Fever II Flashcards
What are the common causes of meningitis in the neonatal period?
E. Coli
Group B strep
Others include: H. Influenza, Pneumococcus, Meningococcus (N. Meningitidis), Viral infection
What is the most common cause of death of bacterial meningitis?
Central Nervous system failure
What is the most common cause of death of meningococcal septicaemia?
Cardiovascular system failure
Will there be vomiting in meningitis?
Yes
What are the signs and symptoms of meningococcal septicaemia?
Rigors Rash Fever (or hypothermia in infants) Cold peripheries Tachypnoea and Tachycardia Pale or mottled skin Sleepiness and confusion/delirium Aches
What are the signs and symptoms of meningitis in infants?
Bulging fontanelle Vomiting Fever Sleepiness Seizures
What should be suspected if the child presents with fever for more than 5 days
Consider Kawasaki’s disease
Lumbar puncture is performed in which categories of children?
Infants younger than 1 month old with fever
All infants aged 1 to 3 months old with fever and appears unwell.
All infants aged 1 - 3 months old with fever and having a WBC count of less than 5x10^9/L or greater than 15x10^9/L
Lumbar puncture is performed before or after the administration of antibiotics?
Perform lumbar puncture without delay when indicated before the administration of antibiotics
What must also be given if parental antibiotics are indicated for infants less than 3 months of age?
A third generation cephalosporin (Ceftriaxone or Cefotaxime)
Plus an antibiotic active against listeria (Ampicillin or Amoxicillin)
What is Cushing’s triad? What is it indicative of?
Cushing’s triad involves irregular breathing, Bradycardia and hypertension.
It is indicative of raised intracranial pressure
In a child presenting with fever and suspected of serious bacterial infection needing immediate treatment, what is done?
Antibiotics directed against
Neisseria Meningiditis,
Streptococcus Pneumoniae,
Escherichia Coli,
Staphylococcus Aureus and
Haemophilus Influenza type b should be given.
A third generation cephalosporin (Ceftriaxone or Cefotaxime) should be given until culture results are available.
For infants less than 3 months old, an antibiotic active against Listeria (eg Ampicillin or Amoxicillin), should also be added.
What is given to children suspected of meningococcal disease?
Parenteral antibiotics, either Benzyl-penicillin or a third generation cephalosporin such as Ceftriaxone or Cefotaxime.
Kawasaki disease is most common in which age group?
Kawasaki disease is most common in under 2 year old.
What are the complications of Kawasaki disease?
Coronary artery aneurysms
Myocardial infarction
Myocarditis
What are the most common signs and symptoms of UTI in infants <3 months old?
Lethargy
Irritability
Fever
Vomiting
What is the recommended method for urine collection in children suspected of UTI?
A clean catch urine sample
What is tested positive in urine dipstick if a child has a UTI?
Leukocyte esterase and nitrites are positive
What is suspected in children with bacteriuria but asymptomatic?
What is suspected in children with bacteriuria with fever of less than or more than 38 degree Celsius?
Cystitis or lower urinary tract infection.
For children with fever, upper urinary tract infection or acute pyelonephritis should be suspected.
What is the management plan for infants and children above 3 months old and suspected with acute pyelonephritis?
Treat with oral antibiotics for 7 - 10 days. Recommended antibiotic is Cephalosporin or Co-Amoxiclav
What is the management plan for infants and children above 3 months old and suspected of cystitis?
Treat with oral antibiotics for 3 days: Trimethoprim, Nitrofurantoin, Cephalosporin or Amoxicillin.
Can asymptomatic bacteriuria in infants and children be treated with antibiotics?
No.
What is suspected if a boy presents with unilateral epididymo-orchitis, trismus, and a fever?
It resolves within 1 week on its own without treatments.
Mumps.
In 25% of males, Mumps can present as unilateral epididymo-orchitis without parotitis.
