Paediatrics - infectious disease Flashcards
(219 cards)
1
Q
What criteria can be used to judge how ill a child with an infection is?
A
Nice traffic light system for the unwell child
2
Q
What criteria are included in the traffic light system for the unwell child?
A
- Colour
- Activity
- Respiratory
- C/H circulation/ hydration
- Other
3
Q
What are the green, amber and red criteria for colour?
A
- Green = normal
- Amber = pallor (reported by carer)
- Red = mottled/ blue/ extremely pale
4
Q
What are the green, amber and red criteria for activity?
A
- Green = normal
- Amber = difficult to wake, decreased activity
- Red = does not stay awake/ does not wake up, inconsolable
5
Q
What are the green, amber and red criteria for respiratory?
A
- Green = RR < 50
- Amber = RR > 50 (if 6-12 months) or > 40 (if 12+ months), SpO2 < 95, nasal flaring
- Red = grunting, RR > 60, severe chest indrawing
6
Q
What are the green amber and red criteria for circulation/ hydration?
A
- Green = moist mucous membrane, normal skin
- Amber = tachycardia, CRT > 3 seconds, dry MM, reduced urine/ feeding
- Red = reduced skin turgor
7
Q
What are the amber and red criteria for ‘other’?
A
- Amber = 5 day fever, 3-6 month > 39 degrees, rigors, swelling/ non-weight bearing joint
- Red = <3months >38 degrees, NBP rash, status epilepticus
8
Q
What is the management for children green on the traffic light system for unwell children?
A
Safety netting
9
Q
What is the management for children amber on the traffic light system for unwell children?
A
Assess F2F to judge need fro admission
10
Q
What is the management for children red on the traffic light system for unwell children?
A
Urgent admission
11
Q
What is a risk score for sepsis in children (used to predict mortality)?
A
qSOFA:
* RR > 22
* GCS < 15
* BP < 100
12
Q
What are some typical investigations used investigate children with infections (6)?
A
- FBC
- Blood culture
- Urine culture
- CRP
- LP
- CXR
13
Q
What is Kawasaki disease?
A
Systemic medium vessel vasculitis
14
Q
Who is typically affected by Kawasaki disease (2)?
A
- Under 5 years
- Asian (Japanese/ Korean)
15
Q
What are the signs/ symptoms of Kawasaki (6)?
A
- Persistent high fever for 5 days
- Conjunctivitis
- Rash - erythematous maculopapular
- Adenopathy
- Strawberry tongue
-
Hands + feet desquamation
CRASH
16
Q
What are some findings on bloods for kawasaki disease (3)?
A
- Raised ESR
- Raised WCC
- Raised platelets
raised LFTs
17
Q
What is a significant complication of Kawasaki?
A
Coronary artery aneurysms
18
Q
What is an important investigation to request for those with Kawasaki?
A
Echo (look for coronary artery aneurysms)
19
Q
How is Kawasaki treated (2)?
A
- IVIg (reduce risk of CAA)
- Aspirin (reduce risk of thrombosis)
20
Q
What are the 3 stages of Kawasaki disease?
A
- Acute (most unwell with fever + rash, 1-2 weeks)
- Subacute (desquamation, CAA, 2-4 weeks)
- Convalescent stage (Sx settle, 2-4 weeks)
21
Q
What is a risk when giving aspirin to children?
A
Reyes syndrome
22
Q
What is reyes syndrome and what are the symptoms (3)?
A
Neurological disease:
* Vomiting
* Seizures/ LOC
* Personality changes
23
Q
What are the signs/ symptoms of varicella zoster virus (4)?
A
- Maculo-papular with vesicles (blisters) rash
- Fever
- Itch
- General fatigue
24
Q
What is the progression of the chicken pox rash?
A
Macularpapular rash –> vesicles –> pop + crust over
25
Where does the rash in chicken pox often start?
Chest/ face
26
What is the incubation of chicken pox?
3 weeks
27
When is the infectious period for chicken pox?
4 days before rash --> 5 days after (or when all lesions have crusted over)
28
How is chicken pox treated?
Supportive - can give aciclovir
29
What must not be given to those with chicken pox?
NSAIDs (can precipitate superinfection/ necrotising fascitis)
30
What are some complications of VZV/ chicken pox (4)?
* Bacterial superinfection
* Shingles/ Ramsey hunt
* Encephalitis
* Dehydration
31
What is shingles?
VZV (also known as herpes zoster virus) lies dormant in the sensory dorsal root ganglia and reactivate later in life (usually if immunosuppressed)
32
What is Ramsey hunt syndrome?
