General Infection Flashcards
What is the most common HSV 1/2 infection in 10m - 3yr olds?
Gingivostomatitis. Vesicular lip, gum and tongue or hard palate lesions. Can lead to painful ulceration and bleeding.
High fever, eating and drinking problems. If severe or dehydrated need IV fluids and aciclovir
What are the 8 human herpes viruses HHV?
HSV 1 and 2 VZV CMV EBV HHV 6, 7 and 8
3 skin manifestations of HSV 1/2?
HSV 1 = cold sores on lips
Eczema herpeticum - serious, infection over pre-existing eczematous areas
Herpetic whitlows = painful erythematous, oedematous white pustules on fingers (broken skin)
Other important presentations of HSV 1 and 2?
Eye - blephorotis, conjunctivitis -> corneal ulceration
CNS or disseminated disease
When is a VZV primary infection infectious to others?
From -2 to 5 days or so
Course of lesions in primary VZV infection?
Papules -> vesicles -> pustules -> crusts (in crops)
Serious complications of primary VZV infection? And when are they indicated?
Secondary bacterial superinfection
-> staphylococcal or group A strep infection - toxic shock or nec fas
Encephalitis (usually not too bad), indicated by ataxia and cerebellar signs
Indicated by persistently high or recurrent fever
VZV complications in immunocompromised individuals?
Haemorrhagic lesions
Pneumonia or pneumonitis
Disseminated infection
DIC
Medical treatments for primary VZV?
Nothing in most cases
IV aciclovir if immunocompromised
Valaaciclovir for adults or adolescents
VZIG for high risk individuals
What viruses can cause infectious mononucleosis (glandular fever)?
Most commonly EBV
Uncommonly CMV
What cancerous conditions is EBV implicated in?
Burkitt lymphoma
Nasopharyngeal carcinoma
Lymphoproliferative disease in immunocompromised
Common presentations of glandular fever?
Fever and malaise
Severe tonsillopharyngitis (can restrict airway)
Prominent cervical lymphadenopathy, adenopathy
Other possible symptoms of glandular fever?
Splenomegaly (50%) or hepatomegaly
Maculopapular rash
Jaundice
3 diagnostic methods for glandular fever?
Monospot test
Atypical (big) T lymphocytes on blood film
Seroconversion of IgM and IgG to EBV antibodies
What treatment is used for airway compromise in glandular fever and which antibiotics must be absolutely avoided?
Give corticosteroids Avoid amoxicillin (florid maculopapular rash)
Methods of transmission of CMV?
Saliva, genital
Breast milk, transplacental
Blood or organ transplants
Which mild CMV infections can occur in normal individuals?
Mild mononucleosis syndrome: fever, pharyngitis, lymphadenopathy
But negative monospot test
What pathogen is important in blood or organ transplant and therefore commonly screened for?
CMV
What does HHV 6+7 most commonly cause?
Roseola infantum in under 2s
Febrile convulsions
What is commonly misdiagnosed as measles or rubella due to the similar nature of its rash and presentation?
Roseola infantum
3 types of enterovirus?
Coxsackie, poliovirus and echovirus
What might a vomiting/diarrhoea/contact history suggest in a non-specifically ill child?
Enterovirus
What feature of enterovirus infection can lead to admission and treatment with ceftriaxone?
Petechial rash (?meningitis)
5 specific enterovirus syndrome?
Hand foot and mouth Herpangina Meningitis/encephalitis Pleurodynia Myocarditis/pericarditis
