I&I managements Flashcards
What is the management for measles?
No antiviral treatment
Prevention - by vaccination e.g. the MMR @ 13 months and booster at 3-5y/o
A child not immunised against measles has <72hrs to be offered MMR vaccine if came into contact with measles.
Otherwise = supportive management and isolation of child while infectious = 2 days before rash and 6 days after
what is the management of mumps?
No antiviral treatment
Prevention - by vaccination e.g. the MMR @ 13 months and booster at 3-5y/o
Otherwise = supportive management and isolation of child while infectious = until 7 days after the onset of parotitis.
What is the management of rubella (german measles)?
No antiviral treatment
Prevention - by vaccination e.g. the MMR @ 13 months and booster at 3-5y/o
Otherwise = supportive management and isolation of child while infectious = most infective during prodrome e.g. is mild w/low grade fever
What is the management of HSV-1 and HSV-1?
Aciclovir
What is the management of VZV (chickenpox/shingles)?
Calamine lotion
School exclusion from at least 5 days from rash onset/no new lesions
if immunocompromised/peripartum exposed newborns: Varicella zoster immune globin (VZIG) and IV Aciclovir
IF SHINGLES:
use oral aciclovir if immunocompromised or have opthalmic involvement (also get these an opthalmic review)
What is the management for infectious mononucleosis?
a major cause of mononucleosis syndrome is Epstein-Barr virus
Symptomatic treatment :
if breathing compromised use corticosteroids
5% will have group A strep on tonsils and so give these children PENICILLIN
NB: avoid amoxicillin and ampicillin in those with glandular fever as causes widespread rash
How do you treat cytomegalovirus?
is normally subclinical or mild and self limiting but if there are serious severe symptoms e.g. retinitis, colitis and pneumonitis in those with T-cell deficiency =
ganciclovir (has lots of side effects) or
foscarnet (used to prevent retinitis in HIV)
but only if bens outweigh the (lots of) side effects of these drugs
How do you manage HHV6 / Roseola?
symptomatic, mostly just give serological test to ensure its not rubella or measles
e.g. roseola infantum can have high fever and malaise for a few days then a macular rash.
HHV6 causes 1/3 of all febrile convulsions in infants and most children have been infected with this by the age of 2.
How do you manage HHV7?
Similar clincial picture to HHV6 and also most children by the age of 2 years have been infected with it.
How do you manage HHV8?
is associated with kaposis sarcoma - a tumous in the immunocompromised e.g. in AIDS
How do you manage strap pneumonia?
Pneunococcal conjugate vacccine is given at 2,3 and 13 months.
if someone has hyposplenism from cickle cell or nephrotic disease and is at increased risk of infection = daily prophylactic penicillin as it is carried in nasopharynx of children (air drop spread) and then causes infection in young infants there and around. (pneumonia, pharyngitis, otitis, conjuctivitis, sinusitis, periorbital cellulitis etc )
How do you manage impetigo?
most common cause = staph aureus. NO return to school before all the lesions are dry.
mild: mupirocin topical antibiotics
severe: cefalexin oral antibiotics
Nasal carriage - mupirocin nasal cream can eradicate it
how do you manage furuncle / boil?
commenest cause is staph aureus via abcess formed due to infection of hair follicle
small lesion: drainage
large: drainage and oral flucloxicillin
intranasal mupirocin to reduce recurrence (stops nasal carriage)
What is the management of periorbital cellulitis?
periorbital cellulitis –> cavernous sinus thrombosis, meningitis etc
1) blood culture
2) IV cefalexin (antibiotics etc)
3) Head CT to determine if there is posterior spread
4) and LP to exclude meningitis.
What is the management of staphylococcal scalded skin syndrome / toxic epidermal necrosis?
will show Nikolskys sign on what looks like non accidental injury dematoses
IV abs
analgesia
fluid balance monitoring
