Infectious diseases Flashcards
Coxsackie transmssion
Fecal-oral
Coxsackie months of inc prevelance
May to October
Coxsackie common ages
1y to 4y
Coxsackie incubation period
3 to 6 days
Sudden onset of fever lasting 1-4 days
Loss of appetite + sore throat
Vomiting and abd pain
Vesicles or ulcers on the anterior pillars of the tonsils, uvula, pharynx, and the edge of the soft palate.
Herpangina (coxsackie a)
Fever
Vesicular eruption of the buccal mucosa of the mouth and maculopapular rash involving the hands and feet with anorexia and vomiting
Hand foot and mouth disease (coxsackie a). Will resolve in 1-2 weeks
Sudden severe chest pain that is pleuritic in nature and aggravated by deep breathing, coughing, or sudden movements.
Waves of spasms 15-20 minutes duration
Pleurodynia (bornholm disease or devil’s grip) caused by coxsackie b
Hepatitis A communicability
2 weeks before to 1 week after onset
Acute illness, malaise, nausea, anorexia, vomiting, dull right upper quadrant pain during exercise, jaundice, dark urine, clay colored stools
Hepatitis A
presence of IgM specific antibodies
Recent infection
IgG specific antibodies
Past infection
Fever, cough, coryza, conjunctivitis, erythematous maculopapular rash, lesions in the mouth (koplik)
Measels
Measels Incubation period
8-12 days after exposure and before the onset of symptoms
Measels contagious period
3-5 days before rash to 4 days after the apperance of the rash
Rubella contagious period
3 days before and 5-7 days after the rash
Rubella incubation period
14-21 days
Erythema infectiousum (Fifths disease) organism
Parvovirus B19
Erythema/Fifths disease incubation period
4 to 14 days but can go up to 21 days
“Slapped cheek” rash
Lacy rash that moves to arms thighs and btt
Can last 1 month
Fifths disease/ erythema infectiosum
Varicella zoster incubation period
10 to 21 days.
14 to 16 days is commonly seen
Varicella Zoster treatment
Benadryl
In high risk patients give acyclovir
Infectious mononucleosis infectious agent
Epstein barr virus (herpes family)
Mono/EBV transmission
Fomites/close contact w saliva
Mononucleosis incubation period
2 to 6 weeks
20-30 days average
> 10% atypical lymphocytes and 50% lymphocytosis
Kids >4 must be ill for 2 weeks before seroconverting
EBV/mono
Exanthem Subitum (roseola infantum) infectious agent
Human herpesvirus 6
Exanthem Subitum (roseola infantum) incubation period
9 to 10 days
Exanthem Subitum (roseola infantum) communicable period
During fever
Fever (101-105) followed by defervescence (after 3-5 days) where child will be playful and alert after fever
Exanthem Subitum (roseola infantum)
Distinictive rash of discrete rose pink macules approximately 2-3 mm in size that appear on trunk, fade on pressure and last 1-2 days
Exanthem Subitum (roseola infantum)
Mumps duration of precaution
5 days after the onset of parotid swelling. Children must be excluded from school for 5 days after onset of swelling
Mumps incubation period
14-18 days but can last from 12-25 days
Influenza incubation period
1 to 3 days
Influenza communicable period
24 hours before onset of symptoms and shed virus for 7 days after the onset of illness.
sick! sudden onset of fever headache chills/coryza vertigo sore throat back pain and extremeties dry hacking cough
Influenza
Influenza management
Amantadine for type A
Rimantadine > 14 years old. start w/in 48 hours of onset of symptoms
Neuraminidase inhibitors (tamiflu > 1 year)
(Zanamivir/Relenza > 7 years)
Croup infectious agent
Parainfluenza virus (Paramyxovirus/mumps virus)
Croup incubation
2 to 6 days
Croup treatment
Supportive
No antiviral therapy
Oral dexamethasone in mild croup
Herpesviruses incubation period
2 to 12 days
Children 1-4
High fever with an edematous and erythematous gum line with anterior redis that is swollen and bleeds easily. White plaques on buccal mucosa/anterior part of the tongue,
Acute herpetic Gingivostomatitis
Acute herpetic Gingivostomatitis treatment
runs its course in 5 to 14 days.
Antipyretic for fever
Soft acid free foods like popsicles and jello
Cluster of grouped vesicles surrounded by an erythematous base on the lips or skin surrounding the mouth
Herpes simplex (herpes labialis). Gets better after 2-3 days
Tick feeding time
36 to 48 hours for nymphs
48-72 hours for adults
Lyme disease causative agent
Borrelia burgdorferi a spirochete
Lyme disease incubation period
3 to 30 days
Erythema migrans. Erythematous papule with central clearing
lyme disease
Pauciarticular or monarticular arthritis
Swelling of ankles and knees with not much pain
Lyme disease
Lyme disease treatment
Amoxicillin in patients younger than 8. 50 mg/kg/day tid for 14-21 days
Doxycycline 100 mg PO bid for 14-21 days
High fever with chills, rigor, sweats, and paroxysmal headache
Malaria
Mosquito that causes malaria
Anopheles species.
