Differential Diagnosis in PEDIATRICS
Differential Diagnosis in PEDIATRICS
Editor-in-Chief
K Nedunchelian MD DCH FIAP
Senior Consultant Pediatrician Head—Research and Academics Mehta Multispeciality Hospitals India Pvt Ltd Chennai, Tamil Nadu, India
Academic Editor
P Ramachandran MD (Ped) DNB (Ped) FIAP
Professor of Pediatrics and Associate Dean (PG Studies) Sri Ramachandra Institute of Higher Education and Research Chennai, Tamil Nadu, India
Executive Editor
S Thangavelu MD DCH DNB MRCP (Ped)
Senior Consultant Pediatrician Director Department of Pediatrics Mehta Multispeciality Hospitals India Pvt Ltd Chennai, Tamil Nadu, India
Managing Editor
NC Gowrishankar MD DCH DNB FIAP
Senior Consultant Pediatrician and Pediatric Pulmonologist Head—Clinical Operations and Quality Department of Pediatrics Mehta Multispeciality Hospitals India Pvt Ltd Chennai, Tamil Nadu, India Editor-in-Chief Indian Journal of Practical Pediatrics
Foreword
Santosh T Soans
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Differential Diagnosis in Pediatrics
First Edition: 2020
9789352707003
Printed at
- A Aravindan MD (Ped)
- DM Resident
- Institute of Rheumatology
- Madras Medical College
- Chennai, Tamil Nadu, India
- A Balamurugan BDS MSc (Forensic Odontology)
- Tutor in Dentistry
- Department of Pedodontics and Preventive Dentistry
- Sri Ramachandra Dental College
- Sri Ramachandra Institute of Higher Education and Research
- Chennai, Tamil Nadu, India
- A Ramesh MD DD DIP NB (DVL)
- Professor
- Department of Dermatology
- Madras Medical College and
- Rajiv Gandhi Government General Hospital
- Chennai, Tamil Nadu, India
- A Somasundaram MD (Ped) PGDDN
- Consultant in Developmental and Behavioral Pediatrics
- Kanchi Kamakoti CHILDS Trust Hospital
- Chennai
- Chief Mentor
- D’Soul Child Development Centre
- Chennai, Tamil Nadu, India
- A Victor Jerome DCH MRCPCH European Respiratory Society (ERS) Diplomate in Pediatric Respiratory Medicine, Diplomate of Asian Pediatric Pulmonology Society (APPS)
- Consultant Pediatrician
- Sri Ramakrishna Hospital
- Coimbatore, Tamil Nadu, India
- Aathira Ravindranath MD
- Senior Registrar
- Department of Pediatric Gastroenterology
- Sanjay Gandhi Postgraduate Institute of Medical Sciences
- Lucknow, Uttar Pradesh, India
- Abiramalatha T MD (Ped) DCH DM (Neo)
- Assistant Professor
- Department of Neonatology
- Sri Ramachandra Institute of
- Higher Education and Research
- Chennai, Tamil Nadu, India
- Abraham K Paul MD DCH FIAP FNNF
- Consultant Pediatrician
- Cochin Hospital
- Cochin, Kerala, India
- Aditi Sinha MD (Ped) DNB (Ped)
- Assistant Professor
- Division of Nephrology
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Ahila Ayyavoo DCH DNB PhD
- Consultant in Pediatric
- Endocrinology and Diabetes
- GKNM Hospital
- Coimbatore
- Aditi Hospital
- Trichy, Tamil Nadu, India
- Akila Devi V DNB (Ped) FPEM (Fellowship in Ped Emer Med)
- Junior Consultant
- Department of Pediatrics and
- Pediatric Emergency
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Chennai, Tamil Nadu, India
- Amish Udani DCH DNB (Ped) Fellow Pediatric Nephrology (ISPN & The TN Dr MGR University)
- Consultant Pediatric Nephrologist
- Department of Pediatric Nephrology
- BJ Wadia Hospital for Children
- Mumbai, Maharashtra, India
- Anbezhil Subbarayan MD FRCPCH MSc
- Consultant Pediatric Endocrinologist
- Apollo Children's Hospital
- Chennai, Tamil Nadu, India
- Anju Seth MD (Ped)
- Director Professor
- Department of Pediatrics
- Lady Hardinge Medical College
- New Delhi, India
- Ankita Saikia MDS BIRAC Fellow
- Consultant Pediatric Dental Surgeon
- Pedo Planet—Children Dental Centers
- Chennai, Tamil Nadu, India
- Anna Simon DCH MD (Ped) FRCP (Edin)
- Consultant in Pediatric Endocrinology and Metabolism
- Professor and Head
- Child Health Division
- Christian Medical College and
- Hospital
- Vellore, Tamil Nadu, India
- Annamalai Vijayaraghavan MD DCH
- Consultant Pediatrician
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Former Deputy Superintendent and Professor
- Department of Pediatrics
- Institute of Child Health and
- Hospital for Children
- Madras Medical College
- Chennai, Tamil Nadu, India
- Anoop Subash DNB (Ped Surg) MRCS
- Consultant Pediatric Surgeon
- Shishoo—The Children's Hospitals
- Mysuru, Karnataka, India
- Antony Terance Benjamin MD (Ped) MRCPCH
- Consultant—Pediatrics and
- Pediatric Pulmonology
- G Kuppuswamy Naidu Memorial Hospital
- Coimbatore, Tamil Nadu, India
- Anuradha Srinivasan MD (Ped) PG Dip Developmental Neurology
- Consultant
- Developmental Pediatrics
- Mehta Multispeciality Hospitals India Pvt Ltd
- Chennai, Tamil Nadu, India
- Anurag Bajpai MD (Ped) FRACP (Ped Endo)
- Consultant Pediatric and Adolescent Endocrinologist
