Intrasession Lecture: Infectious Disease

Question 1

A kid who is six days old –going by the rule of sixes –will have what important host, environment, and organism features?

Answer 1

• Host: immature immune system; maternal IgG; colostrum
• Environment: congenital infections; vaginal flora
• Organisms: GBS, E. coli, L. monocytogenes, Enterococcus, CMV, HSV, HIV, enterovirus, HBV, and Toxo

Question 2

What two cephalosporins are used in neonatal infection?

Answer 2

• Cefotaxime
• Ceftazidime

Remember that ceftriaxone causes hyperbilirubinemia.

Question 3

What are the three types of herpes?

Answer 3

• First: skin, eye, mucous membranes
• Second: disseminated: liver
• Third: CNS: seizures, encephalitis, developmental delay

They don’t have to occur in order. Some can be skipped.

Important!! Fever is not a necessary finding.

Question 4

A kid who is six weeks old –going by the rule of sixes –will have what important host, environment, and organism features?

Answer 4

• Host: immature immune system; maternal IgG; self-made IgG; breastmilk
• Environment: daycare bugs
• Organisms: GBS (late),

Question 5

Intrapartum treatment for GBS only protects against _____________.

Answer 5

early GBS infection

Question 6

Late-onset GBS is more likely to present with ________________.

Answer 6

bacteremia, meningitis, and septic arthritis

Question 7

For the vaccines given at 2, 4, and 6 months, kids are not usually protected until _____________.

Answer 7

the second dose

Question 8

Steroids have only been shown to be helpful in meningitis caused by which two organisms?

Answer 8

• Haemophilus influenzae B (most evidence for this!)

* Streptococcus pneumoniae (some evidence for this)

Question 9

Specifically, giving steroids in those with meningitis has been shown to reduce the risk of _____________.

Answer 9

hearing loss

Question 10

What viruses can cause exudative pharyngitis?

Answer 10

• Adenovirus
• CMV
• EBV
• HIV (initial presentation)

Question 11

Scarlet fever presents with the following: 
•Fever
•Pharyngitis
•Strawberry tongue
•Morbilliform rash
•\_\_\_\_\_\_\_\_\_\_\_\_\_
•\_\_\_\_\_\_\_\_\_\_\_\_\_

Answer 11

Pastia’s lines (erythematous lines in the flexor surfaces); rash worsening in the groin

Question 12

What is the treatment for toxic-shock syndrome?

Answer 12

• Vancomycin (for Gram-positive coverage)
• Ceftriaxone (for potential Gram-negative infection)
• Clindamycin (to “turn off” toxin production)

Question 13

If a kid seems like they have Coxsackie A, you need to rule out _______________.

Answer 13

RMSF

Question 14

What infectious rash presents with a “herald lesion”?

Answer 14

Pityriasis rosea