovered within a few days.- Reactivation may be caused by trauma, fever or an illness Another is being suffered. 
 
HSV type 2:- The virus is the cause of genital herpes, although it can also be caused by virus type 1.- Genital Herpes occurs primarily in adults and transmitted Sexual- Primary and recurrent infections may occur, with or without symptoms.

Diagnosis of Herpes Simplex
Based on the clinical picture

ManagementTreatment of Herpes Simplex:- Therapy include:§ Idoksuridin for skin lesions§ ointment and povidone-iodine paint§ Acyclovir for initial and recurrent genital herpes, 5 times a day, 200-400 mg.§ i.v infusion acyclovir for encephalitis H. simplex and patients with immunosuppression.- Local Treatment for shingles should include cleaning wound with salt water and keep it dry. Gentian violet   can be applied to the wounds.- The standard treatment for HSV is acyclovir in pill form to five time basis at the health center.

Hepatitis

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HEPATITIS VIRUS

Definition Acute Viral Hepatitis is an inflammation of the liver due to infection by one of the five viral hepatitis (virus A, B, C, D or E); inflammation emergent arrived and lasted only for a few weeks.



CauseHepatitis A, B, C, D, E.Clinical- Symptoms usually appear suddenly, such as:§ decreased appetite§ feel unwell§ nausea§ vomiting§ fever.- Sometimes there arises joint pain and urticaria (itchy skin), especially if cause is infection by the hepatitis B virus- A few days later, the urine turns a darker color and raised yellow (jaundice). At this time the other symptoms disappeared and the patient feel better, despite worsening jaundice.- Can symptoms of cholestasis (bile flow interruption or reduction) in the form of pale stools and itching all over the body.- Jaundice usually peaked at week 1-2, then disappeared at week 2-4.

Diagnosis- The diagnosis is based on symptoms and the results of blood tests to liver function.- On physical examination, liver palpable soft and sometimes a bit bigger.- The diagnosis must be obtained if the blood tests found viral proteins or antibodies against the hepatitis virus.
ManagementTreatment:- In case of severe acute hepatitis, then the patient is treated at home sick, but usually hepatitis A do not require special treatment.- After a few days, appetite reappeared and the patient does not need undergo bed rest. Food and activities the patient does not need to be limited and do not need extra vitamins.- Most patients can return to work after the jaundice disappeared, although the results have not been completely normal liver function.

Prevention:- Good hygiene can help prevent the spread of viral hepatitis A. Highly infectious feces. On the other hand, the patient does not need to be sequestered; exile in few patients only help the spread of hepatitis A, butdid not prevent the spread of hepatitis B and C.- The possibility of transmission of infection through blood transfusion can be reduced using blood that has been filtered to hepatitis B and C.- Hepatitis B Vaccination stimulates the formation of immune and provide effective protection.- Hepatitis A vaccine is given to people who are at risk high, such as the travelers who visit areas where the disease are found.- For hepatitis C, D and E have not found a vaccine.- For those who have not been vaccinated but has been exposed to hepatitis, can get the preparation of antibodies for protection, the serum globulin. Provision of antibodies aimed at providing immediate protection against hepatitis virus.- To the infants born to mothers with hepatitis B immune granted globulin hepatitis B and hepatitis B. This combination can prevent occurrence of chronic hepatitis B in approximately 70% of infants.

Glaucoma

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Definition of Glaucoma
Glaucoma is a symptom of a collection of diseases that cause a the resultant increase in intra-ocular pressure is sufficient to cause degeneration of the optic disc or visual field abnormalities.






Cause of Glaucoma
Increased intra-ocular pressure.Must be distinguished from ocular hypertension is a condition in which the pressure elevated intraocular without damage to the optic disc and visual field abnormalities.


Clinical of Glaucoma
Glaucoma can be classified as follows:1. Primary Glaucomaa. Primary open angle glaucoma (glaucoma simple, wide angle glaucoma, chronic simple glaucoma) is the most common type of glaucoma found.b. Primary angle closure glaucoma (narrow angle glaucoma, closed-angle glaucoma, acute congestive glaucoma).

