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Paediatrics > Infection > Flashcards

Infection Flashcards

1
Q

What is the definition of paediatric sepsis?

A

Systemic inflammatory response syndrome (SIRS) + suspected or proven infection

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2
Q

What are the symptoms of SIRS?

A 
Fever or hypothermia
Tachycardia
Tachypnoea
Leucocytosis
Leucocytopaenia
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3
Q

What is paediatric severe sepsis?

A

Sepsis + multi organ failure

Acute respiratory response syndrome (inflammatory response of the lungs)

Septic shock

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4
Q

What can cause SIRS?

A 
Trauma
Burns
Haemorrhage
Pancreatitis
Liver disease
Toxins and drugs
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5
Q

What are the pathogens responsible for paed sepsis?

A

Neonates

  • Group B strep
  • E. coli
  • Listeria

Children

  • S. pneumoniae
  • Meningococci
  • Group A strep
  • S. aureus
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6
Q

What are the symptoms of sepsis?

A 
Fever or hypothermia
Cold hands / feet, mottled
Chills and rigors
Limb pain
Vomiting and diarrhoea
Muscle weakness and pain
Skin rashes
Reduced urine output
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7
Q

What is the treatment for sepsis?

A 
Supportive
A
B
C
DEFG

Causative treatment

  • AB’s
  • 3rd generation cephalosporins and amox if neonate
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8
Q

What are the investigations for sepsis?

A 
FBC
CRP
Cogulation factors
U+E's. LFT's
Blood gas
Glucose
Cultures

CSF - cell count, culture, protein and glucose

Urine culture, skin biopsy culture and imaging (CT/MRI head)

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9
Q

What are the pathogens responsible for meningitis

A

Neonates =

  • B strept
  • E. coli
  • Listeria

Children

  • S. pneumoniae
  • Meningococci
  • H. influenza
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10
Q

What are the symptoms of meningitis +/- sepsis?

A 
Neuchal rigidity
Headaches, photophobia 
Reduced consciousness
Neurological abnormalities
Seizures
Rash
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11
Q

What is the treatment for meningitis?

A

Chemoprophylaxis

Steroids

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12
Q

What are pneumococcal meningitis complications?

A

Brain damage
Hearing loss
Hydrocephalus

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13
Q

What endotoxin is associated with meninigococcal disease?

A

Lipooligosaccharide

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14
Q

What is used to treat streptococci?

A

Penicillin

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15
Q

What is used to treat staphylococci?

A

Flucoloxacillin

unless resistant

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16
Q

What is a typical group A strep infection

A

Scarlet fever
Incubation 2-4 days
Fever, malaise, rash and strawberry tongue

17
Q

How much percentage of the population has group A strep in the URT?

A

10%

18
Q

What is the treatment for group A strep?

A

10 days penicillin

19
Q

What are some complications of group A strep?

A 
Impitigo 
Erysipilis (cellulitis of the face)
Necrotising fasciitis 
Rheumatic fever
Glomerular nephritis
20
Q

What complications can S. aureus cause?

A 
Impetigo
Cellulitis
Infected eczema
Ulceration
Staph scalded skin syndrome
Toxic shock syndrome
21
Q

What is impetigo?

A

Caused by S. pyogenes and S. aureus

Highly contageous
Golden sores
No systemic symptoms

22
Q

What is SSSS?

A

S. aureus causes it

Fever, widespread redness, blisters which rupture easily

23
Q

What is TSS?

A

Caused by S. aureus and S, pyogenes

Systemically unwell
Widespread redness, desquamation, multi-organ failure and can be fatal

24
Q

What is Kawasaki disease?

A

Self limiting vasculitis of medium-sized arteries

25
Q

What are the symptoms of kawasaki disease?

A 
Fevere
Bilateral conjunctival infection
Cracked lips and strawberry tongue
Lymphadenopathy
Polymorphous rash

No test, need to exclude DD

26
Q

What is the treatment of Kawasaki disease?

A 
Immunoglobulins 
Aspirin
Steroids
Other immunosupression 
Cardiology assessment
27
Q

What else can cause persistent fever and rash?

A

HSP vasculitis

Associated with previous non-specific viral illness

28
Q

What is VZV?

A

Incubation 10-21 days
Clinical = malaise, fever and itchy
Papules -> vesicles -> pustules -> crustae

Complications = secondary strep/staph infections
Meningioencephalitis and arthritis

T = Aciclovir
P = vaccination
29
Q

What causes hand foot and mouth disease

A

Enterovirus 81

Coxsackie A16

30
Q

What is the presentation of hand foot and mouth disease?

A

Incubation is 3-6 days
Exanthema
Painful lesions
Recovery in 5-10 days

May cause complications in neonates

31
Q

What are primary immunodeficiencies?

A

Rare
Group of 300 disorders
Missing or improper functions of the bodies immune system
Usually due to a genetic defect

32
Q

What are secondary immunodeficiencies?

A

More common
Acquired disease affecting the immune system
Components of the immune system are all present and functional

33
Q

What are the investigations for the immune system?

A 
FBC
Immunoglobulins
HIV test
Functional Ab's
Lymphocyte subset
Complement
NBT
34
Q

What does defective B-cell function present with?

A

Recurrent bacterial infections (LRTI’s)

35
Q

What does impaired T-cell function present with?

A

Opportunistic infections

Recurrent / severe viral infections or FTT

36
Q

What does defects in phagocyte function present with?

A

Sepsis
Abscess
Fungal infections

37
Q

What do complement deficiencies present with?

A

Sepsis

Paediatrics (15 decks)

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