Infection Flashcards
vaccinations at 8 weeks old
- 6 in 1 vaccine
- Men B
- rotavirus
infections protected against in 6 in 1 vaccine
diptheria
tetanus
pertussis
hep B
polio
h.influzena hype b
vaccinations at 12 weeks old
- 6 in 1
- rotavirus
- pneumococccal 13 conjugate
vaccinations at 16 weeks old
- 6 in 1
- Men B
vaccinations at 1 year old
- Men C and H. influenza B
- MMR
- pneumococcal conjugate 13
vaccinations at 3 years old
- diptheria, tetanus, pertussis, polio booster
- MMR
vaccinations at 12-13 y/o
HPV vaccine = against human papillomovirus 16 +18
se= bronchospasm
vaccinations at 14 y/o
- Men ACWY
- tetanus, diptheria and polio
examples of live vaccines
BCG
MMR
rotavirus
influenza
varicella
yellow fever
PO polio
contraindications to live vaccines
- immunosuppression
- DiGeorge
- chemo/ radiotherapy in last 6 months
- bone marrow trnasplant in last 6 months
- immunoglobulins in last 3 months
- anaphylaxis
inheritance of SCID
autosomal recessive
X link ADA deficiency in newborn boys
define SCID
absence of T and B cell function which causes lymphopene and hypogammaglobulinaemia
presentation of SCID
present around 6 months old with
- recurrent infections e.g pCP, influenza, bacetrial and fungal
- faltering growth
- persistent diarrhoea
- oral thrush / candidiasis
- BCG vaccine complications
- skin rashes
presentation of Omenn syndrome
first few weeks of life with..
- generalised erythematous rash
- chronic diarrhoea
- oedema
- lymphadenopathy
diagnosis of SCID
- Lymphopenia
- reduced IgG, IgA and IgM
- reduced CD3 count
- CXR - absent thymus shadow
- purine nucleoside phoshorylase enzyme activity - test for underlying syndrome
cure for SCID
stem cell transplant
inheritance of hypogammaglobulinaemia
x linked
presentation of hypogammaglobulinaemia
present around 2 y/o …
- recurrent infection - sinusitis, strep pneumoniae
-persistent diarrhoea
- faltering growth
- recurrent herpes
diagnosis of hypogammaglobulinaemia
- reduced IgG, IgM, IgA
- PHA test normal - normal t cell function
presentation of chronic granulomatous disease
< 5 y/o…
- recurrent bacterial and fungal infections
e.g. burkholderia, pseudomonas
- abscesses
- chronic colitis
- lymphadenitis
diagnosis of chronic granulomatous disease
- dihydro-rhodamine neutrophil burst assay - absent
- nitroblue tetrazolium test -ve
cure for chronic granulomatous disease
stem cell transplant
presentation of IgE mediated allergic reaction
type 1 hypersensitivity reaction
anaphylaxis
angioedema
acute urticaria
vomiting
rhinorrhoea
diagnosis of IgE mediated reaction
- skin prick testing - wheal >2cm.
- serum IgE testing
inheritance of hereditary angioedema
autosomal dominant
describe hereditary angioedema
type 1 - deficiency of C1INH on chromosome 11.
