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Pediatrics > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

3 Criteria for Virulence of Infection

A
  1. inflict serious harm
  2. go unrecognized my immune system
  3. spread efficiently
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2
Q

Diagnostic Aids for Infection

A
  1. CBC
  2. Platelet count
  3. C-reactive protein
  4. Procalcitonin
  5. Erythrocyte sedimentation rate
  6. Cultures and stains
  7. DNA/RNA
  8. Immunoserology
  9. Imaging (MRI)
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3
Q

What can a CBC tell you about infection?

A
  • Leukocytosis: bacterial
  • Leukopenia: viral
  • Differential further focuses diagnosis
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4
Q

What can a C-reactive protein tell you about infection?

A
  1. Acute-phase reactant
  2. Increases in presence of acute inflammation
  3. Nonspecific
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5
Q

What can a platelet count tell you about infection?

A

Thrombocytosis in active phase of infection

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6
Q

What can procalcitonin tell you about infection?

A
  • Biomarker for differentiating some viral from serious bacterial infections
  • Increased in bacteremia/ can reflect severity
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7
Q

What can Sed-Rate tell you about infection?

A
  1. Acute-phase reactant; nonspecific
  2. Useful to evaluate therapy when antibiotics used
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8
Q

Typical Infections in Child Care Setting

A
  1. Hand foot mouth
  2. Erythema infectiosum
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9
Q

Physical Examination of Hand Foot Mouth Disease

A
  1. Skin: macular-papular; urticarial, vesicular, petechial
  2. Vesicles
  3. Febrile more than 3 days
  4. Mild URI
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10
Q

Physical Examination of Erythema Infectosium

A
  1. Prodrome: mild fever, myalgia, HA, malaise, URI symptoms
  2. Rash: 7-10 days after prodrome
    • “slapped cheek” with circumoral pallor
    • lacy, maculopapular rash (may last a month)
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11
Q

Clinical Findings for West Nile Virus

A
  1. Mimics influenza, GI infection
  2. Mild symptoms will resolve in 1 week
  3. Severe - neuroinvasive involvement
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12
Q

Diagnostics for West Nile Virus

A

MAC - ELISA

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13
Q

Tick-Bourne Diseases

A
  1. Lyme Disease
  2. Rocky Mountain Spotted Fever
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14
Q

Stage 1 of Lyme Disease

A
  • erythema migrans (bulls eye rash)
  • may resemble nummular eczema
  • some may have flu like symptoms
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15
Q

Stage 2 of Lyme Disease

A
  • early disseminated disease
  • secondary annular lesions
  • neurologic signs
  • cardiac signs
  • generalized manifestations (may last 2 weeks to 2 years)
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16
Q

Stage 3 of Lyme Disease

A
  • Late disease
  • Pauciarticular arthritis weeks to months after bite
17
Q

Diagnostics Studies for Lyme Disease

A
  • No other tests are needed if erythema migrans is present
  • IgM antibodies not positive for 2-4 weeks
  • IgG antibodies not positive for 4-6 weeks
  • High rate of false positives
  • CDC: ELISA - if neg then no more tests; IgG and IgM Western blot if having symptoms over 30 days
18
Q

Management of Lyme Disease

A
  1. Prophylactic doxycycline/amoxicillin
  2. Amoxicillin or doxycycline in early localized disease
  3. Early or late disseminated disease - consult ID
19
Q

Clinical Findings for Rocky Mountain Spotted Fever

A
  1. Fever, chills, myalgia, GI symptoms, photophobia, AMS
  2. Focal neurologic deficits with disease progression
  3. Maculopapular rash: wrists, forearms, ankles –> spreads to trunck
20
Q

Diagnostics Studies for Rocky Mountain Spotted Fever

A
  1. PCR testing or IFA
  2. Thrombocytopenia, hyponatremia, leukocytosis, anemia
21
Q

Management of Rocky Mountain Spotted Fever

A
  • Antibiotics prior to onset of rash
  • Disease may progress rapidly
  • Doxycycline for 7-10 days for all ages
22
Q

