17. Infectious diseases in children Flashcards
What is sepsis?
SIRS accompanied by a suspected/proven infection
What is SIRS?
Systemic inflammatory response syndrome (fever or hypothermia, tachycardia, tachypnoea, leucocytosis)
What organisms are responsible for sepsis in neonates?
Group B streptococci
E. Coli
Listeria monocytogenes
What organisms cause sepsis in children?
Strep pneumoniae
Meningococci
Group A streptococci
Staph aureus
What are the symptoms of sepsis in the young?
Fever or hypotheria Cold hands/feet mottled feet Prolonged cap refill >2 secs]Chills/rigors Limb pain Vomiting and/or diarrhoea Muscle weaknesses Muscle/joint aches Skin rash Diminished urine output
What are 6 key symptoms to look out for when looking at sepsis in children?
temperature <36 or >38 inappropriate tachycardia Poor peripheral perfusion Altered menal state Inappropriate tachypnoea Hypotension
How do you treat sepsis in the young?
A
B
C
DEFG
Antibiotics with broad spectrum activity and good CSF penetration, 3rd generation cephlasporin (+amoxicillin if neonate
What is the management of sepsis in the young?
Give high flow O2 Obtain IV/IO access and obtain bloods Give IV/IO antibiotics Consider fluid resuscitation Consider ionotropic support Involve senior/specialist help early
How do you investigate sepsis in children using the blood?
FBC- high white count, low platelets
CRP- elevated
Coagulation factors- deranged clotting due to DIC
U&E’s renal and hepatic dysfunction
Blood gas- metabolic acidosis, raised lactate
Glucose- hypoglycaemia
Culture
How do you investigate sepsis in children using the CSF?
Lumbar puncture- cell count and proteins
Viral- raised proteins, normoglycaemia, increased lymphocytes, clear-cloudy
Bacterial- very high proteins, hypoglycaemia, increased neutrophils, cloudy appearance
What other investigations would you carry out for a young person with sepsis?
Urine culture
Skin biopsy- look for meningiococcal sepsis
Imaging CT/MRI
What organisms cause meningitis in neonates?
Group B strep
E.coli
Listeria monocytogenes
What organisms cause meningitis in children?
Streptococcus pneumoniae
Meningococci
Haemophilus influenza
What are the sign of meningitis in children?
Nuchal rigidity Headaches, photo phobia Diminished consciousness Focal neurological abnormalities Seizures
What are the signs of meningitis in neontes?
Lethargy, irritability
Bulging fontanelle
seizures
