Ch 40 PEDS infections: Viral, rickets, enteroviruses/parecho, Rashes (hand,foot,mouth) Flashcards
What are common predisposing illnesses that can lead to bacterial respiratory infections?
(SOAP)
Otitis media
Sinusitis
Pneumonia
Acute otitis media/menigitis (bacterial CAP)
Symptoms often found in a common cold include:
runny nose (rhinorrhea) nasal congestion sore throat tearing cough sneezing low-grade fever
What pathogens frequently cause common cold symptoms?
Rhinoviruses Adenoviruses RSV Parainfluenza Human metapneumovirus Influenza Enteroviruses
What are some expected outcomes of the common cold?
MAL
morbidity for 5 - 7 days
local mucosal swelling
altered local immunity (precursors for more severe illness, OM, pneumonia, sinusitis)
T/F Prescribing antibiotics for the common cold may prevent complications and limit duration of purulent rhinitis
FALSE - antibiotics cannot PREVENT complications and will not LIMIT duration of purulent rhinitis
How should the NP treat a child that is < 2 years old for the common cold?
Supportive measures such as:
hydration
humidified air
suctioning
How should the NP treat a child that is over the age of 2 for the common cold?
PO antihistamines
PO decongestants
PO cough suppressants
What treatments have no/limited effective reliability to improve symptoms for the common cold?
topical decongestants
Vitamin C
Zinc
Childhood ______ is caused mostly from enteric adnoviruses in children less than 4 years old
diarrhea
Adenovirus
What is the incubation period?
Early s/s?
Associated rash?
Lab test findings?
incubation: 4 - 5 days
early s/s: URI, cough, fever
rash: Morbilliform (petechial) resembles MMR
lab: leukopenia sometimes
What viruses have an incubation period greater than 2 weeks (14 days)?
Mononucleosis
Rubella
What specific adenovirus presents with fever, adenopahty, exudative tonsillitis, rhinitis, and influenza-like systemic illness findings? This is also the most common adenovirus disease.
Pharyngitis
What specific adenovirus will have no lower respiratory symptoms, conjunctivitis associated with preauricular adenopathy, fever, pharyngitis, and cervical adenopahty?
Pharyngoconjunctival fever (viral pharynigitis)
What two specific adenoviruses may present with a foreign-body sensation in the eye?
Pharyngoconjunctival fever
Epidemic keratoconjunctivitis
What specific adenovirus presents with severe conjunctivitis, photophobia, swelling of the eyelids, and subconjunctival hemorrhage?
Epidemic keratoconjunctivitis
On chest XRAY, bilateral peribronchial and patchy ground-glass interstitial infiltrates are present in the lower lobes. What should the NP suspect? What kind of virus may have caused this?
Pneumonia
adenovirus
What are complications of adenovirus pneumonia? What serotype is unusually severe and fatal in children and adults?
Bronchiectasis (hard to clear mucus)
Bronchiolitis (inflammation)
Bronchiolitis Obliterans (inflammatory obstruction of the lung’s)
serotype 14
What rash is absent in adenovirus?
kolpik spots
What adenovirus serotypes are causes of short-lived diarrhea in afebrile children? What age range is this finding common in?
serotype 40 and 41
< 4 years old
Any treatment specific for adenovirus illness?
What would you consider for the immunocompromised patient with severe pneumonia?
none!
IV IG for immunnocompromised patients
What types of diagnostic tests can identify adenoviruses?
Viral culture - 48 hours
PCR - rapid
ELISA - diarrheal
What viral infection presents as fever, cough, pharyngitis, malaise, congestion, pneumonia, and encephalitis in late fall to mid spring?
Influenza
Influenza
What is the incubation period? Early s/s? Young children specific findings? Older children specific findings? Lab test finding?
incubation: 2 - 7 days
early s/s: sudden high fever, severe mylagia, headache and chills
young children: abdominal pain, fever, diarrhea, vomitting
older children: high fever/mylagia/HA/chills, dehydrating enteritis, adenopathy
lab: low leukocytes
What specific diagnostic tools are preferred for influenza illness?
PCR*
Rapid culture technique
What two other viral illnesses present similarly to influenza?
Parainfluenza
RSV
What should a NP rule out in a suspected influenza child with protracted vomitting or irrational behavior during flu season?
Rule out Reye Syndrome!
most common causes are varicella and influenza type B
What are prevention methods for Influenza?
flu vaccine
can still get if allergic to eggs, consider inpatient vaccination setting
What two medications can be considered as prophylaxis for Influenza? What are the age requirements and/or contraindications of those medications?
> 3 months = Oseltamivir (Tamiflu)
> 5 years old = inhaled Zanamivir (NO ASTHMA/chronic pulmonary diseases)
all antivirals need to be given 48 hours after symptom onset and for 5 days