infection Flashcards
kawasakis disease presentation (My HEART)
mucosal involvement - dry lips, strawberry swollen tongue
hand and feet with oedmea
eyes - non purulunt bilateral conjunctivitis
andenopathy - cervical, unilateral
rash - truncal and pleomorphic (maculopapular)
temperature - non remittting fever at least 5 days
kawasakis disease what is it
idiopathic systemic vasculitis
causes coronary aneurysms - echocardiogram
kawasakis disease management
aspirin (beware reyes syndrome) IV immunoglobulin (reduces fever and myocardial inflammation)
measles (notifiable disease) presentation (4cs) and rash
prodrome - cough, coryza, conjunctivitis, cranky
rash - first behind ears, forehead, spreads to involve trunk and limbs
also grey/white spots in mouth
measles (notifiable disease) complications
otitis media - most common
pneumonia - most common cause of death
subacute sclerosing panencephalitis - chronic complication, develops 7-13yrs after measles with changes in behaviour, dementia, death
measles (notifiable disease) management
nutrition
vitamin A in developing world
scarlet fever (notifiable disease) presentation
sore throat and fever
rash on chest, axilla or behind ears
red ‘pin prick’ blanching rash, facial flushing and strawberry tongue
scarlet fever (notifiable disease) management
penicillin or clarithromycin
scarlet fever (notifiable disease) complications
sydenhams chorea (involuntary jerking movements)
scarlet fever (notifiable disease) cause
endotoxin from strep pyognes (group A haemolytic)
rubella (notifiable disease) presentation
macular rash
suboccipital lymphadenopathy
rubella (notifiable disease) complications
small joint arthritis infection during fetal development causes: week 1-4 eye anomaly week 4-8 cardiac abnormality week 8-12 deafness
rubella (notifiable disease) managment
RNA virus - vaccine
chicken pox cause and presentation
varicella zoster virus
itchy vesicles
chicken pox management
calamine lotion
flucloxacillin if bacterial superinfection
chicken pox DD
shingles
shingles presentation
reactivation of vzv in posterior root ganglia
confined to one dermatone
diphtheria presentation
tonsilits
may cause polyneuritis
dysphagia, muffled voice, upper airway obstruction
diphtheria treatment
anti-toxin and erythromycin
pertussis (whooping cough) (notifiable disease)
bordetella pertussis (gram -ve coccobacillus)
diphetheria cause
toxin from corynebacterium diphtheriae
pertussis signs
apnoea
barking cough - worse at night
pertussis management
macrolides - azithromycin/clarithromycin
TB signs and symptoms
suspect with overseas travel weight loss low fever malaise cough
TB diagnosis
tuberculin hypersensitivity (mantoux test)
culture and ziehl neelson acid fast stain
CXR - consolidation, miliary spots
TB management RIPE +SE
rifampicin - 6 months Nausea; thrombocytopenia; vomiting
isoniazid - 6 months hepatitis
pyrazinamide - 2 months hepatitis
ethambutol - 2 months Hyperuricaemia; nerve disorders; visual impairment
HIV diagnosis
CD4 count <200 = AIDS (CD4 count useful for staging)
HIV viral PCR
p24 antigen
HIV considerations
children should always be bottle fed if mother +ve (risk of vertical transmission) consider in children with: pyrexia of unknown origin hepatosplenomegaly persistant diarrhoea
HIV management
highly active antiretroviral therapy ccr5 antagonists nucleotide and non nucleotide reverse transcriptase inhibitors integrase strand transfer inhibitors protease inhibitors
meningitis aetiology 3 children 3 neonates
children: neisseria meningitis, haemophilus influenza, strep pneumoniae
neonates: group B haemolytic step (via mothers vagina), e.coli, listeria
meningitis presentation (septic and meningeal signs)
septic signs: increased temp, pulse and RR decreased BP abnormal cry / skin colour cold extremities
meningeal signs:
neck stiffness
kernings sign
photophobia
bacterial meningitis diagnosis opening pressure WBCs appearence glucose protein
elevated polymorphs - neutrophils turbid low elevated
viral meningitis diagnosis opening pressure WBCs appearence glucose protein
normal lymphocytes clear normal elevated
meningitis management
IV cefotaxime STAT, then cultures/CSF
in community - benzylpenicilin
contact tracing - close contacts have Ciprofloxacin one dose or Rifampicin BD 2 days
if viral - acyclovir
encephalitis signs
flu like prodrome
behaviour changes
vomiting
fits
encephalitis causes
Herpes simplex virus also mumps, varicella zoster
encephalitis management
HSV - aciclovir
slapped cheek syndrome (erythrovirus) cause
parovirus B19 (respiratory droplets spread)
slapped cheek syndrome (erythrovirus) presentation
malar erythema (slapped cheek rash), spreads to limbs (mainly extensor surfaces) may cause aplastic crisis
slapped cheek syndrome (erythrovirus) diagnosis
B19 IgM - current / recent infection
B19 IgG - immunity
slapped cheek syndrome (erythrovirus) complications
growth restriction
hydrops
fetal death in pregnancy
impetigo cause
staph aureus +/- strep pyogenes
impetigo management
fusidic acid and oral flucloxacilin
toxic shock syndrome cause
s.aureus + group a step (rare)
toxic shock syndrome signs
fever, hypotension, malar rash
toxic shock syndrome management
ITU
ceftriaxone + clindamycin
coxsackies disease presentation
mildly unwell
vesicles on palms, soles and mouth
red flags for serious illness colour activity respiratory circualtion other
pale no response grunting, RR>60 reduced turgor non blanching rash, bludging fontanelle, seizures, neck stiff <3months old
orange flags for serious illness colour activity respiratory circulation and hydration other
pallor not responding normally to social ques nasal flaring RR>50 tachycardia, CRT>3, dry mucus membranes prolonged fever, 3-6 months, rigors
TORCH infections - teratogenic
most common perinatal infections
toxoplasmosis
other - syphilis (can cause miscarriage. benzylpenicilin), varicella zoster, parovirus B19
rubella
CMV - most common, growth retardation (IUGR) may develop hearing, visual and mental impairment
herpes simplex - blindness, low IQ
