infection and immunity Flashcards
How to safety net febrile child
come back if: seizures unwell > 5 days rashes child looks generally unwell concerned you can't look after child
What organisms cause meningitis
<3 months group b strep e. coli listeria 3 months - 6 years n. meningitides strep pneumonia h. influenza
what are the contraindications for LP
neuro signs of inc. ICP
cardio resp fragility
thrombocytopenia
coagulopathy
Mx meningitis
- benzylpenicillin ASAP
- 3rd gen cephalosporin (+ supportive - anticonvulsants, saline)
- Dexamethasone if: v. turbid csf, CSF WCC >1000, bacteria on gram stain
don’t use steroids in meningococcal speticaemia
give ciprofolxacin prophylaxis to all household after meningococcal meningitis or h.influenza
Causes of atypical meningitis
Lyme’s disease
TB
mycoplasma
fungal
Mx encephalitis
treat all w/ IV aciclovir until cause is determined supportive care in ICU HSV1+2 - IV aciclovir VZV- aciclovir/ganciclovir CMV - ganciclovir +foscarnet EBV - aciclovir
What causes toxic shock syndrome
toxin producing staph a
group a streptococci
how does toxic shock syndrome present
fever
hypotension
widespread erythematous macular rash
NB- some staph a have PVL which causes necrotising fasciitis
after 2 weeks get desquamation of palms + soles
Mx of toxic shock syndrome
ICU
surgically debride infected areas
start BSA before cultures come back
What does impetigo look like
honey crusted lesions on nose and mouth
Mx impetifo
advice about hand washing
topical or oral abx
mx
admission
IV abx (flucloxacillin)
emollient
How does HSV present in most children
gingivostomatitis
secondary presentations (from reactivation):
cold sores
eczema herpeticum (can get overlying bacterial infection)
herpetic whitlow on skin by nails
eye problems
Which children get disseminated HSV
neonates
immunocompromised
get encephalitis and aseptic meningitis
Mx HSV
symptomatic
if severe: aciclovir and IV fluids