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Systems: Paediatrics AB > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

How do infectious diseases differ between children and adults?

A
  • Most characterised by fever and rash
  • Range of disease severity
  • Developing immune system so different clinical presentation
  • Can be presenting symptom of primary immunodeficiency
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2
Q

Define paediatric sepsis

A

Systemic inflammatory response syndrome with suspected/ proven infection

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3
Q

How doe sepsis present?

A
  • Fever or hypothermia
  • Tachycardia
  • Tachypnoea
  • Leucocytosis or leucocytopaenia
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4
Q

What is bacteraemia?

A

Bacteria multiplying in the blood

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5
Q

What are the normal vital signs for <1 year?

A

RR
30-40

HR
110-160

SBP
70-90

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6
Q

What are the normal vital signs for 1-2 years?

A

RR
25-35

HR
100-150

SBP
80-95

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7
Q

What are the normal vital signs for 2-5 years?

A

RR
25-30

HR
95-140

SBP
80-100

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8
Q

What are the normal vital signs for 5-12 years?

A

RR
20-25

HR
80-120

SBP
90-110

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9
Q

What are the normal vital signs for >12 years?

A

RR
15-20

HR
60-100

SBP
100-120

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10
Q

What is severe sepsis?

A

SIRS + multi organ failure

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11
Q

How is severe sepsis defined?

A

SIRS +2 or more

  • Respiratory failure
  • Renal failure
  • Neurologic failure
  • Haematological Failure
  • Liver failure
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12
Q

What is ARDS?

A

Acute respiratory response syndrome

-Inflammatory response of the lungs

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13
Q

What is the incidence of sepsis?

A
  • Children 1:2,000
  • M>F
  • Incidence decreases with age
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14
Q

What pathogens are implicated in sepsis in neonates (<1 month)?

A
  • Group B streptococci
  • E.coli
  • Listeria monocytogenes
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15
Q

What pathogens are implicated in sepsis in children?

A
  • Strep. pneumoniae
  • Meningococci
  • group A streptococci
  • Staph aureus
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16
Q

What is the pathophysiology of sepsis?

A
  • LPS and bacterial components act on endothelium, neutrophils and monocytes
  • Release of oxygen radicals, cytokines and lipid mediators
  • Activation of complement leading to chemotaxis and lysosomal enzymes
  • Increased TF and PAI1 have a procoagulant effect
  • Microvascular occlusion, vascular instability
  • Sepsis and multi-organ failure
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17
Q

What are the symptoms of sepsis in children?

A
  • Fever or hypothermia
  • Cold hands/feet, mottled
  • Prolonged capillary refill time
  • Chills/rigors
  • Limb pain
  • Vomiting and/or diarrhoea
  • Muscles weakness
  • Muscle/joint aches
  • Skin rash
  • Diminished urine output
18
Q

What pathogens are implicated in meningitis in neonates (<1 month)?

A
  • Group B streptococci
  • E coli
  • Listeria monocytogenes
19
Q

What pathogens are implicated in meningitis in children?

A
  • Strep pneumoniae
  • Meningococci
  • Haemophilus inflaeunzae
20
Q

What are the symptoms of meningitis in children?

A
  • Nuchal rigidity
  • Headaches, Photophobia
  • Diminished consciousness
  • Focal neurological abnormalities
  • Seizures
21
Q

What are the symptoms of meningitis in neonates?

A
  • Lethargy, Irritability
  • Bulging fontanelle
  • Nappy pain’
22
Q

How is meningitis +/- sepsis treated?

A
  • ABCD approach
  • Antibiotics with good penetration in CSF and broad-spectrum (3rd generation cephalosporin’s and amoxicillin if neonate
  • Chemoprophylaxis for close household contacts (particularly meningococcus B and strep A)
23
Q

What will be seen on bloods of meningitis?

A
  • FBC (leucocytosis, thrombocytopenia)
  • Elevated CRP
  • Low coagulation factors (DIC)
  • Hypoglycaemia
24
Q

How is meningitis investigated?

A
  • Bloods
  • Blood and CSF cultures (PCR)
  • CSF (pleocytosis, increased protein level, low glucose)
  • Urine culture, skin biopsy
  • Imaging including T cerebrum
25
Q

How is strep pneumoniae transmitted?

A

By droplets

26
Q

Where does strep pneumoniae colonise?

A

Colonizes upper airways

  • 5-10% adults
  • 20-40% children
27
Q

What is strep pneumoniae?

A
  • Gram-positive Duplo-cocci (Diplococcus pneumoniae)

- 90 serotypes identified

28
Q

What is a predisposing factor for invasive disease by strep pneumoniae?

A

Viral infection

29
Q

What can pneumococcal disease cause in the alveoli?

A

Pneumonia

30
Q

What are the possible complications of pneumococcal meningitis?

A
  • Brain damage
  • Hearing loss
  • Hydrocephalus
31
Q

What is haemophilus influenza type B?

A
  • Gram-negative bacterium
  • Encapsulated H. influenza (resists phagocytosis and complement mediated lysis)
  • 6 serotypes
32
Q

What conditions is haemophilus influenza type B associated with?

A
  • Bacteraemia
  • Meningitis
  • Pneumonia
  • Epiglottitis
33
Q

How can meningococcal disease lead to meningitis?

A
  • Meningococcus in nasopharynx
  • Passage through epithelia
  • Meningococcus in the bloodstream
  • < 12 hours signs of septic shock
  • < 18-36 hours signs of meningitis
34
Q

What morbidity is associated with meningococcal disease?

A
  • Amputation (14%)
  • Skin scarring (48%)
  • Cognitive impairment/ epilepsy/ hearing loss
35
Q

What is the case fatality associated with meningococcal disease?

A
  • Case-fatality rate 5-15%

- 50% of deaths in first 12 hrs, 80% within 48 hrs

36
Q

What is meningococcal disease virulence dependent on?

A

Endotoxin levels

-Lipooligosaccharide

37
Q

What can pneumococcal disease cause in the pleura and pericardium?

A

Empyema

38
Q

What can pneumococcal disease cause in the peritoneum?

A

Peritonitis

39
Q

What can pneumococcal disease cause in the joints?

A
  • Arthritis

- Osteomyelitis

40
Q

What can pneumococcal disease cause in the blood?

A

Septicaemia

41
Q

What can pneumococcal disease cause in the meninges?

A

Meningitis

42
Q

What can pneumococcal disease cause in the nasopharynx?

A
  • Otitits media

- Sinusitis

Systems: Paediatrics AB (31 decks)

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