2. Congenital Glaucomaa. Primary congenital or infantile glaucoma (Buftalmos)b. Glaucoma accompanying congenital abnormalities3. Secondary Glaucoma4. Absolute GlaucomaIn acute congestive glaucoma (the attacks) should be given treatment as soon as possible because delayed treatment can accelerate the deterioration visual acuity and visual field.

Acute congestive glaucoma is often suspected / diagnosed as conjunctivitis because the eyes look red. In acute glaucoma will see the injection conjunctiva, ciliary injection, dilated pupils / mid dilated, reflexes lacking.

Examination of eye pressure measurement with tonometri be obtained high value (normal 10 -20 mmHg).
Diagnosis of Glaucoma
Red eyes, wide pupils, reflexes lacking, somewhat cloudy cornea, no eye dirt with complaints of headache and decreased visual acuity and one eye is usually

Glaucoma of Glaucoma
The disorder is not diagnosed as conjunctivitis. Signs of conjunctivitis is the red eye (usually two eyes), there is a dirt eyes, no headache, not decreased visual acuity, pupils are not wide and does not cause blindness.Acute congestive glaucoma is very dangerous and result in total blindness can not be treated.

Management of Glaucoma
With limited personnel and equipment, the prevention of glaucoma which may be done at the Health Center is an acute congestive glaucoma.

administration:a. Timolol 0.5% at a dose of 2 x dailyb. Pilocarpine 2-4% every 2 hoursc. Acetazolamide 250 mg 3 times a dayd. Systemic analgesicSymptomatic treatment with existing symptoms and immediately refer to specialists Eye for further action.

Snakebite

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Snakebite
Definition of SnakebiteA condition caused by the bite of a poisonous snake.

Cause of Snakebite
Broadly venomous snakes can be classified into 3 groups:Colubridae (Mangroce cat snake, Boiga dendrophilia, etc.)Elapidae (King cobra, Blue coral snake, Sumatran spitting cobra, etc.) Viperidae (Borneo green piton viper, Sumatran pit viper, etc.).

Clinical of Snakebite
- Generally not poisonous snake bites, such as water snakes and only requires governance is simple. However, when the snakes are not known, it should be prevention efforts with Snake Serum Anti Could polyvalent.- The possibility is suspected when there is a history of snakebite.- Patients may:§ Looks bluish§ Fainting§ Paralyzed§ Shortness of breath

Effects caused by snake bites can be divided into three:1. Local effects.Some species such as coral snakes, Krait will give the effect of a rather difficult to be detected and only minor but some species bite can produce substantial effects such as swelling, blisters, bleeding, bruising to necrosis. What must be aware of is secondary hypovolemic shock caused by the migration of vascular fluid into the tissue due to the systemic effects of the venom.

2. Systemic EffectsSnakebite will produce non-specific effects such as headache, nausea and vomiting, abdominal pain, diarrhea until the patient becomes collapsed. Symptom found such as an alarm for health workers to give help soon.
 
3. Specific systemic effects
      Specific systemic effects can be divided by: 
• coagulopathy 
Several species of snakes can cause coagulopathy. Signs clinical signs that can be found are continuous bleeding from the site of the bite, gums and venipuncture from when developing will cause hematuria, haematomesis, melena, and coughing up blood. 

• neurotoxic 
This snake bites can cause flaccid paralysis. This is usually Hazardous in case of respiratory paralysis. Usually the signs who first encountered was the cranial nerves such as ptosis, oftalmoplegia progressive when it did not receive anti-venom will happen limb weakness and respiratory paralysis. Usually full paralysisit will take 12 + hours, in some cases used to be faster, 3 hours after the bite. 

• Miotoksisitas 
Miotoksisitas only be found when someone is attacked or bitten by a sea serpent. Snakes on land that is normally not a miotoksisitas cause severe. Symptoms and signs are:muscle pain, tenderness, mioglobinuria and the potential for failure, kidney, hyperkalemia and cardiotoxicity.

Diagnosis of snake bites
A history of bites with symptoms / signs of venomous snake bites in the form of securities local (the bite) as well as systemic effects and specific systemic effects.

