Infection Flashcards
give examples of systemic manifestations caused by group A streptococcal infection?
impetigo erysipelas glomerulonephritis necrotising fasciits rheumatic fever
what is kawasaki’s disease?
vasculitis of medium sized arteries
self limiting
what is the presentation of kawasaki’s disease?
fever for 5 days plus;
- bilateral conjunctival infection
- cracked lips/ strawberry tongue
- cervical lymphadenoapthy
- polymorphous rash
- changes of the extremities i.e. coffee coloured hands, swelling
how is kawasaki’s disease diagnosed?
clinical diagnosis
- do microbiology to test for bacterial or viral cause
what is the management for kawasaki’s disease?
aim prevent complications (coronary aneurysms)
- immunoglobulins
- aspirin
- steroids
- immunosuppressive agents
- cardiology assessment
in what age groups is varicella zoster more serious?
< 1 year old
adults
what are the complications of herpes simplex virus in neonates?
high mortality rate if not treated (> 50%)
majority have disseminated infections
- sepsis
- meningoencephalitis
- hepatitis (jaundice, bleeding)
what is the causative organism of hand foot and mouth?
enteroviruses
- coxsackie A16
- enterovirus 71
what is the common age prevalence of hand foot and mouth?
< 10 yrs
what is the clinical presentation of hand foot and mouth?
exanthema
painful
painful lesions
what time of the year is hand foot and mouth most common?
summer / early autumn
what are warning features of immunodeficiency in children?
faltering growth
deep skin infections or organ abscesses
need for IV antibiotics (> once)
family history
others; > 4 ear infections/year > 2 sinus infections/year >2 pneumonias >2 months antibiotics persistent thrush/fungal infections
what investigations would you carry out if you suspected immunodeficiency in a child?
FBC immunoglobulins HIV test functional antibodies lymphocyte subsets Nitroblue test TBT (tests for chronic granulomatous disease)
if a child presented with severe meningococcal sepsis and you suspected an immunodeficiency, what investigation would you carry out?
specific complement testing
what is the main risk factor for transmission of HIV from mother to baby?
high viral load
a 5 year old boy presents unwell with abdominal pain and fever.
he has recurrent skin infections and chronic diarrhoea and occasional cough.
investigations;
USS shows liver abscess
CXR shows aspergilloma
NBT test is positive
what is the diagnosis?
chronic granulomatous disease
what are the red flag features of an immunodeficiency?
SPURSS
Serious infection (hospitalisation or IV antibiotics) Persistent Unusual (organisms i.e. PJP) Recurrent Runs in the family
what are differentials of a vesicular rash + fever in a child?
herpes zoster virus (shingles)
herpes simplex virus
varicella zoster virus (chicken pox)
hand foot and mouth
what antibiotic is used against streptococcal infections?
penicillin
what antibiotic is used against staphylococcal infections?
flucloxacillin
what is the presentation of scarlet fever?
malaise, fever, pharyngitis
rash - sandpaper like, spares perioral area
strawberry tongue
squamation of hands and feet
what is the causative organism of scarlet fever?
group A streptococcus
what is the treatment for scarlet fever?
penicillin
what is the causative organism of hand foot and mouth?
enteroviruses i.e. coxsackie A16
enterovirus 71
what is the presentation of hand foot and mouth?
vesicular rash + fever
painful lesions
exanthema
at what time of the year is hand foot and mouth most common ?
summer/ early autumn
in what age group is hand foot and mouth most common?
< 10 years
how is HSV transmitted from mother to baby?
direct contact through the birth canal
give 2 differentials of a strawberry tongue.
scarlet fever
kawasaki’s disease
