05-06 Infections in Early Life Flashcards Preview

AA - SBM I.D. > 05-06 Infections in Early Life > Flashcards

Flashcards in 05-06 Infections in Early Life Deck (16):
1

What congenital infections do you worry about?

Toxo, VZV, Rubella, CMV, HSV/HepB/C/HIV, Enteroviruses, Syphilis

2

Complications of congenital rubella syndrome?

Hearing impairment, heart defect, PDA, microceph, low birth weight, MR, purpura (PIC), retinopathy (PIC) and on and on

3

Risk of maternal to fetal transmission w/o breastfeeding w/o tx?

25%

4

Risk of maternal to fetal transmission WITH breastfeeding w/o tx?

40-50%

5

What peripartum infx should you worry about?

HSV, GBS, E. coli

6

Neonatal HSV Complications

encephalitis: can lead to CP

7

Bugs that cause resp tract infx (airways) in kids?

RSV, para-flu, flu, human metapneumovirus

8

Types of otitis media

1. secretory (transudate build-up)
2. Acute Suppurative Otitis (purulent exudate)
3.

9

Most common bugs causing Acute Suppurative Otitis Media in kids?

35% Strep pneumo
20% H. flu
15% Moraxella catarrhalis
<5% S. aureus

25% no org found

10

Acute Suppurative Otitis Media
—Tx
—Major Adverse Outcomes if not tx'd

Watchful Waiting or give Rx w/ instructions to fill in two days if not better if reasonable in older infants/children (per AAFP)
— > 75% of cases resolve without therapy within 5-10 days

Antibiotic Therapy
—First line: amoxicillin
—2nd line: amoxicillin + clav OR
cefpodoxime
cefuroxime
ceftriaxone
—Beta-lact allergy: clinda or azithro

Major Adverse Outcomes w/o Tx
—CHRONIC develops in 10% of untreated pts which leads to:
—CN V palsy
—mastoiditis -> brain abscess
—osteomyelitis of the petrous ridge of temporal b
—venous sinus thrombosis

11

Which Ig's cross the placenta?

Only IgG for the most part
—IgM does not, so can be used in dx in infants

12

Congenital CMV Infx

1% of babies have detectable CMV infx at birth
—90% asx
—can cause sensorineural hearing loss in infancy

13

Congenital infx timing

Early-to-mid gestation is more risky and can cause all kinds of crazy problems:
—fetal demise
—cardiac defects
—pretty much any abnormality imaginable

Acute Infx in late pg or close to birth
—No defects
—mild-to-severe dz
—present days-weeks post-partum

Subsequent Reactivation: infancy and childhood
—VZ
—HSV
—CMV

14

Do C-sections lower the rate of HIV transmission in infants of un- or under-treated mothers?

yes

15

Herpes Simplex in infants
—When?
—Severity?
—Is Rx effective?
—Presentation(s)
—Tx

Newborns susceptible 4-8wks
—reactivates from latent states
—high mortality
—Rx effective if started early

Presentations
**Vesicles may appear only later or never
—SEM: skin, eyes, mouth vesicles
—Disseminated: 29% mortality
—sepsis-like jaundice
—coagulopathy
—pneumonia
—CNS only: lethargy, szs (4% mort)
—Congenital: vesicles, brain damage, microcephaly

Tx
—IV acyclovir

16

Group B Strep
—When to screen?/How to tx?
—Early onset neonate ( < 7days old) sx?
—Later onset neonate (7-89 days) sx?
—Prevention

When to screen?/How to tx?
—Screen at 35-37 wks; tx w/ intrapartum abx if +

Early onset neonate ( < 7days old) Sx
—PNEUMONIA, sepsis, meningitis

Later onset neonate (7-89 days) Sx
—sepsis, meningitis

Prevention
—there's a vaccine in the pipeline