Infections Flashcards
What is Tonsillitis?
A form of Pharyngitis where intense inflammation of the tonsils leads to a purulent exudate
What are some of the common causative pathogens of Tonsillitis?
Group A Strep
Epstein-Barr Virus
What are some symptoms of Tonsillitis?
Headache Apathy Abdominal Pain Painful Swallow White Tonsillar exudate Cervical Lymphadenopathy
Which diagnostic criteria can be used to assess the severity of Tonsillitis?
Fever-Pain
CENTOR
What are the criteria for Fever-Pain?
Fever Absent Cough Symptom onset <3d ago Inflamed Tonsils Tonsillar Exudate
What does a Fever-Pain of 1 suggest?
Abx are not indicated
What does a Fever-Pain of 2-3 suggest?
Consider delayed Abx script
What does a Fever-Pain of 4-5 suggest?
Antibiotics are indicated
What are the criteria for CENTOR?
Fever Tonsillar Exudate Absent Cough Anterior Cervical Lymphadenopathy Age 3-14
Which CENTOR score suggests treatment with Abx is necessary?
3 or more
Which Antibiotic should be given if required for Tonsillitis?
Penicillin V
Erythromycin if Penicillin allergic
When should children be referred for a tonsillectomy?
If they present with recurrent tonsillitis
What are some indications for a tonsillectomy?
Recurrent severe tonsillitis
Presence of a Peritonsillar Abscess (Quinsy)
Obstructive Sleep Apnoea
What are some clinical features of a Measles infection?
Rash Conjunctivitis and Coryza Koplik Spots Fever Marked malaise
How does the rash present in Measles?
Discrete Maculopapular rash which becomes blotchy and confluent. Starts initially behind the ears, spreads to the entire body
What are Koplic spots?
White spots found on Buccal Mucosa, Pathognomic for Measles
How should a confirmed Measles case be managed?
Supportive
What are some complications of a Measles infection?
Respiratory - Pneumonia, secondary infection
Neuro - Seizures, Encephalitis
Other - Diarrhoea, Hepatitis, Appendicitis
When does a Mumps infection usually present?
Winter and Spring Months
What are some features of a Mumps infection?
Fever
Malaise
Parotiditis
Earache/Pain when E+D
How severe is a Mumps infection usually?
Mild, self-limiting
What are some potential complications of a Mumps infection?
Viral Meningitis and Encephalitis
Orchitis
Hearing loss - Unilateral, transient
What is Rubella?
A mild disease in childhood that usually presents in winter and spring
Which patients have to be particularly wary of a Rubella infection?
Pregnant women, as there are risks to the Fetus
How does Rubella present?
Maculopapular rash initially of the face, then spreading to the entire body
Prominent lymphadenopathy
How should a Rubella infection be managed?
Supportive
What are some potential complications of a Rubella infection?
Arthritis
Encephalitis
Thrombocytopenia
Myocarditis
When do children recieve the MMR vaccine?
First Dose - 1y
Second Dose - 3y 4m
What is Acute Epiglottitis?
Swelling of the epiglottis and surrounding tissues
Which organism is responsible for Acute Epiglottitis?
H.Influenza B
When is acute epiglottitis most common?
1-6y
What are some signs of potential acute epiglottitis?
High fever in a very ill, toxic-looking child
Intensely painful throat that prevents speaking or swallowing
Drooling of saliva down chin
Inspiratory stridor with increasing respiratory difficulty
Child sitting immobile and upright with an open mouth to optimise airway
Minimal/absent cough
Why shouldn’t you examine the throat of a child with suspected Epiglottitis?
This can lead to acute oedema, giving airway obstruction and death
How should acute epiglottitis be managed?
ENT management Intubation under GA Blood Cultures IV Cefotaxime Prophylactic Rifampicin for close household contacts