Complications of Rocky Mountain Spotted Fever

A
  • Neurologic deficits
  • 20% fatality if untreated
  • Prevention: tick precautions
23
Q

Bacterial Infections in Children

A
  1. Community-Acquired MRSA
  2. Cat Scratch Disease
  3. Meningococcal Disease
  4. Group A Strep (GAS)
24
Q

Clinical Clues for Community-Acquired MRSA

A
  1. Boil, abscess without pus; rapid onset
  2. Other family members have similar infections
  3. Neonate with skin/soft tissue infection
  4. Hx of recurrent small, non-tender, maculopapular lesions; multiple lesions
  5. Ethnic minority or lower socioeconomic status
  6. Hx of hospitalization in past year
  7. Attends day care; is less than 2 years old
25
Q

Management of Community-Acquired MRSA

A
  1. Superficial skin lesions - topical antibiotic
  2. Widespread impetigo - oral/IV antibiotics
  3. Warm compresses to localize pus in nonfluctuant
  4. Cultures for non-draining fluctuant abscess
    **Refer immunocompromised patients to ID specialist
26
Q

Clinical Findings for Cat-Scratch Disease

A
  1. 3-5 mm erythematous papules which heal; lymphandenopathy in 1-4 weeks; persists up to 1 year
  2. Parinaud oculograndular syndrome - painful non-supportive conjunctivitis/preauricular lymphadenopathy in small percentage
  3. In immunocompromised patients - recurrent fevers, bacteremia, weight loss
27
Q

Diagnostic Studies for Cat Scratch Disease

A
  1. IFA for serum antibodies
  2. CBC - mild leukocytosis
  3. ESR/CRP elevated early
28
Q

Management of Cat Scratch Disease

A
  • Most resolves spontaneously
  • Antibiotics only if concerns for systemic CSD
  • Treatment for immunocompromised patients: oral agents and parenteral gentamycin
29
Q

Complications of Cat-Scratch Disease

A
  1. Small percentage have systemic illness with high fever, malaise, fatigue, anorexia
  2. Enlarged mediastinal nodes - pleurisy, obstruction
  3. Splenic/hepatic abscesses
30
Q

Clinical Findings for Meningococcal Disease

A
  1. Occult bacteremia - febrile URI or GI infection; may resolve without intervention
  2. Meningococcemia - rapid progression over several hours: fever, septic shock, petechiae to purpura fulminans, hypotension, DIC, adrenal hemorrhage, organ failure, coma: death in 12 hours
  3. Meningococcal meningitis - fever, HA, stiff neck
31
Q

Diagnostic Studies for Meningococcal Disease

A
  1. Positive culture/Gram stain from CSF, blood, or synovial fluid
  2. PCR assays useful if antibiotics given
32
Q

Management of Meningococcal Disease

A
  • hospital is mandatory
  • IV antibiotics pending cultures
  • chemoprophylaxis within 24 hours of index case regardless of immunization status
  • Prophylaxis during outbreak: vaccination and chemoprophylaxis
33
Q

Clinical Findings of Group A Streptococcus (GAS)

A
  1. Respiratory tract infection - peritonsilar abscess, cervical lymphadenitis, GABHS
  2. Scarlet fever
  3. Bacteremia
  4. Vaginitis and TSS
  5. Perianal streptococcal cellulitis
  6. Skin infections
  7. Rheumatic fever
  8. Necrotizing fasciitis
34
Q

Clinical Findings Scarlet Fever

A
  • erythogenic toxin
  • abrupt illness with sore throat
  • fever
  • vomiting
  • HA
  • chills
  • malaise
  • erythematous tonsils/exudate
  • strawberry tongue
  • sandpaper rash
35
Q

Management of GAS

A

Antibiotics

36
Q

Complications of GAS

A

Pediatric autoimmune neuropsychiatric disorders
1. OCD
2. Tic disorders
3. Tourettes

Pediatrics (12 decks)

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