VZV lies dormant in facial nerve and causes facial drooping
33
How can Ramsey hunt and bells palsy be differentiated?
Otoscopy (may reveal changes to tympanic membrane in Ramsey hunt)
34
How can itching caused by chicken pox be treated?
Chlorphenamine (antihistamine)
35
What six diseases have traditionally caused an eruptive widespread rash ('viral exanthema')?
* First disease = measles
* Second disease = scarlet fever
* Third disease = rubella
* Fourth disease = dukes disease
* Fifth disease = parvovirus B19
* Sixth disease = roseola
36
What are the signs/ symptoms of measles (5)?
* Maculopapular rash
* Fever
* **C**ough
* **C**onjunctivits
* **C**oryzal Sx
37
What is a pathognomonic feature of measles?
Koplik spots (found on buccal mucosa)
38
Where does a measles rash classically start?
On face behind the ears
39
What are some complications of measles (5)?
* **Otitis media**
* Dehydration
* Pneumonia
* Hearing/ vision loss
* Meningitis/ encephalitis
40
What is another complication of measles that may occur several years after infection?
Subacute sclerosing panencephalitis
41
How can measles be treated?
Give MMR within 72 hours of Sx
42
How is measles diagnosed?
Serology testing (IgM + G) > 72 hours
*PCR swab <72 h from onset*
43
What causes scarlet fever?
Group A strep (strep pyogenes)
44
What is the underlying cause of scarlet fever?
Exotoxin B,C,F production (from GAS strains)
45
What does scarlet fever often start as?
Tonsilitis
46
What are the signs/ symptoms of scarlet fever (6)?
* **Rough "sandpaper" rash**
* **Strawberry tongue**
* Fever
* Sore throat
* Lymphadenopathy
* Lethargy
47
What age group does scarlet fever usually occur in?
Under 10 years
48
Where does the rash in scarlet fever typically start?
On chest
49
How is scarlet fever treated?
Phenoxymethylpenicillin (penicillin V) - 10 days
50
What are some complications of scarlet fever (3)?
* Rheumatic fever
* Post strep glomerulonephritis
* Abscess (tonsillar)
51
How can scarlet fever be diagnosed?
If clinical uncertainty a **throat swab** can be taken
52
What are the signs/ symptoms of rubella (6)?
* Erythematous macular rash
* **Lymphadenopathy** (behind ears + neck)
* Coryzal Sx
* Fever
* Arthritis
* Sore throat
53
How long is the incubation period for rubella?
2 weeks
54
How long does the rash typically last in rubella?
3 days
55
How is rubella diagnosed?
Serology testing (IgG)
56
What must children with rubella avoid?
**Pregnant women** (very dangerous for them)
57
What are some complications of rubella (2)?
* Thrombocytopenia
* Encephalitis
58
What is dukes disease?
Not associated with a particular virus or bacteria, more of a historic term. It is likely a non-specific viral rash
59
What is parvovirus B19 also known as?
Slapped cheek syndrome
60
What are the signs/ symptoms of slapped cheek syndrome (5)?
Starts with:
* Fever
* Coryzal Sx
* Muscle aches
then:
* Bright red rash on cheeks
then:
* Reticular (net-like) rash spreads to trunk
61
How is slapped cheek managed?
Symptoms usually very mild - self limiting illness
62
Who is at particular risk of parvovirus B19?
Those with anaemic blood disorders e.g. SSD, thalassaemia
*these patients should receive serology testing, FBC, reticulocyte count*
63
When is slapped cheek infectious?
Prior to the rash forming
64
What are some complications of slapped cheek (2)?
* **Aplastic anaemia** (those with pre-existing anaemias affected)
* Encephalitis/ meningitis
65
What causes roseola?
* Human herpes virus 6
* Human herpes virus 7
66
What are the signs/ symptoms of roseola (5)?
* Very high fever for 3-5 days (40 degrees)
* Coryzal Sx
* Sore throat
* Lymphadenopathy
* Rash (on arms, legs, trunk) after fever settles
67
What is a feature of the rash in roseola?
It is not itchy
68
What are some complications of roseola (4)?
* **Febrile convulsions**
* Myocarditis
* Thrombocytopenia
* Guillian barre
69
What age is typically affected by roseola?
Infants (2-3)
70
How is mumps spread?
Respiratory droplets through the air
71
What is the typical incubation period of mumps?
14-25 days
72
What are the signs/ symptoms of mumps (2)?
