Infection

Question 1

In suspected meningitis, if a child has a fever and purpura, what needs to be given urgently?

Answer 1

Antibiotics

Question 2

Which are the most common bacterial agents for meningitis in:

1) neonates
2) 1-5 years
3) 5+ years

Answer 2

1) gram -ve (birth canal e.coil, Kleb) and group B strep, listeria
2) strep pneumonia, meningococcal, HIb
3) strep pneumonia, n.meningitis

Question 3

How can you tell the difference between viral and bacterial CSF infection in meningitis?

Answer 3

Viral - clear - protein ⬆️glucose 〰

Bacterial - cloudy- protein ⬆️⬆️glucose ⬇️

Question 4

When is a lumbar puncture contraindicated?

Answer 4

Prolonged or focal seizure
Focal neurology
Gcs<13
Purpuric rash 
Abnormal pupils or posture 
Coagulation disorders
Cushings triad (high bp/ wide pulse pressure, Brady cardiac, irregular breathing) -> raided ice

Question 5

Rx for septicaemia in children?

Answer 5

Fluid resuscitation 
Iv Ceftriaxone
Corrections (glucose, electrolytes, dic)
Intubation if required 
Inotropes

Question 6

Rx for meningitis?

Answer 6

Iv dexamethasone before abx

Iv ceftriaxone

Question 7

Sore eyes, white spots in mouth, fever and cough indicated what infection?

Answer 7

Measles

Question 8

Which infections have fever and vesicular rashes?

Answer 8

Chickenpox
Herpes simple
Hand foot and mouth

Question 9

How is the chicken pox risk in I

Immune compromised patients managed?

Answer 9

Avoid exposure
Prophylaxis with zoster immune globulin
Treatment with Iv acyclovir

Question 10

How would you treat listeria in neonates?

Answer 10

Ampicillin / amoxicillin

Question 11

What infection do you think of with 5 days fever, plus sore lips, conjunctivitis, cervical lymphadenopathy, oedema in hands and feet, and rash.

Answer 11

Kawasaki disease
Rx - high dose Iv Ig, aspirin

Do an ECHO - coronary artery aneurysms