Infection Flashcards
What organisms are commonly the cause of meningitis in neonates?
Group B strep
E-Coli
Staph aureus
Listeria
What organism causes meningitis in children 3 month to 5 yo?
Meningococcus (N. Meningitidis)
Pneumococcus (strep. Pneumonae)
And???
What does the vaccine DTaP/IPV/ HiB
aka the 5in1 vaccine protect against?
Diphtheria Tetanus Pertussis (whooping cough) Polio Haemophilia influenza B
When is the vaccine DTaP/IPV/ HiB
aka the 5in1 given?
2months
3months
4months
What is the success rate of the rota virus vaccination?
70%
When do children receive the MMR vaccine?
12-13 months
And
3 years 4 months old
What is the incubation of chicken pox?
14-21 days
How long after the onset of the rash in chicken pox is the child infectious?
Infectious for 5 days
When might you give a child which chickenpox IV Or oral Aciclovir
IV if immunocompromised
Oral if has atopic eczema
What virus causes infectious mononucleosis?
Epstein-Barr virus
Neonatal conjunctivitis is a notifiable disease. What organisms cause it?
Staph aureus
Gonorrhoea
Chlamydia
What is opthalmia neonatoum?
A purilent conjunctivitis occurring within 3 weeks of life
What virus causes measles?
Paramyxovirus
More specifically the morbillavirus
Where does the rash start in measles? And how does it spread?
Starts behind the ears and spreads across face and trunk.
When is measles infective?
4 days before and 4 days after the rash.
Why is a vitamin A deficiency bad combined with measles?
At greater risk of blindness and even death - crazy.
What is the treatment for measles?
Supportive treatment.
Also it is a notifiable disease
Who do you inform if you have a notifiable disease?
Proper office of local health protection team.
Who in turn inform the health protection agency
What investigation do you do to identify measles?
Salivary swab or serum sample for measles specific IGM
Taken within 6 weeks
What causes diptheria?
Corynebacterium diptheriae
What organism causes tetanus?
Clostridium tetani
What does tetanus do? Why is it dangerous?
Causes progressive painful muscle spasms
If it involves respiratory muscles can lead to death
What can polio cause?
Anterior horn cell damage leading to paralysis and pain.
What are the complications of mumps?
Aseptic meningitis, sensorineural deafness, orchitis (infertility)
What antibiotic should be avoided in tonsillitis and why?
Amoxicillin
Because if it is caused by ebv then may cause widespread rash
If a child has signs and symptoms of meningitis and the CSF have signs of bacterial infection but nothing grows in culture what may have happened?
The child may have had oral antibiotic tx leading up to the lumbar puncture
What are the leptomeninges?
The arachnoid and pia mater
Name 4 mains symptoms of meningitis in older children
Headache
Fever
Neck stiffness
Altered mental state
What is kernings a sign?
Pain on lower leg extension whilst the hip is flexed
What is brudzinskis sign?
When the neck is flexed the child flexes knee and hip involuntarily
What are the most common cause of meningitis in neonates (up to 3 month)?
Group b strep
Ecoli
Staph a
Listeria monocytogenes
What are the common bacterial causes of meningitis?
Neisseria meningitidis
Strep pneumonia
HiB - not so much
What happens to proteins to glucose bacterial meningitis?
Protein is raised and glucose is low
What is the normal ratio between glucose in CSF and the blood stream?
CSF glucose should be two thirds of the serum glucose
What cells would you see in CSF in bacterial or viral meningitis?
Bacterial - neutrophils
Viral - lymphocytes
( although bacterial infection may start with high neutrophils)
Which of the 2 main bacterial causes are more likely to cause neurological impairment post meningitis infection?
Pneumococcal or meningococcal
What are the complications of meningitis?
Hearing loss Local vasculitis leading to cranial nerve palsys or focal lesions Seizures/ epilepsy Sub dural effusion Hydrocephalus Cerebral abscess
What type of bacteria is neisseria meningitidis?
Gram negative diplodocus
What type of bacteria is streptococcus pneumonae?
Gram positive alpha haemolytic anaerobe
Grow in grape like clusters
What sis the most common cause of septic shock in children?
Meningococcal
Commonest cause of sepsis in neonate?
Group B strep
Why might myocardial dysfunction occur in sepsis?
Inflamm cytokines and circulating toxins depress myocardial contractility
Name two major complications of sepsis?
Multiorgan failure
DIC
What signs should you look for in dehydration?
Prolonged CRT Abnormal skin turgor Weak pulse Mucous membranes Respiratory pattern Cold peripheries
After an infection SAIDH can occur, what hormone is increased?
Antidiuretic hormone (adh) (Aka vasopressin)
Where is ADH released from?
Where does it act?
Released from hypothalamus, acts on kidneys
What does ADH do to the urine production?
Less urine produced
But increased conc
So basically more water is absorbed back into body
What infections can cause SAIDH?
Pneumonia
Meningitis
Should antibiotics be prescribed for otitis media?
No
Just need pain relief
What is a delayed antibiotic prescription given in otitis media?
Can be collected if child had not improved within 4 days or gets worse
Who would you give antibiotics too in children with otits media?
Age less than two with bilateral OM
With perforation of discharge in ear canal
If less than 3mo or with severe fever consider admission
What antibiotics would you prescribe for OM?
5 day course of penicillin
How many episodes do you have to have to have recurrent OM?
3 in 6mo
4 in 12mo
What can be done in recurrent OM?
Grommits
What is the proper term for grommits?
Tympanostomy tubes
Which vaccine is thought to help prevent recurrent otitis media?
Pneumococcal
What is the proper term for glue ear?
Otitis media with effusion
How is glue ear different to acute otitis media?
In glue ear there is fluid in the middle ear but no symptoms or signs of acute inflammation
How common is glue ear in children age 2?
Age 7?
20%
8%
Is glue ear more common in girls or boys?
Boys
What is the pneumococcal vaccine given?
2 mo
4 mo
1 year
What does DTaP stand for?
Diptheria
Tetanus
Accellular pertussus
What does IPV stand for?
Inactivated polio virus
When is the influenza vaccine given?
Age 2 and 3
Also to high risk children such as those with asthma or immunocompromised
How is the influenza vaccine administered in toddlers?
Nasal spray
When is the meningitis C vaccine given?
3 months
1 year
14 years
When is the pneumococcal vaccine given?
2 months
4 months
1 year
(65 years old)
What are the vaccines given at 2 months old?
5in1
Pneumococcal
Rotavirus
What are the vaccines given at 3 months old?
5in1
Men C
Rotavirus
What are the vaccines given at 4 months old?
5 in 1
Pneumococcal
What vaccines are given at 14 years old?
3 in 1 (diptheria, tetanus, polio)
Men C
When is the influenza vaccine given?
Age 2 and 3
Also to high risk children such as those with asthma or immunocompromised
How is the influenza vaccine administered in toddlers?
Nasal spray
When is the meningitis C vaccine given?
3 months
1 year
14 years
When is the pneumococcal vaccine given?
2 months
4 months
1 year
(65 years old)
What are the vaccines given at 2 months old?
5in1
Pneumococcal
Rotavirus
What are the vaccines given at 3 months old?
5in1
Men C
Rotavirus
What are the vaccines given at 4 months old?
5 in 1
Pneumococcal
What vaccines are given at 14 years old?
3 in 1 (diptheria, tetanus, polio)
Men C
