Fever II Flashcards

1
Q

What are the common causes of meningitis in the neonatal period?

A

E. Coli
Group B strep
Others include: H. Influenza, Pneumococcus, Meningococcus (N. Meningitidis), Viral infection

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2
Q

What is the most common cause of death of bacterial meningitis?

A

Central Nervous system failure

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3
Q

What is the most common cause of death of meningococcal septicaemia?

A

Cardiovascular system failure

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4
Q

Will there be vomiting in meningitis?

A

Yes

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5
Q

What are the signs and symptoms of meningococcal septicaemia?

A
Rigors
Rash
Fever (or hypothermia in infants)
Cold peripheries
Tachypnoea and Tachycardia
Pale or mottled skin
Sleepiness and confusion/delirium
Aches
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6
Q

What are the signs and symptoms of meningitis in infants?

A
Bulging fontanelle
Vomiting
Fever
Sleepiness
Seizures
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7
Q

What should be suspected if the child presents with fever for more than 5 days

A

Consider Kawasaki’s disease

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8
Q

Lumbar puncture is performed in which categories of children?

A

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

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9
Q

Lumbar puncture is performed before or after the administration of antibiotics?

A

Perform lumbar puncture without delay when indicated before the administration of antibiotics

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10
Q

What must also be given if parental antibiotics are indicated for infants less than 3 months of age?

A

A third generation cephalosporin (Ceftriaxone or Cefotaxime)

Plus an antibiotic active against listeria (Ampicillin or Amoxicillin)

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11
Q

What is Cushing’s triad? What is it indicative of?

A

Cushing’s triad involves irregular breathing, Bradycardia and hypertension.
It is indicative of raised intracranial pressure

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12
Q

In a child presenting with fever and suspected of serious bacterial infection needing immediate treatment, what is done?

A

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.

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13
Q

What is given to children suspected of meningococcal disease?

A

Parenteral antibiotics, either Benzyl-penicillin or a third generation cephalosporin such as Ceftriaxone or Cefotaxime.

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14
Q

Kawasaki disease is most common in which age group?

A

Kawasaki disease is most common in under 2 year old.

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15
Q

What are the complications of Kawasaki disease?

A

Coronary artery aneurysms
Myocardial infarction
Myocarditis

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16
Q

What are the most common signs and symptoms of UTI in infants <3 months old?

A

Lethargy
Irritability
Fever
Vomiting

17
Q

What is the recommended method for urine collection in children suspected of UTI?

A

A clean catch urine sample

18
Q

What is tested positive in urine dipstick if a child has a UTI?

A

Leukocyte esterase and nitrites are positive

19
Q

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?

A

Cystitis or lower urinary tract infection.

For children with fever, upper urinary tract infection or acute pyelonephritis should be suspected.

20
Q

What is the management plan for infants and children above 3 months old and suspected with acute pyelonephritis?

A

Treat with oral antibiotics for 7 - 10 days. Recommended antibiotic is Cephalosporin or Co-Amoxiclav

21
Q

What is the management plan for infants and children above 3 months old and suspected of cystitis?

A

Treat with oral antibiotics for 3 days: Trimethoprim, Nitrofurantoin, Cephalosporin or Amoxicillin.

22
Q

Can asymptomatic bacteriuria in infants and children be treated with antibiotics?

A

No.

23
Q

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.

A

Mumps.

In 25% of males, Mumps can present as unilateral epididymo-orchitis without parotitis.