Management of snake bites
First aid in snake bite: 
- If the bitten limb, use a swivel cord cross next to the wound. Turn the rope so tight until the pulse at the end of the members almost not palpable. Ties loosened every 15 minutes for 1 minute. 
- If the bite occurs in less than half an hour, make an incision place cross bite until blood came out and suck it with vacuum, do not ever with mouth. 
- If available, injections of serum Anti Could Snake  and polyvalent iv around the wound
- ATS procain 900 000 IU of penicillin and can be considered as prophylaxis.
- The general symptoms such as shock, paralysis and shortness of breath, the patient should refer immediately to the hospital.

gastritis

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definition of gastritis
Epigastric pain that is intermittent / persistent may be accompanied by nausea /vomiting.

the causes of gastritis
The main cause of gastritis are stomach irritation such as by food stimulate gastric acid, alcohol, drugs or stress. In this situation occurs impaired balance between the production of gastric acid and mucosal resistance.Systemic diseases, smoking, infection of the bacteria Helicobacter pilori also role in this disease.

Heart failure

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definition of Heart failure
Heart failure is a clinical syndrome that arises because of the declining power the heart pumps. Why other kinds of anemia, hypertension, thyrotoxicosis, coronary heart disease or heart valve disorders.

Heart failure

 
cause of Heart failure
- anemia
- hypertension
- titotoksikemia
- Chronic heart disease
- Abnormalities of the heart valves

avian influenza

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Definition avian influenza
Bird flu (avian influenza) is an acute infectious disease caused by virus, which generally attacks the birds and can also be transmitted from birds to humans. 

avian influenza

Cause avian influenza
Type A influenza virus subtype H5N1 Modes of Transmission Transmission of the disease to humans can be through: a. Animals: direct contact with sick birds or poultry products  b. Environment: air or contaminated equipment such viruses either derived from poultry feces or secretions of the bird flu virus (AI) c. Man: very limited and inefficient (the discovery of several cases in the group / cluster) d. Consumption of poultry products that have not cooked to perfection potential transmission of avian influenza virus. 

Diarrhea

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definition of Diarrhea
Diarrhea is a state of waste water with plenty of fluids and symptomatic of certain diseases or other disorders.Acute diarrhea is defecating mushy / liquid watery consistency, more often than is usually accompanied by a slimy, fishy odor, foaming may even be water only a frequency more often than usual.
Nonspecific diarrhea is diarrhea caused by germs that are not specific or parasites.

cause of Diarrhea
The cause is a virus, which stimulates food contaminated or toxin, digestive disorders and so on.

Clinical Overview of Diarrhea
- A fever that often accompanies the disease aggravate dehydration. symptom dehydration will not appear until the fluid loss reaches 4-5% by weight body.

- Symptoms and signs of dehydration include:
§ thirst, dry mouth and lips
§ Decreased skin turgor
§ The reduced weight gain, hypotension, muscle weakness
§ shortness of breath, anxiety
§ sunken eyes, no tears
§ large sunken fontanel in infants
Oliguria and anuria §
§ Decreased consciousness, drowsiness

- The lack of fluid reaches 10% or more patients fall into if the continuing severe dehydration and shock and death may occur.

diagnosis of Diarrhea
Determined from the symptoms of bowel movements over and over again more often than usual with a soft consistency and liquid

management of Diarrhea
- WHO has set four main elements in the prevention of acute diarrhea
namely:
§ Provision of fluids, oral rehydration of actions (Uro) to prevent or treat dehydration.
§ Continue feeding as usual, especially milk, for diarrhea and the healing period.
§ Do not use antidiarrheal, while antibiotics and antimicrobial only to cases of suspected cholera, dysentery, or giardiasis or proven amubiasis.
§ The provision of effective guidance for the mother and child and family about oral rehydration efforts at home, referring to signs and how to prevent diarrhea in the future.
- Then do as did the rehydration efforts against dehydration due to cholera.
- In patients with diarrhea without dehydration: (Treatment A)
§ Give fluids (water starch, salt sugar solution, ORS) as much as desired
until the diarrhea stops, as the instructions given after every
CHAPTER
o Children <1 year: 50 - 100 ml
o Children 1-4 years: 100-200 ml.
o Children> 5 years: 200-300 ml
o Adult: 300 - 400 ml
§ Continue feeding or breast milk for babies
- In patients with diarrhea with mild dehydration - is being (Treatment B):
ORS § given 75 ml / kg within 3 hours, not with a bottle.
§ If the child is vomiting (due to too rapid infusion of fluids), wait 5-10 minutes and then repeat again, by giving more slowly (one tablespoon per 2-3 minutes).

