Paeds (Infection and Immuno) Flashcards
(32 cards)
Measles
Prodrome: irritable, conjunctivitis, fever, Koplik spots (white spots “grain of salt” on buccal mucosa)
Rash: starts behind face (ears) then spreads to whole body, discrete maculopapular rash becoming blotchy and confluent and koplik spots (white papules on the buccal mucosa that often present before the rash)
High fever, cough, coryza, irritability, red eyes and poor appetite.
Vaccination schedule: 2 months
5in1- DTaP/IPV(polio)/Hib
PCV (pneumococcal)
Rotavirus
Vaccination schedule: 3 months
5in1- DTaP/IPV(polio)/Hib 2nd dose
Men C
Rotavirus 2nd dose
Vaccination schedule: 4 months
5in1- DTaP/IPV(polio)/Hib 3rd dose
PCV (pneumococcal) 2nd dose
Vaccination schedule: 12-13 months
Hib/Men C booster
MMR
PCV (pneumococcal) 3nd dose
Vaccination schedule: 2, 3, 4 yrs plus years 1 + 2 school
Flu vaccine
Vaccination schedule: From 3 yrs 4 months up to year 1 school
MMR 2nd dose
4 in 1 pre-school booster - DTaP/IPV
Vaccination schedule: 12- 13 yrs girls
HPV
Vaccination schedule: 13-18 years
3in1 booster - TD/IPV
Vaccination schedule: 13-15 years
Men C booster
Chicken pox
Initial mild flu-like symptoms
Itchy, pustular rrash, starting on head/trunk before spreading.
Initially macular then papular then vesicular
The infection may spread from about 2 days before appearance of rash. They remain infectious for roughly 5-7 days after the appearance of the rash and until the last lesions have burst and crusted over.
Incubation period : 10-21 days
Incubation period
period of time between exposure to an infection and the appearance of the first symptoms.
Common complications of measles
common: otitis media, pneumonia
uncommon: bronchitis, Encephalitis, meningitis
Common complication of mumps
Orchitis (nflammation of the testes)
Scarlett fever
- sandpaper rash (facial sparing)
- swollen “strawberry” tongue
- rash starting on abdomen and spreading to back and limbs
- lymphadenopathy.
Mx:
- 10-day course of penicillin V for an underlying group-A strep
- advised to stay off school for 24h after starting the antibiotics
- and public health should be notified.
Kawasaki disease
4/5 features with fever for >5 days: Bilateral conjunctivitis Cervical lymphadenopathy Polymorphic rash Cracked lips/strawberry tongue Oedema/desquamation of the hands/feet
Complications
coronary artery aneurysm- screened via echo
Pityriasis rosea
- related to HHV 7
- self-limiting rash 6-12 weeks
- recent viral infection- herald patch (usually on trunk)
followed by erythematous, oval, scaly patches which follow a characteristic distribution with the longitudinal diameters of the oval lesions running parallel to the line of Langer. [‘fir-tree’ appearance]
Mx of measles infection
supportive care- antiprexial
vitamin A if >2y
Glandular fever
infectious mononucleosis (EBV)
positive ‘Paul Bunnell’ test
Clinical features: sore throat, flu-like symptoms, fatigue and cervical lymphadenopathy
Mx bacterial meningitis
<3 months old:
- Antibiotics: IV ampicillin/amoxicillin + cefotaxime
>3 months old:
- IV ceftriaxone
- If shocked: fluid bolus of 20 ml/kg sodium chloride 0.9% over 5–10
- if signs of raised ICP - dexamethasone
1st line Mx impetigo
- topical fusidic acid
- school exclusions until lesions have crusted over
Advice on infection for pt with slapped cheek syndrome
Once the rash appears, children are no longer infectious.
Advice on infection for pt with Scarlett fever
Children remain infectious until 24 hours after the first dose of antibiotics.
Management of croup
acronym ODA
Oxygen (humidified)
Dexamethasone PO 0.15g/kg or budesonide neb 2mg
Severe: Adrenaline nebulised (5ml 1:5000) (0.4ml/kg
