Infectious Disease part 1 Flashcards
Define sepsis
SIRS + suspected/ proven infection (bacteraemia)
Define SIRS
Systemic inflammatory response syndrome Presents as Fever or hypothermia, tachycardia, tachypnoea, leucocytosis or leucocytopaenia
normal resp rate, heart rate and systolic Bp based on age
Resp rate: <1 - 30-40 1-2 25-35 2-5 25-30 5-12 20-25 >12 15-20 Heart rate: <1 110-160 1-2 100-150 2-5 95-140 5-12 80-120 >12 60-100 Systolic BP: <1 80-90 1-2 85-95 2-5 85-100 5-12 90-110 >12 100-120
cause of SIRS
trauma haemorrhage burns pancreatitis liver disease toxins/ drugs others
define paediatric severe sepsis
sepsis + multi-organ failure >1 of: -resp failure -renal failure -neurological failure -haematological failure -liver failure
Define ARDS
Acute resp response syndrome -Inflammatory response of the lungs
Paediatric sepsis what age group is most likely to be affected
newborn and infant and boys more than girls
responsible pathogens for paediatric sepsis in neonates (<1 month)
group B streptococci eschericha coli listeria monocytogenes
responsible pathogens for paediatric sepsis in children
streptococcus pneumoniae meningococci group A streptococci staph aureus
Pathophysiology of paediatirc sepsis
endothelium, neutrophils and monocytes cause microvascular occlusion, vascular instability, sepsis and multi organ failure
Paediatric sepsis symptoms (12)
fever or hypothermia, cold hands/ feet, mottled skin, prolonged cap refill, chills/rigors, limb pain, vomiting, diarrhoea, muscle weakness, muscle/joint aches, skin rash, diminished urine output
Low, medium and high risk symptoms for sepsis in a child from categories: Colour Activity Respiratory Circulation and hydration Other
What is the paediatric sepsis 6 recognition tool?
Sepsis treatment
ABCDEFG Antibiotics with broad-spectrum (cephalosporins or amoxicillin if neonate) and good CSF penetration Paediatric sepsis 6: O2, Obtain IV access and bloods IV antibiotics Fluid Early inotropic support (consider) Involve senior/ specialist help early
sepsis investigations
Blood: FBC (Leucocytosis, thrombocytopaenia) CRP (elevated) Coagulation factors (deranged due to DIC) U&Es, LFTS (renal and hepatic dysfunction) Blood gas (metabolic acidosis, raised lactate) Glucose (hypoglycaemia) Culture CSF: Cell count and culture (increasing wcc, antigent testing, PCR) Protein and glucose (increased protein level, low glucose) Urine culture Skin biopsy culture Imaging- CT/MRI head
responsible pathogens for paediatric meningitis in neonates
Group B streptococci E.coli Listeria monocytogenes
Responsible pathogens for paediatric meningitis in children
Streptococcus pneumoniae, Meningococci (Neisseria meningitidis), Haemophilus influenza
Meningitis +/- sepsis symptoms in children (7)
Nuchal rigdity Headaches photophobia diminished consciousness Focal neurological abnormalities Seizures Meningociccal rash
Meningitis +/- sepsis symptoms in neonates (4)
Lethargy, irritability, Bulging fontanelle, Seizures
Streptococcus pneumoniae describe
Gram positive diplo-cocci Transmission by droplets Colonises upper airway Viral infections predisposing factor for invasive disease
Pneumococcal disease presentation
menigism pus in brain swollen ear
Pneumococcal meningitis complications
brain damage hearing loss hydrocephalus
Haemophilus influenza type B describe
Gram-negative bacteria encapsulated H.ingluenzae- resisyt phagocytosis and complement-mediated lysis Viral infection predisposing factor for invasive disease
Complication of meningococcal disease
amputation skin scarring cognitive impairment epilepsy hearing loss
Types of meningococcus in the nasopharynx
A,B,C,W,X,Y
Meningococcal disease virulence factor
Endotoxin= lipooligosaccharide
Against what strains of meningitis can you get a vaccine
Meningococcal diseasem Haemophilus influenzae B, Pneumococcal disease
