W12_08 pediatric infectious diseases Flashcards Preview

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Flashcards in W12_08 pediatric infectious diseases Deck (28):
1

what are the big six infectious diseases killers?

HIV/AIDS;
tuberculosis;
pneumonia/influenza;
diarrheal diseases;
malaria;
measles

2

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

3

when does the mother give the baby transplacental maternal IgG?

rule of thumb: 28 weeks

4

what are three anatomical challenges that predisposes kids to infections?

narrower airways;
eustachian tube angle predisposes to ear infection;
anatomic malformations may be present (vesicoureteral reflex)

5

note: age affects disease severity

e.g. rubella is devastating in infants but not a problem in children

6

define fever without a souce in an infant

acute febrile illness without apparent etiology

7

define serious bacterial infection

meningitis, sepsis, bone & joint infections, UTI, pneumonia, enteritis

8

define toxic appearance

clinical picture consistent with the sepsis syndrome

9

what's the incidence of a serious bacterial infection in a child with a toxic appearance?

15-20%

10

what's the management of a serious bacterial infection suspicion?

full septic workup =
CBC/blood culture;
urinalysis and urine culture;
lumbar puncture;
CXR;
stool microscopy and culture

11

what are some life-threatening bacteria infections in infants?

e-coli;
GBS;
listeria monocytogenes

12

what are some life-threatening viruses infections in infants?

herpes simplex virus;
enteroviruses and parechoviruses

13

if meningitis suspected, would you choose gentamycin or cefotaxime?

cefotaxime - 3rd gen ceph has better BBB penetration

14

ampicillin covers E coli, group B strep, and listeria

ok

15

if you suspect herpes simplex virus in an infant, which drug do you give?

acyclovir;
note, it's a tough decision because of side effects of drug

16

pneumonia, septicemia, and meningitis may indicate what?

early onset GBS infection (< 7 days)

17

meningitis, osteomyelitis, soft tissue infections, sepsis may indicate what?

late onset GBS infection (> 7 days)

18

how to manage the GBS infection?

ampicillin and maybe gentamycin;
iv fluids, inotropic support for hypotension, ventilatory support

19

what's the maternal treatment for GBS infection?

penicillin G (no resistance)

20

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

21

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

22

note:neurological symptoms of HSV tend to come later than the skin or disseminated symptoms (assuming the HSV is targeting that region)

ok

23

what's the diagnosis for HSV?

PCR or culture the lesions and bodily fluids;
lumbar puncture essential in all cases

24

what's the treatment for HSV?

IV acyclorvir 60 mg/kg/day

25

the risk of bacterial infection in 1 month old neonates is high even in those without symptoms

ok

26

what are common bacterial pathogens of the 29-90 day infant group?

same as the neonates, but with added
strep pneumo;
n.meningitidis;
staph aureus;
group a strep

27

what's the more common infection in the 3-36 month old child?

viral - treatment most often is to just watch

28

note: you can start to use vancomycin in children older than 1 month for suspected meningitis

ok

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