27 May Ped Infectious Diseases Flashcards
Newborn found to have macrocephaly, corioretinitis, calcifications intracranially. Dx?
These are the classic Sx of congenital Toxoplasmosis
Newborn with IUGR found to have cloudy lenses and hearing loss. Dx? Other common finding in this syndrome?
Congenital Rubella Syndrome
Most commonly due to infection of mother during 1st trimester.
Also commonly have PDA
What diseases require prenatal antiviral therapy and cesarian delivery to decrease transfer to baby?
HIV and Genital Herpes
It is important to not have active herpes lesions during delivery or do a C-section
What is herpangina?
Mouth blisters caused by coxsackie A virus
Most common in kids and in the summer
Causes fever, sore throat, blistering lesions in the mouth
Self-limited, no treatment, Dx clinical
What are leptomeninges?
Pia and arachnoid mater
What is beta trace protein?
Protein produced by the leptomeninges
Can be used to Dx CSF leak from nose and ears and can also be used to estimate GFR
Explain CSF analysis for infectious causes of meningitis such as Bacterial, TB, Viral, Guillain-Barre
Normal: Glucose (40-70), Protein (less than 40), WBC’s (0-5)
Bacterial: Glucose low, Protein high (over 250), WBC’s high (over 1,000)
TB Meningitis: Glucose really low (less than 10), WBC’s elevated but less than 1,000, Protein over 250 like bacterial
Viral: Glucose normal, WBC’s elevated but less than 1,000, protein elevated but less than 100
Guillain-Barre: normal glucose and WBC, but very high protein
What might be the cause of CSF analysis of:
Glucose 40
Protein 250
WBC 1,000
Bacterial (Low glucose, high WBC, lots of protein)
What might be the cause of CSF analysis of:
Glucose 10
Protein 250
WBC 500
TB (really low glucose, lots of protein)
What might be the cause of CSF analysis of:
Glucose 60
Protein 100
WBC 200
Viral (normal glucose, moderate protein, elevated WBC)
What might be the cause of CSF analysis of:
Glucose 60
Protein 500
WBC 4
Guillain-Barre (normal glucose and WBC but really high protein)
What congenital syndrome causes limb hypoplasia, cataracts, and skin scarring?
Congenital varicella syndrome
What are the classic findings of congenital syphilis?
Hepatomegaly, maculopapular rash, sniffles, osteoarticular destruction
What causes toxoplasmosis? How is it acquired?
Toxoplasma gondii
An intracellular parasite from cat feces, undercooked meat, unwashed vegetables
What are the two more common causes of chorioretinitis?
Toxoplasmosis and CMV
What is the treatment for Enterobius vermicularis infection?
This is pinworm where the eggs are laid around the anus leading to itching at night.
Albendazole and pyrantel pamoate are first line with the latter for pregnant patients. All household members should be treated as this is highly infectious.
What are the disease features of Chagas disease and the causative agent? Tx?
Trypanosoma cruzi
Cardiomyopathy, RBBB, megacolon, megesophagus
First line treatment is Benznidazole
How does strongyloidiasis present? Tx? Other disease treated with same medication?
Urticaria, abdominal pain, respiratory problems including cough dyspnea and wheezing
Tx is Ivermectin which also treats Onchocerciasis or river blindness
What are the primary uses for metronidazole?
Protozoan infections like amebiasis, trichomonas vaginitis, as well as intraabdominal anaerobic infections such as diverticulitis, peritonitis, cholangitis, and abscesses
What is quinine used for?
Treats malaria that is resistant to chloroquine
What are the disease features of amebiasis?
Acute dysentery and liver abscesses
What are the primary causes of osteomyelitis in kids with and without sickle cell disease?
Healthy Kids: Staph. aureus
SCD: Salmonella most but also S. aureus
What is the treatment for osteomyelitis in kids?
Most commonly caused by Staph and Salmonella
Must cover Staph with either Nafcillin/Oxacillin if no MRSA suspected and use Clindamycin or Vancomycin if MRSA suspected
Add 3rd gen. cephalosporin in SCD
What are three common causes of neonatal conjunctivitis?
First 24 hrs: chemical caused by silver nitrate ophthalmic prophylaxis
2-5 days: gonococcal
5-14 days: chlamydia
What is the finding on gram stain for gonorrhea infections?
Intracellular gram negative diplococci
What is the difference between gonococcal and chlamydial conjunctivitis in a neonate? How are they treated?
G tends to be more severe with marked eye swelling, profuse purulent discharge, and corneal edema/ulceration that appears 2-5 days after birth
Tx with one dose of IM 3rd gen cephalosporin
C tends to be less severe with mild eye swelling, serosanguinous or mucopurulent discharge appearing 5-14 days after birth
Tx with PO macrolide
