Module 17 viral infections for the toddler

Question 1

physical findings that may be noted with infectious disease

Answer 1

• abnormal vital signs
• irritability: concern for meningitis or kawasaki
• lethargy: meningitis and sepsis
• stiff or painful neck: meningitis
• New murmur: endocarditis, rheumatic fever
• skin or mucous membrane changes

Question 2

Most common infectious diseases for children in child care settings

Answer 2

Respiratory

GI

Question 3

HSV 1

Answer 3

orolabial lesions

- oral secretion and infects the mouth, lips and eyes can progress to the CNS

Question 4

HSV 2

Answer 4

traditionally shed from genital lesions and genital secretions
- most commonly associated with genital and neonatal infection

Question 5

roseola infantum clinical findings

Answer 5

sudden onset of fever 101-103
- 3-7 days, but child seems well 
May be: 
- URI 
- lymphadenopathy 
- lethargy

Question 6

Varicella clinical findings

Answer 6

Communicability is 1-2 days before the rash erupts until all lesions crust over (3-7 days)
PRODROME:
- low fever
- headache
- backache
- anorexia
- mild abdominal pain
- occasional URI s/s
RASH
- centripetal beginning on scalp, face, or trunk
- pruritic lesions
- progress from spots to teardrop vesicles
- cloud over and umbilicate in 24-48 hr
- all morphologic forms can be seen simultaneously

Question 7

influenza clinical findings

Answer 7

• sudden high fever 102-106
• HA
• coryza
• vertigo
• pharyngitis
• pain in back and extremities
• dry hacking cough
• young children: V/D, croup
• Infants: can become septic

Question 8

Measles

Answer 8

characteristic rash, indicating viremia

- droplet contact, formites, aerosol transmission

Question 9

measles clinical findings

Answer 9

incubation: no s/s
prodromal:
- 4-5 days of URI
- low to moderate fever
- cough, coryza, conjunctivitis
- Koplik spots found in oral mucosa
- -small, irregular, bluish white granules
Rash: usually appears day 3-4
- temp rises often to 105
- maculopapular rash first behind ears and on forehead
- papules enlarge, coalesce, and move progressively downward over next 24 hours
- as legs become involved face begins to clear
- entire process takes about 3 days
- URI most severe day 3 of rash

Question 10

Causative organism for measles

Answer 10

measles virus itself
Group A B-hemolytic stroptococci (GABHS)
pneumococci
Hib
S. aureus

Question 11

Mumps

Answer 11

acute generalized viral disease with painful enlargement of one or more salivary glands: usually parotid

Question 12

mumps clinical findings

Answer 12

Prodromal
- rare: fever, headache, anorexia, neck or muscular pain, malaise
Swelling stage:
- 24 hours, painful swelling of one or both parotid, lasts a few hours to a few days
- Rarely: maculopapular, truncal, pink discrete rash is seen
- pain on the affected side can be elicited by having patient at something sour (pickle sign)
- edema r/t lymphatic obstruction of the manubrium and upper chest
- orchitis may occur in individuals who contract mumps after puberty

Question 13

erythema infectiosum

Answer 13

fifth disease/slap cheek

• caused by parvovirus B19
• vertical transmission from mother to fetus
• respiratory tract secretions, percutaneous exposure to blood

Question 14

erythema infectiosum clinical findings

Answer 14

Prodrome:
- mild fever, myalgia, HA, malaise, URI s/s
RASH:
- appears 5-7 days after prodromal period
- 3 stages
– face as intense red eruption on the cheeks with pallor (1-4 days)
– lacy maculopapular eruption appears on the trunk and moves peripherally (can last a month)
– rash subsides
Can have periodic recurrences precipitated by:
- trauma, heat, exercise, stress, sunlight, cold