Infectious Diseases Flashcards
Most common causes of Acute Otitis Media?
SMH
- Strep. Pneumo
- Moraxella
- H. Influenza
What will you see with Acute Otitis Media?
Bulging, red TMs
– May be an effusion or retraction of TM
– May see decreased TM mobility with insufflator bulb
What is the treatment for Acute Otitis Media?
Amoxicillin +/- Clavulanic Acid for 10 days
If a child has Chronic Otitis Media, what may be necessary?
Tympanostomy tubes
Most common cause of Bronchiolitis?
RSV
– Other viruses can cause it too
What symptoms will the child have with Bronchiolitis?
Respiratory distress
Fever
Cough
Rhinorrhea
What examination findings will you see with Broncohiolitis?
Tachypnea
Hypoxia
Retractions
Crackles/Coarse/Wheezes with auscultation
What is the treatment for Bronchiolitis?
O2
Suction
Hydration
Time
When might you use a Bronchodilator with Bronchiolitis?
If the patient has a family history/or has asthma and it helps their symptoms
If a patient has an underlying disease or is immunocompromised what drug can be given for Bronchiolitis? What prophylaxis can be given?
Ribavirin
- Prophylaxis = Palivizumab
Most common cause of Croup?
Parainfluenza
– Other viruses can cause it too
If you get a bacterial superinfection on top of Croup, what can that cause?
Tracheitis
What are the main signs of Croup?
URI symptoms
Inspiratory stridor
Barking cough
Hoarse voice
What are the main signs of Croup?
URI symptoms
Inspiratory stridor
Barking cough
Hoarse voice
What can be seen on XR with Croup? Why?
Steeple sign due to narrowing of the subglottic space
What are the treatment options with Croup?
Oxygen
Corticosteroids
Nebulized Racemic Epinephrine
Most common causes of Epiglottitis?
H. Influenzae
Streptococcus species
What are the signs of Epiglottitis?
Drooling
Muffled voice
Inspiratory stridor
Respiratory distress
What are the signs of Epiglottitis?
Drooling
Muffled voice
Inspiratory stridor
Respiratory distress
How may a child with Epiglottitis sit?
Tripod position with neck like they are a dog sniffing something
What are 2 things you should NOT do with suspected Epiglottitis?
Do NOT examine the throat
Do NOT order an XR
Why should you not examine the throat with Epiglottitis?
Risk of laryngospasm and airway compromise
How is Epiglottitis confirmed?
Direct fiber optic visualization = cherry red and swollen epiglottis
What can be seen on lateral XR with Epiglottitis?
Thumbprint sign
What are the 2 treatments for Epiglottitis?
Secure the airway - intubation/tracheostomy
IV Ceftriaxone
What causes the Whooping cough?
Bordetella Pertussis (gram neg. rod)
How is Pertussis spread?
Aerosol droplets
What are the signs of Pertussis?
URI symptoms
Whooping cough
Posttussive emesis
Posttussive emesis is concerning for?
Pertussis (whooping cough)
What is the treatment for Pertussis and what is unique about it?
Azithromycin
– GIVE IT TO CLOSE CONTACTS TOO
What is the treatment for Pertussis?
Azithromycin for patient and close contacts
What bacteria usually causes Retropharyngeal and Peritonsilar abscesses and which one presents earlier in life?
Group A Streptococcus
– Retropharyngeal abscesses occur earlier!
What are the shared symptoms between Retropharyngeal and Peritonsilar abscesses?
Muffled “hot potato” voice
Drooling
Trismus (stiff jaw)
What are the shared symptoms between Retropharyngeal and Peritonsilar abscesses?
Muffled “hot potato” voice
Drooling
Trismus
What will be present with a Peritonsilar abscess that is not present with a Retropharyngeal?
Uvula deviation to the opposite side
Most common causative organisms for neonates with meningitis?
GEL
- GBS
- E. Coli
- Listeria
Most common causative organisms for infants/children with meningitis?
SNH
- Strep. Pneumo
- Neisseria
- H. Influenza
Most common causative organisms for adolescents with meningitis?
SN
- Strep. Pneumo
- Neisseria
What type of viruses are the most common viral cause of meningitis?
Enteroviruses
Kernig sign with meningitis
Flex the patient’s hip and attempt to straighten knee and they do not want that
Brudzinski sign with meningitis
Flex the patient’s head and they immediately flex their hips
If you see signs of elevated ICP with meningitis, what test should be obtained?
CT of the head
For meningitis, what test should be done and what are you looking for?
LP
- Gram stain/culture
- Protein and Glucose
- Cell count
- Respiratory PCR
What is the treatment of meningitis in neonates?
Ampicillin + Gentamicin/Cefotaxime
What can be added to the treatment of meningitis in neonates if you suspect the mother has HSV?
Acyclovir
What is the treatment for meningitis in children?
Vancomycin + Ceftriaxone
Why should you not use Ceftriaxone in neonates?
Elevates bilirubin
What 3 pathogens cause ocular infections in neonates?
HSV
Chlamydia Trachomatis
Neisseria Gonorrhoeae
Signs of an ocular infection due to Chlamydia Trachomatis?
Late onset eyelid swelling and watery discharge
Treatment of an ocular infection caused by Chlamydia Trachomatis?
Topical and oral erythromycin
Signs of an ocular infection due to Neisseria Gonorrhoeae?
Early onset eyelid swelling and purulent discharge
Treatment of an ocular infection caused by Neisseria Gonorrhoeae?
3rd/4th gen Cephalosporin
Signs of an ocular infection due to HSV?
Vesicular eruptions + watery discharge
Treatment of an ocular infection caused by HSV?
Acyclovir and topical Vidarabine
What tests are used to diagnose HSV and Chlamydia/Neisseria ocular infectionos?
HSV – PCR
Chlamydia/Neisseria – Gram stain/culture
