Fever of Unknown Origin Flashcards
What is erythema migrans?
Pathognomic of Lyme disease
Tick-born spirochaetial infection cauased by Borrelia burgdorferi
Reasons for sending a stool sample?
Suspect septicaemia
Blood or mucus in the stool
Child is immunocompromised
Consider if:
History of travel
Diarrhoea has persisted for more than 7 days
Uncertain about the diagnosis of gastroenteritis
3 stages of Lyme Disease
Early - Non-specific systemic symptoms: fever, arthralgia and malaise, often associated with the typical rash
Second stage - several weeks later, possible aseptic meningitis, facial palsy, arthritis and a carditis
Third stage: may be months to years later - neuropsychiatric manifestations and chronic fatigue (this is rare in children)
What is the treatment for Lyme Disease?
Treatment can be given without serological confirmation
Cefuroxime and amoxicillin
What infections can be caught from contact with lizards?
Salmonella
What is the criteria for Kawasaki’s disease?
Mucocutaneous lymph node syndrome
High temperature >5 days +4/5 Bilateral (non-purulent)conjunctivitis Cervical lymphadenopathy Swollen red lips, tongue Rash- pleomorphic Peeling of skin of hands and feet
What is Brudzinski’s sign?
Involuntary flexion of the knees and hips with neck flexion
What is Kernig’s sign?
Pain on lower leg extension with hip flexed
What is erythema marginatum?
Pink rings on the torso and inner surfaces of the limbs
Come and go for as long as several months
Found primarily on extensor surfaces
Associated with rheumatic fever
What is erythema toxicum?
Blotchy red spots on the skin with overlying white or yellow papules or pustules
Appears in up to half of newborns carried to term, usually between day 2–5 after birth
What is erythema ab igne (EAI)?
Also known as hot water bottle rash
Caused by long-term exposure to heat (infrared radiation)
Prolonged thermal radiation exposure to the skin can lead to the development of reticulated erythema, hyperpigmentation, scaling and telangiectasias
What is erythema nodosum?
Inflammatory condition characterized by inflammation of the fat cells under the skin
Results in tender red nodules or lumps that are usually seen on both shins
Typically resolves spontaneously within 30 days
Linked with medications (sulfa-related drugs, birth control pills, estrogens), strep throat, Cat scratch disease, fungal diseases, infectious mononucleosis, sarcoidosis, Behcet’s disease, inflammatory bowel diseases (Crohn’s disease and ulcerative colitis), and normal pregnancy.
What is the treatment for Kawasaki disease?
IV gamma globulin and oral aspirin - reduces incidence of coronary artery aneurysm
