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HD CC > Bacterial, fungal and protozoal infections in childhood > Flashcards

Bacterial, fungal and protozoal infections in childhood Flashcards

1
Q

Bacteria (prokaryotes)

A 
0.2-2 micro M diameter
Single, circular chromosome
No nucleus
No organelles
Divide by binary fission
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2
Q

Fungi, Protozoa (eukaryotes)

A 
10-100 micro M diameter
Multiple, linear chromosomes
Membrane-bound nucleus
Membrane-bound organelles
Divide by mitosis
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3
Q

Bacterial toxins- Exotoxins

A

Proteins secreted by pathogen

e.g. cholera diarrhoea

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4
Q

Diphtheria

A

Corynebacterium diphtheriae
Sore throat
Fever

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5
Q

Diphtheria toxin

A

Diphtheria toxin (A+B subunits)
–> inhibits protein synthesis
Heart- myocarditis, heart block
Nerves- difficulty swallowing, paralysis, diplopia

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6
Q

Bacterial toxins- Endotoxin

A

Part of outer membrane of Gram-negative bacteria
Released during lysis of organism
Lead to macrophage activation

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7
Q

Pathogenesis of Meningococcal Septicaemia

A

Activation of inflammatory cascade via LPS
IL-6 and TNF-alpha
Myocardial depression
Coagulopathy
Endothelial dysfunction –> capillary leak and shock

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8
Q

Children differences to adults

A

Immunological- immaturity, lack of memory
Anatomical- thinner skin, shorter airways, anatomy of Eustachian tube –> otitis media
Exposure- hygiene, nursery/day-care

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9
Q

Fever

A

Temp > 37.8
Mouth- 0.5 less than rectal temp
Armpit- 1 degree less than rectal temp
Ear- similar to rectal core temp

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10
Q

Severe bacterial illnesses

A 
Septicaemia
Meningitis
Pneumonia
Epiglottitis
Septic arthritis
Osteomyelitis
TB
Tetanus
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11
Q

Common bacterial illnesses

A 
Tonsillitis
Otitis media
UTI
Gastroenteritis
Impetigo
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12
Q

Organisms that cause septicaemia + meningitis

A

Streptococcus pneumoniae
Neisseria meningitidis (group B + C, increase in group W in students)
Haemophilus influenzae B (HiB)

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13
Q

Recognising septicaemia

A 
Tachycardia
Tachypnoea
Prolonged capillary refill
Low BP (late sign)
Rash
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14
Q

Clinical presentation meningitis

A

Not able to tolerate bright lights
Drowsy
Stiff neck

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15
Q

Meningitis diagnosis

A

CSF- lumbar puncture

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16
Q

CSF changes in meningitis- Bacterial

A

Cloudy
polys +++
Protein 0.2-1
<60% of blood glucose

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17
Q

CSF changes in meningitis- Viral

A

Clear CSF
lymphs ++
Protein 0.15-0.45
Normal glucose

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18
Q

CSF changes in meningitis- TB

A

Opalescent
lymphs ++
Protein 0.3-2
<60% of blood glucose

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19
Q

Top 3 organisms in young infants

A

Group B Strep
E. Coli
Listeria

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20
Q

Older children antibiotic

A

Ceftriaxone

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21
Q

Young infant antibiotic (<3 months)

A

Cefotaxime or ceftriaxone

Amoxicillin also needed for listeria cover

22
Q

Neonatal Sepsis

A

Maternal colonization with pathogens- colon, vaginal canal
Early onset- within 48 hours
Late onset- meningitis, bones and joints

23
Q

Gram-positive Cocci

A

Staphylococcus
Streptococcus
Enterococcus

24
Q

Gram-positive Bacilli

A

Corynebacterium
Listeria
Bacillus- cereus, anthracis
Clostridium- tetani, botulinum, difficile

25
Q

Streptococcus Pneumoniae

A

Gram positive
Normal flora in 5-70% people
Diplococci

26
Q

Immune defects predisposing to pneumococcal infection

A

Absent/non-functional spleen
Hypogammaglobulinaemia
HIV infection

27
Q

Splenectomy

A

Vulnerable to encapsulated bacteria- Pneumococcus, HiB, Meningococcus
Vaccination
Lifelong penicillin daily

28
Q

Non-invasive disease

A

Acute otitis media
Sinusitis
Conjunctivitis
Pneumonia

29
Q

Invasive disease

A 
Septicaemia
Meningitis
Peritonitis
Arthritis
Osteomyelitis
30
Q

Empyema management

A

Chest drain +/- urokinase

Video assisted thoracoscopic surgery

31
Q

Pneumococcus vaccination

A

Pneumococcal polysaccharide vaccine - pneumovax (23 serotypes)
Pneumococcal conjugate vaccine- prevenar (13 serotypes)

32
Q

Tetanus

A

Gram positive bacillus
Spores found in soil
Tetanus toxin (exotoxin)- interacts with NMJ

33
Q

Tetanus infection causes

A

Lack of maternal vaccination in pregnancy
Use of unclean blade to cut cord
Application of mud or dung to cord

34
Q

Tetanus symptoms

A 
Weak
Lethargic
Poor suck
Spasms
Fits
35
Q

Fungi classification

A

> 100,00 named species
<500 cause disease
Yeasts
Moulds

36
Q

Yeasts

A

e.g. Candida
Unicellular, oval or round
Asexual budding

37
Q

Moulds

A

e.g. Aspergillus
Filamentous fungi
Branching filaments (hyphae)

38
Q

Fungal disease in children

A

Superficial Mycoses- common, normal hosts

Invasive mycoses- rare, opportunistic infections in immunocompromised hosts

39
Q

Superficial mycoses

A

Candidiasis- nappy rash, treat with topical antifungal e.g. Nystatin
Tinea corporis- ring worm, treat with topical antifungal

40
Q

Invasive mycoses

A

Candidaemia- Extremely preterm infant, can affect kidneys and brain, long course of IV antifungal
Pulmonary aspergillosis- Child with chronic granulomatous disease

41
Q

Defects in neutrophils

A

Low neutrophil count (neutropenia)

Impaired neutrophil function (e.g. chronic granulomatous disease)

42
Q

Defects in T cells

A

Congenital (e.g. SCID)

Acquired (e.g. HIV infection)

43
Q

Classification Protozoa

A

Sporozoa
Amoebae
Flagellates

44
Q

Sporozoa

A 
Plasmodium species (malaria)
Toxoplasma gondii (toxoplasmosis)
Cryptosporidium (diarrhoea)
45
Q

Amoebae

A

Entamoeba histolytica (amoebic dysentery)

46
Q

Flagellates

A

Giardia (diarrhoea, malabsorption)
Trypanasoma (sleep sickness, Chagas)
Leishmania

47
Q

Malaria 4 main species

A

P. Falciparum- most severe, cerebral malaria
P. vivax
P. ovale
P. malariae

48
Q

Malaria in children

A

Can be non-specific- fever, lethargy, vomiting, diarrhoea

Severe disease- anaemia, resp. distress, cerebral malaria, hypoglycaemia

49
Q

Malaria treatments

A

Artemisinin derivatives
Combination treatment
More rapid reduction in parasitaemia

50
Q

Congenital toxoplasmosis

A 
Toxoplasma gondii
Sporozoa
Oocysts excreted by cats
pregnant women infected
Multiply in pregnant women

HD CC (22 decks)

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