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infection Flashcards

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1
Q

what organisms are likely in neonate- 3m meningitis

A

group B strep, E coli, listeria

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2
Q

what is added to cef antibiotics in neonatal meningitis

A

ampicillin

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3
Q

what organisms likely in 3m-6y meningitis

A

Neisseria meningitides, strep pneum, H influenza

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4
Q

what organisms likely in >6y

A

Neisseria meningitides, strep pneum

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5
Q

signs meningococcal infection

A

purpuric rash, non blanching. give IM benzlypenicillin straight away

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6
Q

contraindications to LP

A

cardiorespiratory instability, coagulopathy, signs incr ICP, local infection, thrombocytopenia, focal neuro signs

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7
Q

if CI to LP in meningitis what can be done

A

PCR, rapid antigen test

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8
Q

LP results bacterial

A

turbid, incr polymorphs, incr protein, low glucose

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9
Q

LP results viral

A

clear, incr lymphocytes, normal or incr protein, normal or low glucose

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10
Q

LP results TB

A

clear, turbid or viscous, incr lymphocytes, very high protein, very high glucose

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11
Q

treatment meningitis

A

cefotaxime or ceftriaxone. dexamethasone

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12
Q

complications meningitis

A

hearing loss, hydrocephalus, local vasculitis, local cerebral infarction, subdural effusion, cerebral abscess

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13
Q

what organisms can cause viral meningitis

A

enteroviruses, adeno, EBV, mumps.

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14
Q

what organisms may be more likely in the immunocompromised

A

mycoplasma and borelia (lyme)

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15
Q

commonest cause septicaemia in children

A

meningococcus

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16
Q

signs of septicaemia

A

fever, tachycardia, tachypnoea, purpuric rash, shock.

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17
Q

treatment septicaemia

A

antibiotics, fluids, circulatory support (inotropes), FFP and platelets for DIC

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18
Q

what can cause impetigo

A

staph/strep

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19
Q

signs impetigo

A

lesions on face, hands, neck. erythematous macules which can become vesicular and pustular, can rupture and leak. honey coloured cruster lesions

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20
Q

when can go to school with impetigo

A

when the lesions are dry

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21
Q

treatment impetigo

A

topical mupirocin, flucloxacillin, co amoxiclav

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22
Q

how to eradicate carriage impetigo

A

need to eradicate nasal carriage. nasal cream- mupirocin or neomycin

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23
Q

signs periorbital cellulitis

A

fever, erythema, tender, oedema eyelid. unilateral.

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24
Q

how can periorbital cellulitis occur

A

may follow local trauma. spread from paranasal sinus infection or dental abscess. treat promptly with IV antibiotics to prevent progression to orbital