deficiency of C1 esterase inhibitor causes increase bradykinin which causes leakage in post capillary venules
presentation of hereditary angioedema
episodic attacks of rash , abdo pain, oedema for 1-3 days
not cured by adrenaline or anti histamines
precipitated by stress, trauma, menstruation, ACE-I
diagnosis of hereditary angioedema
- reduced C1 esterase inhibitor
- C4 level reduced
complications of malaria
- resp distress, ARDS
- anaemia
- metabolic acidosis
- hypoglycaemia
- cerebral malaria
- acute tubular necrosos
- nephrotic syndrome
- DIC
diagnosis of malaria
- rapid antigen testing
- thick and thin blood films ( 3 x neg films 12 hours apart excludes diagnosis)
- thick = parasite detection
- thin = species detection. >2% parasites = severe malaria, >10% = exchange transfusion
malaria prophylaxis
malarone
presentation of lyme disease
stage 1 = erythema migrans ‘bulls eye rash’
stage 2 = flu like, neurological disease, myocarditis, 1st degree heart block
stage 3 = arthritis, acrodermatitis chronica atrophicans, polyneuropathy
diagnosis of lyme disease
ELISA test - if +ve, do immunoblot test
Treatment of lyme disease
doxycycline for 21 days (or if <12 y/o, amoxicillin)
presentation of EBV
fever
sore throat
cervical lymphadenopathy
splenomegaly/ hepatomegaly
malaise
maculopapular rash (worse with amox)
complications of EBV
meningitis
GBS
splenic rupture
chronic fatigue
hepatitis
diagnosis of EBV
- monospot test - heterophile abs +ve
- film - atypical lymphocytosis
- EBV antibody titre - IgM +ve
presentation of parvovirus B19 / slapped cheek
erythematous cheeks
fever/ coryza/ headache
maculopapular rash - lacy/ reticular trunk (not infectious when rash appears)
complications of parvovirus in pregnancy
hydrops fetalis
death
complications of parvovirus
aplastic crises in haemolytic disease
arthritis
presentation of measles
infectious 7 days after exposure
fever
Koplik spots - white on buccal mucosa
macular rash - behind ears, spread to face, chest and back
complications of measles
- otitis media
- bronchopneumonia
- subacute sclerosing pan -encephalitis ( 5-10 years after)
- acute demyelinating encephalitis
presentation of subacute sclerosing panencephalitis
5 - 10 years after measles
personality change
seizures
dyskinesia
progressive unresponsiveness
dementia
EEG of subacute sclerosing pan-encephalitis
periodic complexes, slow wave every 4-10 secs
presentation of mumps
fever
malaise
parotid swelling - b/l
complications - orchitis , meningitis
presentation of typhoid fever
(salmonella typhi)
- fever
- bradycardia
- rose spots
- dehydration
- epistaxis
- intestinal haemorrhage
management of typhoid fever
IV cefotaxime or ciprofloxacin
IVF
presentation of giardia
acute diarrhoea
chronic diarrhoea -> malabsorption / partial villous atrophy
management of giardia
metronidazole
presentation of schistomiasis
swimming in dirty water
unwell 4/52 after
painless haematuria
itchy rash
management of schistosimiasis
praziquantel
presentation of dengue fever
fever
rash
arthralgia
haemorrhagic fever! - severe abdo pain and bloody vomits
presentation of cholera
rice water diarrhoea
severe dehydration (50% die)
presentation of visceral leischmaniasis
ulcers with hyperpigmented scars
splenomegaly
hepatomegaly
anaemia
presentation of leptospirosis
contact with contaminated water
jaundice
renal disease ‘weils’
flu like illness
presentation of brucellosis
middle east/ mediterranean
from unpasteurised dairy products
fever
headache
anorexia
papular rash
complications of varicella
- secondary bacterial infection
- thrombocytopenia
- pneumonia
- cerebellitis - one week after rash -> ataxia
- encephalitis
who requires IV immunoglobulin in varicella zoster
- if immunocompromised and exposed
- if babies born to mothers who have chicken pox 5 days before delivery and 2 days after delivery
who requires IV aciclovir in varicella zoser
- neonates
- immunocompromised
- if very unwell
describe chediak hagashi syndrome
defect in lysosomal trafficiking leading to giant granules in white blood cells
presentation of chediak hagashi syndrome
- silvery hair , light skin
- recurrent infections
- peripheral neuropathy
diagnosis of chediak hagashi syndrome
peroxidase stained blood film
presentation of hyper IgE syndrome
mild dysmorphism- coarse facies, prominent forehead
eczema
increased infections (s.aureus pneumonia)
boils
retained primary teeth
autosomal dominant
diagnosis of Hyper igE syndrome
IgE >2000
eosinophilia
management of TB
- 6 months rifampicin
- 6 months isoniazid
- 2 months pyrazinamide
- 2 months ethambutol
side effects of rifampicin
orange/ red urine and tears
hapetotoxicty
pseudomembranous colitis
side effects of isoniazid
peripheral neuropathy
side effects of pyrazinamide
hepatotixicty
arthritis
increased uric acid
side effects of ethambutol
optic atrophy
peripheral neuropathy
treatment of shigella (gram -ve)
ciprofloxacin