* Initial flu like symptoms (fever, muscle aches, headache, lethargy)
* **Parotid gland swelling** (parotitis)
73
What are some complications of mumps (3)?
* **Orchitis** (testicle pain/ swelling)
* **Pancreatitis**
* Meningitis
74
How is mumps diagnosed?
PCR testing on saliva swab
75
What causes hand foot and mouth disease?
Coxsackie A16 virus
76
What is the typical intubation period of HFM?
3-5 days
77
What are the signs/ symptoms of HFM (3)?
* URTI Sx
then:
* Mouth ulcers
* Red blistering spots on hand + feet
78
How should HFM disease be managed?
Supportive management only
79
What are some complications of HFM (3)?
* Dehydration
* Bacterial superinfection
* Encephalitis
80
What causes impetigo (2)?
* **Staph aureus** = mc
* Strep pyogenes
81
What is the typical presentation of impetigo?
Golden crusted perioral lesions
82
What are the two types of impetigo?
* Bullous (always staph aureus, more severe - can be systemic Sx)
* Non-bullous
83
What is the difference between bullies and non-bullous staph aureus?
* Non- bullous = less severe lesions around mouth
* Bullous = more severe larger fluid filled blisters that subsequently burst in various locations on body
84
How is impetigo diagnosed?
Clinically/ send swab for MC&S
85
How is impetigo treated (3)?
* Hydrogen peroxide cream 1%
* Topical Abx e.g. **fusidic acid**
* Oral flucloxacillin
86
What are some complications of impetigo (6)?
* Cellulitis
* Sepsis
* Scarring
* Post strep glomerulonephritis
* Staphylococcus scalded skin syndrome
* Scarlet fever (or staphylococcal scarlet fever
87
What is cellulitis?
Subcutaneous and dermal infection
88
What are signs/ symptoms of cellulitis (6)?
* Erythematous
* Warm
* Odematous
* Shiny
* Tense
* Systemic Sx/ sepsis
89
What bacteria causes cellulitis (3)?
* **Staph aureus**
* GAS (strep pyogenes)
* GCS (strep dysgalactiae)
90
How is the severity of cellulitis determined?
Eron classification (1-4) depending on the extent of systemic illness
91
How is cellulitis treated?
Oral/ IV flucloxacillin
*Penicillin allergy = clarithromycin*
92
How is MRSA cellulitis treated?
Vancomycin
93
What is staphylococcal scalded skin syndrome?
Infection by a type of staph aureus that produces **epidermolytic toxins A and B** that break down and damage the skin
94
What does SSSS look like?
Generalised patches of erythema on the skin followed by the formation of bullae (fluid filled blisters)
*has similar appearance to a burn*
95
What is a key differentiating feature between SSSS and SJS/TEN?
There is no mucous membrane involvement in SSSS
96
What sign is positive for SSSS?
Nikolsky sign = skin rubbing --> skin peels
97
How can diagnosis of SSSS be confirmed?
Biopsy of skin
98
How is SSSS managed (2)?
* IV fluids
* IV Abx (fluclox)
99
What are four risk factors for SSSS?
* Immunocompromised
* CKD
* < 1 year old
* Not breastfed
100
What is necrotising fasciitis?
Infection of the deep soft tissue compartments (dermis, SC tissue, fascia, muscle)
101
What is the most common cause of necrotising fasciitis?
GAS
102
What are the signs/ symptoms of NF (5)?
* Pain disproportionate to presentation
* Swelling
* Erythema (pain beyond extent of erythema)
* "Dishwater" discharge
* Systemic Sx
103
How is NF managed (2)?
* Surgical debridement
* Broad spectrum IV Abx
104
What are some risk factors for NF (3)?
* Wound/ bite
* Immunocompromise
* Prior skin condition e.g. eczema
105
What is toxic shock syndrome?
Systemic condition caused by release of bacterial toxins
106
What bacteria cause toxic shock syndrome?
* Staph aureus
* GAS
107
What are some risk factors for toxic shock syndrome (3)?
* Tampon use (absorbent and leaving it in for a long time)
* Exposed wound
* Cellulitis
108
What are the signs/ symptoms of toxic shock syndrome (5)?
* Fever
* Hypotensive
* Desquamation
* Diffuse erythematous macular papular rash
* End organ damage e.g. deranged LFTs, vomiting, raised creatinine
109
How is toxic shock managed (3)?
* ITU admission
* Supportive care
* Broad Abx
110
What are the two types of HSV?
1 and 2
111
Where does HSV-1 typically affect?
