Childhood infection and illness

Question 1

Whooping cough? Diagnosis and treatment

Answer 1

Pertussis:
Persistent cough >2 weeks
Paroxysmal cough, with inspiratory whoop

NOTIFIABLE ILLNESS

Treat:
<1 month = clarithromycin
>1 month = azithro/clarithromycin
Pregnant = erythromycin

Question 2

Management of UTI in children?

Answer 2

<3 months = admit
3 months - 3 years = antibiotics (unless acute pyelonephritis - admit)
>3 years = antibiotics

Question 3

Unilateral undescended testis management?

Answer 3

If undescended at birth - review at 6-8 weeks
If still undescended - review at 3 months
If still undescended - refer for surgical review

Question 4

Parvovirus B19 aka, diagnosis, management?

Answer 4

Slapped cheek syndrome, fifth disease, erythema infectiosum
Prodromal viraemic phase 2-5 days
Then slapped cheek rash with pallor around mouth
Rash may “spread”
SELF LIMITING

Question 5

Acute otitis media when to admit?

Answer 5

• Patients systemically unwell
• < 3 months
• 3-6 months with fever >39C

Question 6

Management of acute otitis media

Answer 6

Avoid antibiotics, consider delayed if no systemic upset etc.
If necessary 5 days amoxicillin
(eryth/clarithromycin if pen allergy)

Question 7

Kawasaki syndrome diagnosis?

Answer 7

Fever > 5 days and
4 out of 5:
- Bilateral conjunctivitis
- Mucous membrane involvement (strawberry tongue, dry cracked lips)
- Extremity changes (peeling skin, erythema, oedema)
- Rash (polymorphic)
- Cervical lymphadenopathy

Question 8

Roseola infantum cause and diagnosis?

Answer 8

Human herpes virus 6 (HHV6)

• High fever (can cause convulsions) lasts a few days
• mild pharyngitis
• lymphadenopathy
  Fever subsides, followed by
• Rash on trunk spreads to buttocks, thighs