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25
signs orbital cellulitis
proptosis, painful eye movements, decr visual acuity. do CT
26
signs infectious mononucleosis
fever, malaise, tonsillopharyngitis, lymphadenopathy, petechiae on soft palate, spleno/hepatomegaly, maculopapular rash, jaundice
27
diagnosis infectious mononucleosis
monospot test. IgM and IgG to EBV antigens
28
what should you not give in EBV infection
amoxicillin or ampicillin as causes maculopapular rash in EBV
29
treatment EBV
symptomatic. corticosteroids if severe airway compromised. penicillin if group A grown
30
features measles
temp, maculopapular rash- starts behind the ears and involves the whole body, conjunctivitis, Kopliks spots, cough, coryza
31
what are pathognomonic in measles
Kopliks spots- white spots on buccal mucosa
32
complications measles
pneumonia, otitis media, febrile convulsions, encephalitis, subacute sclerosing panencephalitis, hepatitis, diarrhoea, appendicitis, croup
33
when does encephalitis come on in measles
8d after initial infection. initially- headache, lethargy, irritable. convulsions and coma.
34
long term complications encephalitis (measles)
hearing problems, hemiplegia, LD
35
when does subacute sclerosing panencephalitis occur
can occur 7-13y after infection. primary infection usually
36
signs subacute sclerosing panencephalitis
loss of neuro function- behaviour changes, myoclonus, choreoatheotosis, dystonia, leading to dementia and death
37
what can you give if patient is immunocompromised in measles and what to give patients in developing world
ribavirin (anti viral drug). vitamin A
38
how is measles spread
droplets
39
incubation measles
7-12 days, infective from prodrome until 5 days after rash starts
40
infectivity rubella
5 days before to 5 days after start of rash.
41
signs rubella
macular rash, suboccipital lymphadenopathy
42
is the rubella vaccine a live virus
yes
43
complications rubella
small joint arthritis, malformations in utero.
44
what malformations in first four weeks if infected rubella in utero
eye anomaly
45
malformation 4-8 weeks infection rubella in utero
cardiac abnormalities
46
malformation 8-12 weeks rubella infection in utero
deafness
47
spread of mumps
droplets, saliva
48
immunity mumps
lifelong once infected
49
infectivity mumps
7 days before and 9 days after parotid swelling
50
signs mumps
prodromal malaise, incr temp, painful parotid swelling, bilateral in 70%.
51
complications mumps
usually none. orchitis (+- infertility), arthritis, meningitis, pancreatitis, deafness
52
features hand foot and mouth disease
mildly unwell child, vesicles on palms soles and mouth, may cause discomfort until they heal without crusting
53
cause hand foot and mouth
coxsackie virus a16 or enterovirus 71
54
signs erythrovirus (parvovirus 19)
mild acute infection wth malar erythema (slapped cheek) and rash mainly on the limbs ( glove and socks syndrome)
55
complications erythrovirus
aplastic crisis. fetal death in pregnancy- hydrops fetalis.
56
what is roseola infantum
mild self limiting. incr temp, maculopapular rash, ulcers.
57
what causes roseola infantum
herpes virus 6
58
what is Kawasaki disease
systemic vasculitis. 6m-4y
59
features Kawasaki disease
prolonged fever >5 days. conjunctiva, mucous membranes, cervical lymphadenopathy, rash, extremities (red, peeling)
60
treatment Kawasaki disease
IvIg. aspirin- 6 weeks. persistent inflammation- infliximab, steroids
61
what can be affected in 1/3 Kawasaki patients
coronary arteries- aneurysms (give warfarin),MI
62
what is chicken pox
primary varicella zoster infection. spread by resp droplets
63
features chicken pox
vesicular rash- papules vesicles and pustules. starts on head and trunk then spreads to peripheries. temperature.
64
complications chicken pox
bacterial superinfection, staph, strep, toxic shock syndrome, nec fasciitis, encephalitis, meningitis, pneumonitis, DIC, purpura fulminans
65
treatment chicken pox
in immunocompromised- IV acyclovir. then switch to oral valaciclovir. varicella zoster IG to immunocompromised
66
can chicken pox be caught from someone with shingles
yes
67
treatment bacterial superinfection in chickenpox
flucloxacillin
68
what is shingles
herpes zoster. reactivation of latent varicella zoster
69
features shingles
vesicular eruption in dermatomal distribution. unlikely to get neuralgic pain in childhood. common in the thoracic region. if recurrent- immunocompromised
70
treatment shingles
oral analgesia. acyclovir in immuno.
71
what can be given as prophylaxis in pregnancy
varicella zoster globulin
72
what happens if pregnant lady gets infected with varicella zoster
aciclovir
73
what does HSV1 cause
lip and skin
74
what does HSV2 cause
genital lesions
75
what is the most common presentation of herpes simplex in children
gingivostomatitis
76
features gingivostomatitis
vesicles on lips, gum, tongue, palate can ulcerate and bleed. 10m-3y. fever and miserable child
77
what is a herpetic whitlow
painful white pustules on site of broken skin. fingers and thumbs
78
eye complications herpes simplex
blepharitis, conjunctivitis, cornea- scarring, loss vision
79
investigations in osteomyelitis
MRI shows infection with pus and debris, radionuclide bone scan
80
when is the mother at risk of passing on HIV
during pregnancy, during delivery, breastfeeding
81
when is HIV vertical transmission more likely
high viral load or symptomatic
82
diagnosing vertically acquired HIV
HIV DNA PCR- to be clear need 2 negative in first 3m of life 2 weeks after postnatal antiretrovirals
83
how long do children have placentally transferred IgG antibodies HIV
18 months so don't use standard tests
84
when should you consider HIV in children
PUO, lymphadenopathy, hepatosplenomegaly, persistent diarrhoea, parotid enlargement, shingles decr platelets, failure to thrive, clubbing, CMV
85
decreasing vertical transmission HIV
antiretrovirals to mother, avoid breastfeeding, pre labour C section, avoid prolonged rupture of membranes
86
treatment vertically transmitted HIV
highly active antiretroviral therapy PENTA regimen- start at once if AIDs defining conditions or CD4
87
features diphtheria
nasal discharge, bull neck, sore throat, airway obstruction, cardiac and neuro toxins
88
opportunistic infections in HIV
aspergillus, candida, Cryptococcus, cryptosporidium, pneumocystitis, HH8 (Kaposi sarcoma), pseudomonas, CMV encephalitis, TB encephalitis, lymphoma, toxoplasmosis
89
what does cryptosporidium cause (HIV)
chronic diarrhoea
90
what does Cryptococcus cause (HIV)
meningo encephalitis
91
treatment PCP
co trimoxazole
92
what is Kaposi sarcoma
cause HHV-8. 4 types. skin not always involved. can get purple macules papules nodules and plaques affecting limbs, face +- periorbital purpura/raccoon eyes

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