Epilepsy

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Definition of Epilepsy
Epilepsy is a disease characterized by a tendency to experiencing recurrent seizures.The most frequent form of attack is the seizures that began with loss of consciousness, loss of control of the motion and the occurrence of tonic seizures or clonic seizures in the limbs.

Cause of Definition of Epilepsy
Functional brain abnormalities that are recurrent attacks. Organic disorders in the brain can also cause epilepsy, so this possibility should be considered. From the pattern of his attacks, epilepsy, generalized epilepsy such distinguished on epilepsy grand mal, petit mal, or myoclonic epilepsy and partial example focal seizure motor, focal sensory.

Clinical Overview of Definition of Epilepsy
- Grand mal attack is often preceded by an aura of feeling immersed or drift. Temporary impairment of consciousness, head turned to one side, the teeth tightly clenched and loss of bladder control,snoring, mouth foaming and can occur inkontinesia. Then there tonic spasms throughout the body for 20-30 seconds followed by clonic seizures in parts of the muscles, back muscles and neck muscles that lasts 2-3 minutes.After the seizure the patient lying limp or lost sleep 3-4 hours, then gradually recovered consciousness. After the attack the patient is often in a confused state.- Petit mal attacks, also called flax attacks, beginning with loss of consciousness for 10-30 seconds. During the phase of flax (absence) of motor activity stops and the patient was still in action. Sometimes it seemed like there was no attack, but clonic movements sometimes arise in the mouth or eyelids.- Myoclonic attack is a brief contraction of a muscle or group of muscle.- Attacks can be simple partial motor seizures that begin in one sesisi one hand and spread, while the sensory partial seizures can be form of attack unilateral numbness or tingling. Simple partial seizures (psychomotor) complex, people have lost touch with the surrounding environment for 1-2 minutes, moving the arm andlegs in a weird way and without purpose, a sound insignificant, unable to understand what others are sayingand refused to help. The confusion lasted for several minutes and followed by recovery.- In primary generalized epilepsy, patients have seizures as a reaction body against abnormal loads. After which the person may experience headache, while dazed and exhausted. Usually the patient can not remember what happened during the seizure.- Status epilepticus is a seizure of the most serious, in which seizures occur continuously, not stopping. Muscle contraction is very strong, can not breathe properly and the electric charge in the brain is widespread. If not immediately treated, can damage the heart and brain settled and the patient could die.

Diagnosis of Definition of Epilepsy
Diagnosis based on symptoms presented by others who witnessed the occurrence of epileptic seizures in patients and a history previous illness.

Management of Definition of Epilepsy
- General principles of idiopathic epilepsy therapy is to reduce / prevent attacks, whereas organic epilepsy therapy directed toward the cause.- Factors trigger attacks, such as fatigue, emotional or eating break drugs should be avoided.- In the event of a seizure, try to avoid injury due to seizures, such as being bitten tongue or injury or other injury.- An important step is to keep people from falling, loosen clothing (especially in the neck area) and put a pillow under the head of the patient.- If the patient is unconscious should be more tilted position easy breathing and should not be left alone until it is completely conscious and able to move normally.- Anti-seizure medications to prevent further seizures, usually given to patients who have recurrent seizures. Status epilepticus an emergency, because it's anti-seizure drugs given in doses intravenous high- Where possible use a single drug and start with low doses.- When a single drug does not effectively use the maximum dose of two drugs with the lowest dose.- If the attack is resolved not think about the possibility of non-compliance of patients, organic causes, the choice and dosage of drugs that are less precise.- If during 2-3 years of not arise again attack, the drug can be stopped gradually.- Choice of antiepileptic

Diphtheria

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Definition of Diphtheria Diphtheria is an acute infection of the upper respiratory tract caused by the bacteria Corynebacterium diphtheriae. More frequently attacked the children.