- Regency Center for Diabetes Endocrinology and Research
- Kanpur, Uttar Pradesh, India
- AP Sambandam MS DLO
- Former Professor
- Department of ENT
- Institute of Child Health and
- Hospital for Children
- Chennai, Tamil Nadu, India
- Aparna Bhatnagar MBBS MS FMRF
- Consultant
- Trauma, Orbit and Oculoplasty
- Apollo Specialty Hospitals, Vanagaram
- Billroth Hospitals
- Chennai, Tamil Nadu, India
- Aparna Chandrasekaran MD (Ped) DM (Neo)
- Consultant Neonatologist
- Ankura Hospital for
- Women and Children
- Hyderabad, Telangana, India
- Aravind Bhaskaran M MBBS
- Resident in Dermatology
- Trinelveli Medical College
- Trinelveli, Tamil Nadu, India
- Arushi Gahlot Saini MD DM (Ped Neuro)
- Assistant Professor
- Pediatric Neurology Unit
- Department of Pediatrics
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Asir Julin MD DM
- Assistant Professor
- Department of Pediatric Neurology
- Institute of Child Health and
- Hospital for Children
- Madras Medical College
- Chennai, Tamil Nadu, India
- B Sumathi MD (Ped) DCH DM (Gastro)
- Associate Professor
- Department of Medical Gastroenterology
- Government Stanley Medical College
- Chennai, Tamil Nadu, India
- B Umamaheswari MD MRCPCH (UK)
- Associate Professor
- Department of Neonatology
- Sri Ramachandra Institute of
- Higher Education and Research
- Chennai, Tamil Nadu, India
- Baldev S Prajapati MD (Ped) FIAP MNAMS FICMC
- Head and Professor
- Department of Pediatrics
- GCS Medical College
- Hospital and Research Centre
- Aakanksha Children Hospital and Postgraduate Institute
- Ahmedabad, Gujarat, India
- Beena Suresh MBBS MS DNB
- Consultant
- Department of Clinical Genetics and Genetic Counseling
- Mediscan Systems
- Chennai, Tamil Nadu, India
- Bhumesh Kumar Katakam MD DVL DCH
- Senior Assistant Professor
- Department of Dermatology, Venereology and Leprosy
- Gandhi Medical College/Hospital
- Secunderabad, Telangana, India
- Bikrant Bihari Lal MD (Ped) PDCC DM (Ped Hepato)
- Assistant Professor
- Department of Pediatric Hepatology
- Institute of Liver and Biliary Sciences
- New Delhi, India
- Bindusha S MD DCH DNB (Ped)
- Associate Professor
- SAT Hospital
- Government Medical College
- Thiruvananthapuram, Kerala, India
- C Leema Pauline MD (Ped) DM (Neuro)
- Professor
- Department of Pediatric Neurology
- Madras Medical College
- Chennai, Tamil Nadu, India
- C Vijayabhaskar MD (Derm) DCH
- Associate Professor
- Institute of Dermatology
- Madras Medical College
- Chennai, Tamil Nadu, India
- Chandrakumar Natarajan MD DNB (Ped) DM (Neo) DNB (Ped)
- Senior Consultant and Head
- Department of Neonatology
- Kanchi Kamakoti CHILDS Trust Hospital
- Chennai, Tamil Nadu, India
- Chetan Kumar Dave MBBS DCH
- Clinical and Research Fellow
- Regency Center for Diabetes Endocrinology and Research
- Kanpur, Uttar Pradesh, India
- Chhaya Sambharya Prasad MBBS DCH PGDDN
- Developmental Pediatrician/
- Adolescent Health Expert
- Director, ASHA, Centre for Autism and Intellectual Developmental Disorders
- Chandigarh
- Chidambaram Balasubramaniam MCh (Neuro Surg)
- Consultant Pediatric Neurosurgeon
- and Head
- Department of Pediatric Neurosurgery
- Kanchi Kamakoti CHILDS Trust Hospital
- Chennai, Tamil Nadu, India
- Chitra Sundaramoorthy DCH MRCPCH MSc
- Consultant Pediatric Rheumatologist
- Apollo Children's Hospital
- Chennai, Tamil Nadu, India
- D Nirmala DCH MD DM (Gastro)
- Professor and Head
- Department of Pediatric Gastroenterology
- Institute of Child Health and
- Hospital for Children
- Chennai, Tamil Nadu, India
- D Vijayasekaran MD DCH PhD FIAP
- Former Professor
- Department of Pulmonology
- Madras Medical College
- Pulmonologist
- Kanchi Kamakoti CHILDS Trust Hospital and Apollo Children's Hospital
- Chennai, Tamil Nadu, India
- Deepa Hariharan MBBS AB (Ped) AB (Neo) FAAP
- Senior Consultant
- Pediatrician and Neonatologist
- Sooriya Hospital
- Chennai, Tamil Nadu, India
- E Padmapriya DCH DNB (Ped) Neonatal Training (Australia)
- Senior Consultant
- Department of Neonatology
- SIMS Hospital
- Chennai, Tamil Nadu, India
- Elizabeth KE PhD MD DCH FIAP FRCPCH (Lon)
- Professor and Head
- Sree Mookambika Institute of
- Medical Sciences
- Kanyakumari, Tamil Nadu, India
- G Anandkumar MBBS DCH
- DNB (Ped) Resident
- Mehta Multispeciality Hospitals India Pvt Ltd
- Chennai, Tamil Nadu, India
- G Durai Arasan MD DCH
- Professor of Pediatrics
- Institute of Child Health and
- Hospital for Children and
- Madras Medical College
- Chennai, Tamil Nadu, India
- G Nandhini MBBS DNB (Ped Surg) FIAPS
- Consultant Pediatric Surgeon
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Chennai, Tamil Nadu, India
- G Sangeetha DNB (Ped) Fellowship (Ped Nephro)
- Assistant Professor
- Department of Pediatric Medicine
