Pediatric Infections Flashcards
[Diagnosis: Red eye in neonates]
Red eye with purulent discharge, tense edema of eyelids with marked chemosis
incubation 2-5 days
N. gonorrhoeae
Tx: Ceftriaxone 50mg/kg/day SD
[Diagnosis: Red eye in neonates]
mild to severe swelling of eyelids with copious purulent discharge
incubation 5-14 days
C. trachomatis
Tx: Erythromycin 50mg/kg/day q6 hours for 14 days
Giemsa stain - epithelial cells scraped from the tarsal conjunctiva for intracytoplasmi inclusions
[Diagnosis: Red eye in neonates]
edema of eyelids, purulent discharge, pannus formation, endophthalmitis
P. aeruginosa
Tx: Systemic Abx, gentamicin eye ointment
[Diagnosis: Eye infections]
Conjunctivitis
Red itchy eyes
thin exudates
pain and photphobia
cough and colds
Adenovirus
[Diagnosis: Eye infections]
Conjunctivitis
red eyes
presence of pus
Staphylococcus
[Diagnosis: Eye infections]
Conjunctivitis
red eyes, pus, inclusion bodies
inturned eye lashes, corneal scarring, blindness
Chlamydia
[Diagnosis: Eyelid infections]
stye
staphylococcus
[Diagnosis: Eyelid infections]
Bilateral eyelid swelling, eosinophils, muscle pain, history of infection
Trichnella
[Diagnosis: Eyelid infections]
unilateral inflammation at bite site around eye or mouth
history of travel to mexico or south america
T. cruzi
Most common cause of viral conjunctivitis
Adenovirus
[Drug of choice]
Echinococcus granulosis
Albendazole
[Drug of choice]
ascaris
Albendazole
[Drug of choice]
capillaria
Albendazole
[Drug of choice]
ancylostoma
Albendazole
[Drug of choice]
trichuris
mebendazole
[Drug of choice]
enterobius
pyrantel pamoata
[Drug of choice]
strongyloides
Ivermectin
[Drug of choice]
Wuchererua and brugia
DEC
[Drug of choice]
Trichnella
Thiabendazole
[Diagnosis]
Retinopathy with keratitis in a newborn or a young child
mother has history of drug abuse
CMV
[Skin infections]
Furuncle
Carbuncle
neck, face, axilla, buttocjs
Staphylococcus
[Skin infections]
Furuncle
Carbuncle
has bath tub at home, neck down
Pseudomonas
Hot tub folliculitis
[Skin infections]
Inflammation of sebaceous glands and follicles
Teenager
Propionibacterium
[Cutaneous lesions]
multiple infected wounds on the lower extremities
mosquito bites
PE: multiple, dry, heaped up, tightly adherent crust
Ecthyma
[Cutaneous lesions]
lesion started from a bite
initially vesicular, then becoming honey crusted lesion, catalase negative, no pain, no systemic symptoms
GABHS
[Cutaneous lesions]
lesion started from a bite
initially vesicular, longer lasting, becoming bigger bullae, catalase positive
Staphylococcus
__ disease is the old name for SSSS
Ritter Disease
DOC: Oxacillin
[Diagnose}
Fever, malaise, anorexia, headcahe
Rash that simultaneously appear of all stages
Varicella
Vaccinate exposed within 3-5 days
Indications for passive with VZIG
- ICC
- Pregnant
- Newborns whose mother had chickenpox x 5 days before up to 2 days after delivery
Dose: VZIG 125U/10kg max 625 units to be given within 96 hours after exposure
[Vesicular Lesions]
Neurological pain, dermatomal distribution
Herpes Zoster (shingles)
[Vesicular Lesions]
Very large bullous lesions, progressing rapidly
preceded by fever, fatigue, malaise, toxic patient with denuded areas
SSSS
[Vesicular Lesions]
Multiple vesicular lesions, different stages
Varicella
[Cellulitis or subcutaneous lesions]
Inflamed erythematous skin, tender and warm
red, raised, butterfly rash in appearance with derma pain and rapid spread
Erysipelas (GAS/S. pyogenes)
St. Anthony’s fire
[Cellulitis or subcutaneous lesions]
Inflamed erythematous skin, tender and warm
after contact with saltwater or oysters
V. vulnificus
[Cellulitis or subcutaneous lesions]
Inflamed erythematous skin, tender and warm
burn patient, blue green pus, grape-like odor
Pseudomonas
[Lymphocutaneous lesions]
