Infectious Diseases Flashcards
What is Kawasaki disease?
A vasculitis predominantly seen in children
What are features of Kawasaki disease?
High grade fever >5 days resistant to antipyretics
strawberry tongue
cervical lymphadenopathy
conjunctivitis
bright red cracked lips
red palms and soles which later peel
What is the management of Kawasaki disease?
High dose aspirin, IVIg
What investigation is used to look for a serious long term complication of Kawasaki disease?
Echocardiogram looking for coronary artery aneurysm
What are clinical features of hand foot and mouth disease?
Sore throat, anorexia, cough and pyrexia. Oral ulcers followed later by vesicles on the palms and soles of the feet- can also occur on buttocks, face, legs and genitals
Who normally gets hand foot and mouth?
Children under 10- commonly seen as outbreaks in nurseries
What pathogens cause hand foot and mouth?
Intestinal viruses like coxsackie A16 and entrovirus 71
What advice would you give for hand, foot and mouth disease?
Stay off school until feeling better and symptomatic treatment- hydration and analgesia
What are characteristic features of measles?
Prodromal symptoms, koplik spots (small white spots on buccal mucosa), conjunctivitis and maculopapular rash starting behind the ears
If a child not vaccinated against measles comes into contact with measles, would we give them the MMR vaccine?
Yes, as vaccine induced antibodies develop quicker than that following natural infection
What complications can occur following measles?
Otitis media, pneumonia, encephalitis, subacute sclerosing panencephalitis (5-10 years after illness)
Is measles notifiable?
Yes
How does mumps present?
Prodromal phase, parotid swelling, fever, muscle aches, reduced appetite, headache, dry mouth
What are some complications of mumps infection?
Pancreatitis, orchitis, meningitis, sensorineural hearing loss
How can mumps be diagnosed?
PCR testing on saliva swab. Antibodies from blood or saliva
Is mumps notifiable?
Yes
What is the management of mumps?
Supportive treatment- rest, fluids and analgesia
What is the most common cause of tonsillitis?
Viral infection
Most common bacterial cause is Group A strep (strep pyogenes)
How will tonsillitis present?
Fever, sore throat and pain on swallowing
What signs will be sign on examination with tonsillitis?
Enlarged, inflamed tonsils with or without exudate
What features make a bacterial cause more likely for tonsillitis?
Fever over 38, pus on tonsils, absence of cough, tender anterior cervical lymphadenopathy, attend within 3 days of onset
What is the censor criteria?
Scoring system used to help predict likelihood of bacterial tonsillitis, scored 1-4
A point for: fever over 38, tonsillar exudate, absence of cough and tender lymphadenopathy
What is the FeverPAIN score?
Scoring system predicting likelihood of bacterial tonsillitis, one point for each:
- fever during last 24 hours
- pus on tonsils
- attended within 3 days of symptom onset
- severely inflamed tonsils
- no cough or coryza
When considering centor and FeverPAIN score, when should ABx be given?
Centor = 3 or more
FeverPAIN = 4 or more
What may prompt you to consider antibiotic in a child with tonsillitis other than centor and FeverPAIN scores?
if immunocompromised, at risk of more serious infections, significant co-morbidity or history of rheumatic fever
What is the antibiotic of choice for tonsillitis?
Penicillin V (phenoxymethylpenicillin)
What is one down side of the antibiotic given for tonsillitis in children?
The syrup tastes bad so many children are reluctant to take it
What are complications of tonsillitis? ENT, systemic, kidneys+joints
Chronic tonsillitis, peritonsillar abscess, otitis media
Scarlet fever, rheumatic fever
Post-streptococcal glomerulonephritis and reactive arthritis
What are additional symptoms to tonsillitis which may indicate a peritonsillar abscess?
Trismus (patient unable to open their mouth), change in voice, swelling and erythema in area beside tonsils
How should a quinsy be managed?
Refer to ENT for incision and drainage with ABx before and after surgery
what is the treatment for impetigo?
topical hydrogen peroxide or fusidic acid
