Infectious Diseases Flashcards
what is SIRS
fever or hypothermia
tachycardia
tachypnoea
Leucocytosis or leucocytopaenia
what is ARDS
acute respiratory response syndrome - inflammatory response of the lungs
organisms causing sepsis in neonates
group b strep
e. coli
listeria monocytogenes
organisms causing sepsis in children
strep pneumoniae
meningococci
group a strep
staph a
with a diagram describe the pathophysiology of sepsis
see notes
symptoms of sepsis
- Fever or hypothermia
- Cold hands/feet, mottled
- Prolonged capillary refill time
- Chills/rigors
- Limb pain
- Vomiting and/or diarrhoea
- Muscle weakness
- Muscle/joint aches
- Skin rash
- Diminished urine output
organisms causing meningitis in neonates
o Group B streptococci
o Escherichia coli
o Listeria monocytogenes
organisms causing meningitis in children
o Streptococcus pneumoniae
o Meningococci
o Haemophilus influenza
symptoms of meningitis
• Nuchal rigidity • Headaches, photophobia • Diminished consciousness • Focal neurological abnormalities • Seizures • In neonates: o Lethargy, irritability o Bulging fontanelle o “nappy pain”
toxic shock syndrome is caused bt what bacteria?
strep and staph
treatment of meningitis
• Supportive
o A, B, C, D, E
• Causative treatment
o Antibiotics with good penetration in CSF and broad spectrum
o 3rd generation cephalosporins (+ amoxicilline if neonate)
• Chemoprophylaxis
o Close household contacts
o Meningococcus B and streptococcus group A
diagnosis of meningitis
• Blood: FBC; leucocytosis, thrombocytopaenia
o CRP; elevated
o Coagulation factors; low levels due to DIC
o Blood gas; metabolic acidosis
o Glucose; hypoglycaemia
• CSF: pleocytosis, increased protein level, low glucose
• Blood and CSF cultures (antigen testing, PCR)
• Urine culture, skin biopsy culture
• Imaging: CT-cerebrum
streptococcus pneumoniae: shape
gram +ve duplo-cocci
streptococcus pneumoniae: where does it colonise
upper airways
streptococcus pneumoniae: transmission
droplet
streptococcus pneumoniae: predisposing factor for invasive disease
viral infections
complications of pneumococcal meningitis
brain damage
hearing loss
hydrocephalus
Haemophilus Influenza Type B: shape
gram -ve bacterium
Haemophilus Influenza Type B: infections
bacteraemia
meningitis
pneumonia
epiglottis
meningococcal disease virulence factor
- Endotoxin = lipooligosaccharide
* Association endotoxin levels and mortality
streptococci: shape
gram +ve cocci
streptococci: antibiotic
Penicillin
staphylococci: shape
gram +ve cocci
staphylococci: antibiotic
flucloxacillin
scarlet fever: incubation
2-4 days
scarlet fever: symptoms
maliase fever tonsillitis start exanthema strawberry tongue squamation of hands and feet
scarlet fever: organism
group a beta-haemolytic strep
scarlet fever: virulence factors
m-protein
exotoxins
scarlet fever: complications
o Erysipelas, cellulitis, impetigo
o Streptococcal toxic shock
o Rheumatic fever 0.3-3%
o Glomerulonephritis
scarlet fever: treatment
penicillin 10 days
impetigo: organism
s pyogenes
s aureus
Staphylococcal scalded skin syndrome: what causes it
exotoxins of s aureus
Staphylococcal scalded skin syndrome: who
< 5, mostly newborns
Staphylococcal scalded skin syndrome: signs
fever
widespread redness
fluid filled blisters that rupture easily esp in skin folds
Kawasaki Disease: clinical features
• Fever for at least 5 days and • 4 of: o Bilateral conjunctival infection o Changes of the mucous membranes o Cervical lymphadenopathy o Polymorphous rash o Changes of the extremities • Peripheral oedema • Peripheral erythema • Periungual desquamation
Kawasaki Disease: pathophysiology
- Self-limited vasculitis of medium-sized arteries
- KD reported in all racial and ethnic groups
- Highest prevalence in Japan and Hawaii
- Increased risk in siblings and twins
- Aetiology unknown but infectious cause suggested
Kawasaki Disease: treatment
- Immunoglobulins
- Aspirin
- Other immunosuppressive agents
VZV: incubation
14 (10-21) days
VZV: features
o Mild malaise and fever (kids are not sick)
o Exanthema: papules vesicles pustules crustae (scarring)
o New lesions during 5-7 days
o Itching
VZV: complications
o Secondary strep/staph infections of the skin (10-15%)
o Meningoencephalitis, cerebrellitis, arthritis)
VZV: therapy
o (val)aciclovir
VZV: prevention
o Vaccination (active/passive)
HSV: clinical features
stomatitis
recurrent cold sores
HSV: complications
o (kerato) conjunctivitis
o Encephalitis
o Systemic neonatal infections
o Immunocompromised children
HSV: therapy
o Self-limiting
o (val)acyclovir
HSV in neonates
• Birth canal/direct contact • Day 4-21 of life • 70-80% disseminated/CNS infections o Sepsis o Meningoencephalitis o Hepatitis (jaundice, bleeding) • 20-30% skin/eye/mouth (SEM) disease • 2-3/100,000 • High mortality o Without acyclovir > 50% o With acyclovir 20-30%
hand foot and mouth disease: cause
enteroviruses
coxsackie A16 and enterovirus 71
hand foot and mouth disease: incubation period
3-6 days
hand foot and mouth disease: age
<10
hand foot and mouth disease: when in year
summer and early autum
hand foot and mouth disease: clinical
o Exanthema and enathema
o Painful lesions
o Recovery in 5-10 days
vesicular rashes diagnostics
• Clinical diagnosis • Smear of vesicle (ulcer base) o Tzanck test: no differentiation HSV/VZV • PCR (fluids, CSF, blood) • Serology (past infection)
presenting symptoms of primary immunodeficiency
invasive fungal infections
clinical presentation on neonatal candidemia
o Sepsis syndrome
o 2nd/3rd week of life
o Thrombocytopaenia
o Hyperglycaemia
