MI: Neonatal and Childhood Infections Pt.2 Flashcards

1
Q

Outline the treatment of late-onset sepsis.

A
  • Check local guidelines
  • Example antibiotic regimen: 1st line = flucloxacillin + gentamicin; 2nd line = meropenem
  • If community acquired = ceftriaxone or cefotaxime with calcium infusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some common non-specific symptoms of infections in childhood?

A
  • Fever
  • Abdominal pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List some investigations for meningitis in children.

A
  • Blood cultures
  • LP
  • Rapid antigen screen
  • Blood PCR
  • Serology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why is it dangerous to perform an LP in meningococcal septicaemia?

A

They may be coagulopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The incidence of meningitis caused by which three agents has decreased in incidence since the introduction of vaccination programmes?

A
  • Meningitis C
  • Haemophilus influenzae type B
  • Pneumococcus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the main bacterial cause of meningitis at the moment?

A

S. pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What type of organism is Streptococcus pneumoniae?

A
  • Gram-positive diplococcus
  • Alpha-haemolytic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which diseases can S. pneumoniae cause?

A
  • Meningitis
  • Pneumonia
  • Sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of vaccine is the S. pneumoniae vaccine?

A
  • Conjugate vaccine
  • Old version was called Prevenar 7 (7 serotypes), but a new version has been created call Prevenar 13
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of organism is Haemophilus influenzae?

A
  • Gram-negative cocco-bacilli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the typical causes of meningitis for the following age groups:

  • Under 3 months
  • 3 months to 5 years
  • Over 6 years
A

Under 3 months:

  • Group B Streptococcus
  • Escherichia coli
  • Listeria monocytogenes
  • Neisseria meningitidis
  • Streptococcus pneumoniae
  • Haemophilus influenzae

3 months to 5 years:

  • Neisseria meningitis
  • Streptococcus pneumoniae
  • Haemophilus influenzae

Over 6 years:

  • Neisseria meningitis
  • Streptococcus pneumoniae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common cause of death in:

  • Children (1-9 years)
  • Neonates
A

Children (1-9 years)

  • Cancer (UK)
  • Infections e.g. pneumonia, diarrhoea (worldwide)

Neonates:

  • Prematurity
  • Followed by intra-partum complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most important bacterial cause of respiratory tract infection in children?

A

Streptococcus pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which children are mainly affected by Mycoplasma pneumoniae?

A

Older children (> 4 years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which group of antibiotics are used to treat Mycoplasma pneumoniae?

A

Macrolides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the classical presentation of Mycoplasma pneumoniae.

A

Atypical

  • Fever
  • Dry cough
  • Headache
  • Myalgia
  • Pharyngitis
17
Q

List some extra-pulmonary manisfestations of Mycoplasma pneumoniae.

A
  • Haemolysis - IgM antibodies to I antigen on erythrocytes, cold agglutinins
  • Neurological - encephalitis, aseptic meningitis, peripheral neuropathy, transverse myelitis
  • Polyarthralgia
  • Cardiac
  • Otitis media
  • Bullous myringitis (vesicles on the tympanic membrane)
18
Q

If a respiratory tract infection fails to respond to conventional treatment, which diagnoses should be considered?

A
  • Whooping cough
  • TB
19
Q

How is UTI diagnosed in children?

A
  • Clinically + urine dip
  • MCS - pure growth of > 105 CFU/mL
  • Pyuria
20
Q

What are the main organisms responsible for UTI in children?

A
  • E. coli (most common)
  • Other coliforms (Proteus, Klebsiella, Enterococcus)
  • Coagulase-negative Staphylococcus (S. saprophyticus)
21
Q

Why might renal tract imaging be useful in children who experience UTIs?

A

To check for congenital anomalies e.g. MCUG for vesico-ureteric reflux in children with recurrent UTI

22
Q

What might recurrent childhood infections suggest?

A

Immunodeficiency