Microbiology - Neonatal + Childhood Infections Flashcards
What are the congenital infections?
TORCH
- T: Toxoplasmosis
- O: Other (Syphilis, HIV, HBV)
- R: Rubella
- C: CMV
- H: HSV
How do congenital infections generally present?
Non-specific: TORCH:
- T: Thrombocytopenia
- O: Other (ears/eyes = cataracts, choroidoretinitis)
- R: Rash
- C: Cerebral abnormality (Microcephaly)
- H: Hepatosplenomegaly
How are congenital infections diagnosed?
Serology
What is the treatment for congenital infections?
Prevention - TORCH screen
What are the classic symptoms of rubella?
Triad:
- Cataracts
- Sensorineural deafness
- CHD (PDA)
+ blueberry muffin rash
What are the classic symptoms of CMV?
- Sensorineural deafness
- Microcephaly
- Chorioretinitis
- Pneumonitis
90% asymptomatic at birth
How is congenital CMV treated?
PO Valganciclovir
What are the classic symptoms of HSV?
- Blistering rash
- Liver dysfunction
- Meningoencephalitis
When is the risk of HSV highest?
Third trimester
How is congenital HSV treated?
IV Aciclovir
How does Parvovirus B19 present in pregnancy?
- Haemolytic anaemia (leads to hydrops foetalis)
What is the treatment for Parvovirus B19 in pregnancy?
IVIG post-exposure
What are the classic symptoms of Toxoplasmosis?
- Hydrocephalus
- Chorioidoretinitis
- Intracranial calcifications
How is Toxoplasmosis transmitted?
- Exposure to cats (toxoplasma gondii parasite)
What are the causes of early onset sepsis (<48hr post-birth)?
- Group B streptococci = most common
- E. coli
- Listeria
What are the signs of early onset sepsis (<48hrs post birth)?
Maternal:
- PROM
- Fever
- Foetal distress
Foetus:
- Respiratory distress
- Acidosis
- Asphyxia
How does early onset sepsis (<48hrs post-birth) present?
- Fever
- Unwell - meningitis
How is early onset sepsis (<48hrs post-birth) diagnosed?
Septic screen:
- FBC
- CRP
- Blood culture
- Deep ear swab
- CSF
- Surface swab
- CXR
What is the treatment for early onset sepsis (<48hrs post-birth)?
- ABC
- Supportive
- Nutrition
- Abx: BenPen + Gentamicin (Amox/ampicillin if Listeria)
What are the causes of late onset sepsis (>48hrs post-birth)?
- Coagulase negative staphylococcus + GBS
- E. coli
- Listeria
How does late-onset sepsis (>48hrs post-birth) present?
- Bradycardia
- Apnoea
- Poor feeding
- Irritability
- Convulsions
- Jaundice
- Respiratory distress
- Focal inflammation (examine umbilicus)
How is late onset sepsis (>48hrs post-birth) diagnosed?
- Septic screen
- Urine
How is late onset sepsis (>48hrs post-birth) diagnosed?
- Septic screen
- Urine
How is late onset sepsis (>48hrs post-birth) treated?
- Benzylpenicillin + Gentamicin
- Tazocin + vancomycin (if very ill)
Late-onset in communtiy:
- Amoxicillin + Cefotaxime (Listeria + community meningitis; - BenPen given in GP)
What are some childhood infections?
- VZV
- HSV
- Secondary bacterial infection
How do childhood infections present?
Non-specific:
- Fever
- Abdominal pain
How are childhood infections diagnosed?
- FBC
- CRP
- Blood/urine/sputum culture
What are some common causes of bacterial meningitis in different childhood age groups?
- Neisseria meningitidis = Commonest >3mths (non-blanching petechial rash)
- Streptococcus pneumoniae = <2yrs old
- Haemophilus influenzae = <3mths + unvaccinated children
- GBS, E. coli, Listeria = Common 1-3mths (Empirical Abx at this age = Amox)
What are some common respiratory tract infections in children?
- Viruses (esp. in young)
- S. pneumoniae
- Mycoplasma (possible if >4yrs)
What are some common UTIs in children?
- E. coli
- Proteus
- Klebsiella
- Enterococcus
How are UTIs diagnosed in children?
- Culture: >10^5 cfu/ml
- Microscopy: Pyuria (pus cells)
- Clinical Sx