- Division of Pediatric Nephrology
- Sri Ramachandra Institute of
- Higher Education and Research
- Chennai, Tamil Nadu, India
- Georgie Mathew MD (Ped) DM (Ped Nephro)
- Senior Resident Nephrology
- Division of Nephrology
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Hamsa V MD (Ped) DM (Ped Nephro)
- Senior Resident
- Department of Pediatric Nephrology
- St John's Medical College Hospital
- Bengaluru, Karnataka, India
- Hema Vijaylakshmi Varadarajulu DCH DNB (Ped) DM (Gastro)
- Assistant Professor
- Department of Medical Gastroenterology
- Saveetha Medical College and Hospital
- Thandalam, Chennai
- Consultant Pediatric Gastroenterologist and Endoscopist
- Sri Chakra Multispecialty Hospital
- Chennai, Tamil Nadu, India
- Hemchand K Prasad MD (Ped)
- Consultant
- Department of Pediatric Endocrinology
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Chennai, Tamil Nadu, India
- J Balaji MD (Ped)
- Assistant Professor of Pediatrics
- Institute of Child Health and
- Hospital for Children and
- Madras Medical College
- Chennai, Tamil Nadu, India
- J Dhivyalakshmi MD (Ped) PDCC (Ped Endo)
- Assistant Professor and
- Consultant Pediatric Endocrinologist
- Department of Pediatrics
- Division of Pediatric Endocrinology
- Sri Ramachandra Institute of Higher Education and Research
- Chennai, Tamil Nadu, India
- J Ritchie Sharon Solomon MD DCH DM (Ped Cardio)
- Assistant Professor
- Department of Pediatric Cardiology
- Institute of Child Health and
- Hospital for Children
- Chennai, Tamil Nadu, India
- J Shyamala DNB (Ped) DCH
- Consultant Neonatologist
- Apollo Children's Hospitals
- Chennai, Tamil Nadu, India
- Jagdish Chinnappa MD (Ped)
- Cluster Head
- Manipal Group
- Bengaluru, Karnataka, India
- Jana Priya Sugumar MBBS
- DNB (Ped) Resident
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Chennai, Tamil Nadu, India
- Jeeson C Unni MD DCH FIAP
- Associate Consultant
- Department of Pediatrics
- Aster Medcity
- Kochi, Kerala, India
- Editor-in-Chief, IAP Drug Formulary
- John Mathai DCH MD FAB (Ped Gastro) FIAP
- Senior Consultant Pediatrician and Pediatric Gastroenterologist
- Masonic Children's Hospital
- Coimbatore, Tamil Nadu, India
- Jyoti Singhal MD (Ped) Fellowship in Pediatric Nephrology
- Consultant Pediatric Nephrologist
- KEM Hospital
- Pune, Maharashtra, India
- K Balakumar MS DLO
- Former Director and Professor
- Institute of ENT
- Madras Medical College
- Chennai, Tamil Nadu, India
- K Githa MD DCH
- Consultant Neonatologist and Pediatrician
- Prashanth Fertility Research Centre and Multispecialty Hospitals and Mehta Multispeciality Hospitals India Pvt Ltd
- Chennai, Tamil Nadu, India
- K Lakshminarayanan MD (Ped) DM (Ped Neuro) Fellowship in Epilepsy (RCH, Melbourne)
- Senior Consultant Pediatric Neurologist and Epileptologist
- Rainbow Children's Hospital
- Chennai, Tamil Nadu, India
- K Pandian MD (Ped) DM (Neuro)
- Pediatric Neurologist
- KP Hospital
- St. Thomas Mount
- Chennai, Tamil Nadu, India
- Kalaivani Ganesan MD (Ped) FISPNFPN (TNMGRU)
- Consultant Nephrologist
- Mehta Multispeciality Hospitals India Pvt Ltd
- Chennai, Tamil Nadu, India
- Kalpana Gowrishankar MBBS DCH PhD (Genetics)
- Clinical Geneticist
- Department of Medical Genetics
- Apollo Hospitals
- Chennai, Tamil Nadu, India
- Karthik Muthusamy MD (Ped) DM (Neuro) DNB (Neuro)
- Professor
- Pediatric Neurology
- Department of Neurological Sciences
- Christian Medical College
- Vellore, Tamil Nadu, India
- Karthik Surya Ramanujam DNB (Ped) FND (Cardio)
- Pediatric Interventional Cardiologist
- Kamakshi Memorial Hospital and Sooriya Hospital
- Chennai, Tamil Nadu, India
- Karthikraja P MBBS
- Resident (Final Year) in Dermatology
- Department of Dermatology, Venereology and Leprosy
- Tirunelveli Medical College
- Tirunelveli, Tamil Nadu, India
- KC Vignesh MDS
- Consultant and Pediatric Dentist
- Pedo Planet—Children Dental Centers
- Chennai, Tamil Nadu, India
- Kollencheri Puthenveettil Vinayan MD (Ped) DCH DNB (Ped) DM (Neuro)
- Professor and Head
- Division of Pediatric Neurology
- Department of Neurology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- L Subramanyam MD (Ped)
- Senior Pulmonologist
- Mehta Multispeciality Hospitals India Pvt Ltd
- Chennai, Tamil Nadu, India
- Leena Srivastava MBBS DCH PGD-DN (Developmental Neurology) IAP Hon’ Fellowship in Childhood Disability and Early Intervention
- Head
- Division of Developmental and Behavioral Pediatrics
- Department of Pediatrics
- Bharati Vidyapeeth University Medical College and Hospital, Pune
- Consultant, Developmental Pediatrics
- Cloudnine Hospital
- Pune, Maharashtra, India
- Fellowship in Pediatric
- Neurology-Epilepsy
- Lekha Hrishikesan MD DCH DNBDM DNB MRCP MRCPCH FRCPCH
- Senior Consultant
