INFECTIOUS Flashcards
Mechanisms of fever production (3)
- Pyrogens (endogenous /exogenous )
- Heat production exceeding loss (salicylate poisoning or malignant hyperthermia)
- Defective heat loss (ectodermal dysplasia / severe heat exposure)
4 subtypes of fever of unknown origin
Classic FUO
Health-care associated
Immune-deficient
HIV related
Define Classic FUO
- Fever >38 C
- > 3 weeks
- > 2 visits or > 1 week in hospital
Define Health-care associated FUO
- Fever > 38 C
- > 1 week
- Not present or incubating on admission
Children with this defect can have a history of delayed cord separation and recurrent infections of the skin, oral mucosa, and genital tract beginning early in life.
Leukocyte adhesion defects
- Caused by defects in the β chain of integrin (CD18), which is required for the normal process of neutrophil aggregation and attachment to endothelial surface.
- Neutrophil count in the peripheral blood is usually extremely elevated and pus is not found at the site of infection
Children who have congenital asplenia or splenic dysfunction due to hemoglobinopathies such as sickle cell disease or have undergone splenectomy are at risk for serious infections from these pathogens (2)
- encapsulated bacteria
- blood-borne protozoa such as Plasmodium and Babesia
> consider prophylaxis with penicillin, esp in children under 5 yo
most common causative organisms include Streptococcus pneumoniae, Haemophilus influenzae type b, and Salmonella, which can cause sepsis, pneumonia, meningitis, and osteomyelitis
Terminal complement defects (C5, C6, C7, C8, and C9) are associated with recurrent infections with this pathogen
Neisseria
> Vaccines for S. pneumoniae, H. influenzae type b, and Neisseria meningitidis should be administered to all children with abnormalities in opsonization or complement pathways.
Antibody deficiency that leads to a lack of production of secretory antibody at the mucosal membranes
Selective IgA deficiency
- recurrent sinopulmonary infection and GI disease are the major clinical manifestations
X-linked recessive disease associated with eczema, thrombocytopenia, a reduced number of CD3 lymphocytes, moderately suppressed mitogen responses, and impaired antibody response to polysaccharide antigens
Wiskott-Aldrich syndrome
> infections with S. pneumoniae or H. influenzae type b and PCP are common
W- Weeping skin lesions- eczema
A- Absent platelets- thrombocytopenia - leading to petechiae
S- Severe immunodeficiency…… (low IgM and high IgA & IgE levels)
Triad of Botulinum
- acute onsset of SYMMETRIC flaccid, descendin paralysis w clear sensorium
- NO FEVER
- NO PARESTHESIA
The only bacterium known to infect Schwann cells of peripheral nerves
Mycobacterium leprae
> Hansen disease
> Leonin facies
Hutchinson Triad
Seen in?
- Hutchinson teeth
- 8th Cranial nerve deafness
3.interstitial keratitis
Congenital syphilis
WHO criteria for diagnosis of C. trachomatis (4)
WHO: at least 2 of 4 criteria must be present for a diagnosis of trachoma
1. lymphoid follicles on the upper tarsal coniunctivae
2. typical conjunctival scarring
3. vascular pannus,
4. limbal follicles
Classic triad of EBV (esp in adols and adults)
FPG
1. fatigue
2. Pharyngitis
3. generalized lymphadenopathy - nontender, bilateral, ant post cervical and submandibular
> may have organomegaly> splenic rupture
MC cause of eosinophilic meningitis worldwide
Angiostrongylus cantonensis
MC form of HSV reactivation
Herpes labialis
MC cause of viral intrauterine infection
CMV
Classic CMV presentation
SGA/IUGR
Microcephaly
chorioretinitis
deaf - SNHL - MC sequelae in sx children
periVentricular calcifications
hepatomegaly/jaundice
MC cause of viral meningitis in mumps-immunized population
Enterovirus
Which is the most common congenital infection that causes congenital hearing loss
CMV
Classic triad of Congenital toxoplasmosis:
CHI
chorioretinitis, hydrocephalus, and intracranial calcifications
Dendritic keratitis is unique to _ infection
A. CMV
B. HSV
C. Rubella
D. Measles
B. HSV
1st virus associated w malignancy
EBV
> nasopharyngeal carcinoma
> Burkitt’s lymphoma
> Hodgkin
> Duncan sundrome (X-linked lymphoproliferative disease)
Minor variation in influenza virus A and B causing seasonal epidemics
DNS
Antigenic Drift
miNor
Seasonal epidemic
SJP
antigenic Shift
maJor
Pandemics
Gold standard diagnosis of malaria.
A. Microscopy
B. Culture
C. PCR
D. Rapid diagnostic tests
A. microscopy
MC cause of osteomyelitis and suppurative arthritis in children
Staph aureus
Strawberry cervix, 2nd MC STI
frothy vaginal discharge
Trichomonas vaginalis
MC nosocomial bacteria
CONS - Staph epidermidis
DOC for CONS
Vancomycin
PANDAS (Pediatric autoimmune neuropsychiastric disorder associted with strep) associated with _
S pyogenes
MC cause of STI
N gonorrhea
_ and _ cells are the primary defenses against TB ab
macrophages and T-cell lypmhocytes
MC clinically significant form of disseminated TB
A. Primary
B. Primary progressive
C. Miliary
D. Secondary
Miliary TB
MC form of extrapulmonary TB
TB lymphadenitis
Most severe form of EPTB
TB Meningitis
Stages of TBM (3)
1st stage
> personality changes
> fever, irritability, anorexia, listlessness
2nd stage:
> signs of increased ICP
> drowsiness, stiff neck, CN abn
3rd stage: convulsions
MC Brain CT or MRI features of TBM in children
hydrocephalus (80%) and basal meningeal enhancement (75%)
- TBIC 2016
_ are radiologic hallmarks in reactivation TB
A. caseation necrosis
B. Cavitation
C. Ghon complex
Cavitation
Major indications for IM immunoglobulin therapy
A. Replacement therapy for children with antibody deficiency disorders
B. Measles exposure
C. Hepatitis A exposure
D. AOTA
D. AOTA
Major indications for IV immunoglobulin therapy
A. Replacement therapy for primary immunodeficiency disorders
B. Kawasaki disease
C. Replacement therapy for serious bacterial infections in children infected w HIV
D. Immune-mediated thrombocytopenia
E. Prevention of serious bacterial infections with hypogammaglobulinemia
F. AOTA
F. AOTA
