Flashcards in W12_08 pediatric infectious diseases Deck (28)
what are the big six infectious diseases killers?
note: newborns don't have an adaptive system - no T cells, so typically T-cell independent responses
thus they have poor responses to polysaccharide antigens
when does the mother give the baby transplacental maternal IgG?
rule of thumb: 28 weeks
what are three anatomical challenges that predisposes kids to infections?
eustachian tube angle predisposes to ear infection;
anatomic malformations may be present (vesicoureteral reflex)
note: age affects disease severity
e.g. rubella is devastating in infants but not a problem in children
define fever without a souce in an infant
acute febrile illness without apparent etiology
define serious bacterial infection
meningitis, sepsis, bone & joint infections, UTI, pneumonia, enteritis
define toxic appearance
clinical picture consistent with the sepsis syndrome
what's the incidence of a serious bacterial infection in a child with a toxic appearance?
what's the management of a serious bacterial infection suspicion?
full septic workup =
urinalysis and urine culture;
stool microscopy and culture
what are some life-threatening bacteria infections in infants?
what are some life-threatening viruses infections in infants?
herpes simplex virus;
enteroviruses and parechoviruses
if meningitis suspected, would you choose gentamycin or cefotaxime?
cefotaxime - 3rd gen ceph has better BBB penetration
ampicillin covers E coli, group B strep, and listeria
if you suspect herpes simplex virus in an infant, which drug do you give?
note, it's a tough decision because of side effects of drug
pneumonia, septicemia, and meningitis may indicate what?
early onset GBS infection (< 7 days)
meningitis, osteomyelitis, soft tissue infections, sepsis may indicate what?
late onset GBS infection (> 7 days)
how to manage the GBS infection?
ampicillin and maybe gentamycin;
iv fluids, inotropic support for hypotension, ventilatory support
what's the maternal treatment for GBS infection?
penicillin G (no resistance)
what's the threshold for WBC count in a baby that looks well and with risk of maternal GBS infection?
if WBC < 5, then FSWU and treat pending culture results
note: you cannot exclude HSV infection in the infant on the basis of maternal history
60-80% of women who deliver an HSV infected child have never had genital lesions
note:neurological symptoms of HSV tend to come later than the skin or disseminated symptoms (assuming the HSV is targeting that region)
what's the diagnosis for HSV?
PCR or culture the lesions and bodily fluids;
lumbar puncture essential in all cases
what's the treatment for HSV?
IV acyclorvir 60 mg/kg/day
the risk of bacterial infection in 1 month old neonates is high even in those without symptoms
what are common bacterial pathogens of the 29-90 day infant group?
same as the neonates, but with added
group a strep
what's the more common infection in the 3-36 month old child?
viral - treatment most often is to just watch