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Yaws

• Definition: Chronic, relapsing, tropical infection caused by Treponema pallidum pertenue.

• Epidemiology: Mostly affects children in rural, tropical regions; transmitted via direct skin contact.

• Clinical Features: Primary stage: papillomatous skin lesions, painless ulcer; secondary stage: generalized skin rash, periostitis, bone pain; late stage: destructive lesions of bones and cartilage.

• Investigations: Clinical diagnosis; serologic tests for treponemal antibodies (VDRL, RPR), PCR in research settings.

• Management: Single-dose oral azithromycin or intramuscular benzathine penicillin, hygiene education.

• Complications: Bone and joint deformities, chronic disfigurement if untreated.

Yolk Sac Tumor (Endodermal Sinus Tumor)

• Definition: Rare malignant germ cell tumor, usually arising in the testes or ovaries of children.

• Clinical Features: Rapidly enlarging mass, abdominal distension or pain (if retroperitoneal), signs of precocious puberty in some cases.

• Investigations: Serum alpha-fetoprotein (AFP) markedly elevated, ultrasound/CT scan for tumor localization, biopsy for histopathology.

• Management: Surgical resection, chemotherapy (cisplatin-based regimens).

• Complications: Metastasis (liver, lungs), recurrence, chemotherapy toxicity.

Yeast Infection (Candidiasis)

• Definition: Fungal infection caused by Candida species, commonly Candida albicans.

• Epidemiology: Common in neonates, infants, and immunocompromised children.

• Clinical Features: Oral thrush (white plaques in mouth), diaper rash (erythematous, sometimes with satellite lesions), intertriginous involvement.

• Investigations: Clinical diagnosis; KOH preparation or fungal culture if atypical or recurrent.

• Management: Topical antifungals (nystatin, clotrimazole), systemic antifungals (fluconazole) for severe cases, hygiene measures.

• Complications: Esophagitis, systemic infection in immunocompromised children, discomfort, feeding difficulties.

Yellow Fever (Pediatric)

• Definition: Acute viral hemorrhagic disease caused by flavivirus transmitted via Aedes mosquitoes.

• Epidemiology: Endemic in parts of Africa and South America; vaccination-preventable.

• Clinical Features: Fever, headache, myalgia, jaundice, hemorrhagic manifestations, nausea/vomiting; severe cases progress to multi-organ failure.

• Investigations: Serology (IgM antibodies), PCR, liver function tests.

• Management: Supportive care: hydration, antipyretics (avoid NSAIDs if hemorrhagic), ICU care for severe disease.

• Prevention: Yellow fever vaccine, vector control.

• Complications: Hepatic failure, renal failure, hemorrhage, death.

Yersiniosis (Pediatric)

• Definition: Gastrointestinal infection caused by Yersinia enterocolitica.

• Epidemiology: Often transmitted via contaminated food (especially pork) or water.

• Clinical Features: Fever, abdominal pain (right lower quadrant), diarrhea (sometimes bloody), vomiting; may mimic appendicitis.

• Investigations: Stool culture, serology in atypical cases.

• Management: Supportive care (hydration, nutrition); antibiotics (e.g., ceftriaxone, trimethoprim-sulfamethoxazole) for severe or immunocompromised patients.

• Complications: Reactive arthritis, post-infectious erythema nodosum, sepsis in immunocompromised children.

Y Chromosome Microdeletion Syndromes (Pediatric Endocrine/Genetic Disorders)

• Definition: Genetic abnormalities involving deletions in the Y chromosome affecting spermatogenesis and sexual development.

• Clinical Features: Infertility, hypospadias, ambiguous genitalia, delayed or incomplete puberty.

• Investigations: Karyotyping, PCR-based Y chromosome microdeletion analysis, hormone assays (FSH, LH, testosterone).

• Management: Multidisciplinary approach: endocrinology for hormone replacement, fertility counseling, urology for genital abnormalities.

• Complications: Primary infertility, gonadal dysgenesis, psychosocial issues.