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Infections in Childhood Flashcards

1
Q

What are the features of mumps?

A

Prodromal malaise
Fever
Parotitis - may start unilateral and become bilateral

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2
Q

Which viral infection of childhood is associated with arthritis as a complication?

A

Rubella

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3
Q

What is ‘German Measles’?

A

Rubella

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4
Q

How does rubella present if it is acquired in childhood?

A

Prodromal illness - low grade fever
Rash which starts on face and spreads over body
Lymphadenopathy - posterior auricular and occipital nodes

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5
Q

What is the incubation period of rubella?

A

2-3 weeks

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6
Q

For which childhood viral infection are Koplik’s spots pathognomonic?

A

Measles - although these are sometimes hard to see

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7
Q

What is a very rare, late (from 7 years after initial infection) complication of measles, and how does it present?

A

Subacute sclerosing pan encephalitis - Presents with loss of neurological function which progresses over many years, leading to dementia and death

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8
Q

What is the incubation period of measles? How long is a child infectious for?

A

5-14 days (average about 10 days)…Infectious until about Day 5 of the rash

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9
Q

Give some clinical features of measles

A 
Prodromal illness
Coryza, cough
Conjunctivitis
Koplik's spots
Maculopapular rash late in the illness (starts from the ears and spreads downwards, covering entire body)
Encephalitis - rare
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10
Q

What are Koplik’s spots and when are they seen?

A

White spot on buccal mucosa which are pathognomonic of measles infection although they can be difficult to see on the mucosa

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11
Q

What is the treatment for measles?

A

Symptomatic
Isolate infected children if in hospital
Prevention with vaccination

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12
Q

Which age-group are most commonly affected by measles?

A

Age 5-10

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13
Q

Which virus causes glandular fever?

A

Epstein-Barr virus (EBV)

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14
Q

By what name(s) is erythema infectiosum also known?

A

‘Fifth’ disease

Slapped cheek disease

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15
Q

Which virus causes erythema infectiosum?

A

Parvovirus B19

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16
Q

What are the features of erythema infectiosum?

A 
Fever, lethargy
Malar rash ('slapped cheek' appearance), spreading to limbs
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17
Q

What are the complications of erythema infectiosum?

A

Aplastic crisis - the virus suppresses bone marrow

Complications in pregnancy - Hydrops fetalis and fetal death

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18
Q

Describe the progression of the rash in chickenpox

A

Macules, then papules, then vesicles, then pustules, then crusts

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19
Q

What are the 2 common features of chickenpox?

A

Fever

Rash which follows a particular progression

20
Q

True / False: Vaccination against VZV is given to everyone in the UK

A

False - There is a vaccination available but it is not routinely given in the UK

21
Q

Which virus causes hand, foot and mouth disease?

A

Coxackie A16 virus

22
Q

What are the features of hand, foot and mouth disease

A

The child is mildly unwell, perhaps with fever
Vesicles appear on palms, soles and in mouth
There may be associated sore throat
Treatment is symptomatic

23
Q

Which organism causes 95% of UTIs in children

24
Q

How might a child / infant with a UTI present?

A 
Non-specific illness!!
Fever
Irritability
Poor feeding
Vomiting
25
What are the guidelines for when to investigate of UTI in infants / children?
Single, uncomplicated UTI in infant/child over 6 months = No investigation required Investigate if: - Any UTI in infant under 6 months old - 2 or more UTIs in infant/children over 6 months old
26
What should always be considered in an infant / child with an unexplained fever?
UTI - Often presents with non-specific symptoms
27
What is the investigation(s) of choice for UTI in infants and children?
Ultrasound scan within 6/52: Typical UTI in infant / child under 6 months old, recurrent UTI in children over 6 months old DMSA: All infants and children under 3 yrs old if atypical or recurrent UTIs MCUG: Infants under 6 months with atypical / recurrent UTI Acute ultrasound scan: All infants and children if atypical UTI
28
What is an MCUG?
Micturating cystogram - Aims to detect vesicoureteric reflux in under 6/12 olds
29
What is a DMSA?
A radio-isotope scan which clearly visualises the renal anatomy and looks for any scarring which may have been caused by recurrent UTIs
30
Give some examples of enteroviruses
Coxackie virus A and B Poliovirus Echovirus
31
What are the features of polio?
Over 90% are asymptomatic Mild symptoms such as fever, headache, malaise May cause aseptic meningitis 'Paralysis polio' is caused when the virus destroys the anterior horn cells of spinal cord
32
What are the 2 manifestations of enteroviruses to be aware of in paediatrics?
Hand, foot and mouth disease (Coxackie virus) | Polio (poliovirus)
33
What is the presentation of infectious mononucleosis?
``` Fever Malaise Tonsillopharyngitis Cervical lymphadenopathy Petechiae on soft palate Florid, maculopapular rash may develop if amoxicillin is given Hepatosplenomegaly ```
34
What is the treatment for infectious mononucleosis?
Symptomatic treatment
35
What are the consequences to the baby of listeria infection in pregnancy?
``` Miscarriage Stillbirth Prematurity Sepsis Conjunctivitis Petechial rash Leucopenia Meningitis ```
36
What are the neonatal symptoms of antenatal toxoplasmosis infection?
``` Neurological symptoms: Hydrocephalus, encephalitis, epilepsy Hepatosplenomegaly Thrombocytopenia Jaundice Mental retardation ```
37
How does rubella affect the baby if acquired antenatally?
``` Sensorineural deafness Congenital cataracts Cardiac lesions Jaundice Hepatosplenomegaly Purpura Cerebral malsy Microcephaly Mental retardation Microphthlmia Retinitis ```
38
What is the cause of roseola infantum?
Herpesvirus 6
39
List some features of roseola infantum
``` High fever for 2-5 days Maculopapular rash develops suddenly as the fever is subsiding Febrile convulsion Diarrhoea Cough ```
40
List some complications of mumps
Orchiditis Pancreatitis Meningitis Oophoritis
41
How is measles diagnosed?
Detection of virus nucleic acid in throat swab or urine | Detection of measles IgM
42
How should an immunocompromised patient who comes into contact with measles (and who is not themselves immune) be managed?
Check immune status | Give measles immunoglobulin if not immune
43
True / False: Measles vaccination is given to immunocompromised patients who come into contact with a patient with measles and who are not immune themselves
False - The measles vaccine is part of the live MMR vaccine and so cannot be given to immunocompromised patients
44
Give 3 infections in childhood which cause vesicular rashes
HSV VZV (Chickenpox) Hand, foot and mouth disease (enterovirus)
45
A rash which appears after a fever has subsided is typical of which childhood infection?
Roseola infantum

Child Health (13 decks)

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