Paediatric Infections

Question 1

why can children with infections present differently than in adults?

Answer 1

because their immune system is not fully developed yet

Question 2

what two clinical processes need to be present to diagnose sepsis?

Answer 2

SIRS (severe immune response syndrome) PLUS infection (bacteraemia)

Question 3

what is severe sepsis?

Answer 3

sepsis PLUS 2+ organ failure

Question 4

failure of which systems can signify severe sepsis?

Answer 4

• respiratory failure
• renal failure
• neurological failure
• haematological failure
• liver failure

Question 5

failure of which system leads to septic shock?

Answer 5

cardiovascular failure

Question 6

what is the epidemiology of sepsis in paediatrics?

Answer 6

boys more common than girls

usually under age 2

Question 7

what are the commonest organisms to cause sepsis in children?

Answer 7

strep pneumoniae
meningococci
group A strep
staph aureus

Question 8

name a few signs/symptoms of sepsis in children

Answer 8

• tachycardia
• fever/hypothermia
• grey colour
• tachypnea
• cold or mottled hands/feet
• oliguria
• non blanching rash
• muscle pain
• vomit

Question 9

what are the main domains to consider when assessing severity in children with sepsis?

Answer 9

• colour
• activity
• respiratory
• cardiovascular
• age/fever/rigors/limb or joint swelling

Question 10

what is the initial management of sepsis?

Answer 10

ABC(DEFG) (intubate if necessary)
IV access
Sepsis 6

Question 11

what antibiotics are used in paediatric sepsis?

Answer 11

cephalosporins (ceftriaxone) (+amoxycillin if newborn)

Question 12

what investigations are carried out to diagnose sepsis in children?

Answer 12

blood tests
lumbar puncture
urine culture
skin biopsy culture
imaging (CT/MRI)

Question 13

name a few blood test investigations that are done to diagnose sepsis in children

Answer 13

• FBC
• CRP
• U&E
• LFT
• glucose
• ABG
• coagulation factors
• lactate

Question 14

what are the most likely organisms to cause sepsis/meningitis in neonates?

Answer 14

group B strep
E coli
listeria monocytogenes

Question 15

what are the most likely organisms to cause meningitis in children?

Answer 15

strep pneumoniae
meningococci
haemophilus influenza

Question 16

name a few symptoms/signs of meningitis in children

Answer 16

meningism
photophobia
non-blanching rash
photophobia
headaches
reduced consciousness
seizures

Question 17

name a few symptoms/signs of meningitis in neonates

Answer 17

irritability
lethargy
poor feeding
bulging fontanelle

Question 18

what treatments are given to children with meningitis?

Answer 18

cephalosporins (+ amoxicillin in neonates)

steroids

Question 19

name a few complications of pneumococcal meningitis in children

Answer 19

brain damage
hearing loss
hydrocephalus

Question 20

vaccines against which organisms now exist to prevent bacterial meningitis?

Answer 20

meningococci
haemophilus influenza
pneumococcus

Question 21

what antibiotics are given for streptococcal infections in children?

Answer 21

penicillin 10 days

Question 22

what antibiotics are given for staphylococcal infections in children?

Answer 22

flucloxacillin

Question 23

which organism causes scarlet fever?

Answer 23

strep pyogenes

Question 24

what is the incubation period for chicken pox?

Answer 24

10-21 days

Question 25

when is the contagious stage of chicken pox over?

Answer 25

when the vesicles have crusted over

Question 26

what is the treatment for scarlet fever?

Answer 26

penicillin 10 days

Question 27

what class of bacteria is strep pyogenes?

Answer 27

Group A streptococci

Question 28

name a few complications of scarlet fever

Answer 28

• skin infections: impetigo, erysipelas, necrotising fasciitis
• IgA nephropathy (nephritic syndrome)

Question 29

which organism can cause rheumatic fever?

Answer 29

strep pyogenes

Question 30

name a few features of scarlet fever

Answer 30

sandpaper rash
strawberry tongue
pharyngitis
malaise/fever
hand/food desquamation