- Department of Pediatric Nephrology
- Ananthapuri Hospitals and
- Research Institute
- Thiruvananthapuram, Kerala, India
- M Pradeepkumar MD (Ped) DCH FCG
- Consultant Geneticist
- Geneomm Medical Centre
- Coimbatore, Tamil Nadu, India
- M Ranjitkumar MD (Ped) DM (Neuro)
- Pediatric Neurologist
- Sri Ramachandra Institute of
- Higher Education and Research (SRIHER)
- Chennai, Tamil Nadu, India
- M Suresh Babu MS (Ortho) FPO (Fellowship in Ped Ortho)
- Senior Assistant Professor
- Department of Pediatric Orthopedics
- Institute of Child Health and
- Hospital for Children
- Chennai, Tamil Nadu, India
- Madhuri Prabhu MBBS MRCPCH
- Senior Consultant and Head
- Department of Neonatology and Pediatrics
- Motherhood Hospital
- Chennai, Tamil Nadu, India
- Mahesh Janardhanan MD MRCPCH FRCPCH CCT (UK) MSc (Rheumatology)
- Consultant Pediatric Rheumatologist
- Sri Ramachandra Institute of Higher Education and Research
- Chennai, Tamil Nadu, India
- Malathi Sathiyasekaran MD (Ped) MNAMS (Ped) DM (Gastro)
- Consultant Pediatric Gastroenterologist
- Sundaram Medical Foundation and
- Kanchi Kamakoti CHILDS Trust Hospital
- Chennai, Tamil Nadu, India
- Maulik Patel D (Ortho) DNB (Ortho)
- Consultant Pediatric
- Orthopedic Surgeon
- Happy Kids Ortho Hospital
- Ahmedabad, Gujarat, India
- Maya Peethambaran MD DNB (Ped) DNB (Gastro) MRCPCH
- Pediatric Gastroenterologist
- PVS Memorial Hospital
- Kochi, Kerala, India
- Maya Thomas DCH MD (Ped) DM (Neuro)
- Professor and Head
- Pediatric Neurology
- Department of Neurological Sciences
- Christian Medical College
- Vellore, Tamil Nadu, India
- Mohamed Sajjid MD (Ped) DM (Neo)
- Assistant Professor
- Department of Neonatology
- Institute of Obstetrics and Gynecology and Government Hospital for
- Women and Children
- Madras Medical College
- Chennai, Tamil Nadu, India
- Moinek Sen Sarma MD DM (Ped Gastro)
- Assistant Professor
- Department of Pediatric Gastroenterology
- Sanjay Gandhi Postgraduate
- Institute of Medical Sciences
- Lucknow, Uttar Pradesh, India
- Moorthy G MBBS MRCS (UK) MCh (Ped Surg) DNB (Ped Surg)
- Consultant—Pediatric Surgeon
- Dr Kamakshi Memorial Hospital
- Chennai, Tamil Nadu, India
- MS Muthu MS MDS PhD MFDSRCPS (Glas)
- Head
- Department of Pedodontics and Preventive Dentistry
- Sri Ramachandra Dental College
- Sri Ramachandra Institute of
- Higher Education and Research
- Chennai, Tamil Nadu, India
- MS Vishwanathan MD (Ped) MRCPCH FRCPCH CCT
- Senior Consultant
- Pediatric Gastroenterologist and Hepatologist
- Apollo Children's Hospital
- Chennai, Tamil Nadu, India
- Mullai Baalaaji AR MD DNB IDPCCM DM (Ped Crit Care)
- Consultant Pediatric Intensivist
- Kovai Medical Center and Hospital
- Coimbatore, Tamil Nadu, India
- Murugan Thimiri Palani MD (Ped)
- Assistant Professor
- Department of Developmental Pediatrics
- Christian Medical College
- Vellore, Tamil Nadu, India
- N Mahesh MD (Ped) DM (Neuro)
- Consultant Pediatric Neurologist
- Mehta Multispeciality Hospitals India Pvt Ltd
- Chennai, Tamil Nadu, India
- N Srinath Reddy MD DM (Cardio)
- Consultant Cardiologist
- Children's Heart Institute
- Ramesh Hospitals
- Vijayawada, Andhra Pradesh, India
- N Thilothammal MD DCH DM (Neuro) MPH
- Former Professor
- Department of Pediatric Neurology
- Institute of Child Health and
- Hospital for Children
- Madras Medical College
- Chennai, Tamil Nadu, India
- NC Gowrishankar MD DCH DNB FIAP
- Senior Consultant Pediatrician and Pediatric Pulmonologist
- Head, Clinical Operations and Quality
- Department of Pediatrics
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Chennai, Tamil Nadu, India
- Editor-in-Chief
- Indian Journal of Practical Pediatrics
- Nikhil Lohiya DNB (Ped) FCPE (Ped Endo)
- Clinical and Research Fellow Endocrinology
- Hirabai Cowasji Medical Research Institute and Jehangir Hospital
- Pune, Maharashtra, India
- Nirmala Devi P MD (Derm)
- Head
- Department of Dermatology
- Trinelveli Medical College
- Trinelveli, Tamil Nadu, India
- P Ramachandran MD (Ped) DNB (Ped) FIAP
- Professor of Pediatrics and
- Associate Dean (PG Studies)
- Sri Ramachandra Institute of
- Higher Education and Research
- Chennai, Tamil Nadu, India
- PAM Kunju MD (Ped) DCH DM (Neuro) WHO Fellowship in Pediatric Neurology
- Dean
- Faculty of Medicine
- Kerala University
- Professor and Head
- Department of Pediatric Neurology
- Government Medical College
- Thiruvananthapuram, Kerala, India
- Prabhu K Chakravarthi DNB (Ped Surg)
- Fellow in Pediatric Laparoscopy
- Indira Gandhi Institute of Child Health
- Bengaluru, Karnataka, India
- Prajnya Ranganath MD (Ped) DM (Med Gen)
- Associate Professor and Head
- Department of Medical Genetics
- Nizam's Institute of Medical Sciences (NIMS) and Adjunct Scientist
