Flashcards in Peds Infectious Diseases Deck (154):
Avoid tetracycline and minocycline in kids <____ years old
Fluoroquinolone ophthalmic solutions not ind. in children <___ years old
Which layers of the meninges are involved with meningitis?
pia and arachnoid
At what age is the greatest chance of getting bacterial meningitis?
1st month of life
What are the most common causes of bacterial meningitis in the neonate?
Group B strep and E. Coli
Petechiae and purpura are most common with bacterial meningitis d/t what?
What will the CSF show if a pt has bacterial meningitis?
Elev. CSF protein, decreased CSF glucose
Typical empiric abx tx for neonates with meningitis typically includes?
ampicillin, gentamycin, +/- cefotaxime
What abx are used to treat bac. meningitis if it is for an infant or child?
3rd gen ceph and vanco
If a neonate survives meningitis, what should be evaluated after recovery?
What is the most common cause of viral meningitis?
What is the clinical presentation of enterovirus infections?
conjunctivitis, pharyngitis, rash, herpangina, hand-foot and mouth disease
What diagnostic study do you want to get if you suspect HSV encephalitis in a kid?
What type of conjunctivitis is more common in kids?
Bacterial conjunctivitis in kids is usually caused by what 3 bacteria?
H flu, M. catt, strep pneumo
First line therapy for bacterial conjunctivitis?
erythromycin ophthalmic ointment or polymyxin/trimethoprim drops
If conjunctive has a "bumpy" appearance, what should you think of?
What sinuses are present at birth?
maxillary and ethmoid
By what age do sphenoid sinuses normally develop?
These sinuses develop by 7-8 years of age
Children <6 have an avg of ?? colds per year with typical symptom duration of 14 days
Is a fever more or less common with school-aged children that have the common cold?
What should you tell parents to avoid when their child has a cold when their child is <12?
OTC cough and cold meds
What are the most common pathogens for acute bacterial rhinosinusitis?
m. catt, h flu, s. pneumo
When a child has a cold, when should you worry about acute bacterial rhinosinusitis?
If symptoms are present for > or equal to 10 days WITHOUT improvement
When is imaging necessary for acute bacterial rhinosinusitis?
If complications are suspected
What meds are NOT recommended for acute bacterial rhinosinusitis?
Complications of acute bacterial rhinosinusitis?
intracranial extension, periorbital and orbital cellulitis, septic cavernous sinus thrombosis, meningitis or brain abscess, osteomyelitis, epidural or subdural abscess
When is it considered chronic rhinosinusitis?
complex inflammatory condition of the paranasal sinuses lasting >12 weeks despite medical therapy
What are the most common pathogens of otitis externa?
P. aeruginosa, S. epidermidis, and S. aureus
This condition commonly presents with ear pain, pruritis, discharge and hearing loss
With this ear condition, the TM should have NORMAL mobility but have evidence of erythema/edema?
What age group has the peak occurence of otitis media?
btw 6-18 mos
When should you worry about eardrum rupture?
If sudden drainage occurs from the ear
Bulging TM think?
Are decongestants/antihistamines rec. for AOM?
When are abx useful with acute otitis media?
if the child is 2 with bilateral disease or otorrhea
First line therapy if abx are used for AOM?
What is 2nd line therapy for AOM?
When is AOM considered recurrent?
> or equal to 3 distinct and well documented episodes of AOM within 6 mos or > or equal to 4 episodes or AOM within 12 mos
What are treatment options for recurrent AOM?
Abx prophylaxis or refer for tympanostomy tubes
Presence of a middle ear effusion in the absence of acute signs/symptoms of infection is?
Serous Otitis Media
Serous Otitis Media is accompanied by ?
conductive hearing loss
Treatment options for serous otitis media?
referall for surgery or watchful waiting
EBV infection begins with?
malaise, HA, low grade fever
What will a PE look like with someone with EBV/Mono?
exudative tonsillopharyngitis, posterior cervical LAD, +/-spleno and hepatomegaly, and occ. rash
What is the most common cause of sore throat?
