Ch. 7 Infectious Diseases Flashcards
Typical Bacterial Pathogens and Empiric Abx for Infants and Children with Suspected Sepsis/Meningitis
0-1 mo
1-3 mo
3 mo-3 yrs
3 yrs-adult
Most common complication of meningitis
Hearing Loss (up to 25% pts)
Most common cause of viral meningitis in U.S.
Enterovirus
2 types of bacterial pharyngitis - what organisms?
-
Group A Strep
- Lack of other URI symptoms (rhinorrhea, cough)
- Exudate on tonsils, petechiae on soft palate, strawberry tongue
- Fever
- Scarlatiniform rash
-
Diphtheria
- Grey adherent tonsillar membrane
Most common pathogens for otitis externa?
- Pseudomonas
- S. aureus
- Candida
Impetigo vs. Erysipelas vs. Cellulitis
Impetigo = superficial skin infection involving upper dermis
Erysipelas = skin infection that involves dermal lymphatics
- Tender, erythematous skin with distinct border
Cellulitis = skin infection that involves dermal later
Complications of GABHS infections
- PSGN
- Rheumatic fever
- Post-strep arthritis
- Pediatric AI neuropsychiatric disorders associated with strep infection (PANDAS)
Classic electrolyte finding in bacterial diarrhea
Non-AG hyperchloremic metabolic acidosis (due to bicarb loss in stool)
Mgmt of infants born to HIV-infected mothers
- Zidovudine for 6 weeks for post exposure prophylaxis
- TMP/SX for Pneumocystis carinii pneumonia (PCP) prophylaxis until HIV DNA PCR at age 4 mo. is negative
- No breastfeeding
- Urine CMV culture to detect coinfection with CMV (ocurs in 5%)
EBV complications (5)
- Neurologic complications, including cranial nerve palsies/encephalitis
- Severe pharyngitis, which may cause upper airway obstruction
- Amoxicillin-associated rash. Pts with EBV infection who are misdiagnosed with GABHS pharyngitis and prescribed amox often develop diffiuse pruritic maculopapular rash 1 week after starting abx. Not an allergic rxn but is idiosyncratic
- Splenic rupture
- Malignancy (nasopharyngeal carcinoma, Burkitt’s lymphoma)
Most common complication of mumps
Aseptic meningitis
Orchitis in postpubertal males –> can impair fertility
Two common complications of acute otitis media
Facial nerve palsy / Mastoiditis
Common complication of rubella infection
Arthritis
Complication seen in primary measles / varicella
Pneumonia
Clinical phases of pertussis
- Catarrhal (1-2 weeks): Mild cough, rhinitis
- Paroyxsmal (2-6 weeks): Whooping cough, posttussive emesis, subconjunctival hemorrhages (from increased intraorbital pressure)
- Convalescent (weeks to months): sx gradually resolve
Treatment for localized non-bullous impetigo
Topical mupirocin
Measles virus (rubeola)
Transmission
Clinical Presentation
Prevention
Treatment
- Transmission: airborne
- Clinical px:
- Prodrome (e.g. cough, coryza, conjunctivitis, fever > 104, Koplik spots)
-
Maculopapular exanthem:
- Cephaocaudal & centrifugal spread
- Spares palms/soles
- Prevention:
- Live-attenuated measles vaccine
- Tx:
- Supportive
- Vitamin A for hospitalized pts
How does congenital toxoplasmosis classically present?
How is dx made?
- Diffuse intracerebral calcifications
- Ventriculomegaly / macrocephaly
- Majority of infants are asymptomatic at birth but develop chorioretinitis in adulthood due to reactivation of their infection
Dx made by serology; presence of infant IgM or IgA is confirmatory
Primary distinguishing feature between herpangina vs. herpetic gingivostomatitis
Herpangina = coxsackie A
- 3-10 y/o
- seasonal - summer/early fall
- GRAY VISCLES/ULCERS ON POSTERIOR OROPHARYNX
- Tx: supportive
Herpetic gingivostomatitis = HSV
- 6 mo-5 yrs
- seasonal - none
- clusters of small vesicles on anterior oropharynx
- Tx: oral acyclovir
Classic triad of congenital rubella syndrome (CRS)
- Machine-like systolic murmur of PDA
- Sensorineural hearing loss
- Leukocoria (white pupillary reflex) from cataracts
Features specific for congenital syphilis
- Copious clear, purulent, or serosanguineous rhinorrhea (snuffles)
- Diffuse maculopapular rash that can involve the palms and soles and may desquamate
- Abnormal long-bone radiographs (eg. metaphyseal lucencies)
Anterior vs. posterior cervical lymphadenopathy
Anterior: scarlet fever (S. pyogenes)
Posterior: EBV
3 most commonly implicated organisms that cause acut bacterial rhinosinusitis
Treatment of choice
- S. pneumo
- H. influenzae
- Moraxella catarrhalis
Treatment of choice: amox-clavulanic acid
In an infant with meningococcemia, what out for __________.
Waterhouse-Friderichsen syndrome, which is characterized by a skin rash (i.e., large purpuric lesions on the flanks) due to adrenal hemorrhage
