Infection and immunity Flashcards
(35 cards)
Give some examples of causative organisms for bacterial meningitis
< 1 month = Group B strep
> 1 month:
- Neisseria meningitis
- Streptococcus pneumoniae
What are the symptoms and signs of meningitis in infants and children?
Symptoms:
- Infants = very non specific, e.g. irritability, lethargy, poor feeding
- Older children who are able to talk may be able to also describe the classical symptoms of headache, neck stiffness and photophobia
Signs:
- Fever
- Non-blanching purpuric rash
- Positive Kernig’s sign (with the child lying supine and the hips and knees flexed, extension of the knee elicits back pain)
Describe the investigation of suspected meningitis
Septic screen:
- FBC
- CRP
- Blood cultures
- Urine culture
- LP (contraindicated in meningococcal septicaemia)
Describe the management of suspected meningitis in infants and children (and their contacts)
Which other medication is given in the treatment of bacterial meningitis to children over 3 months?
- Community/GP: IM benzylpenicillin
- Hospital: IV broad spectrum antibiotics*
- Household contacts: ciprofloxacin
- Choice of antibiotics depends on age:
- < 3 months old = cefotaxime + amoxicillin (listeria cover)
- > 3 months old = ceftriaxone
Dexamethasone
What is the organism that causes chickenpox?
Varicella zoster virus (VZV)
What are the clinical features of chickenpox?
- Fever
- Itchy, vesicular rash which covers the whole body
Describe the management of chickenpox for the patient and contacts
Do children need to be excluded from school?
- Patient = supportive treatment
- Contacts (who are non-immune PLUS immunocompromised or pregnant) = VZIG 7-14 days post exposure
- Yes, until all lesions have crusted over
What are the potential complications of chickenpox?
- Encephalitis
- Secondary bacterial infection
- Disseminated disease in immunocompromised
Describe the clinical features of measles
- Fever
- 3 C’s (and 1 K): coryza, cough, conjunctivitis, Koplik spots (white spots on buccal mucosa)
- Erythematous widespread rash
Describe the management of measles
Do children need to be excluded form school?
Supportive
Yes, until 4 days after onset of rash
Describe the clinical features of mumps
- Fever
- Parotitis
Describe the management of mumps
Do children need to be excluded form school?
Supportive
Yes, until 5 days after onset of swollen glands
What are the potential complications of mumps?
- Encephalitis
- Hearing loss (usually transient and unilateral)
- Orchitis
Which organism causes hand, foot and mouth disease?
Coxsackie virus (a type of enterovirus)
What are the clinical features of hand, foot and mouth disease?
- Fever
- Painful vesicular lesions on the hands, feet and mouth (and often also on the buttocks)
Describe the management of hand, foot and mouth disease
Do children need to be excluded form school?
Supportive
No
Describe the NHS vaccination programme for…
- Babies aged under 1 year
- Children aged 1-15 years
Babies under 1 year: 8 weeks: 6MR - 6-in-1 (diphtheria, tetanus, polio, pertussis, hep B, Hib) - MenB - Rotavirus
12 weeks: 6PR
- 6-in-1
- Pneumococcal vaccine
- Rotavirus
16 weeks: 6M
- 6-in-1
- MenB
Children aged 1-15 years: 1 year: PMHM - Pneumococcal - MenB - Hib/Men C - MMR
2-10 years:
- Flu vaccine (every year)
3 years 4 months:
- MMR
- 4-in-1 pre-school booster (diphtheria, tetanus, polio, pertussis)
12-13 years:
- HPV vaccine for girls AND boys
14 years:
- 3-in-1 teenage booster (diphtheria, tetanus, polio)
- MenACWY
Describe the aetiology of scarlet fever
Scarlet fever is a bacterial infection caused by Streptococcus pyogenes (group A streptococcus)
What are the clinical features of scarlet fever?
- Fever
- 3 S’s: Sore throat (strep pharyngitis), Strawberry tongue, Sandpaper rash
- Rash: erythematous, widespread
Describe the management of scarlet fever
Do children need to be excluded from school?
Are there any complications of scarlet fever?
Management:
- 10 day course of penicillin
Yes, until 24 hours after commencing antibiotics
Complications:
- Rheumatic fever
‘Slapped cheek syndrome’ is also known as…?
- Fifth disease
Describe the aetiology of slapped cheek syndrome
Parvovirus B19
Describe the clinical features of slapped cheek syndrome
Are there any complications of slapped cheek syndrome?
Clinical features:
- Fever
- Coryza
- Rash: erythematous; on the cheeks
Complications:
- Aplastic crisis (reticulocytopenia) in children with chronic haemolytic anaemia (e.g. sickle cell anaemia, thalassaemia)
Describe the management of slapped cheek syndrome
Do children need to be excluded from school?
Supportive
No
