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Pediatrics Infectious Diseases > Diphtheria, Mumps, Pneumococcal infections, Meningococcal infection, H. Influenzae infection > Flashcards

Diphtheria, Mumps, Pneumococcal infections, Meningococcal infection, H. Influenzae infection Flashcards

1
Q

Diphtheria

A
  • Toxigenic and non-toxigenic
  • Toxin is produced only when infected with a bacteriophage that integrates the toxin-encoding genetic elements into the bacteria
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2
Q

Diphtheria

  1. incubation period
  2. characteristics
  3. treatment
  4. prevention
A
  1. 2-5 days (range, 1-10 days)
  2. may involve any mucous membrane, grey patch forms in the throat
  3. Diphtheria anti-toxin (effective in early stages of the disease), antibiotics – Metronidazole, Macrolides, Procaine, Penicillin G
  4. vaccination – Diphtheria toxoid
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3
Q

Mumps

A
  • Humans are the only natural hosts

* Systemic viral infection affecting different organs –> meningitis, parotitis, pancreatitis, orchitis

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4
Q

Mumps

  1. diagnosis
  2. treatment
  3. prevention
A
  1. based on clinical symptoms, history of vaccination should be taken into account
  2. no specific treatment, only symptomatic
  3. vaccination
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5
Q

Pneumococcal infections

  1. leading cause of…
  2. source of infection
  3. route of infection
  4. more common in which age
A
  1. Leading cause of acute otitis, community acquired pneumonia, bacteremia, meningitis –> S. pneumoniae
  2. sick person or carrier
  3. respiratory droplets
  4. More common in children under 2 years of age and older than 65 years of age

*** Common asymptomatic resident of the human nasopharynx –> part of normal bacterial flora

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6
Q

Pneumococcal infections

-risk factors (9)

A 
all children under 2 years, 
children attending day care centers, 
chronic lung/heart/liver/kidney diseases, 
diabetes, 
immunodeficiency, 
asplenia or splenic dysfunction, 
cochlear implants, 
CSF leaks,
children of certain races or ethnic groups
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7
Q

Pneumococcal infections - Acute otitis media

  1. most common cause
  2. symptoms
  3. treatment
A

often as a complication of upper respiratory tract infection.

  1. S. pneumoniae
  2. fever, irritable, trouble sleeping, poor feeding, ear pulling, otalgia, discharges from ear, hearing loss
  3. Amoxicillin
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8
Q

Pneumococcal infections - Community acquired pneumonia

  1. most common cause
  2. symptoms
  3. treatment
A
  1. S. pneumonia
  2. acute onset, fever, cough, tachypnea, intoxication, general malaise, chest pain, abdominal pain, headache
  3. Amoxicillin (non-severe), Benzylpenicillin IV (severe)
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9
Q

Pneumococcal infections - Pneumococcal meningitis

  1. most common cause
  2. symptoms
  3. treatment
A
  1. S. pneumonia
  2. fever, headache, photophobia, loss of appetite, vomiting, irritability, seizures, meningeal symptoms, bulging fontanelle
  3. III generation cephalosporins, glucocorticoids at the beginning
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10
Q

Pneumococcal infections

  1. diagnosis
  2. prophylaxis
A
  1. Labs: blood count, CRP, CSF analysis, bacterial culture, PCR
    - Other tests: otoscopy, chest X-ray, etc.
  2. vaccine
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11
Q

Meningococcal infection

  1. virulence factor
  2. route of infection
  3. source of infection
  4. incubation period
  5. pathogenesis
A
  1. capsule
  2. respiratory droplets/ secretions
  3. humans
  4. 1-10 days (most commonly 4d.)
  5. defect in the complement system
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12
Q

Meningococcal infection

-clinical forms

A

-Most dangerous are asymptomatic carriers –> young people up to 24 years old

  • Invasive: nasopharyngeal colonization (asymptomatic carriers), acute nasopharyngitis
  • Noninvasive: meningococcemia, meningitis, meningococcemia and meningitis
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13
Q

Meningococcal infection

  1. diagnosis
  2. prevention
  3. treatment
  4. chemoprophylaxis
A
  1. Blood count, CRP, bacterial culture, blood culture
    - Optimal period for taking blood for blood culture –> before starting antibiotics, beginning of fever period
  2. vaccination
  3. antibiotics – 7 days
    - Ceftriaxone 80mg/kg x 1d. i/v
    - Cefotaxime 50 mg/kg every 6h, if younger <3months
    * **Person shall be isolated for up to 24h counting from the beginning of antibiotic therapy (later no longer contagious to others)
  4. Should be started as soon as possible, no longer than 7 days after contact
    - Ceftriaxone and Ciprofloxacin
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14
Q

Meningococcal infection

-symptoms

A
  1. Waterhouse-Friedrichsen syndrome: massive adrenal hemorrhage. Clinical features are fever, septic shock, DIC, hemorrhage in the skin and mucous membranes
  2. Hemorrhagic rash:
    - Glass test – when the skin is pressed with the glass, the hemorrhagic rash does not disappear and remains visible through the glass
  3. Fulminant meningococcal septicemia: sudden/acute onset, progresses within hours, development of shock, hemorrhagic rash, coagulation disorders, adrenal, renal and cardiac failure, coma, death
  4. Meningitis: Stiff neck, Brudzinski’s sign, Kernig sign, Floppy baby
    - Fever and/or vomiting, severe headache, rash (anywhere), sleepy, difficult to wake, confused, seizures
    - Bulging fontanel, refusing to eat, irritable when lifted, high-pitched moaning and crying
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15
Q

H. influenzae

  1. which serotype causes most of invasive clinical forms?
  2. route of infection
  3. source of infection
  4. most common age
  5. seasonality
A

1 Serotype B

  1. respiratory droplets
  2. sick or healthy person (carrier)
  3. 4-6 months, 5-7 years
  4. spring and autumn

***Make up the normal microbial flora of the human respiratory tract

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16
Q

H. influenzae

  1. risk factors
  2. pathogenesis
  3. differential diagnosis
A
  1. younger than 5 y.o, immunodeficiency, chronic diseases, attending day care, artificial feeding of infants, acute viral respiratory infections
  2. polysaccharide capsule, outer membrane (proteins and lipooligosaccharides), IgA protease
  3. Meningitis – most common cause in children
    - Epiglottis – 4D (dysphagia, dyspnea, dysphonia, drooling), neck pain, sore throat, sudden onset, febrile fever, upper respiratory tract obstruction
    - Pneumonia
    - Bacteremia
17
Q

H. influenzae
1, diagnosis
2. treatment
3. prevention

A
  1. blood count, CRP, serology, blood culture, PCR, imaging tests
  2. Amoxicillin (if beta lactamase is not produced), II or III generation cephalosporins
    - Meningitis: III generation cephalosporins 10d. and glucocorticoids
    - Epiglottis: III generation cephalosporins 10-14d.
    - Acute otitis media, pneumonia: amoxicillin, aminopenicillin with a beta lactamase inhibitor or II generation cephalosporins for 5-10d.
  3. vaccine

Pediatrics Infectious Diseases (5 decks)

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