Common childhood illnesses Flashcards
Flu-like symptoms - coryza, anorexia, low grade fever
Progresses to LRT signs e.g. increased RR, cough
Seen in which population most?
Bronchiolitis (inflammation of the small airways - affects under 2s most
Most commonly due to Respiratory syncytial virus (RSV)
Fever
Fussiness
Ear-pulling
Otitis media
Flu-like symptoms
Develops
Barking cough
Respiratory impairment if severe, including stridor
Croup:
- inflammation of upper airways usually due to parainfluenze viruses 1-4
- self-limiting usually in about a week
- I respirratory problems, admit and give single dose of PO dexamethasone .15mg/kg, and paracetamol for fever/distress (ibup in above 612)
Flu-like symptoms including high fever.
Then red spots on tongue and inside of motuh which become painful oval yellow-grey ulcers w/ red edges, then rash develops ;on palms of hands, soles of feet, buttocks & raised and become blisters with grey centre.
Lymphadenopathy
Hand-foot-and-mouth disease
caused by
COXSACKIEVIRUS A
- summer / early autumn
- usually self limiting around 1w-10d
Tearing Redness Gritty feeling Itching Crusty eyelashes
Conjunctivitis
- Self limiting - no ABx
Note bilateral suggests allergic
If pain in eyes, photophobia, visual change or intense rednes in one or both eyes, should go to GP
Often flu-like symptoms then 1-2 days later, a bright red rash on face, may also be on torso, arms or legs
Can also cause ReA, lymphadenopathy, diarrhoea
Fifth disease
Erythema infectiosum
Slapped cheek syndrome
PARVOVIRUS B19
Most infectious while with rash
Diarrhoea
Rotavirus
High and prolonged fever lasting over 5 days
Change to mucous membranes of upper respiratory tract e.g. chapped red lips, patchy rash
Change to limbs e.g. oedema, purpura
Bilateral conjunctivitis
Rash
Cervical lymphadenopathy
KAWASAKI DISEASE
Form of vasculitis, can cause damage to coronary arteries and so needs treatment.
Most common in 1-2 year olds.
Echo.
Treated with high dose aspirin (anti-inflammatory) and immunoglobulin. Note implications for measles and chicken pox vaccine (?6 months or 12 months wait)
Prodroma flu-like symptoms then
Erythematous pruritic macules which develop into papules and fluid-filed vesicles
Chickenpox
VARICELLA ZOSTER
- paracetamoll
- calamine lotion
- lays dormant in dorsal root ganglia and recurs as shingles
- foetal varicella syndrome (FSV) risk in first 28 weeks of pregnancy; scarring, eye defects like cataracts; shortened limbs; brain damage; prematurity
- now vaccine availability
- can cause compications in newborns, adults and pregnant women
Prodromal flu-like symptoms, swollen eyelids, watery eyes, photophobia, high fever (up to 40), small greyish white spots (called?), sore throat and coryza
Becomes:
Full body rash; small red-brown macular or papular rash, may joint to form blotchy patches. Often begins at ears and hairline, and spreads to rest of body. Often not itchy, but can be.
Measles
PARAMYXOVIRIDAE MORBILLIVIRUS
- vaccine available so usually only affects unvaccinated; very rare if vaccinated
- self limiting to around 2w but some develop pneumonia etc
The spots are called…
Koplik spots
Swollen glands between ear and jaw
Mumps
- vaccine available
- can be asymptomatic
- associated with orchitis (swollen, red, hot testicle, +/- systemic symptoms)
Flu-like symptoms; low fever etc
Red-pink rash spreads from behind ears to head and neck and then to rest of body
Occipitial, pre-auricular and cervical lymphadenopathy common.
Rubella (german measles)
Caused by rubella virus which is a togavirus (rubivirus)
MMR prevention!
- teratogenic in pregnant women before 20 weeks: CRS with high incidence of PFO; also cataracts, deafness, CNS disorders
- can be asymptomatic
- self limiting around 10d; supportive treament
Initial coryzal symptoms with low fever
Around a week later, very violent coughing bouts start causing breathlessness and noisy inhale.
Usually thick mucus production, coughing bouts last for a few minutes at a time. Strange noise on gasping.