CBC will reveal what if someone has mono?
bacterial tonsillopharyngitis is typically d/t ?
Group A strep
What are signs/symptoms of group A strep infection?
scarlatiniform rash, palatal petechiae, pharyngeal exudate, vomiting, and tender cervical lymph nodes
Common age for bacterial strep?
Bacterial tonsillopharyngitis involves ANT or POST cervical LAD?
What should you do if you think your patient has bac. strep throat but their rapid strep test is neg?
Should get confirmatory throat culture
What is the treatment for bacterial tonsillopharyngitis?
PCN V or amoxicillin; erythromycin if PCN allergy
When is strep throat no longer considered contagious?
until 24 hours after abx are started
What are Pastia's lines?
bright red color in creases of the underarm of someone who has scarlet fever
What is the treatment for scarlett fever?
PCN V or amoxicillin (same as for strep)
This condition typically occurs 14-28 days after strep throat or scarlett fever?
Rheumatic fever most commonly affects kids of what ages?
Pancarditis that results in chest pain and dyspnea is usually?
Erythema marginatum and sydenham chorea can be assoc. with what condition?
What condition will you have an elevated or rising antistreptolysin O Ab titer?
What may a CBC show with Rheumatic Fever?
mild normochromic, normocytic anemia
Treatment of Rheumatic Fever?
Abx (acute and long term prophylaxis), antiinflammatories, and possibly antiepileptics if sydenham chorea is severe
What are the most common VALVULAR complications of Rheumatic Fever?
mitral and aortic stenosis
This disease is characterized by a thick pharyngeal membrane and marked cervical adenopathy
What are the "3 D's" assoc. with? (drooling, dysphagia, and distress)?
How is someone's voice described if they have epiglottitis?
"hot potato" voice
What is the "classic presentation" of someone with epiglottitis?
respiratory distress, anxiety and the characteristic "tripod" or "sniffing" position
Thumbprint sign = ?
Treatment of epiglottitis?
Admit to hospital (ICU), maintain airway, broad spectrum abx, +/- CS, supportive care
Pharyngeal abscesses generally affect kids < what age?
Symptoms of this disease can include dysphagia, stiff neck, torticollis, changes in voice quality, respiratory distress, neck swelling, trismus, chest pain and often have a fever
Imaging for a potential pharyngeal abscess can include?
lateral neck Xray or CT
Tx of pharyngeal abscesses include?
Hospitalize, maintain airway, may req. surgical drainage, abx, supportive care
What are the "more serious" complications of the Mumps?
meningitis, encephalitis, and orchitis
What is the treatment for mumps?
Acute bronchiolitis is usually caused by?
This condition usually affects kids <2 and usually occurs in the winter months?
What is the typical course of acute bronchiolitis?
typically begins with 1-3 day hx or URI symptoms followed by fever, cough and mild resp. distress
Auscultory findings with acute bronchiolitis?
exp. wheezing, prolonged exp phase, coarse and fine crackles
What treatments are NOT rec. for acute bronchiolitis?
GC, Abx, antivirals, hypertonic saline, heliox
What meds can you trial with acute bronchiolitis?
How is a diagnosis of RSV confirmed?
analysis of respiratory secretions
Treatment of RSV? Infants? Older kids?
Supportive, older kids you can trial CS but not in infants
This resp. illness is char. by inspiratory stridor, cough, and hoarseness
What is the hallmark sign of Croup?
Is croup more common in boys or girls?
What virus most commonly causes Croup?
parainfluenza type 1
How long do Croup symptoms usually last?
The "steeple sign" on Xray indicates what?
subglottic narrowing (Croup)
What treatment can you possibly consider in Croup?
Single dose of CS
If patient has Croup with significant stridor, what therapy may you consider?
Which pulm disease is assoc. with 3 different stages?
What is the "catarrhal" stage of pertussis?
nonspecific prodrome lasting 1-2 weeks
What is the "paroxysmal" stage of pertussis?
persistent coughing attacks lasting 2-6 weeks
What is the "convalescent" stage of pertussis?
cough decreases over several weeks to mos.
