Paediatric Infections Flashcards
why can children with infections present differently than in adults?
because their immune system is not fully developed yet
what two clinical processes need to be present to diagnose sepsis?
SIRS (severe immune response syndrome) PLUS infection (bacteraemia)
what is severe sepsis?
sepsis PLUS 2+ organ failure
failure of which systems can signify severe sepsis?
- respiratory failure
- renal failure
- neurological failure
- haematological failure
- liver failure
failure of which system leads to septic shock?
cardiovascular failure
what is the epidemiology of sepsis in paediatrics?
boys more common than girls
usually under age 2
what are the commonest organisms to cause sepsis in children?
strep pneumoniae
meningococci
group A strep
staph aureus
name a few signs/symptoms of sepsis in children
- tachycardia
- fever/hypothermia
- grey colour
- tachypnea
- cold or mottled hands/feet
- oliguria
- non blanching rash
- muscle pain
- vomit
what are the main domains to consider when assessing severity in children with sepsis?
- colour
- activity
- respiratory
- cardiovascular
- age/fever/rigors/limb or joint swelling
what is the initial management of sepsis?
ABC(DEFG) (intubate if necessary)
IV access
Sepsis 6
what antibiotics are used in paediatric sepsis?
cephalosporins (ceftriaxone) (+amoxycillin if newborn)
what investigations are carried out to diagnose sepsis in children?
blood tests lumbar puncture urine culture skin biopsy culture imaging (CT/MRI)
name a few blood test investigations that are done to diagnose sepsis in children
- FBC
- CRP
- U&E
- LFT
- glucose
- ABG
- coagulation factors
- lactate
what are the most likely organisms to cause sepsis/meningitis in neonates?
group B strep
E coli
listeria monocytogenes
what are the most likely organisms to cause meningitis in children?
strep pneumoniae
meningococci
haemophilus influenza
name a few symptoms/signs of meningitis in children
meningism photophobia non-blanching rash photophobia headaches reduced consciousness seizures
name a few symptoms/signs of meningitis in neonates
irritability
lethargy
poor feeding
bulging fontanelle
what treatments are given to children with meningitis?
cephalosporins (+ amoxicillin in neonates)
steroids
name a few complications of pneumococcal meningitis in children
brain damage
hearing loss
hydrocephalus
vaccines against which organisms now exist to prevent bacterial meningitis?
meningococci
haemophilus influenza
pneumococcus
what antibiotics are given for streptococcal infections in children?
penicillin 10 days
what antibiotics are given for staphylococcal infections in children?
flucloxacillin
which organism causes scarlet fever?
strep pyogenes
what is the incubation period for chicken pox?
10-21 days
