Clinical infections - Childhood and pregnancy Flashcards

1
Q

TORCH

A
  • Infections that can cause congenital abnormalities
  • Toxoplasmosis
  • Other: Syphilis, zika, VZV, parvovirus 19
  • Rubella
  • CMV
  • Herpes simplex/HIV
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2
Q

Infections acquired during passage through the birth canal =

A

Group B streps, herpex simplex, gonorrhoea, chlamydia, HIV, Hep B

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3
Q

Group B streps (GBS)

A
  • Cause severe infections in pregnancy
  • Women treated with prophylaxis if:
  • Previous baby with B strep (GBS) disease
  • GBS in current pregnancy
  • Women who are pyrexial in labour – offer broad spectrum antibiotics including antibiotic for prevention of neonatal early onset GBS disease
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4
Q

Zika virus

A
  • Mosquito or sexually transmitted

- New-born microcephaly and other congenital deformities

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5
Q

Intra-Amniotic Infections

A
  • Infections of the chorion, amnion, amniotic fluid, placenta or combo
  • Bacteria of the vagina ascend through cervix
  • Causative organisms = GBS, E.coli
  • Treatment = Anti-microbial at time of diagnosis
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6
Q

Puerperal Endometritis definition

A

Infection of uterus during puerperium (6 week period after delivery) – can develop into puerperal sepsis which is a major cause of maternal death

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7
Q

Puerperal Endometritis features

A
  • ~5% of pregnancies
  • Risk factors = C section, prolonged labour, rupture of membranes
  • Symptoms = fever, foul-smelling lochia, abdominal pain
  • Causative organisms = GBS, GAS, E.coli
  • Diagnosed by transvaginal endometrial swab
  • Treatment = broad spectrum IV antibiotics
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8
Q

Early Onset Neonatal Sepsis (EOS)

A
  • Develops within 72 hours of delivery – infection from mother via vertical transmission
  • High mortality rates - death in 1 in 4 babies
  • Typically present with multisystem involvement and pneumonia
  • Causative organisms = mostly GBS
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9
Q

Late Onset Neonatal Sepsis (LOS)

A
  • Develops after 72 hours of delivery – usually babies are low weight, premature and are susceptible to HCAI
  • Causative organisms = usually staphs
  • These babies more likely to have candida infections so are sometimes started on antifungal prophylaxis
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10
Q

URTI’s in children

A
  • Common cold
  • Tonsillitis - 75% viral, 25% streps
  • Acute otitis media
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11
Q

LRTI’s in children

A
  • Pneumonia - grunting tachypnoea
  • Acute bronchitis
  • Bronchiolitis - RSV major cause
  • Causative organisms = RSV, Influenza A+B, S.pneumoniae
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12
Q

Pertussis (whooping cough)

A
  • Affects children before vaccination
  • 3 stages:
    Catarrhal phase (7-10 days) = cold-like symptoms
    Paroxysmal phase (2-6 weeks) = no fever, characteristic whooping cough
    Convalescent phase (few weeks) = recovery
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13
Q

Meningitis

A
  • GBS most common cause in neonates
  • Diagnosis - polymorphs predominant in CSF
  • Non specific + specific symptoms
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14
Q

Viral meningitis

A
  • Most common infection of CNS in <1yr
  • Causative organisms = enteroviruses are most common – 50%. Others = HSV, influenza, EBV, adenovirus, CMV
  • Diagnosis = mononuclear lymphocytes present in CSF
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15
Q

Meningococcaemia

A
  • Neisseria meningitidis in the bloodstream
  • macropapular or petechial rash
  • peak incidence <5 years
  • mortality 5-10%, morbidity 10%
  • Immunisation programme for Men C and B – Men B commonest cause
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16
Q

UTIs in Children

A
  • Infants have non-specific symptoms - fever, vomiting
  • E.coli most common cause
  • Diagnosed via urine sample
  • up to 7% girls and 2% boys experience prior to 6 years old
17
Q

Impetigo

A
  • Causative O = A streps, S.aureus
  • Classically ruptured vesicles with honey-coloured crusting
  • Very contagious
  • more common in people with pre-existing skin diseases
  • Treatment = topical antibiotics or oral flucloxacillin
18
Q

Scarlet fever

A
  • Develops 2-4 days after streptococcal pharyngitis
  • Flushed face, rash, rough skin, white strawberry tongue
  • School age children
  • Diagnosed via throat swab
  • Treatment = 10 day penicillin