How do you treat pertussis?
abx if early in course (macrolides = 1st line), supportive care, bronchodilator therapy
When can kids with pertussis return to school?
5 days after Abx therapy
Obtain PA/AP view for CXR if child in question of PNA is <4?
If child you think has PNA is >4, what view CXR should you obtain?
When should you always hospitalize if a child has PNA?
If they are <3-6 months old with suspected bac. PNA
What is first line therapy for O/P tx of PNA?
What is generally first line tx of PNA if the patient is in the hospital?
3rd gen. ceph
VIRAL PNA is more likely to occur when child has exposure to ?
Most common symptoms/signs of this are fever, cough, tachypnea, malaise, emesis, hypoxemia, decreased breath sounds, and crackles
Bac. PNA in neonates is usually d/t?
Group B strep
Infants and children <5, which type of PNA is more common?
Children >5, what is the most common type of PNA?
Bacterial, S. pneumo, M. pneumo, and chlamydophilia pneumo
HSV 1 is commonly referred to as?
How does HSV 1 usually present in kids?
What other condition can occur with HSV 1 in kids?
What can in utero transmission of HSV cause?
hydrops fetalis and fetal in utero demise
This disease affects everywhere on the body EXCEPT the mucous membranes?
This disease has a course of 3-5 days of high fever followed by a rash
What is roseola infantum usually caused by?
herpes virus 6
What age is typically affected by roseola infantum?
young kids, btw 7-13 months of age
What type of rash does someone get with roseola infantum?
blanching macular or maculopapular rash
How long does the rash of roseola infantum persist usually?
Treatment of roseola infantum?
supportive, typically is self-limiting, can control fever with tylenol
Acute febrile illness of unk etiology = ?
This disease usually affects kids >5 and affects more boys than girls
W/ Kawasaki disease, what do symptoms occur from?
they occur as a result of widespread inflamm of medium and small sized blood vessels
If you have a kid with a fever that persists 7-10 days and is resistent to antipyretics, what should you think of ?
Besides fever, what other symptoms are common with Kawasaki disease?
mucocutaneous inflamm--bilat. conjunctivitis, erythema of the lips and oral mucosa, rash
Conjunctivitis and strawberry tongue....think?
What is the treatment of kawasaki disease?
IVIG and ASA
What test should a kid with Kawasaki disease have at diagnosis and 6-8 weeks after onset?
Erythema infectiosum is caused by?
What is erythema infectiousum?
a viral illness that leads to rash on cheeks, arms and legs
Erythema infectiosum occurs most often in what season?
With this disease, the kid's rash fades from the center outwards, giving a lacy appearance and typically resolves within 1-2 weeks
Tx of erythema infectiosum?
Self limited, no tx
What are other names for erythema infectiosum?
Fifth disease, Slapped Cheek
How long is someone infected with Measles usually before they have symptoms?
What does the "prodrome" for measles look like?
fever, malaise, anorexia followed by conjunctivitis, coryza, and cough
What is the sign that is pathognomic for measles?
What is rash like assoc. with measles?
maculopapular, blanching rash beg. on the face and spreading cephalocaudaly
How long does a measles rash typically last? What happens after?
3-4 days, followed by fine desquamination
Tx of Measles?
With this disease, you worry about congenital infections?
_______= "3 day" or "German" measles
All pregnant women are tested for immunity to this bc of risk of congenital infections?
What is the most frequent defect assoc. with congenital rubella infection?
hearing loss, foll. by mental retardation, C/V defects and ocular defects
When is antiviral treatment indicated for chickenpox?
If the child is >12
Hand, foot and mouth disease is caused by ?
enteroviruses (coxsackie A16)
What age of kids usually get Hand, foot, and mouth disease?
Rash for this disease are usually on the palms of the hands and soles of the feet?
Hand, foot, and mouth disease
Is there a vaccine to prevent Hand, foot and mouth disease?
What is the most sig. cause of ped. viral gastroenteritis worldwide?
Disease occurence of rotavirus increases in what season(s)?
winter and spring
Is there a vaccine available for rotavirus?
What are RotaTeq and Rotarix vaccines for?