Infectious Diseases Flashcards
1
Q
What is sepsis and its general symptoms in children?
A
- sepsis = SIRS + infection
- multiorgan failure, ≥ 2;
- respiratory, renal, enurological, haematological, liver
- Systemic Inflammatory Response Syndrome
- fever/hypothermia
- tacycardia
- tachypnoea
- leukocytosis/leukocytopenia
- acute respirartory response syndrome
- septic shock
2
Q
What are the pathogens for sepsis in children?
A
Neonates (< 1 month):
- group B strep
- e. coli
- listeria monocytogenes
Children:
- strep pneumoniae
- meningococci
- group A strep
- staph aureus
3
Q
What are the symptoms of sepsis in children?
A
- fever/hypothermia
- cold hands/feet, mottled
- prolonged CRT
- chills/rigors
- limb pain
- vomiting/diarrhoea
- muscle weakness
- muscle/joint aches
- skin rash
- diminished urine output
4
Q
What are the investigations for sepsis in children?
A
- FBC (leukocytosis, thrombocytopenia)
- CRP (inc)
- coagulation factors (deranged, DIC)
- U + Es (renal dysfunction)
- LFTs (liver dysfunction)
- blood glucose (hypoglycaemia)
- blood gas (metabolic acidosis, inc lactate)
- blood culture
- CSF- cell count + culture (inc WCC)
- CSF- protein + glucose (inc protein level, dec glucose)
- urine culture
- skin biopsy culture
- CT/MRI
5
Q
What is the treatment for sepsis in children?
A
- ABC,DEFG
- antibiotics
- broad spectrum
- good CSF penetration
- 3rd generation cephalosporins
- amoxicillin if neonate
6
Q
What are pathogens for meningitis?
A
Neonates (< 1 month):
- group B strep
- e. coli
- listeria monocytogenes
Children:
- strep pneumoniae
- meningococci
- haemophilus influenza
7
Q
What are symptoms of meningitis?
A
Neonates (< 1 month):
- lethary, irritability
- bulging fontanelle
- seizures
- pin prick rash
Children:
- nuchal rigidity
- headaches, photophobia
- diminished conciousness
- focal neurological abnormalities
- seizures
8
Q
What is the treatment for meningitis?
A
- chemoprophylaxis
- steroids
9
Q
What are complications of pneumococcal meningitis?
A
- brain damage
- hearing loss
- hydrocephalous
10
Q
What are common streptococcal infections in children?
A
- impetigo
- STSS
- bacteraemia
- cellulitis
- septic arthritis
11
Q
What are features of scarletina?
A
- strep A
- 2-4 days incubation
- M protein, extocixins
- malaise, fever, tonsillitis, exanthema, ‘strawberry’ tongue, squamation (hands + feet)
- erysipelas, cullulitis, impetigo, Strep toxic shock, rheumatic fever, glumerulonephritis
- penecillin 10 days
12
Q
What are features of kawasaki disease?
A
- fever for 5 days + 4 of; bilateral conjunctival injection, changes of the mucous membrane, cervical lymphadenopathy, polymorphous rash, changes of the extremities
- peripheral oedema, peripheral erythema, periungual desquamation
- self limiting vasculitis of medium-sized arteries
- immunoglobulins, aspirin, immunosuppressants
13
Q
What are features of varicells zoster virus?
A
- varicella, zoster, chickenpox
- 10-21 days incubation
- mild malaise and fever
- exanthema: papules -> vesicles -> pustules -> crusts (-> scarring)
- secondary skin infection, meningoencephalitis, cerebellitis, arthritis
- aciclover
- vaccination
14
Q
What are features of herpes simplex virus (HSV)?
A
- HSV1 (oral), HSV2 (genitial)
- stomatitis, recurrent cold sores
- keratoconjunctivitis, encephalitis, systemic neonatal infections, immunocompromised children
- aciclover
- birth canal/direct contact (4-21 days)
- disseminated/CNS infections
- skin/eye/mouth (SEM) disease
- high mortality
15
Q
What are features of hand foot and mouth disease?
A
- enterovirus, Coxsackie A16, enterovirus 71
- 3-6 day incubation
- exanthema, enanthema, painful lesions
- 5-10 day recovery