Causes repeated coughing bouts that can last months at a time
Bordatella pertussis (whooping cough); gram-ve coccobacillus
- DTaP vaccine lasts for a few years only
- babies and young children get it worse
- pregnant women get a booster with every pregnancy
- acutely unwell +
Headache Fever Stiff neck Flu-like symptoms Floppiness Irritability Non-blanching rash
Meningitis
IV ceftriaxone
IV cefotaxime + amoxicillin or ampicillin if
Sore throat beyond a week Coughing Headache Earache Nausea Lethargy Odynophagia Dysphagia White, pus filled spots on tonsils or white coated tonsils High fever
Strep throat (bacterial tonsillitis)
- Supportive care; antibiotics (pen V) may not be given as dont change course of disease but have A/Es
- Viruses can cause tonsilitis e.g. paraflu, flu, rhinovirus, EBV
Rarely can lead to rheumatic fever without treatment -> heart damage… but rare as vaccinated against
Initially sore strep throat, headache, high fever, flushed face and strawberry tongue.
Rough red blanching rash begins on chest and abdomen (looks like sunburn and feels like sandpaper) but spreads all over body
Usually cheeks become flushed but not rashed, and area around mouth stays quite pale.
May peel for several weeks after rash.
Scarlet fever
Caused by STREP PYOGENES (group A beta hemolytic streptococcus)
- ANTIBIOTICS recommended: 10 day course of penicillin or amoxicillin; macrolide if allergic
ABx are to reduce compications; ear infection, throat abscess, sinusitis, pneumonia, rheumatic fever, glomerulonephritis
- Paracetamol, soft foods if sore throat, hydration, calamine lotion or antihistamine for itching
Social isolation for 24h after starting ABx
Usually begins a few days after a viral infection; persistent, effortless vomiting drowsiness rapid breathing seizures delirium coma
Unknown cause but usually FOLLOWING ASPIRIN DURING A VIRAL ILLNESS
Reye’s syndrome
Serious liver abd brain damage due to damage to mitochondria
Clusters of tiny blisters forming an ooze and golden crust
May affect skin around nose and mouth, or around trunk, depending on type
Impetigo
- ABx: topical or PO
Red scaly ring on skin or round patch of hair loss
Ringworm
FUNGUS!
Circular rash at the site of the tick bite 3-30 days after bite (erythema migrans) -
looks like a bulls-eye on a dart board (“target shaped rash”). Size of rash varies but is typically around 15cm across. No rash in 1 in 3.
Some have fever
Chills
Body aches
Lyme disease
BORRELIA Burgdorferi BACTERIA
Test for antibodies against borrelia if no rash but symptomatic
Spread by tick bite.
- Antibiotics - 14-21 day course of DOXYCYCLINE 100mg BD, or AMOXICILLIN 500mg TDS; for children, AMOXI
- Also remove tick and kill!
Later symptoms, weeks months or years later if lyme is left untreated include:
- Inflammatory arthritis
- Nervous system problems
- Heart problems (myocarditis, pericarditis, heart block, heart failure)
- Meningitis
- Post-infectious Lyme disease (like fibromyalgia)
High fever Chills Myalgia Faigue N&V
Flu
May get sudden onset high fever with flu-like symptoms and coryza, diarrhoea, swollen e
N&V
Rosey pink spots surrounded by white haloes (not always) on neck and trunk develops as child systemically improves after rash appears.
Roseola infantum aka sixth disease
HHV 6
- rest, paracetamol etc
- latnt in macrophages and T lymphocytes so relapse
Can cause febrile seizures, leukopenia
Bright red eruption 5-9 days ater exposure to amoxicillin or ampicillin
EBV
member of Herpes virus family
Small pearly skin-colour dome-shaped papules.
Not painful & no other symptoms
Molluscum contagiosum virus (MSC)
POXVIRUS (molluscipoxvirus)
Most have around 20-30 spots. Can take months to go away completely.
Abrupt onset of multiple skin “target lesions” - central dusky zone surrounded by inner ring of pale edema and outer ring of erythema
coldsores usually preceding by several days
Erythema multiforme
Hypersensitivity reaction usually triggered by HSV (coldsores usually)
Also HIV, CMV, adenovirus, HVZ, adverse effect ofdrugs
usuallly no treatment, just supportive care. corticosteroids in very severe cases.
Skin with: Redness Tenderness Swelling Warmth
Local to affected area
Cellulitis
- Staph / strep often responsible
- Flucloxacillin
Warts
Small rough growths
VIRAL
HUMAN PAPILLOMAVIRUS (HPV)
Some are associated with cancers e.g. cervical
Shingles
VIRAL
Reactivation of VARICELLA ZOSTER VIRUS
- chickenpox is the initial presentation of first infection, and then the virus may remain inative in nerve cells
- old age, poor immune function
Rash occurring on one side of the body, not crossing the midline
Pain / tingling
Usually self limiting - 2-4w
Hypo/hyperpigmentation of skin in patches
Rash
Pityriasis versicolor
Yeast grows out of control (FUNGUS)
Spaghetti and meatballs
