14. Complex and unusual paediatric infections

Question 1

Kawasaki disease:

Answer 1

Necrotising panvasculitis of early childhood

May develop coronary artery lesions

Question 2

Kawasaki disease symptoms:

Answer 2

Fever for 5 days +4-5 symptoms:

1) Oropharyngeal changes
2) Bilateral conjunctivitis
3) Peripheral oedema
4) Polymorphic rash
5) Lymphadenopathy

Question 3

Kawasaki disease treatment

Answer 3

• Aspirin
• Steroids
• Anti-TNF (infliximab)
• High dose IVIG 2g/kg

Question 4

Tuberculosis diagnosis:

Answer 4

TST (tuberculin skin test)>5mm, positive sputum, CXR changes

Question 5

Tuberculosis symptoms:

Answer 5

Fever, night sweats, weight loss, cough, rigours

Question 6

Tuberculosis pathogen:

Answer 6

Mycobacterium tuberculosis, acid fast bacillus (purple on Ziehl-Neelsen)

Question 7

Active TB with no CNS involvement treatment:

Answer 7

6 months of Rifampicin and Isoniazid + 2 months of Pyrazinamide and Ethambutol

Question 8

TB meningitis treatment:

Answer 8

12 months of Isoniazid + 2 months of Pyrazinamide + Steroids

Question 9

Latent TB infection treatment:

Answer 9

3 months of Rifampicin and Isoniazid OR 6 months Isoniazid alone