paeds infxn Flashcards
what causes roseola infantum?
HSV 6 (sometimes 7, but rarer)
do children with roseola infantum need to be excluded from school?
no
what are the symptoms of roseola infantum?
fever maculopapular rash nagayama spots: papular enanthem on the uvula and soft palate febrile convulsions diarrhroea and cough eyelid swelling and lymphoedema
how is roseola treated?
symptomatic treatment
what causes hand foot and mouth?
coxsackie a
enterovirus
Picornaviridae family of viruses
very contagious
what are the symptoms of hand foot and mouth
sore throat
fever
oral ulcers
followed later by vesicles on the palms and soles of the feet
how is hand foot mouth treated?
symptomatic and hydration
do children need to be excluded for hand foot mouth?
no
what causes scarlet fever?
group A haemolytic strep usually strep pyogenes
how is scarlet fever spread?
respiratory droplets
what are the symptoms of scarlet fever?
fever malaise headache nausea sore throat STRAWBERRY TONGUE sandpaper (pinprick) circumollar pallour peeling after rash
how is scarlet fever diagnosed?
throat swab, but start treating before results
how is scarlet fever treated?
pencillin V
if allergic, azithromycin
do children with scarlet fever need exclusion?
yes, until 24 hrs after Abx
is scarlet fever notifiable?
yes. students out of school for 24hrs following starting Abx
what are the complications of scarlet fever?
otitis media
rheumatic fever
glomerulonephritis
what is slapped cheek also known as
erythema infectiosum
what causes slapped cheek?
parvovirus B19
how does slapped cheek present?
fevery illness
rose red rash on cheeks that may spread to body, sparing palms and soles
what does heat trigger in a person previously infected with slapped cheek?
recurrence of the rash
what is the treatment for slapped cheek?
supportive
do children with slapped cheek need to be excluded?
no, they are no longer infectious by time rash appears
but pregnant women should be avoided
which stage of pregnancy should women avoid slapped cheek?
first 20 weeks
what do pregnant women who come into contact with slapped cheek need to do?
let antenatal care know so that she can be checked for IgG IgM
what are complications of slapped cheek?
aplastic crises in sickle cell
pancytopaenia in immunosuppressed
what virus causes measles?
RNA paramyxovirus
how is measles spread?
droplets
what are the symptoms of measles?
conjunctivitis fever Koplik spots before rash rash starts behind ears then to whole body maculopapular rash becomes confluent
how is measles diagnosed?
IgM
how is measles managed?
supportive
hospitalisation of pregnant/immunocompromised
what are the complications of measles?
otitis media
pneumonia
encephalitis
is measles notifiable?
yes
which virus causes chickenpox?
varicella zoster virus
how is chickenpox spread?
respiratory route
how does Chicken pox present?
fever, itchy rash on head/trunk and spreads
initially macular
then papular
then vesicular
how is Chicken pox treated?
keep cool
trim nails
calamine lotion
how long is Chicken pox infectious?
1-2 days before rash until the rash crusts over.
what should you give immunocompromised patients/neonates who get Chicken pox?
IV acyclovir
if no rash, but exposure - Varicella zoster Ig
what are some rate complications of chicken pox?
pneumonia
encephalitis
disseminated haemorrhagic chickenpox
arthritis, nephritis, pancreatitis
how does rubella present?
fever
maculopapular rash
suboccipital, post-auricular LN
what is the problem with rubella?
risk of pregnant contracting - congenital rubella syndrome, esp before 20 weeks
what causes rubella?
rubella virus (a togavirus)
what are the effects of congenital rubella syndrome?
sensorineural deafness congenital cataracts congenital heart disease (e.g. patent ductus arteriosus) growth retardation hepatosplenomegaly purpuric skin lesions 'salt and pepper' chorioretinitis microphthalmia cerebral palsy
is rubella notifiable?
yes
when should rubella vaccine be given to pregnant women who are not immune?
after birth
what causes Whooping cough?
bordatella pertussis
what are the symptoms of whooping cough?
coryza coughing bouts (esp nocte and after feeding) inspiratory whoop (not always present) central cyanosis when crying infants may have apnoeic spells!!
how might infant with whooping cough present?
apneoic spells
cough persisting
post-cough vomiting
whooping (may not always be present)
how is whooping cough diagnosed?
nasal swab culture
infants under which age with whooping cough should be admitted?
6 months
what is the treatment for whooping cough?
macrolide - clarithromycin erythtromycin etc if cough started less than 21 days ago
why are antibiotics given in whooping cough?
eradicate illness and reduce spread
Abx do not alter course of disease
how long should children with whooping cough be kept away from school?
48 hours post Abx
21 days post cough onset if no abx
what are the complications of whooping cough?
subconjunctival haemorrhages
pneumonia
bronchiectasis
seizures
how are contacts for pertussis treated?
erythromycin prophylactic
is pertussis notifiable?
yes
what causes kawasaki disease?
cause: vasculitic
what are the symptoms of kawasaki?
- high-grade fever which lasts for > 5 days
- conjunctival infection
- bright red, cracked lips
- strawberry tongue
- cervical lymphadenopathy
- red palms and soles of the feet which later peel
how is kawasaki diagnosed?
clinical
what is the treatment for kawasaki?
aspirin
IVIG
Echo to screen for coronary aneurysm
what are the complications of kawasaki?
coronary aneurysm
what bacteria cause impetigo?
strep pyogenes
staph aureus
how does impetigo present?
golden crusty rash around the mouth
how is impetigo treated?
topical fucidic acid
if systemic, oral fluclox
if allergic, erythromycin
how long should children be out of school for impetigo?
until crusted
or 48 hours after abx tx
which organism causes meningitis in neonates?
group b strep (prolonged labour, premature)
E. Coli
listeria
which organisms cause meningitis in children?
N. Meningitidis
strep pneumoniae
haemophilus influenzae
how is meningitis treated in children?
IV amoxicillin and cefotaxime (younger than 3m)
amoxicillin to cover listeria
IV cefotaxime in older than 3m
which prophylaxis for meningitis contacts?
ciprofloxacin preferred over rifampicin
what is the treatment for threadworm?
oral mebendazole (antihelminitic) for the whole household even if asymptomatic