Head - oral ulcers, encephalitis
*you have 1 head*
112
Where does HSV 2 typically affect?
2 affects genitals (ulcers)
*you have 2 balls*
113
What are some complications of HSV (3)?
* Encephalitis
* Eczema herpeticum (like lots of angry chicken pox clumped together)
* Erythema multiforme
114
What is tuberculosis (name of pathogen)?
Infection with mycobacterium tuberculosis
*or sometimes mycobacterium bovis*
115
What are the stages of TB disease?
1. Ghon focus = primary granuloma
2. Ghon complex = infltrated lymph nodes
3. Miliary (disseminated severe) or latent TB
116
What are the signs/ symptoms of TB (8)?
* Haemoptysis
* Weight loss
* Night sweats
* Fever
* Meningitis
* Lymphadenopathy
* Addisons
* Erythema nodosum
117
How is TB investigated (3)?
* Manoux test (judges immune response) = past infection, latent or active
* CXR
* Sputum MC&S
118
What stain is used to diagnose TB, what colour does it turn and what is this known as?
**Ziehl Neelsen** stain turns **bright red** known as **"acid fast"**
119
What type hypersensitivity is the mannoux test?
Type 4
120
What may be seen on an X-ray of someone with TB (3)?
* Bilateral hilar infiltration
* Upper lobe consolidation
* Pleural effusion
121
How is latent TB treated?
* Rifampicin (3 months)
* Isoniazid (3 months)
*or isoniazid for 6 months*
122
How is active TB treated?
* **R**ifampicin (6 months)
* **I**soniazid (6 months)
* **P**yrazinamide (2 months)
* Ethambutol (2 months)
123
What are the side effects of TB medications?
* Rifampicin = red urine (red-am-pissing)
* Isoniazid = peripheral neruopathy (I-so-numb-am)
* Pyrazinamide = gout (py-ra-owwwwwwww-zin-a-mide)
* Ethambutol = optic neuritis (ethan's-blind)
124
What vaccine can protect against TB?
BCG vaccine
*live attenuated mycobacterium bovis*
125
Who is offered BCG vaccine?
Those at higher risk e.g. parents born in country with high levels of TB
126
What causes polio?
Poliovirus
127
What percent of polio cases are asymptomatic?
75%
128
How is polio spread?
Faeco-oral transmission
129
Is polio in the uk vaccination schedule?
Yes children are vaccinated against it as the inactivated polio vaccine
130
What is a severe complication of polio?
Paralytic polio (less than 1%)
*patients put in iron lung*
131
What are the signs/ symptoms of polio?
Fever + sore throat
132
What causes diphtheria?
Corynebacterium diphtheriae
133
What are the signs/ symptoms of diphtheria (5)?
* Fever
* Thick grey membrane covering tonsils (pseudomembrane)
* Cervical lymphadenopathy
* Stridor
* Croup like symptoms
*diphtheria can actually cause croup - used to be a common cause*
134
What is the mechanism of infection with diphtheria?
Diphtheria toxin produced when c. diphtheriae infected with bacteriophage (virus that replicates inside bacteria). This toxin causes illness
135
How is diphtheria diagnosed (2)?
* Throat swab + culture
* Elek test (determines virulence)
136
How is diphtheria treated?
* DAT (diphtheria antitoxin)
* Erythromycin/ penicillin
137
What is scabies and how does it cause infection?
**Parasitic** infection whereby they lay **eggs in skin**
138
How long do symptoms of TB typically take to develop?
8 weeks
139
What are the signs/ symptoms of scabies (2)?
* Itchy small red spots
* Track/ burrow marks
140
When are symptoms typically worse in scabies infestations?
At night, when the mites come out to play
141
Where does scabies infection typically start?
Between the finger webs
142
How is scabies diagnosed (3)?
* Usually a clinical diagnosis
* Dermoscopy
* Ink burrow test (burrows show up when ink rubbed on skin)
143
How is scabies managed (2)?
* Permethrin cream to all members of household
* Hygiene advice e.g. hoovering + washing clothes
144
What is a complication of scabies?
Crusted scabies/ norwegian scabies
145
What is an alternative treatment for crusted scabies/ difficult to treat scabies?
Oral ivermectin
146
How can itching associated with scabies be treated?
Chlorphenamine
147
What is the medical term for headlice?
Pediculus humanus capitis
148
How are headlice treated?
1. Wet combing
2. Dimeticone 4%
*treatment only indicated if a live headlice found*
149
What infection causes small spots that look like individual chicken pox?
