Common Infectious Disease

Question 1

When an infant < 3 months has fever, what investigations to do?

Answer 1

1. FBC
2. Cultures
3. CRP
4. Urine (SPA) - suprapubic aspirate
5. Lumbar puncture (unless contraindicated)

+/- stool culture (only if diarrhoea)
+/- CXR (only if respiratory symptoms present)

Question 2

Infant 29 days to 3 months, temp > 38.0. How to mx

Answer 2

Assess promptly & discuss with senior doctor

Question 3

Infant 29 days to 3 months, temp > 38.0. On assessment, has no unwell features & clinically obvious focus

Answer 3

Investigate & mx clear cause.

Admit or discharge. Review within 24 hours

Question 4

Infant 29 days to 3 months, temp > 38.0. On assessment, has no unwell features & no clinically obvious focus

Answer 4

MSU, +/- FBC, CRP, blood cultures

Consider admin for observation. Remains well + investigations normal, discharge + follow up in 24 hours

Question 5

Infant 29 days to 3 months, temp > 38.0. On assessment, has unwell features & no clinically obvious focus

Answer 5

Assess for signs of sepsis. Septic screen:
- Sepsis 6: oxygen, broad spect abx, fluids. Take urine output, bloods and cultures

Bloods: FBC, CRP, lactate, WCC, VBG, platelets.
Do LP

Admit
Empiric abx:
- Ceftriaxone
- Flucloxacillin

Question 6

Infant 29 days to 3 months, temp > 38.0. On assessment, has unwell features & clinically obvious focus

Answer 6

Investigate & management for focus

Consider further investigations for co-infections & complications.