Paediatric infections Flashcards
what is a serious complication of pertussis?
hypoxic encephalopathy
how might we treat pertussis?
Clarithromycin 7.5 mg/kg (for child > 1month) up to 500 mg po 12H for 7d
(No Clarithromycin syrup available at present)
Azithromycin 10 mg/kg (for infant < 1 month) daily for five days
how might we ix pertussis?
PCR/serology
what is the 100 day cough?
pertussis
what bugs can cause periorbital celluitis?
staphlococcus
streptococcus
HIB
what pathogen causes epiglottis?
HIB
what do you give for an unvaccinated child with periorbital celluitis?
flucloxacillin
+ ceftriaxone (for haemophillis!)
what are the complications of mumps?
orchitis
encephalitis
how do we ix bronchiolitis?
bronchiolitis is a clinical diagnosis really, but if you had to you could do a nasopharyngeal aspirate and PCR, ABG +/- CXR
who is at risk of bronchiolitis?
preterm babies, babies with chronic illnesses, babies with cardiorespiratory issues/insufficiency
what is the usual age for bronchiolitis?
less than 1 yr old
what alternative diagnosis would we consider for a 1-4 yr old patient with a ‘viral induced wheeze’?
asthma, but really > 4yrs is required for an asthma diagnosis
what are some signs of severe bronchiolitis in a child?
apneoic episodes nasal flaring/tracheal tug/intercostal recession etc cyanosis lethargy irritability problems with feeding
what should we hear on auscultation for a child with bronchiolitis?
widespread crackles and wheeze
inspiratory fine crackles
prolonged expiratory time
what are some things we need to monitor/consider in a child who has been admitted to hospital with bronchiolitis?
Hospital admissions: monitor vitals + O2 sats,
consider NGT feeding, use suction as required
supplemental O2, close monitoring if requiring ICU care;
monitor FLUID STATUS; maintenance fluids
Ensure infection control procedures are followed.
what is the RSV immunoglobulin?
palivizumab, monoclonal antibody given IM
what are the main clinical indicators that croup is severe and the child requires hospitalisation?
stridor at rest and lethargy
what antibiotic is best used for bacterial sinusitis?
augmentin
how might we manage an empyema in a child?
drainage with chest drain
with either fibrinolytic agent (urokinase) or surgical decortication.
surgical decortication is preferred as urokinase can cause adhesions
A young child presents with a fever. They are presumed to have an infection and given antibiotics. A maculopapular rash then appears 1 to 2 days after, and the child is thought to have a drug reaction. What is the most likely situation?
Roseola infection caused by herpes virus 6. Fever presents first and then rash appears later as fever goes down
What are the complications of Kawasaki disease?
Coronary artery dilation or aneurysm formation
Describe the management of Kawasaki’s disease
Administration of IVIG preferably within the first 10 days of illness and then aspirin once a day for at least 6 to 8 weeks plus or minus paracetamol
what are the usual pathogens and clinical cause of haemolytic uraemic syndrome?
Usually bloody diarrhoea and afebrile; child does not look that unwell.
- commonly associated with big outbreaks in uncooked meat
- caused by shiga toxin producing e.coli
what are the pathogens that cause toxic shock syndrome?
streptoccocus pyogenes/ staph aureus