Table Of ContentFeigin and Cherry’s
Textbook of
Pediatric
Infectious Diseases
Feigin and Cherry’s
Textbook of
Pediatric
Infectious Diseases
EIGHTH EDITION
JAMES D. CHERRY, MD, MSc WILLIAM J. STEINBACH, MD
Distinguished Research Professor of Pediatrics Professor of Pediatrics
David Geffen School of Medicine at UCLA; Professor in Molecular Genetics and Microbiology
Attending Physician Chief, Pediatric Infectious Diseases
Pediatric Infectious Diseases Director, Duke Pediatric Immunocompromised Host Program
Mattel Children’s Hospital UCLA Director, International Pediatric Fungal Network
Los Angeles, California Duke University School of Medicine
Durham, North Carolina
GAIL J. HARRISON, MD
Professor PETER J. HOTEZ, MD, PhD
Department of Pediatrics Dean, National School of Tropical Medicine
Section of Infectious Diseases Professor, Pediatrics and Molecular & Virology and
Baylor College of Medicine; Microbiology
Attending Physician Head, Section of Pediatric Tropical Medicine
Infectious Diseases Service Baylor College of Medicine;
Texas Children’s Hospital Endowed Chair of Tropical Pediatrics
Houston, Texas Center for Vaccine Development
Texas Children’s Hospital;
SHELDON L. KAPLAN, MD Professor, Department of Biology
Professor and Executive Vice-Chair Baylor University
Head, Section of Infectious Diseases Waco, Texas;
Department of Pediatrics Baker Institute Fellow in Disease and Poverty
Baylor College of Medicine; Rice University
Chief, Infectious Disease Service Houston, Texas;
Head, Department of Pediatric Medicine Co-Editor-in-Chief, PLoS Neglected Tropical Diseases
Texas Children’s Hospital
Houston, Texas
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
FEIGIN AND CHERRY’S TEXTBOOK OF PEDIATRIC INFECTIOUS DISEASES, ISBN: 978-0-323-37692-1
EIGHTH EDITION
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
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Practitioners and researchers must always rely on their own experience and knowledge in evaluating
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Previous editions copyrighted © 2014, 2009, 2004, 1998, 1992, 1987, 1981 by Saunders, an imprint of
Elsevier, Inc.
Chapters 189 and 232 are in the public domain.
Hookworm and tick images courtesy of Anna Grove Photography. Staphylococcus aureus image from
CDC Public Health Image Library (provided by Frank DeLeo, National Institute of Allergy and Infectious
Diseases). Mosquito scanning electron micrograph from DCD Public Health Imaging Library (provided by
Dr. Paul Howell, CDC).
ISBN: 978-0-323-37692-1
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Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
To my wife, Jeanne M. Cherry, who passed away on June 2, 2017
To my children, James Cherry, Jeffrey Cherry and Kass Hogan,
Susan Cherry, and Kenneth and Jennifer Cherry
To my grandchildren, Ferguson, Dennis, and Siena Rose Cherry
James Cherry
To my husband, Neil Harrison
To my children and sons-in-law, Emily Wolfe and Josh Wolfe,
Kelly Green and Daniel Green, Matthew Demmler, Amy Demmler,
Anna Rose Demmler, and Haley Harrison
To my grandchildren, Jensen Wolfe and William Green
To my brother, Loddie Naymola
Gail Harrison
To my wife, Marsha Kaplan
To my children, Lauren Kaplan, Mindy Kaplan Langland,
and son-in-law Lance Langland
To my grandchildren, Reece and Macy Langland
Sheldon Kaplan
To my wife, Sandy Steinbach
To my children, Amelia Steinbach, Aidan Steinbach, and Conner Franzen
To my parents, Charles and Kathy Steinbach
William Steinbach
To my wife, Ann Hotez
To my children, Matthew, Emily, Rachel, and Daniel Hotez
To my mother, Jean Hotez, and mother-in-law, Marcia Frifield
To the memories of my father, Ed Hotez, and father-in-law, Don Frifield
Peter Hotez
Ralph D. Feigin, MD
April 3, 1938–August 14, 2008
This eighth edition of the Textbook of Pediatric Infectious Diseases is At Washington University and St. Louis Children’s Hospital, Ralph
dedicated to Ralph D. Feigin. As everyone in pediatrics and, in particular, developed one of the finest infectious diseases divisions in the country.
