infectious dz Flashcards
bronchiolitis
inflammation of the bronchioles/small airways
bronchioles obstreucted w/ mucus and edema–> air trapped–> wheezing
average age of bronchiolitis vs bronchitis
bronchiolitis is typically less than 2 years old
most common cause of bronchiolitis
respiratory syncytial virus (RSV)
late fall & winter; can be afebrile
common cause of croup
parainfluenzae
- lower resp tract in young kids
- only URI sx most times followed in 1-3 days w/ wheezing, worse cough, dyspnea
RSV bronchiolitis
diagnostic testing for RSV bronchilitis
nucleic acid testing
treatment of bronchiolitis
supplemental oxygen PRN
saline nose drops & suctioning PRN
6 indications for hospitalization for CAP
- Hypoxemic – O2< 90%
- Age < 6 months
- Toxic appearance
- Respiratory distress
- Known pathogen with increased virulence
- uncertain of adherence to tx at home
tachypnea in under 2 mo vs 1 yr vs 5 yrs
- under 2 mo: over 60
- under 1 yo: over 50
- under 5 yo: over 40
- over 5yo: over 20
most common cause of pneumonia in under 3 months vs under 4 yrs vs over 5 yrs
- under 3 months: chlamydia trachomatis, RSV, HMPV, B pertusis
- under 4 yo: RSV, HMPV, flu, mycoplasma
- over 5: mycoplasma, chlamydophilia pneumo.
s. pneumo in all age groups
4 signs of meningitis in infants
- constant or weak crying
- increased sleeping/lethargic
- vomiting
- bulging fontanelle- but not always
which age group is bacterial vs viral pneumonai more common
- bacterial is more in under 3mo
- preschool is most likely viral
expected CBC finding with bacterial meningitis
WBC over 15k w/ bandemia
CSF findings for bacterial meningitis (3)
- glucose under 40
- protein over 50
- polymorphonuclear cells
3 most common bacterial meningitis etiologies in under 1 month
- ecoli
- GBS
- listeria mono.
two most common bacterial etiologies in 1 mo. to 10 y.o
s. pneumo
n. meningitidis
most common bacterial etiology for bacterial meningitits
N. meningitidis
empiric tx for bacterial meningitis in onver 1 month old
vancomycin and ceftriaxone
tx of bacterial meningitis d/t N. meningitidis
ceftriaxone for 5-7days
2 things recommended after meningitis resolves
hearing test
neurodevelopmental f/u
most common cause of viral meningitis
enterovirus
how is viral meningitis diagnosed
NAT of CSF-multiplex PCR
- altered mental status
- seizures
- behavioral or personal changes
- focal neurologic signs
encephalitis
most common cause of encephalitis
viral (HSV, enterovirus, arbovirus)
other than viral etiologies, other treatable cause of encephalitis
rickettsia– Rocky Mountain SF, Anaplasma phagocytophilum, Coxiella burnetti, Ehrlichia chaffeensis
doxycycline
gram negative coccobacillus blood culture with meningitis
Neisseria meningitidis
Vasculitis with N. meningitidis
inflammation and damage of small blood vessels that progresses very fast
seen less d/t meningococcal vaccines that tend to target N. meningitidis
diff between SIRS and sepsis
- SIRS– dysregulation of the immune response
- Sepsis is SIRS in presence of known or suspected infection
all septic patients have SIRS but not all SIRS patients have sepsis
definition is different in adults
criteria for peds SIRS
- core temp over 38.5 or under 36
- tachycardia or brady in under 1 month old
- tachypnea
- elevated or depressed WBC
also could have delayed refill, cool extremities, ARDS
when do you typically see hypotension in children
late
