Infectious diseases Flashcards
what are the 6 viral exanthemas
1st - measles 2nd - scarlet fever 3rd - rubella 4th - duke's disease 5th - parovirus B19 6th - roseola infantum
- Prodromal : Fever, conjunctivtis , irritable
- Koplick spots : white spots on bucaal mucosa
- Rash starting behind ears, then rest of body
- Notifiable disease
- Isolate until 4 days after rash
measles
- Red-pink, blotchy, macular rash with rough ‘sandpaper’ skin
- Fever
- Lethargy
- Flushed face
- Sore throat
- Strawberry tongue
- Cervical lymphadenopathy
scarlet fever
what cause scarlet fever and how is it managed
- Group A strep
- Oral penicillin V or 10 days
- Notify public health
- Keep off school until 24 hrs after starting abx
- Prodrome : low grade fever
- Rash : maculopapular, initially on face before spreading to whole body
- Suboccipital and postauricular lymphadenopathy
-Notify public health
Rubella
- Starts with fever, coryza and non specific symptoms
- 2-5 days later : diffuse bright red rash on both cheeks
- few days later : raised itchy rash on trunk and limbs
- Once rash has formed - back to school
Parvovirus B19
- High fever lasting a few days.
- When fever settles, rash appears
- Nagayama spots in uvula and soft palate
- Febrile convulsions and diarrhoea are common
- Complications : febrile convulsions
roseola infantum
what causes chicken pox
varicella zoster virus (VZV)
Spread via resp route
what can be given to immunocomprised patients, neonates and those at risk of complications of chickenpox
aciclovir
give 6 complications of chickenpox
- bacterial superinfection - dehydration - conjunctival lesions - pneumonia - encephalitis (ataxia) - shingles or ramsay hunt syndrome if the virus lays dormant in sensory dorsal root ganglion cells
caused by coxsackie A
initial URTI
mouth ulcers
blistering red spots on hands, feet and around mouth
hand, foot and mouth disease
- Prodrome of flu like symptoms
- Unilateral or bilateral parotid gland swelling (‘earache, pain on eating’
- Notify public health
- Supportive management
Mumps
give 4 complications of mumps
- pancreatitis : abdo pain
- orchitis : testicular pain
- meningitis : confusion, neck stiffness, headache
- sensorineural hearing loss
what kind of virus are hep B and hep C
Hep b: DNA
Hep c : RNA
what is the most common cause of encephalitis is children
Viral infection with HSV-1
- In neonates : HSV-2 from genital warts
What is kawasaki disease ?
Systemic medium-sized vessel vasculitis
Who does kawasaki disease typically affect?
- Children <5 yrs
- Asian children (japanese or korean)
- Boys
What is a key complication of kawasaki disease ?
-Coronary artery aneurysm
What are the key features of kawasaki disease ?
CRASH AND BURN
- C : conjunctivitis (bilateral)
- R : rash (widespread erythematous maculopapular)
- A : adenopathy (cervical & usually unilateral)
- S : strawberry tongue and cracked lips
- H : hands (desquamation)
-BURN : high fever >5 days
Give 3 investigation results usually seen in kawasaki disease
- FBC : anaemia, leukocytosis and thrombocytosis
- LFTS : hypoalbuminaemia and elevated liver enzymes
- Raised ESR
How is kawasaki disease managed ?
- High dose aspirin
- IV immunoglobulins
- Echo
What is a risk of using aspirin in children ?
-Reye’s syndrome
What is the most common cause of hand, foot and mouth disease ?
-Coxsackie A virus
What kind of vaccine is rotavirus ?
-Oral, live attenuated vaccine
altered consciousness altered cognition unusual behaviour acute onset of neurological symptoms acute onset of focal seizures fever
encephalitis
how is encephalitis investigated
- LP for CSF with viral PCR testing (lymphocytosis and elevated protein)
- CT if LP is CI : usually affects parietal and temporal lobes
how is encephalitis managed
IV Aciclovir for HSV and VZV
Ganciclovir for CMV
3 complications of scarlet fever
- Otitis media (most common)
- Rheumatic fever : 20 days after infection
- Acute glomerulonephritis : 10 days after infection
give 3 complications of measles
- Otitis media (most common)
- Pneumonia (most common cause of death)
- Encephalitis (1-2 wks following onset)
When can you return to school with rubella
5 days after rash develops
Give 4 complications of rubella
Arthritis
Thrombocytopenia
Encephalitis
Myocarditis
What 2 things can parvovirus B19 cause
- Aplastic crisis in sickle cell
- Hydrops fetalis in pregnancy
what causes Roseola infantum
HHV6
what can increase the risk of secondary bacterial infection of the lesions in chickenpox
NSAIDs
when can a child return to school following chicken pox
after lesions have crusted over
what bacteria causes scalded skin syndrome
staph aureus
what medications are used to treat TB
2 mnths of RIPE
- Rifampicin : red secretions
- Isoniazid : peripheral neuropathy
- Pyrazinamide : hyperuricaemia (gout)
- Ethambutol : optic neuritis
4 mnths
- Rifampicin
- Isoniazid
- Fever >38.9
- Hypotensiom : systolic <90
- Diffuse erythematous rash
- Desquamation of rash
- Involvement of 3 or more organ systems
Staphylococcal toxic shock syndrome
what deficiency is seen in measles and how does it present
- Vitamin A
- Xerophthalmia
