Infection Flashcards
what does SIRS stand for?
systemic inflammatory response syndrome
state some symptoms of SIRS?
fever
tachycardia
tachypnoea
leucocytosis
state some pathogens that cause sepsis in neonates ?
group B strep
E coli
listeria monocytogenes
state some pathogens that cause sepsis in children ?
strep pneumonia
meningococci
group A strep
staph aureus
state some symptoms of sepsis ?
fever cold hands prolonged cap refill limb pain vomiting malaise reduced urine output chills
what two things are required for paediatric sepsis?
SIRS and a proven or suspected infection
what is ARDS?
acute respiratory distress syndrome
what is toxic shock syndrome?
warm shock
- vasodilation due to toxins released by strep or staph
what is the presentation of meningitis in children?
Nuchal rigidity, headaches, reduced GCS, seizures, irritability, bulging fontanelle, nappy pain
what investigations should be done for sepsis ?
FBC CRP Coagulation factors blood gases glucose CSF urine culture CT cerebrum (not in acute presentation)
what will the FBC show in sepsis ?
leucocytosis
thrombocytopenia
will the CRP be elevated or reduced during meningitis?
elevated
what will the ABGs show during meningitis ?
metabolic acidosis
will glucose be reduced or increased during meningitis?
reduced
will CSF have increased or reduced protein during meningitis?
elevated
what antibiotics should be used with good CSF penetration for meningitis ?
3rd generation cefalosporins
+ amoxicillin in neonates
with what meningitis infections should close family be treated for as well?
meningococcus B and strep group A
what are some complications of pneumococcal meningitis ?
brain damage
hearing loss
hydrocephalus
what are some complications of meningococcal meningitis ?
amputation and skin scarring
are there vaccinations to reduce the incidence of meningitis ?
yes
- meningoccocal
- pneumococcal
- haemophilus influzena B
what endotoxin does meningococcal disease release?
lipooligosaccharide
- increased levels increases mortality
out of strep and staph what has higher resistance?
staph
what is strep treated with?
penicillins
what is staph treated with?
flucloxacillin
what is the resistant form of staph called?
MRSA
is MRSA becoming more or less common?
more common
is scarlet fever a strep or staph infection?
strep infection
- usually S pyogenes
state some symptoms of scarlet fever?
malaise fever tonsillitis strawberry tongue exanthema (sand paper rash)
what is the treatment of scarlet fever?
10 day penicillins
what are some complications of scarlet fever?
cellulitis
impetigo
rheumatic fever
GN (glomerulonephritis)
what are the two virulence factors of scarlet fever?
M proteins
Exotoxins
state two skin infections caused by strep and staph ?
impetigo
SSSS (staphlococcal scalded skin syndrome)
out of impetigo and SSSS what one is more mild?
impetigo
what is impetigo treated with?
topical Tx
what is SSSS treated with?
IV antibiotics
is impetigo highly contagious?
yes
state three types of vesicular rashes?
herpes simplex
varicella zoster
enertovirus
what are the two types of HSV
1 - oral
2 - genital
what are some symptoms of HSV?
stomatitis
recurrent cold sores
finger infections
what is the Tx for HSV?
self limiting
acyclovir
what age range is more at risk of HSV complications?
neonates
state some complications of HSV?
sepsis
meningoencephalitis
hepatitis
is varicella zoster virus very prevalent ?
yes
- in children and adults
- remains latent in nerve roots
within what time period after infection should new lesions appear in chicken pox?
5 days
what is reactivation of varicella zoster called?
shingles
state some compilations of varicella zoster ?
secondary skin infections ( form scratching)
meningoencephalitis
cerebelitis
state some warning signs that the chicken pox may be fatal
high fever
new lesions after 10 days
inflamed lesions
general malaise
what are the two risk groups for complications ?
<1yrs
T cell deficiencies
give an example of an enterovirus infection?
hand foot and mouth disease
what is the management for enterovirus infections?
supportive
- no treatment available
what investigations should be done for viral infections?
smear of vesicle (ulcer base)
PCR (fluids, CSF, blood)
serology
what infection does kawasaki disease mimic?
strep A infections
give an example of a strep A infection?
scarlet fever
what organism causes scarlet fever?
S pyogenes
what is a complication of kawasaki disease?
coronary artery disease
state some symptoms of kawasaki disease?
fever for at least 5 days peripheral oedema and erythema strawberry tongue conjunctivitis cervical lymphadenopathy change in mucous membranes - lips and tongue
what are the two treatments for kawasaki disease
immunoglobulins
- stop inflammation
aspirin
- stop thrombotic events in inflamed vessels
what is the cause of kawasaki disease
unknown
what is a DD for kawasaki disease?
strep infections
henoch scholein purpura
what are some symptoms of henoch scholein purpura ?
vasculitis
non blanching
generally well
what medication is used to treat staph infections?
flucloxacillin
what gram is meningococcal disease?
gram negative