- Diagnostics Division, Centre for DNA Fingerprinting and Diagnostics (CDFD)
- Hyderabad, Telangana, India
- Prasanth KS DNB (Ped) DCH DM (Gastro)
- Consultant Pediatric Gastroenterologist
- Sree Avittom Thirunal (SAT) Hospital and
- Assistant Professor
- Department of Gastroenterology
- Government Medical College
- Thiruvananthapuram, Kerala, India
- Preeti Singh MD (Ped)
- Assistant Professor
- Department of Pediatrics
- Lady Hardinge Medical College
- New Delhi, India
- Priya Pais MD MSc Diplomate of the American Board of Pediatrics and Pediatric Nephrology
- Associate Professor
- Department of Pediatric Nephrology
- St John's Medical College Hospital
- St John's National Academy of
- Health Sciences
- Bengaluru, Karnataka, India
- PS Rajakumar MBBS MD DNB MRCPCH
- Associate Professor of Pediatrics and Senior Consultant in
- Pediatric Intensive Care
- Department of Pediatrics
- Sri Ramachandra Medical College and Research Institute
- Chennai, Tamil Nadu, India
- R Bhanu Vikraman Pillai MD FAAP Diplomate of the American Board of Pediatrics and Pediatric Gastroenterology
- Consultant and Head
- Department of Pediatric Gastroenterology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- R Ganesh MBBS DNB (Ped) MRCPCH MNAMS PhD
- Senior Consultant Pediatrician
- Department of Pediatrics
- Rainbow Children's Hospital
- Chennai, Tamil Nadu, India
- R Karthik Narayanan MD (Ped) DM (Crit Care)
- Senior Consultant
- Pediatric Intensive Care
- Rainbow Children's Hospital
- Chennai, Tamil Nadu, India
- R Madhu MD (Derm) DCH
- Senior Assistant Professor
- Institute of Dermatology (Mycology)
- Madras Medical College
- Chennai, Tamil Nadu, India
- R Madhu MS DNB MCh (Ped Surg)
- Associate Professor
- Sri Ramachandra Institute of
- Higher Education and Research (SRIHER)
- Chennai, Tamil Nadu, India
- R Ravichandran MD (Ped) DM (Rheum)
- Director (Rtd)
- Institute of Rheumatology
- Madras Medical College
- Chennai, Tamil Nadu, India
- R Saileela MD (Ped) DNB (Ped) FNB (Ped Cardio)
- Consultant Pediatric Cardiologist
- MIOT Hospitals
- Chennai, Tamil Nadu, India
- R Sankar MS (Ortho)
- Consultant Orthopedic Surgeon
- Apollo Hospitals
- Chennai, Tamil Nadu, India
- R Venkateswaran MD FICAP
- Consultant Child and
- Adolescent Psychiatrist
- Mehta Multispeciality Hospitals India Pvt Ltd
- Chennai, Tamil Nadu, India
- Radhika Raman DCH DNB
- Intensivist
- Kanchi Kamakoti CHILDS Trust Hospital
- Chennai, Tamil Nadu, India
- Rajal B Prajapati MD (Ped) D (Ped)
- Professor
- Department of Pediatrics
- VS General Hospital and
- AMC MET Medical College
- Ahmedabad, Gujarat, India
- Rajeev Khanna MD (Ped) PDCC (Ped Gastro) Fellow Pediatric Hepatology
- Associate Professor
- Department of Pediatric Hepatology
- Institute of Liver and Biliary Sciences
- New Delhi, India
- Rekha Krishnan DCH DNB (Ped)
- Associate Professor
- Department of Pediatrics
- SAT Hospital and
- Government Medical College
- Thiruvananthapuram, Kerala, India
- Rema Chandramohan MD DCH DNB PGDDN PGD Epi FIAMS PhD
- Professor of Pediatrics
- Institute of Child Health and
- Hospital for Children
- Madras Medical College
- Chennai, Tamil Nadu, India
- Riyaz A MD DCH DNB DM (Gastro) FRCP
- Pediatric Gastroenterologist
- Professor and Head
- Department of Pediatrics
- Kannur Medical College
- Kannur, Kerala, India
- S Anne Princy MD (Gen Medicine) DM (Cardio)
- Assistant Professor
- Department of Cardiology
- Institute of Child Health and
- Hospital for Children
- Chennai, Tamil Nadu, India
- S Balameena MD (Ped) DM (Rheum)
- Senior Assistant Professor
- Institute of Rheumatology
- Madras Medical College
- Chennai, Tamil Nadu, India
- S Gnanasambandam MD (Ped) DCH DM (Cardio)
- Professor
- Department of Cardiology
- Institute of Child Health and
- Hospital for Children
- Chennai, Tamil Nadu, India
- S Kalpana MD (Ped)
- Senior Assistant Professor of Pediatrics
- Institute of Child Health and
- Hospital for Children
- Chennai, Tamil Nadu, India
- S Mani Ram Krishna DNB (Ped)
- Assistant Professor
- Department of Pediatric Cardiology
- Amrita Institute of Medical Sciences
- Kochi, Kerala, India
- S Shanthi MD DCH
- Professor
- Department of Pediatric Hematology
- Institute of Child Health and
- Hospital for Children
- Madras Medical College
- Chennai, Tamil Nadu, India
- S Thangavelu MD DCH DNB MRCP (Ped)
- Senior Consultant Pediatrician
- Director
- Department of Pediatrics
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Chennai, Tamil Nadu, India
- S Thirunavukkarasu MBBS DLODNB
- Consultant Pediatric ENT and
- Airway Surgeon
- Kanchi Kamakoti CHILDS Trust Hospital
- Chennai, Tamil Nadu, India
- S Velusamy MD (Ped) DM (Neuro)
- Professor and Head
- Department of Pediatric Neurology
- Government Stanley Medical College
- Chennai, Tamil Nadu, India
