Infection Flashcards
(32 cards)
What is the definition of sepsis?
SIRS + suspected/proven infection
What is the definition of SIRS?
Systemic inflammatory response syndrome
What is severe sepsis?
Sepsis + multi-organ failure (>2 of the following): Respiratory failure - common Renal failure Neurologic failure Liver failure
What are causes of sepsis in neonates?
(<1 month)
Group B streptococci
Eshericha coli
What are the causes of sepsis in children?
Group A streptococci
Strep pneumoniae
Meningococci
Staph aureus
What are the symptoms of sepsis?
Fever/hypothermia Cold peripheries Prolonged capillary refill time >2 seconds Chills/rigors Limb pain Vomiting and/or diarrhoea Muscle/joint aches Diminished urine output
How is sepsis investigated?
Sepsis 6 recognition tool FBC – decreased WCC, decreased platelets CRP – elevated Metabolic acidosis Raised lactate Hypoglycaemia CSF Urine culture
How is sepsis treated?
Supportive – ABCG – O2
Broad spectrum antibiotics – 3rd generation cephalosporins (Benzylpenicillin + gentamycin
Rifampicin )
What is meningitis?
Inflammation of the meninges
What are the causes of bacterial meningitis in neonates?
Group B streptococci
E. coli
What are the causes of bacterial meningitis in children?
Step pneumonia
Neisseria meningitidis
Haemophilus influenzae
What are the signs of meningitis in neonates?
Lethargy
Irritability
Bulging fontanelle
Seizures
What are the signs of meningitis in children?
Nuchal rigidity (neck stiffness) Headaches Photophobia Diminished consciousness Seizures Rash - late sign
How is meningitis investigated?
Blood culture
Lumbar puncture
Tumbler test if rash (non-blanching)
Kernig’s test - patient lies on back flexing hip and knee, straightens leg (keeping hip flexed) pain down meninges
Brudzinski’s test - touch chin with neck and see involuntary flexion of hips/knees
How is meningitis treated?
<3 months – IV cefotaxime + amoxicillin
>3 months – IV ceftriaxone
Both before tests come back
Dexamethasone – to reduce the chance of long-term outcomes
What are the complications of meningitis?
Hearing loss Cerebral palsy Seizures and epilepsy Cognitive impairment Epilepsy Memory loss
What are the differentials of a fever in a child?
Mild - URTI, mild gastroenteritis, non-specific viral infection
Significant - pneumonia, meningitis, encephalitis, meningococcal sepsis, UTI, septic arthritis, kawasaki’s disease
Infants under 3 months with a temp of 38C need to be treated for sepsis until proven otherwise
What is Kawasaki disease?
Medial vessel vasculitis
Affects young children <5
Increased risk in siblings and twins
What are the symptoms of kawasaki disease?
Fever for 5 days + 4 of: Bilateral conjunctival infection Cracked lips/strawberry tongue Cervical lymphadenopathy >1.5cm Polymorphous rash Change of the extremities
How is kawasaki disease treated?
Aspirin
IV immunoglobulins
Cardiology assessment as it’s the leading cause of heart disease
What are the complications of kawasaki disease?
Coronary artery aneurysms
Varicella zoster
Primary infection - varicella, chickenpox
Recurrent infection - zoster (shingles)
Incubation period - 14 days
What are the symptoms of a varicella zoster infection?
Mild malaise
Fever
Itchy
Exanthema - papule, vesicles, pustules
How is varicella zoster infection treated?
Aciclovir if immunocompromised or severely unwell
Prevented with vaccine