Molluscum
150
What causes molluscum?
Molluscum contagiosum
151
What type of virus is molluscum contagiosum?
Pox virus
152
What is the presentation of molluscum?
Small flesh coloured umbilicated (dimple in middle) papules occurring in crops
153
How is molluscum treated?
Does not need treatment
154
Where does ringworm affect and what is it known as in these different areas?
* Tinea pedis = foot
* Tinea capitis = head
* Tinea corporis = body
* Tinea cruruis = groin
* Onychomycosis = fungal nail
155
How is ringworm treated?
* Clotimazole = fungal cream
* Ketonazole = fungal shampoo
* Fluconazole = oral anti fungal
156
What is tinea incognito?
Steroid cream is used to initially treat the fungal infection (as it is mistaken for dermatitis) so the fungus spreads and is less visible
157
What species of bacteria causes lyme disease?
Borrelia
158
What is the feature of Lyme disease?
Raised itchy "bulls eye" rash (erythema migrans)
159
What are some complications of Lyme disease (2)?
* Neuroborreliosis
* Joint involvement
160
How is Lyme disease treated?
Doxycycline
161
What is meningitis?
Inflammation of the meninges
162
What are the most common causes of meningitis in neonates (3)?
* GBS = MC
* Listeria
* E. coli
163
What are the most common causes of meningitis in children older than 1 month (3)?
* Neisseria meningitidis
* S. pneumoniae
* H. influenzae (up to 6 years)
164
What is the classification of Neisseria meningitidis?
Gram negative diplococci
165
What are the signs/ symptoms of meningitis in neonates (8)?
* High pitched cry
* Fever
* Respiratory distress
* Poor feeding
* Inconsolable
* Bulging fontanelle
* Vomiting
* Non-blaching rash
166
What are the signs/ symptoms of meningitis in older children (7)?
* Headache
* Fever
* Neck stiffness
* Photophobia
* Vomiting
* Drowsy
* Non-blanching rash
167
What are two special tests that indicate meningitis?
* **Kernigs test** - straightening leg when bent up to chest causes spinal pain
* **Brudzinski test** - lifting head/ neck when lying flat --> involuntary flexion of hip + knee
168
How is bacteria meningitis managed in the community?
IM benzylpenicillin
*if meningitis and non-blanching rash*
169
How is meningitis treated in hospital?
Ceftriaxone
*blood culture and LP ideally taken before antibiotics*
170
How is meningitis treated in hospital of those under 3 months?
Cefotaxime + AMOXICILLIN (for listeria cover)
171
What other medication is used to treat those with meningitis?
Dexamethasone (if child over 3 months)
172
What antibiotic is given to close contacts of those with meningitis?
Ciprofloxacin
173
What are the most common causes of viral meningitis (3)?
* HSV (most commonly 1)
* Enterovirus
* VZV
174
How can an LP differentiate between a viral and bacterial meningitis (4)?
* Appearance (bacteria = cloudy; virus = clear)
* Protein (raised in bacterial)
* Glucose (low in bacterial)
* WCC (neutrophils in bacterial; lymphocytes in viral)
175
What are some complications of meningitis?
* **Hearing loss**
* Seizures/ epilepsy
* Cognitive impairment
* CP
176
What are some contraindications to an LP (6)?
* Meningococcal septicaemia
* Bulging fontanelle
* Focal neurological signs
* Papilloedema
* GCS < 9
* Haemodynamically unstable
*essentially any signs of raised ICP*
177
What are the most common causes of encephalitis (6)?
* **HSV** (1 in children; 2 in neonates - as 2 lives in vagina) = MC
* VZV
* CMV (immunodeficiency)
* EBV
* Enterovirus
* MMR + polio
178
What are the signs/ symptoms of encephalitis (5)?
* Fever
* Headache
* Focal neurological Sx
* Seizures
* Decreased consciousness
179
How is encephalitis treated (3)?
* HSV or VZV = aciclovir
* CMV = ganciclovir
* Other causes = supportive
180
What is another name for glandular fever?
Infectious mononucleosis
181
What causes infectious mononucleosis?
EBV
182
What are some signs/ symptoms of infectious mononucleosis (5)?
* Fever
* Sore throat
* Lymphadenopathy
* Tonsillar enlargement
* Splenomegally
183
What sort of antibodies are produced in response to infectious mononucleosis and what is special about them?
Heterophile antibodies - these are non-specific to EBV
184
What are some complications of infectious mononucleosis (5)?
