Infectious Diseases Flashcards
What is the gold standard method to take neonate/infant temps?
rectal
all infants 0-29d with possible infection get what diagnostics (hint: think three locations)?
Urinalysis and urine culture
CBC, +/- inflammatory markers (PCT, CRP) and blood culture
Lumbar puncture and CSF culture
Infants 30-59d get what diagnostics?
Can depend on institutional guidelines
Minimum urine and blood evaluation
Based on those results and clinical presentation, consider LP
Infants 60-90d get what diagnostics?
Can depend on institutional guidelines
Minimum urine evaluation
Consider blood evaluation (10% of pyelo will have bacteremia)
Based on those results and clinical presentation, consider LP
under 3 months of age, who has a higher incidence of UTIs, boys or girls?
Boys, particularly those who are uncircumcised.
Risk Factors for UTI
Urologic abnormalities (hypospadias, vesicoureteral reflux)
Neurologic abnormalities (tethered cord, spina bifida, neurogenic bladder)
Poor hygeine (front to back!)
Sexual activity
Behavioral dysfunctional voiding
Constipation
What is the gold standard to Dx UTI? and what is the criteria for Dx?
Urine Culture
PYURIA/BACTERIURIA AND >50K COLONIES OF A SINGLE ORGANISM
Early UTI can suggest?
A GU abnormality: Vesicoureteral reflux Posterior urethral valves Single/horseshoe kidney Duplex collecting system
Under 2 mos of age with UTI warrants what diagnostics to be performed?
Renal ultrasound
Consider voiding cystourethrogram
2 mos to 2 years with UTI, diagnostic consideration?
Free pass for first UTI, then ultrasound
VCUG if ultrasound abnormal or recurrent UTIs
What are the most common infections in infants under 90d?
10% urinary tract infections/pyelonephritis
2% bacteremia
1% meningitis
What are the most common bacterial pathogens associated with acute otitis media?
SHM
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Otitis Media Tx
Watchful waiting (could be viral) Pain control 1st line- Amoxicillin 2nd line- Augmentin (Amoxicillin/Clavulanic Acid) 3rd line- Ceftriaxone IM
Tx for frequent/persistent otitis media infections?
Tympanocentesis
Myringotomy tube placement
Bacterial sinusitis symptoms
Severe nasal discharge
Persistent respiratory symptoms (>2wks)
Cough, headache, facial pressure, tooth pain, halitosis
Bacterial sinusitis treatment
watchful waiting
amoxicillin
which sinuses are present at birth?
maxillary sinus and ethmoid sinus
Classic symptoms of Strep Pyogenes?
Fever Pharyngitis (Palatal petichiae, Tonsillar exudate, Strawberry tongue) Tender cervical lymphadenopathy Headache Abdominal pain +/- vomiting Rash Absence of cough
S. Pyogenes Tx?
Penicillin/amoxicillin
Bacterial Gastroenteritis Tx?
Rarely treated, tends to resolve without antibiotics
Antibiotics must be used cautiously, many strains can cause Hemolyic Uremic Syndrome
S/sx of bacterial meningitis
Fever Lethargy Headache Neck stiffness Irritability Vomiting Bulging fontanelle Petechiae
What pathogens most commonly cause bacterial meningitis in infants <3mos.
E. Coli
GBS
Listeria
What pathogens most commonly cause bacterial meningitis in older infants/children
Strep pneumo, Neisseria meningitis, H. Flu
early complications of bacterial meningitis
Brain abscess Subdural empyema Seizures SIADH Sensorineural deafness
