16.2. Paediatric Infectious Diseases - Streptococcal / Staphylococcal Infections

Question 1

What are the Features of:

1. Streptococci?
2. Staphylococci?

Answer 1

1. a) Gram-Positive Cocci
2. b) No Resistance Issues - Penicillin Treatment
3. a) Gram-Positive Cocci
4. b) Resistance is an Issue - Flucloxacillin Treatment

Question 2

What is the Cause of Scarlatina?

Answer 2

Group A Beta-Haemolytic Streptococci

Question 3

Who commonly gets Scarlatina?

Answer 3

Children < 2 Years old

Question 4

What is the Symptoms / Sign History of Scarlatina?

Answer 4

1. Contact
2. Incubation 2-4 days
3. Malaise / Fever / Tonsillitis
4. Start Exanthema
5. Strawberry Tongue
6. Squamation - Hands and Feet

Question 5

What are the Complications of Scarlatina?

Answer 5

1. Erysipelas / Cellulitis / Impetigo
2. Streptococcal Toxic Shock
3. Rheumatic Fever
4. Glomerulonephritis

Question 6

What is the Treatment of Scarlatina?

Answer 6

Penicillin for 10 days

Question 7

What are the Features of Impetigo?

Answer 7

1. Caused by both Strep Pyogenes and Staph Aureus
2. Highly Contagious
3. Sores / Blisters / No Systemic Symptoms
4. Yellow-Brown Crustae

Question 8

What are the Features of Staphylococcal Scalded Skin Syndrome (SSSS)?

Answer 8

1. Caused by Staph Aureus Exotoxins
2. Appears in Modly Kids < 5 Years
3. Fever / Widespread Redness / Fluid Filled Blisters which Rupture Easily

Question 9

What is the Pathophysiology of Kawasaki Disease?

Answer 9

Self-Limited Vasculitis of Medium Sized Arteries

Note - Aetiology is unknown but an Infectious Cause is Suspected

Question 10

What are the Clinical Features of Kawasaki Disease?

Answer 10

1. Fever for at Least 5 Days + 4 of:
2. 1. Bilateral Conjunctival Injection
3. 2. Changes of the Mucous Membranes
4. 3. Cervical Lymphadenopathy
5. 4. Polymorphous Rash
6. 5. Changes of the Extremities
7. Peripheral Oedema
8. Peripheral Erythema
9. Periungal Desquamation

Question 11

What is the Treatment of Kawasaki Disease?

Answer 11

1. Immunoglobulins
2. Aspirin
3. Other Immunosuppressive Agents

Question 12

Other than Infections, what can cause Persistent Fever and Rash?

Answer 12

1. Henoch-Schonlein Purpura
2. Vasculitis - Skin / Kidneys / G.I. Tract
3. Associated with Previous Aspecific Viral Illness

Question 13

What are the Clinical Features of Varicella Zoster Virus Infections?

Answer 13

1. a) Primary Infection = Varcella (Chickenpox)
2. b) Recurrent Infection = Zoster
3. Mild Malaise / Fever
4. Exanthema: Papules - Vesicles - Pustules - Crustae
5. Itching

Question 14

What are the Complications of Varicella Zoster Virus Infections?

Answer 14

1. Secondary Strep / Staph infections
2. Meningoencephalitis
3. Cerebellitis
4. Arthritis

Question 15

What is the Therapy for Varicella Zoster Virus Infections?

Answer 15

1. None - The Kids are Fine
2. Prevention - Vaccinations
3. (Val)Aciclovir

Question 16

What are the Clinical Features of Herpes Simplex Virus Infection?

Answer 16

1. Stomatitis
2. Recurrent Cold Sores
   Note - HSV1 - Oral / HSV2 - Genital

Question 17

What are the Complications of Herpes Simplex Virus Infection?

Answer 17

1. (Kerato)Conjunctivitis
2. Encephalitis
3. Systemic Neonatal Infection
4. Immunocompromised Children

Question 18

What is the Treatment of a Herpes Simplex Virus Infection?

Answer 18

1. None - Self-Limiting

2. (Val)Aciclovir

Question 19

What are the Causes of Hand-Foot-Mouth Disease?

Answer 19

Enteroviruses:

1. Coxsackie A16
2. Enterovirus 71

Question 20

What are the Clinical Features of Hand-Foot-Mouth Disease?

Answer 20

1. Exanthema
2. Enanthema - Rash Inside the Body
3. Painful Lesions