Childhood infections Flashcards
What can cause bacterial conjunctivitis?
Symptoms?
Mucopurulent discharge, often have otitis media too
Haemophilus influenza
Strep pneumo
Staphylococci
Gram neg bacilli
Neisseria meningitidis
Gonorrhea/chlamydia in neonate
What causes viral conjunctivitis? What is its symptoms?
Watery discharge, perauricular adenopathy
Adenovirus from swimming pool
HSV - herpes
Entero/coxsackier
Rubella
Rubeola
Otitis media: symptoms, pathogens, treatment
Ear pain, purulent acute infection of ear
Esp in winter, <2 yo, immunocompromised
Recurrent infections can cause hearing loss, mastoiditis, brain abscess
Strep pneumo (GAS, GBS)
H influenza
Moraxella catarrhalis
Viral infections can do coninfection (RSV, parainfluenza, influenza, enterovirus)
Treat with amoxil = pink medication
What is tracheobronchitis? Treat?
What causes it?
Barking seal cough, inspiratory wheezing, steeple sign of CXR
Control airway edema wtih steroids, humidifier
Parainfluenza, RSV, influenza, adenovirus
What causes sinusitis in children?
How does it present?
Persistent nasal discharge 10d+cough, or nasal discharge 3d+fever
Strep pneumo, H influenza, M catarralis, Staph Aureus, Anaerobes
What are childhood illnesses with rashes?
Measles
Scarlet fever
Rubella
Fifth disease
Roseola
What’s measles?
Rubeola
Highly contagious!! Seen in unvaccinated or travelers
H, F, M proteins
2 week prodrome (conjunctivitis, cough, rhinitis)
Koplik’s spots prior to rash = red lesions with blue/white centers in the mouth (think cop licking a red-white-blue lollipop)
Rash (after prodrome/Kopkik’s spots): flat/slightly bumpy, spreads out from forehead to face/neck/torso, hits feet on 3rd day & disappears in same order (Think pouring a bucket of paint on head and it drips off the person)
Complications: pneumonia, eye damage, otitis media, heart involvement, encephalitis (rare but deadly)
Diagnose wtih serology (IgM), viral culture
Best treatment is prevention
Whats SSPE?
Subacute sclerosing panecephalitis
Occurs 7-10 years after measles
CNS effects that progress to vegatative state
What is German measles?
Rubella
Associated wtih congenital infection
C, E1, E2 proteins - replicatoin in lymph nodes –> viremia –> rash (3 day rash versus Rubeola is 14 days rash)
Also head to toe rash
Diagnose by culturing pharynx, PCR, or see IgM rise
Congenital rubella?
IUGR, cataracts, hepatosplenomegaly, deafness, blueberry muffin rash
Whats mumps?
HN, F, 7 structural proteins
Vaccine but not great immunity
Infection form resp viral secretions –> replication in nasopharyngeal mucosa/regional lymph nodes –> viremia, seeding of organs (CNS, testes, salivary glands)
Unilateral parotid swelling, red rash, fever, or can be asymptomatic
Titers IgM or clinical diagnosis, cultures/PCR also possible
Complications: aseptic meningitis, orchitis (testicular atrophy), arthritis, myocarditis, gestational mumps
Whats roseola?
“Sixth disease”
6m-3years old
DNA virus
Reactivation of latent virus in CNS, immunocompromised
Fever 3-5 days, BOOM rash, fever gone
Bulging fontanelle
Complications include seizures, hepatitis
Whats fifth disease?
Parovirus B19, DNA virus, replicates only in human erythrocytes
Sometimes asymtomatic
“Sock glove rash” = rash around wrists/ankles/hands
Slapped cheek appearance
Aplastic crisis, esp in children with hemoglobinopathy
Chronic bone marrow failure in HIV/AIDS/immune deficiency; Polyarthropathy in adults; Can cause miscarriage, hydrops fetalis
Head to toe rash?
If 14 days, Measles (rubeola)
If 3 days, German measles (rubella)
Blueberry muffin rash
Congenital rubella