pediatric infectious diseases, knows, Ralph was an extraordinary individual, His “Feigin Rounds” were an unparalleled learning experience and were
and his untimely death in 2008 leaves a void that will never be filled. legendary among medical students and residents. In 1977, Ralph moved
Ralph Feigin was born in New York City on April 3, 1938. He gradu- to Houston, Texas, to accept the challenge of being the Chair of Pediatrics
ated from Columbia College in New York City in 1958 and received for Baylor College of Medicine and the Physician-in-Chief at Texas
his M.D. from Boston University School of Medicine in 1962. He married Children’s Hospital. During the ensuing 30 years, the Department grew
Judith S. Zobel, a childhood friend, in 1960 while in medical school. from 43 faculty members to almost 500. One of us (SLK) came under
Ralph completed his first two years of pediatric residency at Boston Ralph’s spell in St. Louis and moved to Houston with him. Another
City Hospital and his third year at the Massachusetts General Hospital. one of us (GJH), an intern in Houston in 1977, was waiting for Dr.
He then fulfilled his military service requirement at the United States Feigin when he arrived.
Army Research Institute of Infectious Diseases, Ft. Detrick, Frederick, In Houston, Ralph served as the Chair of Pediatrics for Baylor College
Maryland. While at the United States Army Research Institute, he of Medicine and the Physician-in-Chief at Texas Children’s Hospital
participated in significant studies relating to circadian periodicity and for 31 years. For 7 years of his tenure, he also served as President and
susceptibility to infections, as well as other studies that resulted in eight CEO of Baylor College of Medicine. In addition to his commitments
publications for which he was the first author. After completing his in Houston, Ralph served in leadership roles on more than 100 local,
service commitment, he was Chief Resident at Massachusetts General regional, and national committees and professional societies. His efforts
Hospital during the 1967-68 academic year. in persuading government officials of all ranks helped children in Texas,
Ralph was recruited to Washington University in St. Louis by Phil the United States, and in all parts of the world. Many consider him to
Dodge in 1968, and soon thereafter he and one of us (JDC), who was have been the foremost pediatrician in the world.
then at St. Louis University, got together and forged an academic and Not only was Dr. Feigin a powerhouse of energy, speed, and unsur-
personal friendship that continued until the time of his death. Over 40 passed accomplishments, but he also was a gentleman, full of compassion,
years ago, Ralph and Jim recognized the need for a comprehensive book warmth, and kindness, and a man who kept people and patients first
on pediatric infectious diseases, but because of their busy schedules in his heart and mind. He was a loving husband to his wife, Judy, and
the plan was put on hold, and in 1973 Jim moved to California. In a proud father to his three children, Susan, Debra, and Michael; doting
1976, the pediatric research meetings were held in St. Louis, and at this grandfather to his six grandchildren, Rebecca, Matthew, Sarah, Rachel,
time Jim and Ralph met with W. B. Saunders representatives, and the Jacob, and Eli; and a mentor to so many in the field of pediatrics and
book was conceived. The first edition of the textbook was published 5 pediatric infectious diseases. Ralph Feigin is missed by everyone who
years later in the fall of 1981. In comparison with this 8th edition, it knew him, particularly by Judy Feigin and the family as well as by the
was a modest effort, with 44 chapters and 124 contributors. present editors of this eighth edition of Feigin and Cherry.