Solitary or lymphocutaneous lesiosns, rose gardeners, likes lying in the garden
Sporothric schenckii
[Lymphocutaneous lesions]
painful genital ulcer and inguinal femoral lymphadenopahty
C. trachomatis
[Lymphocutaneous lesions]
Painful genital ulcer, inguinal and femoral lyphadenoapthy
C. trachomatic LGV
[Granulomatus lesions]
Granulomatous lesions with draining sinus tracts
Jaw area swelling, carious teeth, dental procedure yellow granules
Actinomyces
Facultative anaerobe, G+
Tx: Penicillin18 to 24 MU for 2 to 6 weeks
then Oral penicillin or amoxicillin for 6 to 12 months
[Granulomatus lesions]
Granulomatous lesions with draining sinus tracts
Tropucal fish enthusias
Mycobacterium marinum
Tx: Clarithromycin or ethambutol
[Granulomatus lesions]
Granulomatous lesions with draining sinus tracts
subcutaneous swelling of shoulder, sinus tract formation, granules
Nocardia
obligate aerobe, partially acid fast, beaded, branching
Tx: TMP-SMX
[Diagnosis]
pustule to dark red fluid filled to necrosis to black eschar
malignant pustule
B. anthracis
Tx: Ciprofloxacin 30mg/kg/day TID
[Diagnosis: Infected Wound]
Fever, headache, rash border bite site
Target Lesion Bulls Eye
Borrerliela burgdorfori
Tick bite, erythema migrans
Tx: Doxycycline 2.2 mg/kg BID for 10 to 14 days
[Diagnosis: Infected Wound]
Animal bite, cellulitis lymphadenitis
Pasteurella
Tx: Co-amoxiclav
[Diagnosis: Infected Wound]
cat scratch, lymphadenopathy with stellate granulomas
B. hensae
Tx: Azithromycin
[Diagnosis: Infected Wound]
shallow puncture wound through tsinelas or rubber shoes
Pseudomonas
[Diagnosis: Infected Wound]
Surgical wounds clean
S. aureus
[Diagnosis: Infected Wound]
surgical wounds dirty
S. aureus
[Diagnosis: Infected Wound]
Trauma
Clostridium
[Diagnosis: ENT Infection]
Red, bulging tympanic membrane, fever
S. pneumoniae
[Diagnosis: ENT Infection]
Sinus pain
Low grade fever
S. pneumoniae
[Diagnosis: ENT Infection]
Common cold
Sneezing
scratching
runny nose
Rhinovirus
[Diagnosis]
No fever, non-exudative throat
pseudomembrane on throat
Diphtheria
Tx: Aqueous Penicillin G or erythromycin
[Diagnosis: Sore throat]
Inflamed tonsils or pharynx
Purulent
Fever
Streptococcal pharyngitis
[Diagnosis: Sore throat]
White papules with red base on posterior palate and pharynx
Herpangina
[Diagnosis: Sore throat]
Purulent tonsils
Fatigue
Lymphadenopathy
Infectious mononucleosis
[Diagnosis: Sore throat]
Low grade fever with gradual onset of membranous nasopharyngitis
bull neck from lymphadenopathy
Diphtheria
[Diagnosis: Sore throat]
Finely papular, erythematous eruption
bright red discoloration of the skin, which blanches on pressure, intense along the creases of the elbows, axillae, and groin
goose-pimple appearance and feels rough
rash fades followed by desquamation
Scarlet fever
[Infectious Arthritis]
Pain, redness, low grade fever, tender joints, reduced ability
all ages except 15 to 40 years old
S. aureus
[Infectious Arthritis]
Pain, redness, low grade fever, tender joints, reduced ability
Sexually active, promiscuous, 15 to 40 years old
N. gonorrhoeae
[Infectious Arthritis]
Pain, redness, low grade fever, tender joints, reduced ability
prosthetic joint
S. epidermidis
[Infectious Arthritis]
Pain, redness, low grade fever, tender joints, reduced ability
After GIT infection few weeks ago
Reiter’s Syndrome
What are the components of Reiter syndrome
- Conjunctivitis
- Urethritis
- Arthritis
[Osteomyelitis]
Fever
Bone pain with swelling, redness associated cellulitis
adults, children, infants with no major trauma or special conditions
Staphylococcus
[Osteomyelitis]
Fever
Bone pain with swelling, redness associated cellulitis
neonates < 1 month old
Staphylococcus
[Osteomyelitis]
Fever
Bone pain with swelling, redness associated cellulitis
Sickle cell anemia
salmonella cholearsius or enterica
[Osteomyelitis]
Fever
