Paediatric Infections Flashcards
define meningococcal infection
an infection due to Neisseria meningitidis - a gram -ve intracellular diplococcus
transmission of meningococci
respiratory droplets spread between humans
clinical features of Neisseria meningitidis
rapidly developing purpuric rash lethargy headache fever +/- rigors vomiting
additional features of Neisseria meningitidis infection
septicaemia hypovolaemic shock (cold peripheries, poor cap refill, tachycardia and ⬇️ urine output)
what is Waterhouse-Friderichsen Syndrome?
a mixture of septicaemia and meningitis with massive adrenal haemorrhage and septic shock
investigations of meningococcal disease
blood cultures
CSF culture
PCR testing
management of meningococcal disease
IM or IV benzylpenicillin
cefotaxime +/- amoxicillin
ICU admission
additional management of meningococcal disease
contacting household members and close contacts to provide prophylaxis rifampicin
contraindications for lumbar puncture
raised ICP
focal neurological signs
fluctuating consciousness
define sepsis
a clinical syndrome presenting with complications of the bodys response to infections
clinical presentation of sepsis in children
lethargy reduced social interactions pale or mottled skin altered conscious level decreased urine output poor feeding rash
signs of sepsis in children
⬆️ respiratory rate + effort
bradycardia or tachycardia
fever
signs of dehydration
red flag symptoms in children with suspected sepsis
non-rousable child bradycardia or tachycardia bradypnoea or tachypnoea mottled skin cyanosis non-blanching rash
risk factors of paediatric sepsis
age > 1yr impaired immune function recent surgery (< 6wks) breaching of skin presence of indwelling catheter/line
first line investigations for paediatric sepsis
bloods (FBC, CRP + U+Es) blood cultures creatinine clotting screen blood gas (VBG)
additional investigations for paediatric sepsis
urinalysis
CXR
abdomen and pelvis imaging
lumbar puncture
management of paediatric sepsis
ABCD approach
broad spectrum antibiotics (e.g. cefotaxime)
if child < 1yr: add amoxicillin
what blood test is most specific to bacterial sepsis?
procalcitonin - shows specific inflammatory markers
indications for ICU admission in paediatric sepsis
high lactate
highly abnormal physical observations
define neonatal sepsis
early onset of sepsis occurring < 72hrs post-birth or late onset which occurs > 72hrs post-birth
common organisms in early onset sepsis
group B strep
toxoplasma
rubella
common organisms in late onset sepsis
staph aureus
e.coli
pseudomonas
staph epidermis
investigations of neonatal sepsis
bloods (FBC, CRP and culture)
CXR
lumbar puncture
management of GBS in neonates
IV penicillin and gentamicin
fluids
management of group B infection of a pregnant woman
IV benzylpenicillin
