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Flashcards in peds82 Deck (49):
1

reactive lymphadenitis

occurs in response to infections in the pharynx, teeth, and soft tissues of the head and neck

2

viral infections that can cause cervical lymphadenitis

EBV, CMV, and HIV, among others

3

kawasaki disease and cervical lymphadenitis

may present with cervical lymphadenitis (in fact, enlarged cervical lymph node is one of the diagnostic criteria)

4

toxoplasma gondii and cervical lymphadenitis

can cause a mono-like disease with cervical lymphadenopathy

5

how can structural lesions in the neck cause a cervical lymphadenitis

can become infected and drain to the lymph nodes in the neck

6

what do the lymph nodes in cervical lymphadenitis look like?

mobile, tender, warm, and enlarged, and the overlying skin is erythematous. Fluctuance may be present

7

management of cervical lymphadenitis

empiric antibiotics directed at strep and staph; initial treatment may include a first gen cephalosporin or an anti-steph penicillin for 7-10 days

8

parotitis

inflamm of the parotid salivary glands

9

etiology of parotitis

mumps and other viruses; bacterial parotitis

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difference in presentation between bacterial and viral parotitis

viral has bilateral involvement; bacterial is unilateral

11

causes of bacterial parotitis

aka acute suppurative parotitis; caused by staph aureus, strep pyogenes, and M tuberculosis

12

clincial features of parotitis

swelling centered above the angle of the jaw and fever; exam of the pharynx may reveal pus expressed from stenson's duct

13

most common cause of viral parotitis

mumps (before vaccination)

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complications of acute suppurative parotitis

formation of an abscess anad osteomyelitis of the jaw

15

impetigo

superficial skin infection involving the upper dermis

16

causative organisms in impetigo

stap aureus and GABHS or strep pyogenes

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clinical features of impetigo

honey colored crusted or bullous lesions are present, commonly on the face, esp around the nares; fever usually absent; infection is easily transmitted

18

management of impetigo

treatment may include topical mupirocin or oral antibiotics like dicloxacillin, cephalexin, or clindamycin

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complications of impetigo

bacteremia, post-strep glomerulonephritis (tx of impetigo does not prevent this), and staph scalded skin syndrome (SSSS)

20

erysipelas

skin infection that involves the dermal lymphatics

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causative organism in erysipelas

GABHS

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clinical features of erysipelas

tender, erythematous skin with a distinct border. Face and scalp are common locations

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management of erysipelas

systemic abx aganst GABHS

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complications of erysipelas

bacteremia, post-strep glomerulonephritis, and necrotizing fasciitis

25

cellulitis

skin infection within the dermis

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causes of cellulitis

staph aureus and GABHS

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infected skin border in erysipelas vs cellulitis

in cellulitis border is indistinct

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management of cellulitis

oral or IV abx (first gen cef or anti staph penicillins)

29

buccal cellulitis

unilateral bluish discoloration of the cheek of a young immunized child

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causative agent in buccal cellulitis

HIB

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what does a child with buccal cellulitis look like?

toxic, and blood cultures usually pos

32

management of buccal cellulitis

IV antibiotics against H influenza, usually a second or third gen cephalosporin; perform LP

33

perianal cellulitis

well-demarcated erythema involveing the skin around the anus

34

how might kids with perianal cellulitis present

constipation

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cause of perianal cellulitis

GABHS

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managmenet of perianal cellulitis

oral antibiotics (cephalaxin, dicloxacillin)

37

necrotizing fasciitis

potentially fatal form of deep cellulitis that extends into the muscle; pain and systemic findings out of proportion to physical findings;

38

causative organisms in necrotizing fasciitis

polymicrobial; may involve GABHS and anaerobic bacteria

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therapy for necrotizing fasciitis

IV antibiotics and surgical debridement are essential components of therapy

40

staph scalded skin syndrome

staph aureus produces a toxin that caues fever, tender skin, and bullae; large sheets of skin slough off; Nikolsky sign is present

41

Nikolsky sign

extension of bullae when pressure is applied to the skin (skin pulls away w lateral pressure)

42

management of SSSS

good wound care and IV antibiotics against Staph aureus

43

scarlet fever

toxin-mediated bacterial illness that results in a characteristic skin rash

44

cause of scarlet fever

GABHS that produces an erythrogenic toxin

45

transmission of scarlet fever

large respiratory droplets or by infected nasal secretions

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clinical features of scarlet fever

exanthem tha develops during any GABHS infection (impetigo, cellulitis, pharyngitis); before or during exanthem, fever, chills, often exudative pharyngitis

47

what does the exanthem of scarlet fever look/feel like?

begins on trunk and moves peripherally; skin is erythematous with tiny skin colored papules ("scarlitiniform") and has texture of sandpaper; rash blanches; petechiae localized within skin creases in a linear distrib (Pastias lines)

48

pastia's lines

petechiae are often localized within skin creases in a linear distribution; seen in scarlet fever;

49

desquamation of dry skin occurs as scarlet fever rash resolves

right; so do not worry if you see it