Intro week-febrile child Flashcards
Normal temperature for children
Normal temperature is 36.5-37.5 °C
Low grade fever for children
Low grade fever is around 38-38.5 °C
HOWEVER TEMP OF 38°C in baby less than 3 months is ‘red flag’ feature
High grade fever for children
High grade fever greater than or equal to 38.5 °C
-In children 3-6 months fever of over 39°C is an “amber flag” feature
symptoms of Kawaskasi disease
Clinical diagnosis of persistent fever (5 days) plus 4 out of five of:
1. Non purulent bilateral conjunctivitis
2. Cervical lymphandopathy
3. Extremity changes
1) Desquamation
2) Erythema, edema
4. Oral mucosal membrane changes (strawberry tongue/cracked lips)
5. Rash (polymorphous)
Differentials of Kawaskasi disease
- Measles (although measles normally have cough- LOOK AT IMMUNISATIONS
- Scarlet fever
treatment for Kawaskasi disease
IV immunoglobulins
What ages to children get febrile convulsions?
febrile convulsions happen between 6 months and 6 years
What are features of TYPICAL febrile convulsion?
TYPICAL febrile convulsions • Generalised (tonic clonic) •Unconscious • Short- lasts <5 mins • Associated with fever •Rousable afterwards-come round relatively quickly (30 mins)
What are features of ATYPICAL febrile convulsion?
ATYPICAL febrile convulsions
• Lasts longer than 15-20 mins
• Focal features
•2 within 24 hours or within same febrile illness
Differentials of febrile convulsions
- Tumour/space occupying lesion
- Raised ICP
- Non febrile seizure/epilepsy
risk factors for developing epilepsy
- Atypical febrile seizure
- Abnormal neurology/neurodevelopment prior to event
- Family history 1st degree relative of epilepsy
0 risk factor-1%
1 risk factor-2%
2 risk factor-10%
risk of reoccurrence of febrile seizures?
- 1/3 go on to have a second febrile convulsions
* 1/3 of those can have third
treatment for febrile seizures?
Do you admit?
-admit for first seizure and observe for 6 hours
ADVISE/ REASSURE PARENTS
- recovery position
- nothing in mouth
- anti-pyretics and hydration
- do not sponge the body
- remove excess clothing
- call 999 if seizure stays more than 5 mins
- SAFTY NET-come back if rashes or more symptoms fever more than 5 days
Which bacteria causes Meningococcal septicaemia
Neisseria Meningitidis
Define Petiche
Non blanching up to 2mm-on their own there not particularly worrying
