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Paediatrics > Infectious Disease 2.0 > Flashcards

Infectious Disease 2.0 Flashcards

1
Q

Give me some deets on streptococcal / staphylococcal:

A

Strep

  • Gram-positivecocci
  • Penicillin
  • Noresistanceissues!

Staph

  • Gram-positive cocci
  • Flucloxacillin (= synthetic penicillin resistant to β- lactamases
  • Resistance big issue! • MRSA
  • carriers
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2
Q

What is scarlatina?

A

Scarlet fever - strep A infection

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3
Q

Scarlatina

Cause?

Affects which children?

Complications?

Rx?

A
  • Cause: Group A β-hemolytic streptococci Children < 2 years of age relatively protected
  • > 10 years of age natural protection in 80%
  • Virulence factors: M-protein, exotoxins
  • Complications:
    • Erysipelas, Cellulitis, Impetigo - Streptococcal toxic shock
    • Rheumatic fever 0.3-3%
    • Glomerulonephritis
  • Penicillin 10 days
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4
Q

Scarlatina

SSx?

A
  • Very red sore throat.
  • Fever
  • Lymphadenopathy
  • Whitish coating on the tonsils and throat.
  • Headache or body aches.
  • Nausea, vomiting, or stomach pain.
  • Difficulty swallowing.
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5
Q

What organisms can cause impetigo?

A

Staph aureus and strep pyogenes

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6
Q

What is SSSS?

A

Staphylococcal scalded skin syndrome

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7
Q

SSSS

Caused by?

SSx?

A
  • Exotoxins of S. aureus,
  • Mostly kids < 5 yrs (particularly in newborns)
    • Fever
    • widespread redness
    • fluid-filled blisters
    • rupture easily
    • especially in the skin folds
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8
Q

What is Kawasaki disease?

A

Mucocutaneous lymph node syndrome, is a disease in which blood vessels throughout the body become inflamed. Self-limited vasculitis of medium-sized arteries

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9
Q

SSx of Kawasaki disease?

A
  • Fever for at least 5 days and four of the five
    • bilateral conjunctival injection
    • changes of the mucous membranes
    • cervical lymphadenopathy
    • polymorphous rash
    • changes of the extremities
  • peripheral oedema
  • peripheral erythema
  • periungual desquamation
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10
Q

Rx for Kawasaki disease?

A

To prevent complications like vasculitis coronary arteries:

  • Immunoglobulins
  • Aspirin
  • Other immunosuppressive agents
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11
Q

How can we differentiate between different vesicular rashes and fever?

A
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12
Q

What are the most common varicella zoster viruses?

A
  • primary infection (Varicella, Chickenpox)
  • recurrent infection (Zoster)
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13
Q

SSx of Chickenpox?

A
  • mild malaise and fever (kids are not sick!)
  • exanthema: papules → vesicles → pustules → crustae → (scarring) new laesions during 5-7 days
  • itching
  • Lasts for 10-21 days
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14
Q

Complications of chickenpox?

Prevention of chickenpox?

A
  • secondary strep/staph infections skin (10-15%)
  • meningoencephalitis, cerebellitis, arthritis
  • vaccination (active/passive)
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15
Q

What are more severe versions of varicella zoster virus?

A
  • Fatal varicella (2 : 100.000)
  • <1 year of age (8:100.000)
  • Signs:
    • Fever
    • new lesions >day10
    • Inflammed lesions
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16
Q

What are the most common herpes simplex virus infections?

A
  • Stomatitis (primary infection)
  • Recurrent cold sores
17
Q

Herpes simplex

Complications?

Rx?

A
  • (kerato) conjunctivitis
  • encephalitis
  • systemic neonatal infections
  • They are normally self limiting
  • (or) acylovir
18
Q

What happens if a neonate gets a herpes simplex virus?

A
  • Day 4 -21 of life
  • 70-80% disseminated/CNS infections • Sepsis
    • Meningoencephalitis
    • Hepatitis (jaundice, bleeding)
  • 20-30% skin/eye/mouth (SEM) disease
  • 2-3/100,000
  • High mortality
    • Without acyclovir > 50% • With acyclovir 20-30%
19
Q

Hand foot and mouth disease

Cause?

Incubation period?

When?

SSx?

A
  • Enteroviruses; Coxsackie A16 and enterovirus 71
    • Incubation period: • 3-6 days
  • Children <10 jaar
  • Summer and early autumn
  • Clinical:
    • Exanthema en enanthema
    • Painful laesions
    • Recovery in 5 to 10 day
20
Q

Dx for vesicular rashes?

A
  • Clinical diagnosis
  • Smear of vesicle (ulcer base)
    • Tzanck test: no differentiation HSV/VZV
  • PCR (fluids, CSF, blood)
  • Serology (past infections only)
21
Q

Summary (probs useful just to know this…!)

A
  • Staphylococcus aureus and Streptococcus pyogenes cause comparable diseases, ranging from mild to severe, but choice of antibiotics is organism specific.
    • Scarlet fever is exclusively caused by S. pyogenes
  • Vesicular rashes in childhood are caused by varicella zoster, herpes simplex and enteroviruses in children and in general do not need specific therapy.
    • Those viruses can cause severe neonatal infections
  • Kawasaki disease needs to be differentiated from S. pyogenes infections.

Paediatrics (32 decks)

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