Fever Flashcards
What is the highest risk age group for infection?
Under 3 months old
How long does it take for the body’s immune system to develop?
2 years. Hence, children under 2 years old are most susceptible to serious bacterial infection
What are the investigations done in children presenting with acute fever?
FBC - Leucocytosis will suggest bacterial infection
Throat swab - Group A Streptococcus infection in tonsillitis
Blood Culture - If positive, can suggest septicaemia. Treatment (Ceftriaxone) have to begin before results are shown
Urine analysis - TRO UTI. Pure growth of a single organism with significant leucocytosis is suggestive of bacterial infection. Protein and red cells may be present.
CXR - May reveal cause of fever in infants as chest signs are not always apparant
Lumbar puncture - TRO Meningitis and Encephalitis. Should be performed in seriously ill children where no infection is found, especially in infants <1 year old
Which medication cannot be given to children below 12 years? Why?
Aspirin.
Aspirin can cause severe liver failure such as Reye’s syndrome.
White exudate on the tonsils can be suggestive of which condition?
Tonsillitis
Glandular Fever, aka Infectious mononucleosis
Diphtheria (rare)
What are the commonest causes of acute otitis media?
Streptococcus Pneumoniae
Haemophilus infleunza
viruses
Which virus is the cause of Infectious Mononucleosis?
Epstein Barr Virus
How much fluids are given to children suspected of septic shock?
20 - 40mL per KG
Fever progressing for how many days will be worrying?
Fever progressing more than 5 days
What should be done if the child appears drowsy?
Why?
A blood glucose test: BM stix to check the blood glucose level.
Hypoglycaemia can occur in sepsis
What medication is contraindicated if infected with EBV? Why?
Amoxicillin. AMoxicillin will lead to a maculopapular rash in EBV infection.
What condition is caused by EBV?
Glandular fever/Infectious Mononucleosis
What are the complications of otitis media?
Secretory otitis media - Glue ear
Conductive deafness
Mastoiditis
What are the most common causes of acute otitis media?
Streptococcus pneumoniae
Haemophilus Influenza
Viruses
What are the indications for lumbar puncture?
If meningitis is suspected or if the child is under 1 year old
What are the signs of dehydration?
Prolonged capillary refill time Abnormal skin turgor Abnormal respiratory pattern Weak pulse Cool extremities
What is the respiratory rate in tachypnoeic children:
a) <5months old
b) 6 - 12 months old
c) >12 months old
a) >60 breaths/min
b) >50 breaths/min
c) >40 breaths/min
What are the signs of urinary tract infection in children?
Vomiting Poor feeding Lethargy Irritability Changes in urinary frequency Abdominal pain and tenderness Fever
What are the signs of pneumonia?
Tachypnoea Subcostal recession, etc Fever Nasal flaring Crackles in chest Cyanosis Oxygen saturations <95%
What are the signs and symptoms in Kawasaki’s disease?
Fever persisting for more than 5 days
Any 4 of the following:
- Polymorphous exanthem initially, which may progress to be desquamations.
- Strawberry tongue or red, fissuring lips
- Conjunctivitis (non-purulent, bilateral)
- Cervical lymphadenopathy
- Extremity changes: Swollen fingers or toes, Erythema of palms and soles of feet, Desquamation of fingertips or toes in later stages after rash fades
What anti-viral medication is given to children suspected of infleunza infection?
Oseltamivir (Tamiflu)
Zanamivir (Relenza)
How is the weight of a child calculated in terms of the age?
Weight = (age+4)x2