Bone pain with swelling, redness associated cellulitis
history of trauma
Pseudomonas
[Toxic looking rashes]
Petechiae to purpuric lesions
generalized abrupt onset with fever, chills and shock
N. meningitidis
[Toxic looking rashes]
Petechiae to purpuric lesions
fever, headache, rash that includes palms and soles
R. rickettsii
Tick vector (Rocky Mountain Spotted Fever)
North, central south america
Tx: doxycycline
[Toxic looking rashes]
Petechiae to purpuric lesions
fever, headache, rash that spares the palms and soles
R. prowazekii
Human body louse vector
[Toxic looking rashes]
Erythematous maculo-papular rash, sandpaper like
sore throat and fever
from trunk and knee then extremities
GABHS (Scarlet fever)
[Toxic looking rashes]
Diffuse erythematous macular sunburn-like rash
desquamation on palm and soles
acute onset of fever, pharyngitis, diarrhea, hypotension
Toxic Shock Syndrome
[Maculopapular rashes]
Cough, coryza, conjunctivitis, fever,
Measles / Rubeola
Koplik Spots
[Maculopapular rashes]
Posterior cervical lymphadenoapathy, cervical or auricular
German measles or rubella
[Maculopapular rashes]
slapped cheek, spread to trunk with central clearing
Erythema infectiosum
or 5th disease
5 fingers slapping the face
[Maculopapular rashes]
Abrupt onset of fever with URTI for 3-4 days, fever disappears and rashes appears on trunk and spread
Roseola or 6th disease
[Maculopapular rashes]
Preceded by rapid onset fever, myalgia, ocular pain, hypesthesis, rashes blanch on pressure
Dengue fever
What do you give for measles postexposure prophylaxis?
Measles Ig for prevention and attenuation within 6 days of exposure
0.25mg/kg max 15 mL IM
When do you give measles postexposure prophylaxis for susceptible children > 1 year old?
Within 72 hours
Contraindications to giving live Measles Vaccine
- < 6 months old
- Pregnant
- ICC
Warthin-finkeldey cells
Measles/Rubeola
Paramyxoviridae, RNA
Forschheimer spots
Rubella
Togaviridae, RNA
If termination of pregnancy is not an option, what can you give to pregnant patients exposed to rubella?
0.55 mL/kg IM
Nagayama Spot
Roseola
HHV 6
Etiology of HFMD
Coxsackie virus A16
Etiology of 5th disease
Parvovirus B19
Complication of parvovirus B19
Aplastic crisis
[Period of Communicability]
measles
4 days before
4 days after
[Period of Communicability]
rubella
7 days before
7 days after
[Period of Communicability]
Varicella
1-2 days before rash, 7 days after all lesions have crusted
[Period of Communicability]
Mumps
1-2 days before onset of parotid swelling until 5 days after onset of swelling
What are the alarming manifestations of mumps?
- edema of the homolateral pharynx and soft palate, displacing tonsil medially
- acute edema of the larynx
- Edema over the manubrium and upper chest wall
What is the most frequent complication of mumps?
- Meningoencephalitis (enters the CNS via the choroid plexus)
[Leptospirosis]
Criteria for presumptive diagnosis
- Symptomatic children with titers 1:100 OR greater in 2 or more specimens
- Asymptomatic children with evidence of exposrue and seroconversion
[Leptospirosis]
DOC for leptospirosis in pediatric patients
- Penicillin or Tetracycline
Initiation before 7th day shortens the clinical course
Parenteral Penicillin G 6-8M Units/m2/day in 6 divided doses for 1 week
What is the incubation period of dengue virus?
4-6 days
AST or ALT value in dengue patients with severe organ involvement?
AST or ALT >/1000
Dengue NS1 detects what ____
Virus
[Dengue]
IgM peaks in ___ weeks after onset of symtom
2 weeks
decline in 2 to 3 months
[Dengue]
What are the events present in the critical phase
- Defervescence
- Increasing hematocrit then gradual decline
- Shock/Bleeding
[Dengue]
What are the events present in the Recovery phase of dengue?
- Reabsorption of fluid
- Increasing platelet
- Increasing IgM/IgG