* Splenic rupture
* Glomerulonephritis
* Haemolytic anaemia
* Chronic fatigue
* Cancers (**burkitts lymphoma**)
185
What is important for people with infectious mononucleosis to avoid (2)?
* Alcohol (EBV decreases livers ability to process alcohol)
* Contact sport (increases risk of splenic rupture)
186
What is a common fungal infection in the mouth and vagina?
Candida infection (thrush)
187
What are the symptom of a candida infection (3)?
* White patches/ discolouration
* Vaginal discharge
* Itching
188
What age does thrush occur in the vagina and mouth?
* Mouth = young babies
* Vagina = rarely before puberty
189
What are some causes of immunodeficiency in children (5)?
* Inherited
* HIV
* Malnutrition
* Medications
* Cancer
190
What aspects of the immune system can be affected by immunodeficiency (3)?
* B-cells/ immunoglobulins
* T-cell disorders
* Complement disorders
191
What is the most severe form of inherited immunodeficiency in children?
Severe combined immunodeficiency
192
What are the key B-cell/ immunoglobulin inherited disorders (3)?
* Selective immunoglobulin A deficiency (very common often undiagnosed)
* X-linked agammaglobulinaemia
* Common variable immunodeficiency
193
How do X-linked agammaglobulinaemia and common variable immunodeficiency affect immunoglobulins?
* X-linked agammaglobulinaemia = deficiency in all Igs
* Common variable immunodeficiency = deficiency in IgG, IgA and sometime IgM
194
What are some causes of inherited T-cell disorders (3)?
* DiGeorge syndrome
* Wiskott-Aldrich syndrome
* Ataxic telangiectasia
195
Why does DiGeorge cause a T-cell deficiency?
Underdeveloped thymus gland
196
What are some inherited causes of compliment deficiencies (2)?
* C1 esterase inhibitor deficiency (hereditary angioedema)
* Mannose-binding lectin deficiency
197
What is an important step in treating children with complement deficiencies?
Vaccinations - particularly against encapsulated organisms
198
What medications can cause immunodeficiency (3)?
* Chemotherapy
* Steroids
* DMARDs
199
How does HIV usually present?
* Initial flu like illness
* No other Sx until immunodeficiency occurs
200
What does AIDS stand for?
Acquired immunodeficiency syndrome
201
What cells does HIV enter, destroy and replicate in?
CD4 (T helper cells)
202
How can HIV be spread (3)?
* Blood
* Sex
* Vertical
203
What are 3 ways vertical transmission can take place?
Pregnancy, birth or breastfeeding
204
How should babies be deliver if the mother has HIV (2)?
* Vaginal if the viral load is low
* C-section if the viral load is high
205
What medication can be given to prevent vertical transmission of HIV during a c-section?
Zidovudine IV
206
How is HIV managed (3)?
* Antiretroviral
* Vaccination (live are avoided if immunosuppression severe)
* Treatment of opportunistic infections
207
What are the principles of testing babies of HIV positive parents (3)?
* Test at 3 months if at risk
* Test again at 24 months
* Tests can be positive for 18 months due to antibodies crossing the placenta
208
What are some symptoms/ signs of immunodeficiency in children (5)?
* Recurrent infections (especially LRTI)
* Unusual infections
* Chronic diarrhoea
* Failure to thrive
* Appearing well, but with a serious illness
209
What infectious diseases do not need to be excluded from school (6)?
* Roseola infantum
* Infectious mononucleosis
* Headlice
* Threadworms
* Hand foot and mouth
* Slapped cheek
210
What infectious disease can go back to school after 24 hours of antibiotics?
Scarlet fever
211
What infectious disease can go back to school 2 days after antibiotics?
Whooping cough
212
What disease can go back to school 4 days after rash onset?
Measles
213
What disease can go back to school 5 days after rash onset?
Rubella
214
What disease can go back to school after all lesions crusted over?
Chickenpox
215
What disease can go back to school 5 days after onset of swollen glands?
Mumps
216
What disease can go back to school after symptoms have settles for 48 hours?
Diarrhoea and vomiting
217
What disease can go back to school after lesions crusted and healed or 48 hours after antibiotics?
Impetigo
218
What disease can go back to school once treated?
Scabies
219
What disease are noticeable to PHE (11)?
* COVID-19
* Diphtheria
* Scarlet fever
* Haemolytic uraemic syndrome
* Measles
* Meningococcal septicaemia
* Mumps
* Rubella
* Invasive group A strep
* TB
* Whooping cough
*amongst other more rare ones*
