Infectious Diseases Flashcards
If a fever has lasted longer than 5 days what do you think of?
Kawasaki
If the febrile illness arises days before a rash what is viral cause?
VZV
History questions in sick child presentation?
How long
Chronology
Immunisations
Infected contacts
immunosuppression
Exposure - animals, travel, school, food/drink
Treatment already given - meningitis/penumonia
What temperature would be immediately high risk in a baby under 3 months and a child 3-6 months?
under 3 months = over 38
3-6 months = over 39
Child presenting with cough, conjunctivitis, coryzal rash on face and ears now around bottom, what are differentials?
Scarlet fever
Signs of scarlet fever?
sandpaper rash, strawberry red tongue, pastias lines
Symptoms of Meningitis in children?
Photophobia, neck stiffness, bulging fontanelle, rash, headache, seizures, sepsis, altered GCS
What investigations are needed into suspected meningitis?
Blood culture and LP
What does lumbar puncture look at for meningitis investigation?
Glucose, protein, WCC, microscopy, gram stain, molecular testing
How will CSF present in TB?
yellow with raised WCC, marked raise in protein and very low glucose
What sign is positive for meningitis?
Kernigs
8 causative organisms for meningitis?
Neisseria meningitidis Haemophillus influenza type b Streptococcus pneumoniae group B strep E.Coli TB Fungi Parasites
Treatment for CNS infections?
3rd gen cef = cefotaxime or ceftriaxone
Steroids (HiB)
What follow up is needed in meningitis?
Audiology
clinical
What do steroids allow in meningitis treatment?
reduced hearing loss
Define encephalitis?
Inflammation of brain parenchyma
What 6 viral illnesses can then proceed to encephalitis?
CMV, enteroviruses, HSV, adenovirus, jap encephalitis, arboviruses
Why does HSV encephalitis have unique presentation and what is it?
Temporal region effected following tracking back from temporal lobe ganglion
Presents with haemorrhagic encephalitis
Treatment of HSV encephalitis?
Aciclovir
In encephalitis what investigations on CSF are looked at?
PCR
Serology - arboviruses, lyme disease
Examine - RBCs, protein, oligoclonal bands, pleocytosis
What is ADEM spectrum and when does it occur?
Acute demyelinating encephaliting spectrum in post infectious CNS
What 3 organisms most likely to cause post-infectious encephalitis?
HSV
VZV
Mycoplasma
6 common viral pathogens causing URTI?
RSV Rhinovirus Adenovirus Parainfluenza Influenza Coronavirus
Viral pathogens most likely to cause LRTI?
RSV parainfluenza influenza Adenovirus Metapneumovirus
Bacterial pathogens most likely to cause LRTI?
mycoplasma
strep. pneumoniae
haemophillus
Staph aureus
Tests for moderate to severe pneumoniae?
Blood culture
Nasopharyngeal aspirate - PCR, FISH for virus
Sputum culture - bacterial
Pleural fluid
When is CXR indicated in pneumonia?
When it is very severe with complications or diagnostic doubt
Treatment of CAP? what is added if not effective?
Amoxicillin
Macrolide
What is Pertussis known as? Presents as?
Whooping cough
URTI, rhinorrhoea, cough with whoop, apnoea, vomiting, conjunctival haemorrhages
100 day cough
How is diagnosis of pertussis made?
Nasopharyngeal swab for PCR and culture
lymphocytosis
What drug class is given in pertussis to reduce transmissibility?
Macrolide - clarithromycin, azithromycin
What does the cocooning strategy of pertussis vaccination refer to?
Vaccinating whole household of newborn infant
Primary causative viral agent of gastroenteritis? 2 other viral causes?
Rotavirus
Adenovirus
Norovirus
5 main bacterial causes of gastroenteritis?
Shigella salmonella e.coli campylobacter c. diff
Management of Gastroenteritis?
Supportive
Fluid and electrolyte replacement
Rotavirus vaccine
2 big MSK infections to be aware of?
Septic arthritis
Acute haemotogenous osteomyelitis
Septic arthritis symptoms?
Joint swelling
Fever
limitation of movement
Most common pathogens causing septic arthritis?
S. aureus Group A strep Hib Pneumococcus Kingella Kingae
Symptoms of acute haematogenous osteomyelitis?
pain
fever
swelling
Organisms most likely to cause acute haematogenous osteomyelitis?
Staph aureus Group A strep Hib Pneumococcus Kingella Kingae