Infection Flashcards
what vaccines are given at 8 weeks?
- 6 in 1 vaccine(diphtheria, tetanus, pertussis, polio, haemophilus influenzae type B (Hib) and hepatitis B)
- Meningococcal type B
- Rotavirus(oral vaccine)
what vaccines are given at 12 weeks?
- 6 in 1 vaccine(again)
- Pneumococcal(13 different serotypes)
- Rotavirus(again)
what vaccines are given at 16 weeks?
- 6 in 1 vaccine(again)
- Meningococcal type B(again)
what vaccines are given at 1 year?
- 2 in 1(haemophilus influenza type B and meningococcal type C)
- Pneumococcal(again)
- MMR vaccine(measles, mumps and rubella)
- Meningococcal type B(again)
what vaccines are given at 12-13 years?
- Human papillomavirus(HPV) vaccine (2 doses given 6 to 24 months apart) - ideally before sexually active
- against strain 6 &11 which causes genital warts
- 16 and 18 cervical cancer
wat vaccines are given at 14 years?
- 3 in 1(tetanus, diphtheria and polio)
- ***Meningococcal groups A,C,WandY
What are some risk factors for cadidiasis?
- Hot, humid weather
- Too much time between diaper changes
- Poor hygiene
- Taking medicines such as antibiotics or corticosteroids
- Health conditions that weaken the immune system, such as diabetes, cancer, or HIV
what are some key points in the history of a patient with candidasis?
- skin - rash, patches that ooze clear fluids, pimples, itching or burning
- vagina - white or yellow discharge, itching, redness in extrenal vagina, burning
- penis - redness, scaling, painful rash
- mouth - white patches on tongue, top of mouth, inside cheeks, pain
- fever and chills
what is the management of cadidasis?
- exclude risk factors - DM etc
- miconazole gel, nystatin
- oral hygiene advice, inhaler advice if steroid inhaler like rinse mouth after
- if not responding after 2w or recurrent paediatric referral!
what causes cellulitis in children?
- after trauma which causes opening in skin which leads to bacterial invasion
- group A strep - haemolytic
- strep pneumoniae
- staph aureus
- methicillin-resistant staph aureus
- Predisposing factors include skin abrasions, lacerations, burns, eczematous skin, chickenpox, etc
how does cellulitis present?
- swelling of skin
- tenderness
- warm skin
- pain
- bruising
- blisters
- fever and chills
- headache
- weakness
what are some red flag symptoms of cellulitis?
- very large area of erythema
- fever
- numbness, tingling in area
- skin black
- if swollen area around eye
- DM, immunocompromised
how do you manage cellulitis?
- rest
- oral or IV antibiotics - flucloxacillin
- cool, wet dressings
- surgical intervention and debridement if necrotising
what are the pathophysiology of conjunctivitis?
new born - chemical (2-4 days), gonococcal from vagina of infected mother
- childhood - large outbreaks in schools or day cares caused by bacteria, viruses like herpes or allergies
- bacteria - s.aureus, h.influenzae, s.pneumoniae, chlamydia
- virus - adenovirus, herpes
- allergies and chemicals like new born eye drops
how might conjunctivitis present?
itchy and irritated eyes
discharge - clear for viral, green and thick for bacterial
ear infection in some
swelling of eye lid
how is conjunctivitis managed?
- cleaning with saline or water is all that is required as it resolves spontaneously
- topical antibiotic eyes ointment eg: chloramphenicol or neomycin
- if gonococcal infection start treatment immediately as permanent loss of vision can occur
- 3rd generation cephalosporin IV and cleanse eye frequently
- chlamydia - oral erythromycin for 2w and treat mother and partner
what is the pathophysiology of epiglottitis?
- acute inflammatory swelling of epiglottis and surrounding tissues mostly caused by infection
- life threatening emergency as high risk of airway obstruction
- children higher risk as epiglottis more floppy, broad, long an dangled more into trachea
*H.influenza commonly causes, post vaccination streptococcus, candida and aspergillus in immunocompromised, HSV or parainfluenza etc virally
what are some worrying sign that may lead for you to suspect epiglottitis?
‼️ 4D - duration less than 12h, no cough
- dyspnoea
- dysphagia
- drooling
- dysphonia (hot potato voice)
what are some examination epiglottitis?
- dehydration
- high grade fever
- stridor - late sign
*tripod position - lean forwards, outstretched arms, neck extended and tongue out as attempt to position inflamed structures away from airway
what are complications of epiglottitis?
mediastinitis, retropharyngeal abscess, pneumonia, meningitis, sepsis
what are the initial investigations for epiglottitis?
SECURE AIRWAY
*keep env calm, not supine
- lateral neck XR - thumb print sign, thickened aryepiglottic folds, increased opacity of larynx and vocal cords
- good for ruling out but don’t waste time
what are some management options for epiglottitis?
1.secure airway - call anaesthetist, ENT, avoid distress
a. may require tracheostomy
2. oxygen- parent can hold mask near child
3. nebulised adrenaline - bridging therapy while waiting for definitive airway management by reducing oedema
4. IV steroids - benefit not proven
5. IVI - resuscitation and maintenance, NBM until airway improved
6. secure airway in theatre
What is the new vaccination programme for influenza?
- A new NHS influenza vaccination programme for children was announced in 2013. There are three key things to remember about the children’s vaccine:
- it is givenintranasally
- the first dose is given at2-3 years, thenannuallyafter that
- it is alive vaccine
what are some red flag signs of influenza?
- Signs andsymptoms that require hospital admission
- Presence of alower respiratory tract infection (hypoxaemia, dyspnoea, lung infiltrate)
- Central nervous system involvement
- Significant exacerbation of an underlying medical condition