Microbiology 17: Neonatal and childhood infections

Question 1

List 3 infectious diseases screened for during pregnancy ?

Answer 1

Hep B
HIV
Syphilis

NB- rubella no longer screened due to success of MMR

Question 2

What is the most common cause of congenital deafness in the UK?

Answer 2

CMV

Question 3

Which disease is transmitted by cat poo ?

Answer 3

Toxoplasmosis

Question 4

What are some of the signs of congenital toxoplasmosis infection ?

Answer 4

(Main = deafness, low IQ + microcephaly)

60% asymptomatic 
Choroidoretinitis 
Microcephaly
Seizures
Hepatosplenomegally 
Intracranial calcification
Low IQ + deafness (later)

Question 5

What is the classical triad of signs of congenital rubella infection ?

Answer 5

Cataracts
Congenital heart disease
Sensorineural Deafness

(Brain pathology + BLUEBERRY MUFFIN RASH)

Question 6

What signs do you get with congenital HSV infection ?

Answer 6

Nasty disseminated infection ->:

Blistering rash + ulcers + Meningoencephalitis
High mortality

Question 7

What can Chlamydia trachomatis cause in the neonate ?

Answer 7

Neonatal conjunctivitis (sticky eye neonate think chlamydia)
Pneumonia

Question 8

Which 3 organisms most commonly cause early-onset (<72h) sepsis in the neonate?

Answer 8

GBS (group b streptococcus)
E.coli
Listeria monocytogenes

Question 9

Which organism most commonly causes late-onset (72h+) sepsis in the neonate?

Answer 9

Coagulase negative staphylococci (e.g s.epidermidis, s.saprophyticus)

Question 10

Which antibiotics are often used to treat early onset sepsis in the neonate?

Answer 10

Benzylpenicillin (treats GBS) + gentamicin (treats e.coli) +/- Amoxicillin (treats Listeria)

Question 11

Which bacteria classically causes superinfection with chicken pox ?

Answer 11

Invasive Group A streptococcus (necrotising faciitis)

Question 12

Bullous myringitis (vesicles on the tympanic membrane) and otitis media are suggestive of which organism?

What is a haematological complication of this organism?

Answer 12

Mycoplasma Pneumoniae - commonly causes resp infection in older kids (4+ y)

(Extrapulmonary manifestation)

Autoimmune Haemolysis

Question 13

Which bacteria causes whooping cough ?

Answer 13

Bordatella Pertussis

Question 14

Mx of late-onset neonatal sepsis?

Answer 14

1st line = Cefotaxime (this is brain-penetrative) and vancomycin (this is good for staph)

2nd line = Meropenem

Question 15

What are the TORCH organisms?

Answer 15

Toxoplasmosis
Other (syphilis, HIV, Hep B/C)
Rubella
CMV
HSV

Question 16

What is the cause of a ‘blueberry muffin rash’ and in which infection is it seen?

Answer 16

Extramedullary haematopoiesis

Congenital rubella syndrome

Question 17

Which neonatal infection could be described as ‘catalase-negative, beta haemolytic’?

Answer 17

GBS

Question 18

Treatment of community-acquired late-onset neonatal sepsis?

Answer 18

Cefotaxime

Question 19

Main cause of UTIs in children?

Answer 19

E-coli

Other coliforms (proteus, klebsiella and enterococcus sp)
Coagulase-negative staphylococcus

Question 20

Cause of meningitis in <3 months?

Answer 20

1. GBS
2. E coli
3. Listeria spp.

Question 21

Causes of meningitis in 3months - 6years?

Answer 21

N. meningtidis

HiB (if unvaccinated)
S. pneumoniae

Question 22

Causes of meningitis in 6+ years?

Answer 22

N. meningitids

S. Pneumoniae

Question 23

What type of bacteria is strep pneumoniae?

Answer 23

• Gram positive diplococcus

- α-haemolytic which means it partially haemolyses on the blood agar

Question 24

What type of bacteria is haemophilus influenzae?

Blood agar?

Answer 24

Gram negative cocci-bacilli (rods)

It grows glossy colonies on blood agar

Question 25

Top 3 causes of death in Children under 5 (neonates + postneonates)

Answer 25

Neonates:

1. Prematurity
2. Intra-partum complications
3. Neonatal sepsis

Congenital anomalies, pneumonia + neonatal tetanus

Post-neonatal:

1. Pneumonia
2. Congenital anomalies

Diarrhoea, injuries, malaria, measles, HIV/AIDS