Infectious disease Flashcards
Which vaccines are live attenuated
Can’t be given in immunocompromsied
MMR
BCG
Chicken pox
Flus
What is the child’s vaccination schedule before 1 year
8 weeks
6 in 1 (dip, tet, pertussis, polio, Hib, Heb B)
Men B
Rotavirus
12 weeks
6 in 1
Pneumococcal
Rotavirus
16 weeks
6 in 1
Men B
What is a child’s vaccination schedule from 1 year onwards
1 yr
2 in 1 (Hib and Men C)
Pneumococcal
MMR
Men B
3 years and 4 months
4 in 1 (diptheria, tetanus, pertussis, polio)
MMR
12-13 HPV
What are the most common causes of bacterial meningitis in children
Neonates- GBS
Children- Neiserria meningitidis and strep pneumoniae
When is a lumbar puncture indicated in suspected meningococcal sepsis
Under 1 month with fever
1-3 months with fever and unwell
Under 1 yr with unexplained fever and serious illness features
What are kernig’s and brudzinski’s tests
For meningitis
Kernigs- flex one hip and straighten knee- stretch on meninges - pain
Brudzinski’s test- lie flat on bed and left head and neck off bed- flex chin to chest - flexion of hips and knees
How is bacterial meningitis managed
Comminity- IM benzylpenicillin before transfer
Hospital- Blood culture and lumbar puncture
Meningococcal PCR bloods
Under 3 months- cefotaxime + amoxicillin
Over 3 months - ceftriaxone
Can add vanc if risk of resistance if pneumococcal
Steroids can reduce neuro damage- Dex 4 times daily for 4 days
What post exposure prophylaxis is used in meningococcal meningitis
Prolonged contact within 7 days of onset of illness
Single dose of ciprofloxacin within 24 hrs of diagnosis
What is the main cause of viral meningitis
HSV, enterovirus and VZV
Aciclovir to treat
What are the CSF findings in a bacterial infection of meningitis
Cloudy
High protein
Low glucose
WCC- high neutrophils
Bacteria are big (need high protein and use lot’s of glucose to grow)
What are the CSF findings in Viral meningitis
Clear
Normal/ slightly raised protein
Normal glucose
High lymphocytes
Viral- less problemation just lymphocytes
What are the main causes of paeds encephalitis
Herpes simplex virus
Children - HSV1 cold sores
Neonates- HSV2- genital herpes during birth
Can also be VZV, EBV, CMV
What is the presentation of paeds encephalitis
Altered concious
Confused
Acute Neuro symptoms
Acute seizures
Fever
How is encephalitis managed
Aciclovir for HSV and VZV
Ganciclovir for CMV
Repeat lumbar puncture before stopping antivirals
What are the features of glandular fever (infectious mononucleosis/EBV)
Sore throat
Fever
Intensly itchy maculopapular rash after amoxicillin
Fatigue
Lymphadenopathy
Splenomegaly
Tonsil inlargement
What tests are done for glandular fever/ EBV
Monospot test- test for heterophile antibodies - can take 6 weeks for these to show up
IgM - acute infection
IgG- immunity post infection
What advice should be given post EBV
-Long lasting fatigue after
-Avoid alcohol- affects liver processing it
-Avoid contact sports for 4-6 weeks- splenic rupture risk
-Risk of glomerulonephritis
-Risk of haemolytic anaemia
-Risk of burkitt’s lymphoma
What are the features of mumps
Flu like prodrome
Fever
Muscle aches
Parotid gland swelling
Pancreatitis (abdo pain)
Testicular pain
Supportive management
How is HIV transmission prevented during birth
Normal vag delivery if viral load <50
C-section option if >50 and compulsory if >400
IV zidovudine given during section if viral load >1000
Prophylaxis given to baby
Low risk- mum <50- zidovudine for 4 weeks
High risk- mum >50 - zidovudine, lamivudine and nevirapine for 4 weeks
Breastfeeding never recommended
When are babies to HIV positive parents tested for HIV
-HIV viral load test at 3 months- if neg- no HIV
-HIV antibody test ar 24 months- if contracted since previous 3 month eg. breastfeeding
Antibody test can be positive for up to 18 months from mothers antibodies crossing placenta
When are children screened for hep B
Hep B positive mum (screen at or after 12 months)
Migrants from endemic areas
Close contacts of patients with Hep B
How are babies treated if their mother has Hep B
Within 24 hrs of birth
Neonate given
-Hep B vaccine
-Hep B immunoglobulin infusion
Safe to breastfeed if child is properly vaccinated
