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Child Health > Infections in Childhood > Flashcards

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

A

E. coli

24
Q

How might a child / infant with a UTI present?

A 
Non-specific illness!!
Fever
Irritability
Poor feeding
Vomiting
25
Q

What are the guidelines for when to investigate of UTI in infants / children?

A

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
Q

What should always be considered in an infant / child with an unexplained fever?

A

UTI - Often presents with non-specific symptoms

27
Q

What is the investigation(s) of choice for UTI in infants and children?

A

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
Q

What is an MCUG?

A

Micturating cystogram - Aims to detect vesicoureteric reflux in under 6/12 olds

29
Q

What is a DMSA?

A

A radio-isotope scan which clearly visualises the renal anatomy and looks for any scarring which may have been caused by recurrent UTIs

30
Q

Give some examples of enteroviruses

A

Coxackie virus A and B
Poliovirus
Echovirus

31
Q

What are the features of polio?

A

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
Q

What are the 2 manifestations of enteroviruses to be aware of in paediatrics?

A

Hand, foot and mouth disease (Coxackie virus)

Polio (poliovirus)

33
Q

What is the presentation of infectious mononucleosis?

A 
Fever
Malaise
Tonsillopharyngitis
Cervical lymphadenopathy
Petechiae on soft palate
Florid, maculopapular rash may develop if amoxicillin is given
Hepatosplenomegaly
34
Q

What is the treatment for infectious mononucleosis?

A

Symptomatic treatment

35
Q

What are the consequences to the baby of listeria infection in pregnancy?

A 
Miscarriage
Stillbirth
Prematurity
Sepsis
Conjunctivitis
Petechial rash
Leucopenia
Meningitis
36
Q

What are the neonatal symptoms of antenatal toxoplasmosis infection?

A 
Neurological symptoms: Hydrocephalus, encephalitis, epilepsy
Hepatosplenomegaly
Thrombocytopenia
Jaundice
Mental retardation
37
Q

How does rubella affect the baby if acquired antenatally?

A 
Sensorineural deafness
Congenital cataracts
Cardiac lesions
Jaundice
Hepatosplenomegaly
Purpura
Cerebral malsy
Microcephaly
Mental retardation
Microphthlmia
Retinitis
38
Q

What is the cause of roseola infantum?

A

Herpesvirus 6

39
Q

List some features of roseola infantum

A 
High fever for 2-5 days
Maculopapular rash develops suddenly as the fever is subsiding
Febrile convulsion
Diarrhoea
Cough
40
Q

List some complications of mumps

A

Orchiditis
Pancreatitis
Meningitis
Oophoritis

41
Q

How is measles diagnosed?

A

Detection of virus nucleic acid in throat swab or urine

Detection of measles IgM

42
Q

How should an immunocompromised patient who comes into contact with measles (and who is not themselves immune) be managed?

A

Check immune status

Give measles immunoglobulin if not immune

43
Q

True / False: Measles vaccination is given to immunocompromised patients who come into contact with a patient with measles and who are not immune themselves

A

False - The measles vaccine is part of the live MMR vaccine and so cannot be given to immunocompromised patients

44
Q

Give 3 infections in childhood which cause vesicular rashes

A

HSV
VZV (Chickenpox)
Hand, foot and mouth disease (enterovirus)

45
Q

A rash which appears after a fever has subsided is typical of which childhood infection?

A

Roseola infantum

Child Health (13 decks)

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