Childhood Infections

Question 1

Slapped cheek syndrome - Causative organism?

Answer 1

Parovirus B19 infection

Spread through resp secretions

Question 2

Signs and symptoms of Slapped cheek syndrome
Management

Answer 2

Signs+symptoms:
Diffuse erythematous facial rash on one or both cheeks
Can develop maculopapular rash on trunk, back and limbs

Management - simple analgesia and rest - can go to work/school
Avoid contact with pregnant women

Question 3

Measles - Causative organism?

Answer 3

Morbillivirus (paramyxovirus family)
Notifiable disease

Spread by coughing, sneezing etc
Common in children <5

Question 4

Signs and symptoms of measles
Management

Answer 4

• Fever
• Maculopaular rash - starts behind the ears then spreads to trunk and limbs
• Cough, coryzal symptoms, conjunctivitis
• Koplik spots - white spots in the mouth
• Complications: Otitis media, pneumonia, convulsions

Management- self-limiting, don’t go to work/school

Question 5

Chickenpox - Causative organism?

Answer 5

Varicella-zoster virus
Direct contact with lesions/droplets

Question 6

Signs and symptoms of chickenpox
Management

Answer 6

Prodromal - Nausea, myalgia etc
Small erythematous macules appear on the scalp, face, and trunk. They then progress to papules and pustules - very itchy

Complications - Secondary bacterial infection of the lesions e.g. impetigo, Reye’s syndrome, encephalitis

Management - Consider prescribing oral aciclovir 800 mg 5x a day for 7 days for those who are at risk of complications - present in 24 hours of rash onset

Question 7

Impetigo - causative organism? Types?

Answer 7

Superficial, highly contagious bacterial infection of the skin
Two types:
Bullous - skin eruption is characterized by bullae (fluid-filled lesions over 1 cm in diameter) - caused by S.aureus
Non-bullous - 70% of cases. - caused by S.auerus, strep.pyogenes or both

Question 8

Risk factors for impetigo

Answer 8

Breaks in the skin, cuts, burns, eczema
Warm, humid weather
Poor hygiene
Crowded environments

Question 9

Signs and symptoms of impetigo
Management

Answer 9

Non-Bullous: Pustules rupture to form gold-brown crusts - common in the face and flexural areas
Bullous: flaccid bullae which ruptures and yellow discharge. Leaves a thin crust at the edges

Question 10

Management of impetigo

Answer 10

Management - Advise hygiene, avoid crowded settings until the lesions are healed.
Consider offering hydrogen peroxide 1% cream if they are not unwell and it is localised
If widespread - Fusidic acid 2%
Can give oral or topical antibiotics if unwell (flucloxacillin)

Question 11

Oral candida - causative organism? Types?

Answer 11

Yeast-like fungal infection - caused by candida species
Some forms e.g. pseudomembranous candidiasis, plaque-like etc

Question 12

Risk factors for Oral candida

Answer 12

• Immunocompromised
• Oral corticosteroids
• Poor dental hygiene
• Smoking etc

Question 13

Signs and symptoms of oral candida

Answer 13

Patches of white/yellow plaques - can be easily removed - in the cheeks, gums, palate and tongue
Acute erythematous oral candidiasis - smooth tongue, marked soreness, erythema

Question 14

Management of oral candida

Answer 14

In not immunocompromised: If the infection is local and mild - miconazole oral gel first-line
If this is unsuitable - Nystatin
If severe - prescribe fluconazole

If Immunosuppressed: same as mentioned above
Seek advice if they are taking DMARDs