Neonatal and childhood infections Flashcards
- Which infections are screened for in pregnancy?
HIV
Hepatitis B
Syphilis
- What does ‘TORCH’ stand for?
Toxoplasmosis Other – syphilis, HIV, hep B/C Rubella CMV HSV
- What is the source of toxoplasmosis?
Cat faeces
- What are the possible outcomes for neonates with congenital toxoplasmosis?
Asymptomatic (60%) at birth but go on to develop long-term sequelae such as deafness, low IQ and microcephaly Symptomatic (40%) at birth • Choroidoretinitis • Microcephaly/ hydrocephalus • Intracranial calcifications • Seizures • Hepatosplenomegaly/jaundice
- What is the triad of features in congenital rubella syndrome?
Cataracts
Congenital heart disease (PDA is most common)
Deafness
- How is herpes simplex virus transmitted to the neonate?
Lesions in the genital tract can transmit HSV to the neonate
It causes a blistering rash and can cause disseminated infection with liver dysfunction and meningoencephalitis
- How if Chlamydia trachomatis transmitted to the neonate and what disease does it cause in the neonate?
During delivery
Causes neonatal conjunctivitis or pneumonia
treated with erthyromycin
- What is the definition of ‘early-onset’ infection?
Infection that occurs within 48 hours of birth
- What are the three main organisms that cause early-onset infection?
Group B Streptococcus
E. coli
Listeria monocytogenes
- What type of bacterium is Group B Streptococcus?
Catalase negative, Gram-positive, Beta haemolytic coccus
- List some maternal risk factors for early-onset sepsis.
Premature rupture of membranes Preterm labour Foetal distress Fever Meconium staining Previous history
- List some baby-related risk factors for early-onset sepsis.
Birth asphyxia Respiratory distress Low blood pressure Acidosis Hypoglycaemia Neutropaenia Rash Hepatosplenomegaly Jaundice
- List some investigations that may be useful in early-onset sepsis.
FBC CRP Blood culture Deep ear swab LP Surface swabs CXR
- Which antibiotic combination is often used in early-onset sepsis and why?
Benzylpenicillin and gentamicin
Benzylpenicillin covers Group B Streptococcus whilst gentamicin covers E. coli
- What are the main causes of late-onset sepsis?
Coagulase negative staphylococci (e.g. S. epidermidis)
GBS
E. coli
Listeria monocytogenes
S. aureus
Enterococcus sp.
Gram-negatives (e.g. Klebsiella, Enterobacter, Pseudomonas)
- List some clinical features of late-onset sepsis.
Bradycardia Apnoea Poor feeding Irritability Convulsions Jaundice Respiratory distress
- List some investigations for meningitis in children.
Blood cultures Throat swab LP Rapid antigen screen EDTA for blood PCR Clotted serum for serology
- Why is it dangerous to perform an LP in meningococcal septicaemia?
They may be coagulopathic
- What is the main bacterial cause of meningitis at the moment?
Meningitis B
- What type of organism is Streptococcus pneumoniae?
Gram-positive diplococcus
Alpha haemolytic
- What type of organism is Haemophilus influenzae?
Gram-negative cocco-bacilli
- Which children are mainly affected by Mycoplasma pneumoniae?
Older children (> 4 years)
- Which group of antibiotics are used to treat Mycoplasma pneumoniae?
Macrolides
- Describe the classical presentation of Mycoplasma pneumoniae.
Fever Headache Myalgia Pharyngitis Dry cough
- List some extra-pulmonary manifestations of Mycoplasma pneumoniae.
Haemolysis – IgM antibodies to I antigen on erythrocytes, cold agglutinins
Neurological – encephalitis, aseptic meningitis, peripheral neuropathy, transverse myelitis
Polyarthralgia
Cardiac
Otitis media
Bullous myringitis (vesicles on the tympanic membrane – pathognomonic of Mycoplasma)
- If a respiratory tract infection fails to respond to conventional treatment, which diagnoses should be considered?
Whooping cough
TB