- S Vetri Selvi MBBS DO FRCS (Glasgow)
- Consultant in Medical Retina and Cataract
- Surya Eye Care
- Chennai, Tamil Nadu, India
- Samir Hasan Dalwai MD DCH DNB FCPS LLB
- Developmental Pediatrician
- New Horizons Child
- Development Centre
- Nanavati Super Specialty Hospital
- Hinduja Healthcare
- Mumbai, Maharashtra, India
- Sangeetha Yoganathan MD (Ped) DNB (Ped) DM (Ped Neuro)
- Associate Professor
- Pediatric Neurology
- Department of Neurological Sciences
- Christian Medical College
- Vellore, Tamil Nadu, India
- Santosh Mohan Rao Kanangi DNB (Neuro Surg) MNAMS RCSEd (Fellow Ped Neuro Surg)
- Junior Consultant
- Department of Pediatric Neurosurgery
- Kanchi Kamakoti CHILDS Trust Hospital
- Chennai, Tamil Nadu, India
- Sarath Balaji MD (Ped)
- Fellow
- Department of Pediatric Pulmonology
- Institute of Child Health and
- Hospital for Children
- Chennai, Tamil Nadu, India
- Saravanan Natarajan MS MCh (Ped Surg)
- Assistant Professor
- Department of Pediatric Surgery
- Government Mohan Kumaramangalam Medical College
- Salem, Tamil Nadu, India
- Sathish Kumar MBBS MD (Ped) DCH
- Consultant Pediatric Rheumatologist
- Professor
- Department of Pediatrics
- Christian Medical College
- Vellore, Tamil Nadu, India
- Satyanarayana Garre MBBS MD (Internal Medicine) DNB (Nephro)
- Senior Registrar
- Apollo Hospital
- Hyderabad, Telangana, India
- Selvam A MD (Derm)
- Senior Consultant Dermatologist
- AKJ Skin and Laser Center
- Chennai, Tamil Nadu
- AKJ Skin and Advanced Laser Center
- Tirunelveli, Tamil Nadu, India
- Senthil G Kamaraj MS (Gen Surg) MCh (Ped Surg) DNB (Ped Surg)
- Consultant Pediatric Surgeon
- Kanchi Kamakoti CHILDS Trust Hospital
- Chennai, Tamil Nadu, India
- Shaad Aqbari MD (Ped) FNB (Ped Cardio)
- Assistant Professor and Nodal Officer
- PCE-CS Unit
- In-charge
- Division of Pediatric Cardiology
- Department of Pediatrics
- Jawaharlal Nehru
- Medical College and Hospital
- Aligarh Muslim University
- Aligarh, Uttar Pradesh, India
- Sharada Sathish DNB (Ped) FPEM (Fellowship in Ped Emer Med)
- Pediatrician Consultant
- Pediatric Emergency Medicine
- Mehta Childrens Hospital
- Chennai, Tamil Nadu, India
- Shruthi TK MBBS MD IDPCCM (Ped Crit Care)
- Associate Professor
- Department of Pediatrics
- Sri Ramachandra Medical College and Research Institute
- Chennai, Tamil Nadu, India
- Shweta Priyadarshini MD (Ped) Fellowship in Pediatric Nephrology (ISPN) Fellowship in Pediatric Nephrology (TN Dr MGR University)
- Consultant Pediatric Nephrology
- Apollo Hospital
- Hyderabad, Telangana, India
- Somu Sivabalan MD (Ped)
- Consultant Pediatrician and Pulmonologist
- Kanchi Kamakoti CHILDS
- Trust Hospital and
- Sundaram Medical Foundation
- Chennai, Tamil Nadu, India
- Sophy Korula DCH MD (Ped) MRCPCH
- Associate Professor
- Pediatric Endocrinology and
- Metabolism
- Pediatric Unit 1
- Christian Medical College and Hospital
- Vellore, Tamil Nadu, India
- Soumya Paik MBBS MS (Ortho) DNB (Ortho) Fellowship in Pediatric Orthopedics (NUH, Singapore)
- Kids Orthopedic Clinic
- Kolkata, West Bengal, India
- Sridevi A Naaraayan MD (Ped) PG Depi (Postgraduate Diploma in Epidemiology)
- Associate Professor
- Department of Pediatrics
- Kilpauk Medical College
- Chennai, Tamil Nadu, India
- Srinivas S MBBS DCH DNB (Ped) PDCC (Ped Gastro) Pedgastrofellowship (RCH)
- Senior Consultant
- Department of Pediatric Gastroenterology
- Kanchi Kamakoti CHILDS Trust Hospital
- Chennai, Tamil Nadu, India
- Sriram Krishnamurthy MD Fellowship (Ped Nephro)
- Additional Professor
- Department of Pediatrics
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)
- Puducherry, India
- Sutapa Ganguly MBBS MD (Ped) FIAP
- Professor
- Department of Pediatrics
- KPC Medical College
- Kolkata, West Bengal, India
- Sudha Ekambaram DNB (Ped) Fellowship in Nephrology
- Senior Consultant
- Department of Pediatric Nephrology
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Chennai, Tamil Nadu, India
- Sudhakar P MD (Ped) PGD-Dev Neurology
- Senior Assistant Professor
- Department of Pediatrics
- Institute of Child Health and
- Hospital for Children, Chennai
- Consultant Pediatrician and Developmental Pediatrician
- BFCC Child Care Centre
- Chennai, Tamil Nadu, India
- Sujatha Jagadeesh MBBS DCH DNB
- Head
- Department of Clinical Genetics and Genetic Counseling
- Mediscan Systems
- Chennai, Tamil Nadu, India
- Sumita Danda MD DM (Medical Genetics)
- Professor and Head
- Clinical Genetics Unit
- Christian Medical College and Hospital
- Vellore, Tamil Nadu, India
- Supriya Sule Shinde MBBS
- Resident
- Department of Pediatrics
- Manipal Hospital
- Bengaluru, Karnataka, India
- Susan Uthup MD DNB (Ped) DM DNB (Nephro) FISN
- Additional Professor and Head
- Department of Pediatric Nephrology