Cause of Diphtheria
The cause is the bacteria Corynebacterium diphtheriae. These bacteria are usually attacks the respiratory tract, particularly the larynx, tonsils and throat. But not rare poison also attacks the skin and even cause nerve damage and heart.

Clinical overview of Diphtheria
- The buds 2-7 days- The patient complained of pain in swallowing and breathing snoring sounds (stridor), not rare in children, followed by fever, nausea, vomiting, chills and headache.- The person is short of breath with or without signs of airway obstruction.- A fever is not high.- On examination of the throat appears grayish white membrane that is easy bleed when touched.- These symptoms are not always exist:
A blockage of the airway so that the patient cyanotic, Bad breath , Bleeding nose- There was enlargement of lymph nodes in the neck (bullneck)- Local inflammatory exudate with a lot of the pharynx, the sticky exudate in gray or dark-colored mucosa and soft tissue edema. In children, phase of the disease can lead to airway obstruction.- Systemic disease caused by a bacterial toxin begins 1-2 weeks after the local symptoms. The toxin affects the heart (myocarditis, arrhythmias, especially during the second week of illness) and nervous system(Paralysis, neuritis 2-7 weeks after disease onset). If the patient recovered from the acute phase of illness, comorbid disorder usually resolves without Diagnosis The need for a treatment is decided on the basis of history and  overview
Diagnosis was confirmed by bacterial culture taken from the exudate into the tube to sample bacteria. Samples should be cultured on special media, for that necessary to first notify the laboratory. Smears taken 3 days respectively.

Management of Diphtheria
- Asymptomatic patients given prophylactic antibiotics erythromycin.- Symptomatic patients should be referred to the hospital.

Diabetes Mellitus

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Diabetes Mellitus

Definition Diabetes Mellitus
Diabetes mellitus (DM) is a metabolic disease characterized by high plasma glucose levels (hyperglycemia) caused by impaired secretion of insulin, insulin action or both. 

There are 2 types of Diabetes mellitus on the basis of the initiation of the disease, namely:

Type-1, Insulin Dependent Diabetes Mellitus (IDDM) or juvenile typeIn this type there is destruction of pancreatic beta cells, so it is not cells produce insulin and therefore can not absorb glucose from the blood. Increased blood glucose levels so that excess glucose released by urine. This type is more common in the age of 30 years and most often begins in aged 10-13 years.

2. Type-2, Non Insulin Dependent Diabetes Mellitus (NIDDM) or adult typeThis type is independent of insulin, usually occurs in over 40years with a greater incidence in overweight people and the elderly.

Cause of Diabetes mellitus
Deficiency of the hormone insulin, which serves to utilize glucose as a source energy and synthesize fat.Type-1 cause is not so obvious can be caused by viral infection cause auto-immune reaction to combat excess virus, but it hereditary factors play a role.

Type-2 due to declining function of cells and the accumulation of amyloid betaaround the beta cells.

Function of insulin insufficiency caused by impaired or deficient production of insulin by beta cells of Langerhans pancreas gland, or due to lack of responsiveness of cells to insulin.
 
Clinical Overview of Diabetes mellitus
a. Patients often complain of weakness, sometimes feel tingling or a sense of chronic numbness and itching.b. Patients generally suffer from polyuria (lots of urination) polydipsia (Lots of drinking) and polyphagia (eat a lot).c. Weight loss can not be explained.d. In addition, people will feel very thirsty, loss of energy, feeling faint and tired.e. In case of further decrease in visual acuity may occur 

 Diagnosis of Diabetes mellitus
Based on the symptoms of diabetes with the 3P (polyphagia, polyuria, polydipsia).  

Diagnosis can be confirmed by determination of blood sugar levels.a. When blood glucose levels when 200 mg / dlb. Fasting blood glucose 126 mg / dlc. on Oral Glucose Tolerance Test (TTGO) obtained test results content 2 hour blood sugar of 200 mg / dl after 75 g glucose administration.