vi
James D. Cherry, MD, MSc
Distinguished Research Professor of
Pediatrics
David Geffen School of Medicine at UCLA;
Attending Physician
Pediatric Infectious Diseases
Mattel Children’s Hospital UCLA
Los Angeles, California
Gail J. Harrison, MD William J. Steinbach, MD
Professor Professor of Pediatrics
Department of Pediatrics Professor in Molecular Genetics and Microbiology
Section of Infectious Diseases Chief, Pediatric Infectious Diseases
Baylor College of Medicine; Director, Duke Pediatric Immunocompromised Host Program
Attending Physician Director, International Pediatric Fungal Network
Infectious Diseases Service Duke University School of Medicine
Texas Children’s Hospital Durham, North Carolina
Houston, Texas
Peter J. Hotez, MD, PhD
Sheldon L. Kaplan, MD Dean, National School of Tropical Medicine
Professor and Executive Vice-Chair Professor, Pediatrics and Molecular & Virology and Microbiology
Head, Section of Infectious Diseases Head, Section of Pediatric Tropical Medicine
Department of Pediatrics Baylor College of Medicine;
Baylor College of Medicine; Endowed Chair of Tropical Pediatrics
Chief, Infectious Disease Service Center for Vaccine Development
Head, Department of Pediatric Medicine Texas Children’s Hospital;
Texas Children’s Hospital Professor, Department of Biology
Houston, Texas Baylor University
Waco, Texas;
Baker Institute Fellow in Disease and Poverty
Rice University
Houston, Texas;
Co-Editor-in-Chief, PLoS Neglected Tropical Diseases
Contributors
John Aaskov, BSc, PhD, FRCPath Amy Arrington, MD, PhD
World Health Organization Collaborating Centre for Arbovirus Section Chief, Global Biologic Preparedness
Reference and Research Department of Pediatrics
Institute of Health and Biomedical Innovation Baylor College of Medicine and Texas Children’s Hospital;
Queensland University of Technology Assistant Professor
Brisbane, QLD, Australia Department of Pediatric Critical Care Medicine
Baylor College of Medicine
Kristina Adachi, MD, MA Houston, Texas
Clinical Instructor
Department of Pediatrics Ann M. Arvin, MD
Division of Infectious Diseases Lucile Salter Packard Professor of Pediatrics
David Geffen School of Medicine at UCLA Professor of Microbiology and Immunology
Los Angeles, California Stanford University School of Medicine
Stanford, California
Christoph Aebi, MD
Professor of Pediatrics and Infectious Diseases Robert L. Atmar, MD
Chairman, Department of Pediatrics Professor
University of Bern Department of Medicine
Bern, Switzerland Baylor College of Medicine
Houston, Texas
Kenneth A. Alexander, MD, PhD
Chief Amira Baker, MD
Division of Allergy, Immunology, Rheumatology, and Infectious Fellow, Pediatric Infectious Diseases
Diseases Mattel Children’s Hospital
Nemours Children’s Hospital; University of California–Los Angeles
Professor of Pediatrics Los Angeles, California
University of Central Florida College of Medicine
Orlando, Florida Carol J. Baker, MD
Professor
Ghada N. Al-Rawahi, MD, DTM&H (London), D(ABMM), FRCPC Departments of Pediatrics and Molecular Virology & Microbiology
Medical Microbiologist Baylor College of Medicine
Children’s and Women’s Health Centre of British Columbia; Houston, Texas
Medical Lead, Infection Prevention & Control
BC Cancer Agency; Robert S. Baltimore, MD
Clinical Associate Professor Professor
University of British Columbia Departments of Pediatrics and Epidemiology
Vancouver, BC, Canada Yale University School of Medicine;
Associate Director of Infection Control
Duha Al-Zubeidi, MD Yale-New Haven Hospital
Children’s Mercy Hospital New Haven, Connecticut
Kansas City, Missouri
Stephen J. Barenkamp, MD
Seher Anjum, MD Professor of Pediatrics and Molecular Microbiology
Professor, Division of Infectious Disease Department of Pediatrics
Department of Internal Medicine St. Louis University School of Medicine;
University of Texas Medical Branch Director
Galveston, Texas Division of Pediatric Infectious Diseases