- Government Medical College
- Thiruvananthapuram, Kerala, India
- Swathi Padankatti DCH DNB (Ped) PGDEPI
- Senior Consultant
- Department of Pediatrics and Neonatology
- Sundaram Medical Foundation
- Dr Rangarajan Memorial Hospital
- Chennai, Tamil Nadu, India
- T Karthik MD DNB DCH (London) MRCP (UK)
- Consultant Neonatologist
- Kauvery Hospital
- Chennai, Tamil Nadu, India
- T Murali MD DCH FPEM (Fellow in Ped Emerg Med)
- Associate Professor
- Vellore Medical College
- Vellore, Tamil Nadu, India
- T Sivaraman MD (Ped) Fellowship in Critical Care
- Associate Professor
- Vellore Medical College
- Vellore, Tamil Nadu, India
- TL Ratnakumari MD (Ped) DCH
- Professor
- Department of Pediatrics and Neonatology
- Andaman and Nicobar Islands
- Institute of Medical Sciences
- Port Blair, Andaman and Nicobar Islands
- Uma Maheswari S MD (DVL)
- Assistant Professor
- Department of Dermatology
- Government Villupuram Medical College and Hospital
- Villupuram, Tamil Nadu, India
- V Akila Sivakumar DNB FPEM Fellowship in Pediatric Emergency Medicine
- Consultant
- Pediatric Emergency Medicine
- Department of Pediatrics and Neonatology
- Dr Kamakshi Memorial Hospitals
- Chennai, Tamil Nadu, India
- V Anandan MD (Derm)
- Professor
- Department of Dermatology
- Govt. Stanley Medical College
- Chennai, Tamil Nadu, India
- V Prakash MD (Ped) DM (Neo)
- Senior Assistant Professor
- Department of Neonatology
- Institute of Obstetrics and Gynecology and Hospital for Women and Children
- Madras Medical College
- Consultant Neonatologist
- Cloudnine Hospitals
- Chennai, Tamil Nadu, India
- V Sampath MD (Derm)
- Professor
- Department of Dermatology
- Madras Medical College and
- Rajiv Gandhi Government General Hospital
- Chennai, Tamil Nadu, India
- V Soundaram MD (Ped) Fellow Pediatric and Adolescent Endocrinology
- Consultant Pediatric Endocrinologist
- Apollo Children's Hospital
- Chennai, Tamil Nadu, India
- Vaishnavi Raman MD (Ped) Fellowship in Nephrology
- Senior Consultant in
- Pediatric Nephrology
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Chennai, Tamil Nadu, India
- Vaman Khadilkar MD DNB DCH (London) MRCP (UK)
- Senior Pediatric and
- Adolescent Endocrinologist
- Jehangir Hospital, Pune
- Bombay Hospital
- Mumbai, Maharashtra, India
- Vasanth Kumar S MD DNB FNB (Ped Crit Care)
- Pediatric Intensivist
- Apollo Children's Hospital
- Chennai, Tamil Nadu, India
- Vidya Ahilan DNB
- Pediatrics Trainee
- Department of Pediatric Endocrinology
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Chennai, Tamil Nadu, India
- Vijayakumar Raju MS MCh (Cardiothoracic)
- Director
- Pediatric Cardiothoracic Surgery
- G Kuppuswamy Naidu Memorial Hospital
- Coimbatore, Tamil Nadu, India
- Vijayanad MD (Derm)
- Associate Professor
- Department of Dermatology
- Madurai Medical College
- Madurai, Tamil Nadu, India
- Vikas Rajeshwarrao Basa MBBS DNB (Ortho) Fellow (Ped Ortho)
- Consultant Pediatric Orthopedic Surgeon
- Kokilaben Dhirubhai Ambani
- Hospital and Medical Research Institute
- Mumbai, Maharashtra, India
- Vikrant Sood MD (Ped) DM (Ped Hepatology)
- Assistant Professor
- Department of Pediatric Hepatology
- Institute of Liver and Biliary Sciences
- New Delhi, India
- Vinitha Satish MBBS DO FICO (UK) FRCS (Glasgow)
- Consultant Ophthalmologist
- Mehta Multispeciality Hospitals
- India Pvt Ltd
- Chennai, Tamil Nadu, India
- Vishnu Biradar MD PDCC Fellowship in Pediatric Liver Transplant
- Consultant
- Pediatric Gastroenterologist and Hepatologist
- Pediatric Liver Transplant Physician and Nutrition Specialist
- Deenanath Mangeshkar Hospital
- Surya Mother and Child Care Superspecialty Hospital
- Pune, Maharashtra, India
- Viveka Saravanan MD DM
- Assistant Professor
- Department of Pediatric Neurology
- Institute of Child Health and
- Hospital for Children
- Madras Medical College
- Chennai, Tamil Nadu, India
- VR Ravikumar MS MCh (Ped Surg)
- Professor (Retd)
- Department of Pediatric Surgery
- Coimbatore Medical College
- Past President
- Indian Association of Pediatric
- Surgeons
- Consultant GKNM Hospital
- Coimbatore, Tamil Nadu, India
- VS Shankaranarayanan MD (Ped) DM (Gastro)
- Senior Consultant and Head
- Department of Pediatric Gastroenterology
- Kanchi Kamakoti CHILDS
- Trust Hospital
- Chennai, Tamil Nadu, India
- Yogesh Walkar MBBS MD DNB MNAMS Fellow in Pediatric Gastroenterology and Liver Transplant
- Consultant Pediatric Gastroenterologist and Hepatologist
- Diagnostic and Therapeutic
- Pediatric Endoscopist
- Superspeciality GI Kids Clinics
- Nagpur, Maharashtra, India
