Infectious Disease 2 Flashcards
What are the causes of bacterial meningitis in neonates
E.Coli
Listeria
Group B strep
What are the causes of bacterial meningitis in children
Viral (mumps, HSV, coxsackie, ECHO, polio)
N, meningitis
S pneumoniae
HiB
Clinical feature of viral meningitis
Fever
Headache
Neck stiffness
Head retraction and neck stiffness - late features and not reliable in infants
Clinical features of bacterial meningitis
Drowsiness
Vacant expression with staring eyes
Reduced consciousness - always serious
Coma - severe
Convulsions
High-pitched cry
Refusing feeds
Systemic involvements - fever, cyanosis, apnoeic spells, irritability
Non-blanching rash (pneumococcal infection only)
Signs on examinations for meningitis
Kernig’s sign oft
Bulging frontanelle = late signs
pathophysiology of HIV
Human Immunodeficiency virus
a retrovirus destroys CD4 T cells leading to acquired immunodeficiency syndromes
2 different types of HIV
HIV 1 - a global pandemic
HIV 2 - mainly in West Africa
what is AIDS
acquired immunodeficiency syndromes `
when does AIDS tend to develop
usually, after 6-9 years after infected with HIV
how is HIV transmitted from Mum to child
1.5-2% of infection occurs transplacentally during pregnancy
Vast majority due to transmission of blood during parturition
or
post-natal breastfeeding
what are the risk factors of a child or adolescant leading to HIV infection
infected mother
adolescents –> acquired infection sexually or IVDU
infective intrapartum procedure eg foetal scalp electrodes, forceps, ventouse
rupture of membranes
vaginal birth to an infected mother`
what are the clinical features of a child infected with HIV
recurrent bacterial infection - esp invasive infection eg meningitis, septicemia, and pneumonia
unusual infection in childhood eg pneumocystis pneumonia
immunodeficiency –> FTT, diarrhea, candidiasis, hepatosplenomegaly
developmental regression caused by HIV encephalopathy
unusual rashes - HI dermatitis
signs of congestive heart failure
what is PCP
Pneumocystis jirovecii Pneumonia
most common AIDS-defining opportunistic infection caused by fungal, Pneumocystis jirovecii.
investigation for HIV in childhood
early diagnosis is crucial to allow management and prophylaxis
PCR of viral DNA test performed at 0-2 days, 6 weeks and 3 months
confirmatory test –> HIV RNA PCR,
CD4 count
HIV antigen (not antibodies in < 18 months as maternal IgG can cross the placenta)
Management of HIV in child
antiretroviral therapy (ART) for both expectant mothers and for newborns (esp if breast-feeding)
triple combined therapy = gold standard
C-section = delivery of choice if detectable viral load
