Childhood infections

Question 1

What is scarlet fever?

Answer 1

A reaction to erythrogenic toxins produced by group A Strep (usually strep pyogenes)

Question 2

What virus causes slapped cheek disease?

Answer 2

Parovirus B19

Question 3

How is scarlet fever spread?

Answer 3

Droplet spread via respiratory route.

Question 4

How does scarlet fever present?

Answer 4

Fever
Malaise
Strawberry tongue
fine punctate erythematous rash on the torso with a sandpaper texture.

Question 5

What is the treatment for scarlet fever?

Answer 5

Oral penicillin V for 10 days

Azithromycin if penicllin allergic

Question 6

When can children return to school if they have scarlet fever?

Answer 6

24 hours after commencing antibiotics

Question 7

List three potential complications of scarlet fever?

Answer 7

Ottitis media
Rheumatic fever
Acute glomerulonephritis

Question 8

What are the features of measles?

Answer 8

Prodrome of irratibility, conjuntivitis and fever
Discrete maculopapular rash becoming blotchy and confluent
Koplik spots (before rash) and white spots on buccal mucosa

Question 9

What investigations can you do if you suspect measles?

Answer 9

IgM antibodies can be detected within a few days of rash onset

Question 10

If you see a child that has not had their MMR and they have been in contact with measles what should you do?

Answer 10

MMR given within 72 hours.

Question 11

What is the treatment for threadworm infection?

Answer 11

Single dose of mebendazole for the whol family

Question 12

A 4-year-old boy is brought in by his mother. He was mildly unwell yesterday with a fever, lethargy and sore throat. Today, his mum is alarmed as she has noticed ‘blisters’ in and around his mouth and he is reluctant to eat or drink. On examination the child looks miserable, but not unwell, his temperature is 38.2ºC and he has a mix of shallow ulcers and erythematous papules scattered over his hard palate, tongue and lips. Examining further you also notice that there are a few erythematous maculopapular lesions along the sides of his fingers, around his right heel and over his buttocks. What is the most likely diagnosis?

Answer 12

Hand foot and mouth disease

Question 13

What virus causes hand foot and mouth disease?

Answer 13

Coxsackie A16 and enterovirus 71

Question 14

What are the clinical features of hand, foot and mouth disease?

Answer 14

Mild systemic upset with a sore throat and fever
Oral ulcers
vesicles on the palms and soles of feet

Question 15

Do children need to be kept of school if they have hand foot and mouth disease?

Answer 15

No. Only if they feel unwell