Cardinal Glennon Children’s Medical Center
Monica I. Ardura, DO, MSCS St. Louis, Missouri
Associate Professor
Department of Pediatrics Elizabeth D. Barnett, MD
Ohio State University; Attending Physician
Medical Director, Host Defense Program Boston Medical Center
Department of Pediatrics, Infectious Diseases, and Immunology Boston, Massachusetts
Nationwide Children’s Hospital
Columbus, Ohio Theresa Barton, MD
Associate Professor
Stephen S. Arnon, MD, MPH Department of Pediatrics
Founder and Chief Baylor College of Medicine
Infant Botulism Treatment and Prevention Program Houston, Texas
California Department of Public Health
Richmond, California
viii
Contributors ix
Gil Benard, MD, PhD William J. Britt, MD
Medical Researcher Charles A. Alford Professor of Pediatric Infectious Diseases
Departamento Dermatologia Department of Pediatrics
Faculdade de Medicina; University of Alabama
Laboratorio de Micologia Medica Birmingham, Alabama
Instituto de Medicina Tropical
Universidade de São Paulo David E. Bronstein, MD, MS
São Paolo, Brazil Department of Pediatrics
Southern California Permanente Medical Group
Jeffrey M. Bender, MD Palmdale, California
Assistant Professor
Department of Pediatrics David A. Bruckner, ScD
Division of Pediatric Infectious Diseases Professor Emeritus
Children’s Hospital Los Angeles; Department of Pathology & Laboratory Medicine
Assistant Professor of Pediatrics and Pediatric Infectious Diseases David Geffen School of Medicine at UCLA
University of Southern California Los Angeles, California
Los Angeles, California
Kristina A. Bryant, MD
Gregory J. Berry, PhD, D(ABMM) Professor of Pediatric Diseases
Assistant Medical Director Department of Pediatrics
Division of Infectious Disease Diagnostics University of Louisville
Northwell Health Laboratories; Louisville, Kentucky
Assistant Professor of Pathology and Laboratory Medicine
Hofstra Northwell School of Medicine Steven C. Buckingham, MD, MA†
Lake Success, New York Associate Professor
Department of Pediatrics
Amit Bhatt, MD University of Tennessee Health Science Center
Assistant Professor Memphis, Tennessee
Department of Ophthalmology
Baylor College of Medicine; Carrie L. Byington, MD
Pediatric Ophthalmology Subsection Vice Chancellor, Health Services
Texas Children’s Hospital Senior Vice President, Health Sciences Center
Houston, Texas Jean and Thomas McMullin Professor and Dean
College of Medicine
Charles D. Bluestone, MD Texas A&M University and System
Distinguished Professor Emeritus of Otolaryngology Bryan, Texas
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania Miguel M. Cabada, MD, MSc
Assistant Professor
Jeffrey L. Blumer, PhD, MD Department of Internal Medicine
Professor and Chairman Division of Infectious Diseases
Department of Pediatrics University of Texas Medical Branch
The University of Toledo Galveston, Texas
Toledo, Ohio
Adriana Cadilla, MD
Claire Bocchini, MD, MS Physician
Texas Children’s Hospital Department of Pediatric Infectious Disease
Houston, Texas Nemours Children’s Hospital
Orlando, Florida
Kenneth M. Boyer, MD
Professor and Woman’s Board Chair Judith R. Campbell, MD
Department of Pediatrics Professor
Rush Medical College of Rush University; Department of Pediatrics
Clinical Associate Section of Infectious Diseases
Department of Pediatrics Baylor College of Medicine;
University of Chicago Attending Physician
Chicago, Illinois Infectious Disease Service
Texas Children’s Hospital
John S. Bradley, MD Houston, Texas
Professor and Chief
Division of Infectious Diseases Justin E. Caron, MD
Department of Pediatrics Pathology Resident
University of California–San Diego School of Medicine Department of Pathology
San Diego, California University of Utah School of Medicine
Salt Lake City, Utah
Patricia Brasil, MD, PhD
Clinical Researcher
Instituto Nacional de Infectologia
Fundação Oswaldo Cruz
Rio de Janeiro, Brazil †Deceased.