Diagnosis is the crucial first step in the journey of patient care. The entire treatment plan that a doctor may formulate depends on the outcome of this vital process. An accurate diagnosis enables speedy initiation of effective remedial measures. Today, medical science has progressed far enough to confidently identify, understand and successfully treat many illnesses. However, availability of all these resources becomes meaningful only when the initial diagnosis holds good. Any failure or confusion at this stage can seriously jeopardize the subsequent stages of treatment and valuable time may be lost before realization sinks in that there has been an earlier error in judgment. It goes without saying that such a situation can have serious consequences.
The concept of differential diagnosis came about primarily to act as a tool for ensuring error- free diagnosis. It serves to bring clarity in a situation of lingering confusion in the diagnostic scenario by pointing out differentiation between illnesses exhibiting similar symptoms. Many a time, the confusion arises due to factors like rarity of a disease, lack of clinical exposure to live case studies, ignorance regarding exceptions to otherwise familiar complaints and so on. Hence, authentic sources of ready reference are a ‘must have’ for the clinician to fall back upon for instant validation or course correction, as the case may be.
The book Differential Diagnosis in Pediatrics is meant to fulfil this need. It seeks to tap on the knowledge and expertise readily available within the Indian Academy of Pediatrics (IAP) fold and make essential knowledge regarding illnesses freely available. I am glad to see that this project has come to fruition in a remarkably admirable way. Going through the list of contributors for this work, I am truly awestruck by the extraordinary range of talent available in India. All the comprehensive information contained in this book have been presented in an organized and easily accessible way which is commendable.
I wish to congratulate the Editorial Board of Differential Diagnosis in Pediatrics as well as the individual authors for executing the Herculean task with energy, enthusiasm and imagination. The editorial vision of Drs K Nedunchelian, P Ramachandran, S Thangavelu and NC Gowrishankar deserves special applause.
I wish the reader an enlightening reading experience.
Santosh T Soans
President
Indian Academy of Pediatrics, 2018
Preface
Dear fellow Academicians,
Greetings from the Editorial Board of “Differential Diagnosis in Pediatrics”!
As we are aware, the Indian Academy of Pediatrics (IAP) is actively updating its members with various programs like conferences, continuing medical education programs, workshops, training programs and fellowship programs. One such important academic activity is bringing out textbooks, guidelines, consensus statements, etc. in pediatrics and allied specialties. Under IAP President‘s action plan, this book on Differential Diagnosis in Pediatrics is being brought out.
In the book, the focus is on “The differential diagnosis of symptoms and signs”. Common clinical conditions from various systems are included. It is taken care for each topic to have a format of brief introduction with definition as applicable, enumeration of the differential diagnosis in text, box, table, and figure format as needed, explanation of differentiating each condition based on history, clinical features and investigations leading to particular diagnosis. Wherever possible algorithmic approach been adopted. Where it is essential, illustrations have been incorporated. Each chapter ends with important references for further reading. As the emphasis is on differential diagnosis, treatment aspects are not included as a conscious decision.
Our earnest gratitude is to the faculty of pediatrics and allied specialties from all over the country who have contributed articles amidst their busy schedule.
We take this opportunity to thank the Central IAP, especially Dr Santosh T Soans, President IAP—2018 for giving us the responsibility of editing this book, enriching our knowledge during the process and enlightening our co-pediatricians.
We hope this book will be a most wanted one of the entire medical fraternity, including students in the field of pediatrics, as a desktop ready reckoner.
Yours in Academy Service
K Nedunchelian Editor-in-Chief | P Ramachandran Academic Editor | S Thangavelu Executive Editor | NC Gowrishankar Managing Editor |
We are very grateful to our families for their tremendous support and understanding.
We sincerely thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head), Ms Kritika Dua (Senior Development Editor), Mr Ashwani Kumar (Quality Controller), Mohd Iqbal (Typesetter), Mr Radhey Shyam Singh (Graphic Designer) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for bringing out the book in an elegant reader-friendly format.