Management of Diabetes mellitus
a. Common actions are done for patients with diabetes, among others; diet with caloric restriction, exercise when insulin resistance occurs exercise regularly can reduce it, quit smoking because nicotine can affect the uptake of glucose by cells.b. if public action is not effective in lowering blood glucose in patients Type-2 diabetes, it can be given oral antidiabetic:- Chlorpropamide started with 0.1 g / day in one provision, the maximum 0.5 mg / day- Glibenclamide start with 5 mg / day in one provision, the maximum 10 mg / day- Start with Metformin 0.5 g / day in 2 - 3 times of administration, the maximum 2 g / day.These drugs should be started with the smallest dose. After 2 weeks of treatment, dose can be increased.c. In patients with Type-1 diabetes given insulin for life, not encouraged to drink oral antidiabetics.

hookworm infection

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hookworm infection


definition hookworm infection
Hookworm infection is a disease caused by worms Ancylostoma duodenale and / or Necator americanus. Blood sucking hookworms giving rise to complaints related to anemia, impairedgrowth, especially in children and can cause mental retardation.
 
cause hookworm infection
Ancylostoma duodenale and / or Necator americanus.
 
The clinical
- The incubation period of several weeks to several months depending of the severity of infection and nutritional status of patients.
- By the time the larvae penetrate the skin, patients can experience dermatitis. When the larvae through the lungs can occur coughing
- The main result of this worm is caused by anemia are sometimes so weight to lead to heart failure.

diagnosis
Diagnosis is by finding eggs in fresh feces or stool culture Harada-Mori manner.
 
management
- Pirantel pamoate 10 mg / kg per day for 3 days.
- Mebendazol single dose of 500 mg (once only) or 100 mg 2 x daily for three consecutive days
- Albendazole 400 mg single dose (once only), but should not be used during pregnancy.
- Sulfas ferosus 3 x 1 tablet for adults or 10 mg / kg body weight / time (for children) to overcome the anemia.
 
prevention
Prevention of this disease include environmental sanitation and improved hygiene individuals primarily use shoes or sandal 

Bronchitis

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Definition of Bronchitis
Bronchitis is an inflammation of the bronchi (airways into the lungs). Acute bronchitis is actually a lighter bronko pneumonia.

Cause of Bronchitis
The causes can be viruses, mycoplasma or bacteria.




The clinical of Bronchitis
• Coughing up phlegm (sputum can be colored red), shortness of breath when exercise or exertion, frequent respiratory infections (Eg flu), asthma, fatigue, swelling of ankles, feet and left and right leg, face, palms, or mucous membranes are colored red, reddish cheeks, headache, visual disturbances.• infectious bronchitis often begins with symptoms such as runny nose, the nose phlegm, fatigue, chills, backache, muscle aches, mild fever and pain throat.• Cough is usually the sign of the start of bronchitis. At first the cough no phlegm, but 1-2 days later will issue a colored sputum white or yellow. Sputum will grow much further, yellow or green.• In severe bronchitis, after most of the other symptoms improved, sometimes High fever for 3-5 days and the cough may persist for several weeks.• shortness of breath occurs when the airway is blocked.• Often found wheezing breath sounds, especially after coughing.• It could happen pneumonia. 

 Diagnosis of Bronchitis
• Diagnosis is usually made based on symptoms, especially of the mucus.• On examination with a stethoscope will hear a crackles or abnormal breathing sounds.






Management of Bronchitis
• To reduce fever and malaise, the patient Adults can be given aspirin or paracetamol; to childrenshould only be given paracetamol.• It is advisable to rest and drink plenty of fluids, and stop smoking.• Antibiotics are given to patients whose symptoms indicate that the cause is a bacterial infection (yellow or green phlegm and remained high fever) and patients who previously had lung disease.• To the adult patients given Cotrimoxazole. Tetracycline 250-500 mg4 times daily. Erythromycin 250-500 mg four times daily given for 7-10 days.The dose for children: erythromycin 40-50 mg / kg / day. although Mycoplasma pneumoniae is the suspected cause.• To the people with children given amoxicillin.• If there are signs of obstruction in patients immediately reconciled.