Infectious diseases Flashcards
What is sepsis?
SIRS + suspected/proven infection
What is SIRS?
Systemic inflammatory response syndrome: Fever/hypothermia Tachycardia Tachypnoea Leucocytosis or leucocytopenia
What is severe sepsis?
SEPSIS + multi-organ failure >2 of: - Respiratory failure - Renal failure - Neurologic failure - Haematological failure - Liver failure
What is ARDS?
Acute respiratory distress syndrome - inflammatory response of the lungs
Which sex des sepsis occur in more?
Male
What are the responsible pathogens of sepsis in neonates?
Group B streptococci
E.coli
Listeria monocytogenes
What are the responsible pathogens of sepsis in children?
Strep pneumoniae
Meningococci
Group A strep
Staph aureus
What are symptoms of paediatric sepsis?
Fever/hypothermia Cold hands/feet Mottled skin Prolonged cap refill time Chills/rigors Limb pain Vomiting/diarrhoea Muscle weakness Muscle/joint aches Skin rash Reduced urine output
What is probably the best sign of sepsis?
Tachycardia
What is the treatment for sepsis?
ABC
DEFG - don’t ever forget glucose
Antibiotics with broad-spectrum and CSF penetration
Cephalosporins
What blood investigations would you do for sepsis and the likely results?
FBC - leucocytosis, thrombocytopenia
CRP - elevated
Coag factors - deranged clotting due to DIC
U&Es, LFTs - renal and hepatic dysfunction
Blood gas - metabolic acidosis, raised lactate
Glucose - hypoglycaemia
Culture
What CSF investigations would you do for sepsis and what are the likely results?
Cell count & culture - increased WCC
Protein & glucose - increased protein level, low glucose
What other investigations would you do for sepsis?
Blood CSF Urine culture Skin biopsy culture Imaging: CT/MRI head
What are the responsible pathogens of meningitis in neonates?
Group B strep
E.coli
Listeria monocytogenes
What are the responsible pathogens of meningitis in children?
Strep pneumoniae
Meningococci
Haemophilus influenza
What are the symptoms of meningitis in children?
Nuchal rigidity Headaches, photophobia Diminished consciousness Focal neurological abnormalities Seizures
What are the symptoms of meningitis in neonates?
Lethargy, irritability Bulging fontanelle Seizures High temp Sleepy Breathing fast/difficulty breathing Shivering Vomiting/refusing to feed Blotchy skin Stiff body with jerky movements Cold hands/feet
What is the treatment of meningitis?
Chemoprophylaxis
Steroids
Where does strep pneumoniae colonize?
Upper airways
What is the transmission of strep pneumoniae?
Droplets
What are signs of pnuemococcal meningitis?
Brain damage
Hearing loss
Hydrocephalus
Is strep pneumoniae gram neg or pos?
Gram positive
Is haemophilus influenza type B gram pos or neg?
Gram negative
What can haemophilus influenza type B cause?
Bacteraemia
Meningitis
Pneumonia
Epiglottitis
What are long term complications for survivors of meningitis?
Amputation
Skin scarring
Cognitive impairment/epilepsy/hearing loss
What are vaccine preventable diseases?
Meningococcal disease
Haemophilus influenzae B Pneumococcal disease
What are the first signs of scarlet fever after 2-4 days?
Malaise
Fever
Flu-like symptoms
Pharyngitis
If progressive strep infection what is the next sign after flu-like symptoms?
Rash
What happens to the tongue in scarlet fever
Strawberry tongue
What can happen to hands and fingers in scarlet fever?
Peeling
What time of year is scarlet fever most common?
Winter
When can Group A strep cause complicated presentations?
Immunosuppressed
Chickenpox
What is the treatment for scarlet fever?
Penicillin 10 days
What are some complications of scarlet fever?
Impetigo Necrotising fasciitis Erysipelas Rheumatic fever Glomerulonephritis
What infections can staph aureus cause?
Impetigo Cellulitis Infected eczema Ulceration Staph scalded skin syndrome Toxic shock syndrome
Is streptococci gram positive or gram negative?
Gram positive
What is streptococci treated with?
Penicillin
Does streptococci have resistance issues?
Not usually