Paed strep + staph infections Flashcards
main differences between strep and staph tx
strep: NO RESISTANCE ISSUES - TX PENICILLIN
staph: RESISTANCE BIG ISSUE - Flucloxacillin
scarlatina?
scarlet fever
group A beta haemolytic streptococci
Scarlet fever PC - stages
2-4 incubation
malaise, VERY HIGH fever, tonsillitis, start exanthema (sand paper red rash)
strawberry tongue
recovery: squamation hands feet
peak age for scarlet fever
between 2-10yo
complications of scarlet fever
erysipelas, cellulitis, impetigo
TSS
rheumatic fever
GN
scarlet fever tx
penicillin 10 days
PC SSSS
staphylococcus aurea scalded skin syndrome - systemically unwell. fever, redness, fluid filled blisters, in skin folds
Diagnosis of Kawasaki disease
fever for >5 days
4 of the 5: 1. Bilateral conjunctival injection 2. Changes of mucous membranes 3. Cervical lymphadenopathy 4. Polymorphous rash DIFFERENTIATE FROM MENINGOCOCCAL RASH 5. Changes of the extremities Peripheral oedema Peripheral erythema Periungual desquamation (under/around nails)
pathophysiology of KD
idiopathic trigger
- self limiting vasculitis of medium sized arteries
tx of KD
high dose immunoglobulin
aspirin
get better v quickly
complication of KD
coronary artery disease - do an echo post infection
Henoch Schonlein purpura PC
vasculitis rash on LL - like meningococcal but NO FEVER OR SYSTEMIC UPSET - self limiting
ass w prev viral illness
varicella zoster virus infection
Primary infection - Varicella, (Chickenpox), systemically well - with individual spaced papules - new lesions stop after 7 days
only tx with aciclovir if immunocompromised
characteristic of herpes simplex rash
vesicles are GROUPED TOGETHER
aetiology:
VZV
HSZ 1
HSZ 2
VZV: kids <5yo + adults
HSZ 1: adults (oral)
HSZ 2: <5% (child abuse), adults - genitals
herpes zoster reactivation (VZV)
shingles (adults) secondary infection
hand-foot-mouth disease
causes: enteroviruses, coxsackie
children <10yo
summer/autumn
painful lesion
recognising primary immunodeficiencies - 5 red flags (SPURR)
SEVERE PERSISTENT UNUSUAL RECURRENT RUNS IN THE FAMILY
Antibody def
PC?
tests?
RECURRENT: URTI + LRTIs
strep pneumoniae, h. influenza
tests: IgA, IgM, IgG
then IgG subsets (IgG2)
cellular immunodeficiencies
PC?
Tests?
UNUSUAL/oppurtunistic infections + faltering growth. Eg pneumocystis jirovecii
tests: immunophenotyping + WBC count
innate immune disorders:
defects in phagocyte function
staph aureus + aspergillus
innate immune disorders:
complement deficiencies
N. meningitidis
Chronic Granulomatous disease
aetiology?
65% x linked
35% autosomal recessive
Chronic Granulomatous disease
PC
life threatening recurrent severe bacterial and fungal infections
life time incidence of invasive aspergillosis 40%
main cause of death
peak <2yo
Chronic Granulomatous disease
tx
stem cell therapy
primary immunodeficiency can present similar to?
HIV - contracted via mother to child (rare now)
PC - recurrent resp infection (6per yr) since 2yo - pneumonia
normal growth
4 a/bs each year
RECURRENT - points towards PID
S.pneumonia = Ab def
PC: Meningococcal sepsis 13Mnth yo boy
SEVERE
N. meningitidis
= complement def
PC: slow weight gain, dry cough, difficulty breathing
3 month girl
unusual organism
cellular immunodeficiency
