Infections Flashcards
How is septicaemia managed?
Sepsis Bundle
Neonate: Ampicillin & Gentamicin
Child: Community= Cefotaxime, Hospital= Tazocin
What is the pathophysiology of septicaemia?
Bacterial autolysis causes endotoxin release
Leads to DIC, capillary leak, cariogenic & distributive shock
What are the signs & symptoms of septicaemia?
Fever Malaise Shock Joint pain Tachycardia & tachypnoea Hypotension Maculopapular rash/ Petechial/Purpura Raised ICP Altered consciousness Poor urine output
What causes chicken pox?
Varicella Zoster virus
Which age group is most commonly affected by chicken pox?
1-6yrs
How is chicken pox spread?
Respiratory droplet spread
Direct contact with lesion
How long does it take to incubate chicken pox and for it to be infective?
Inc: 3weeks
Inf: 2days before lesions until last one crusts over
What are the signs & symptoms of chicken pox?
Rash: Head & trunk first then limbs,
Red macules>papules > vesicles >pustule> crusting 5days
Headache
Anorexia
URTI
Fever
Itching
How is chicken pox diagnosed?
Clinical
Serology: IgM
Vesicle fluid
How is chicken pox treated?
Symptomatic relief (antipyretics, cooling baths)
Topical Calamine & Chlorphenamine (>1yr) for itching
Severe/immunoS: Aciclovir 800mg 5/day for 7days
DON’T GIVE NSAIDS: Reye’s Syndrome (liver failure)
What are the complications of chicken pox?
2 bacterial infection from Group A Strep Necrotising fasciitis Toxic shock syndrome Purpura fulminans Stroke Encephalitis life-threatening Pneumonitis Reactivation: Shingles
What does a reactivation of chicken pox lead to?
Shingles
Reactivation of latent infection
What are the signs & symptoms of measles?
Prodrome: Fever, coryza, cough, conjunctivitis, Koplik spots (blue grey spots on buccal mucosa)
Maculopapular rash starting behind the ears spreads cephalocaudally
Generalised lymphadenopathy
Anorexia
Fever
Diarrhoea
What are the complications of measles?
Acute otitis media
LRTI: Pneumonia, bronchiolitis
Encephalitis: After 8days- headache, lethargy, seizures
Subacute Sclerosing Panencephalitis: Rare & fatal neuro disorder- seizures, ataxia, intellectual deterioration 7y post-measles
How is measles managed?
NOTIFIABLE DISEASE Supportive (analgesia & hydration) Abx if bacterial: Vit A Immunoglobulins Prophylaxis: MMR
When does measles become infective?
4days before to 4days after rash appears
What is the exanthematous phase of measles?
Second vireaemia occurs 5-7days after initial infection
Rash develops 14days after initial infection
What is the pathophysiology of measles?
Highly contagious
Droplets inhaled
Affects epithelial cells in trachea by H-protein binding to receptor (CD46)
Fuses and virus enters cell
Virus: single stranded RNA & -ve sense (must be transcribed by cell)
Replication and spread via lymph nodes & blood
How is measles investigated?
Clinical: Koplik spots
Blood film: Leucopenia & lymphopenia
Bloods: LFTs
Serology: IgM
What is the incubation period for measles?
10-14days
What symptoms are seen in the prodromal phase of measles?
Conjunctivitis
Cough
Coryza
(High fever)
What causes Subacute Sclerosing Panencephalitis?
CHRONIC INFLAMMATION OF THE WHOLE BRAIN
Persistent measles infection
Abnormal immune response
Mutated measles strain
What are the causes of generalised lymphadenopathy?
Viral: EBV, HIV, CMV Bacterial: Syphilis, Brucellosis Protozoal: Toxoplasmosis Malignancy: Lymphoma, leukaemia Inflammatory: Rheumatoid, SLE, Sarcoidosis
What are the differentials of a prolonged fever?
TB Systemic JIA Secondary bacteria Infective endocarditis IBD
