Common and Serious Childhood Infections

Question 1

Patients with unexplained fever and higher likelihood for serious infection include:

Answer 1

• Neonates
• Immunocompromised (HIV, congenital immunodeficiency, neoplasms, asplenia, central venous access devices)
• Multiple congenital abnormalities
• Toxic appearing children
• Local epidemiology (e.g. Maori/Pacific Island children)

Question 2

Features of the ‘toxic’ appearance of a child

Answer 2

• Decreased level of arousal
• Decreased peripehral perfusion
• Abnormal respiratory state

Question 3

When does a febrile child (without a focus) need to be reviewed?

Answer 3

After 24 hours

Question 4

What are the main causative organisms of pneumonia?

Answer 4

Streptococcus pneumoniae (pneumococcus)
Mycoplasma pneumoniae
Staphylococcus aureus
Haemophilus influenzae
TB (mycobacterium tuberculosis)
Viral

Question 5

Treatment of pneumonia

Answer 5

Amoxicillin (1st line)
- treats strep
Co-amoxyclav
Erythromycin (if suspect mycoplasma)

Question 6

Is mycoplasma pneumoniae susceptible to penicillins?

Answer 6

No - it lacks a cell wall (which is targeted by beta lactam antibiotics)