x Contributors
Maria Carrillo-Marquez, MD Tempe K. Chen, MD
Assistant Professor Assistant Clinical Professor
Department of Pediatrics Department of Pediatrics
University of Tennessee Health Science Center University of California Irvine School of Medicine
Memphis, Tennessee Irvine, California
Janet R. Casey, MD James D. Cherry, MD, MSc
Director of Research Distinguished Research Professor of Pediatrics
Legacy Pediatrics; David Geffen School of Medicine at UCLA;
Clinical Associate Professor of Pediatrics Attending Physician
Department of Pediatrics Pediatric Infectious Diseases
University of Rochester Mattel Children’s Hospital UCLA
Rochester, New York Los Angeles, California
Luis A. Castagnini, MD, MPH Javier Chinen, MD, PhD
Assistant Professor Associate Professor
Department of Pediatrics Pediatrics, Allergy, and Immunology
Baylor College of Medicine/Children’s Hospital of San Antonio Baylor College of Medicine and Texas Children’s Hospital
San Antonio, Texas Houston, Texas
Mariam R. Chacko, MBBS Natascha Ching, MD
Professor Assistant Clinical Professor
Department of Pediatrics Department of Pediatrics
Section of Adolescent Medicine and Sports Medicine John A. Burns School of Medicine at the University of Hawaii;
Baylor College of Medicine and Texas Children’s Hospital; Physician
Medical Director, Adolescent Medicine Department of Pediatric Infectious Diseases
Baylor Teen Health Clinics Kapiolani Medical Center for Women and Children
Houston, Texas Kapiolani Medical Specialists
Honolulu, Hawaii
Lakshmi Chandramohan, PhD, D(ABMM)
Senior Scientist Ivan K. Chinn, MD
Biopharma Division Assistant Professor
NeoGenomics Laboratories Department of Pediatrics
Houston, Texas Baylor College of Medicine and Texas Children’s Hospital
Houston, Texas
Louisa E. Chapman, MD, MSPH†
Medical Epidemiologist John C. Christenson, MD
Centers for Disease Control and Prevention Professor of Clinical Pediatrics
Atlanta, Georgia Ryan White Center for Pediatric Infectious Disease and Global
Health
Remi N. Charrel, MD, PhD Indiana University School of Medicine
UMR "Emergence des Pathologies Virales" Indianapolis, Indiana
Aix Marseille Université;
Fondation IHU Mediterranée Infection Susan E. Coffin, MD, MPH
APHM Public Hospitals of Marseille Professor of Pediatrics
Marseille, France Associate Chief
Division of Infectious Diseases
Elsa Chea-Woo, MD UPENN School of Medicine;
Professor Associate Hospital Epidemiologist
Department of Pediatrics Children’s Hospital of Philadelphia
Universidad Peruana Cayetano Heredia Philadelphia, Pennsylvania
Lima, Peru
Armando G. Correa, MD
Ira M. Cheifetz, MD, FCCM, FAARC Assistant Professor
Chief Medical Officer Department of Pediatrics
Children’s Services Baylor College of Medicine;
Duke Children’s Hospital; Attending Physician
Associate Chief Medical Officer Texas Children’s Hospital
Duke University Hospital; Houston, Texas
Division Chief, Pediatric Critical Care Medicine
Professor, Departments of Pediatrics and Anesthesiology Elaine G. Cox, MD
Duke University Medical Center Professor of Clinical Pediatrics
Durham, North Carolina Ryan White Center for Pediatric Infectious Disease and Global
Health
Indiana University School of Medicine
†Deceased. Indianapolis, Indiana