Causative agent=Plasmodium falciparum
P. vivax
Malaria diagnostic
Blood smear that is thick and thin film
Serological testing is not helpful
Malaria tx
depends on species. Consider chemoprophylaxis with Mefloquine and Atovaquonone
Nonspecific febrile illness that lasts 2-7 days with joint pain, muscle and bone pain, HA, retroorbital pain and leukopenia w travel to Carribean, latin america, and south asia
Dengue Fever
Dengue Fever incubation period
3 to 14 days
Streptococcus incubation period
2 to 5 days
Strep communicability
1 to 7 days. greatest during acute phase of respiratory illness
Scarlet fever common ages affected and season
6 to 12 years old
Late winter and early spring
Fever, sore throat, HA, chills, rapid pulse, malaise, white exudate on tonsils. May have rash that is red w pinpoint lesions that blanch of pressure and feel as rough as sandpaper.
Strep/Scarlet fever
Diagnostic test for scarlet fever
Throat culture
Impetigo treatment
Bactroban or muciprocin if localized
Negative D test for MRSA
Can use clindamycin
If positive do not use clinda
Rough textured skin with general erythema. The epidermis separates and desquamates
Scalded skin disease/ritter disease
Scalded skin disease tx
IV vancomycin plus a beta lactam (oxacillin)
Meningitis tx
3rd gen cephalosporin such as ceftriaxone 2g IV q24h
Meningococcus prophylaxis
Riafmpin to all household contacts
Cat scratch causitive agent
Bartonella
Cat scratch incubation period
3 to 10 days
Spider bite: local reaction with mild itching or stinging at the time of bite
Painless bite
Pain starts 2-8 hours later with redness around the puncture and a central pusutule or blister
Black star shaped bite with central necrosis and edema
Brown recluse Spider
Spider bite: Severe muscle cramping started from 10 mins to 1 hr post bite. Cramping in the abdomen, flank, thighs, and chest.
Sweating + n/v
CNS w headache, anxiety, salivation, lacrimation, sweating, and htn
Black widow
bite/sting: severe local and painful burning sensation with redness and edema with necrosis
Restless w abnormal eye movements, twitching, sweating and hypersalivation
Death from pulmonary edema, shock, or respiratory failure
Scorpion bite
Rocky mountain spotted fever causitive agent
Rickettsia rickettsii (from wood or dog tick)
Rocky mountain spotted fever incubation period
3 to 12 days
2-8 days, a reddended macule rash that changes to petechiae. It begins on the wrists and ankles and spreads up the arms and legs onto the trunk
Can cover pals and soles. HA, fever.
Rocky mountain spotted fever
Rocky mountain spotted fever treatment
Doxycycline for 7-10 days
Smallpox incubation period
7 to 17 days
Smallpox communicability
24 hours before onset of rash and remains contagious until all lesions are dried up
High fever, HA, abd pain, malaise, and fatigue. Skin lesions on face spreading down to the body on the forearms, trunk, and legs, All vesciles progress at the same rate
Smallpox
Swollen gum line that is reddened and bleeds easily. White shallow ulcers with red borders on the gum, lips, and buccal mucosa.
Pain drooling, anorexia, and significantly high fever
Acute herpetic gingibostomatitis
Rabies incubation period
1-3 months
Unprovoked animal bite
Think rabies
Rabies prophylaxis
2 rabies vaccine with RIG administered directly into the area of the bite with the rest IM. Give rabies vaccine again on days 3, 7, and 14.
Zika virus incubation period
less than 1 week
Zika virus prophylaxis
repellents with a max of 30% DEET for infants. Do not use products w DEET and sunscreen in combo
Roundworm incubation period
8 weeks.
Loss of appetite and nausea and vomiting, may have intestinal obstruction. Hx of travel to underdeveloped country.
Roundworms
Roundworm (Ascariasis) treatment
Albendazole with food
Nitazoxanide bid for 3 days
Single dose Ivermectin
Hx of travel to tropical area with poor sanitation. CC of abd pain that is colicky, n/d, w marked eosinophilia. May lead to anemia
Hookworm infection
Hook worm treatment
Albendazole (Alebnza)
Mebendazole (Vermox)
Pyrantel pamoate (pin x)
Itchy butt at night.
pinworms (enterobius vermicularis)
Giardiasis common infection time
Summer through fall
Giardiasis diagnostic tool
Direct fluorescent antibody
Giardiasis treatment
Metroidazole (flagyl)
Vomiting, fever and diarrhea in the winter causitive agent
Rotavirus
Scabies treatment
Permethrin
Test for hookworm
Stool for ova and parasites
Lyme disease diagnostic
culture edge of rash
Pertussis incubation period
7-10 days but can go up to 21 days
cough, coryza, sbeezubg fever in catarrhal phase.
Staccato, paraoxysmal cough with whoop
Pertussis
When are kids most contagious w pertussis
during catarrhal stage and within the 1st 2 weeks after the cough onset
Highest mortality in kids w pertussis
Kids less than 1 month old
bronchiolitis (rsv) incubation
2-8 days
Croup incubation
2 to 4 days