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Path - Microbiology > Neonatal and childhood infections > Flashcards

Neonatal and childhood infections Flashcards

1
Q

list possible vertically acquired/congenital infections?

A

Hep B
HIV
Syphilis

CMV
Toxoplasmosis
Hep C
Group B Streptococcus
Rubella
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2
Q

which congenital infections do we screen for in uk?

A

Hep B
HIV
Syphilis

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3
Q

mmemonic for screen done in an ill neonate?

what does it stand for?

A

TORCH’ screen :

Toxoplasmosis
Other – syphilis; HIV; hepatitis B/C
Rubella
Cytomegalovirus (CMV)
Herpes simplex virus (HSV)
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4
Q

what are the 2 outcomes of congenital toxoplasmosis?

A

60% Asymptomatic at birth -
may still go on to suffer long term sequelae

40% symptomatic at birth -
mainly CNS symptoms

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5
Q

what is the classic triad of symptoms present in symptomatic congenital toxoplasmosis?

A

Choroidoretinitis
Intracranial calcifications
Hydrocephalus

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6
Q

list the long term sequelae possible in asymptomatic congenital syphilis?

A

Deafness, low IQ, microcephaly

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7
Q

there are many symptoms in Congenital rubella syndrome but what is the classic triad?

A

Cardiac anomalies - Patent ductus arteriosus (PDA)
Cataracts
Deafness

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8
Q

characterise the rash present in Congenital rubella syndrome?

A

+- blueberry muffin rash ; purpura

-> they have a specific look to them - see pix

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9
Q

seizures are present in which congenital infection?

A

congenital toxoplasmosis

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10
Q

when is Chlamydia trachomatis Infection transmitted ?

A

during delivery

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11
Q

which congenital infection causes neonatal conjunctivitis, or rarely pneumonia?

A

chlamydia

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12
Q

what is the neonate period?

A

First 4-6 weeks of life: after birth

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13
Q

why are premature babies at increased risk of infection?

A

Less maternal IgG
Exposure to microorganisms; colonisation and infection

  • Need NICU care
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14
Q

define early onset infection ini neonates and list some causative organisms?

A

Early onset – usually within 48 hours of birth

Organisms:
Group B streptococci
E. coli
Listeria monocytogenes

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15
Q

what Is the catalase Test?

meaning of results?

A

The catalase test is used to differentiate staphylococci (catalase-positive) from streptococci (catalase-negative).

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16
Q

what is the Most common cause of neonatal sepsis?

what organism is 2nd?

A
  1. GBS

2. e.coli

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17
Q

LIST 3 consequences of GBS infection in neonates?

A

Bacteraemia
Meningitis
Disseminated infection e.g. joint infections

18
Q

LIST 3 consequences of E.coli infection in neonates?

A

Bacteraemia
Meningitis
UTI

19
Q

List Maternal risk factors for Early onset sepsis-risk ?

A 
PROM/prem. Labour
Fever
Foetal distress
Meconium staining - fetal stool in amniotic fluids
Previous history
20
Q

List neonatal risk factors for Early onset sepsis-risk ?

A 
Resp. distress
Low BP
Acidosis
Hypoglycaemia
Neutropenia
21
Q

some ivx for Early onset sepsis in babies?

A

Full blood count
C-reactive protein (CRP)
Blood culture

Deep ear swab
Lumbar puncture (CSF)
22
Q

how to Early onset manage sepsis in neonate?

A

give abc at slightest sign of infection

Ventilation
Circulation
Nutrition
Antibiotics: e.g. benzylpenicillin & gentamicin

23
Q

define Late onset sepsis ?

A

after 48-72 hours

24
Q

Late onset sepsis is most commonly caused by which organism?

A

Coagulase negative Staphylococci (CoNS) e.g:

staph saprophyticus

25
Q

list some features of late onset sepsis ?

A 
Bradycardia
Apnoea
Poor feeding/bilious aspirates/ abdominal distension
Irritability
Convulsions

Jaundice
Respiratory distress
Increased CRP; sudden changes in WCC/platelets
Focal inflammation – e.g. Umbilicus; drip sites etc.s

26
Q

which abx to use in early onset sepsis?

A

depends but i.e.: benzylpenicillin & gentamicin

27
Q

which abx to use in Late onset sepsis?

1st and 2nd line?

A

example:

1st line: cefotaxime & vancomycin
2nd line: meropenem

28
Q

which infection is common after VZV infection in kids?

A

iGAS disease - invasive group A strep

can lead to toxic shock syndrome

29
Q

what is the Most important bacterial cause of paediatric morbidity and mortality?

A

meningitis

30
Q

what is the diagnostic work up for meningitis?

A
  1. Clinical features

2.Lab tests:
Blood cultures
Throat swab
LP for CSF if possible

Rapid antigen screen
EDTA blood for PCR

31
Q

what is next line if there is no growth on csf in meningitis?

A

If no growth PCR may be positive

32
Q

which capsular groups cause most disease in meningococcal disease?

A

B - (MenB)

then W

33
Q

LIST 3 consequences of strep pneumonia infection in neonates?

A

Meningitis, bacteraemia, pneumonia

34
Q

what happened with the prevent pneumococcal vaccine in uk?

A

Prevenar responsible for approx 80% of IPD in the UK in 2006

invasive pneumococcal disease

35
Q

which vaccine has replaced prevent?

A

PCV7:

Pneumococcal conjugative vaccines

36
Q

after 3months of age, which organisms are kids at LESS risk of obtaining meningitis from unlike the first 3 months?

A

H. influenzae (Hib) if unvaccinated);
GBS;
E. coli;
Listeria sp.

37
Q

leading cause of Respiratory tract infections in:

  1. under 4s?
  2. over 4s?
A

under 4: S. pneumoniae (pneumococcus)
- penicillins for treatment

over 4s: mycoplasma pneumonia

38
Q 
Fever
Headache
Myalgia
Pharyngitis
Dry cough

this is the classic presentation of?

A

mycoplasma pneumonia

  • similar to Fever in RT apart from the cough
39
Q

list some Extrapulmonary manifestations of mycoplasma pneumonia?

A

Haemolysis:
IgM antibodies to the I antigen on erythrocyte
Cold agglutinins in 60% patients

Neurological (1% cases) - Encephalitis most common

Cardiac
Polyarthralgia, myalgia, arthritis
Otitis media and bullous myringitis

40
Q

criteria for diagnosis of uti in kiddos?

A

Symptoms – if child old enough to give clear history
Pure growth >105cfu/ml
Pyuria – pus cells on urine microscopy

Path - Microbiology (27 decks)

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