Pediatrics Flash Cards - Case 11 - 5 y-o w- fever and adenopathy
Antibiotics should be started w/ in ___ days of onset of Grp A strep disease in order to prevent rheumatic fever?
9
normal HR for a 5 y/o
80-100 BPM
Pediatric rash on palms and soles, DDx?
RMSF, Kawasaki disease, enteroviruses, syphilis, Hand-Foot-and-Mouth
Rash w/ fever DDx?
Measles, Erythema infectiosum, Enterovirus, Menningococcemia, Roseola, Scarlet Fever, VZV
Erythema infectiosum illness script?
parvovirus B19; low-grade fever w/ rash 7-10d later. starts as “slapped cheek”. can spread to the trunk: erythematous macular -> Central clearing -> lacy. rash lasts longest on extremities (lacy, reticular). can also develop polyarthropathy syndrome or (w/ immunodef) aplastic anemia.
Measles illness script?
prodrome of fever (> 38.3 C/101 F), cough, coryza, and conjunctivitis -> maculopapular starts on the neck, behind ears, and along hairline -> downward to feet in 2-3d. initial rash appears on the buccal mucosa as red lesions w/ bluish white center (Koplik spots). These have frequently disappeared by the time patient presents. Immunization very effective.
Meningococcemia illness script?
abrupt onset w/ f/c, malaise, and prostration. Initial rash may be urticarial, maculopapular, or petechial. Fulminant cases: can become purpuric, w/ large hemorrhages into skin. Immunization is effective.
Roseola illness script?
HHV-6/7 macular or maculopapular rash “exanthem subitum/6th’s dz” starts on trunk -> arms and neck. Usually less on face and legs. Preceded by 3-4d of high fevers, which end as the rash appears. It is usually seen in < 2 y/o.
Scarlet fever illness script?
caused by infection with group A Streptococcus, consists of very fine papules, often described as feeling like sandpaper. It is erythematous, but blanches. It starts in the groin, axillae, and neck, but rapidly spreads. The fever can be high, and the disease is usually self-limited, lasting less than 10 days. It is important to treat with antibiotics to prevent nonsuppurative complications of strep, including rheumatic fever.
Varicella illness script?
starts on the trunk and spreads to the extremities and head. Each lesion progresses from an erythematous macule to papule to vesicle to pustule, and then crusts over. Lesions at various stages of development are seen in the same area of the body. There is usually a mild fever. The disease is self-limited, lasting about a week. Immunization is effective in preventing this infection.
Infectious causes of diffuse lymphadenopathy?
mycobacteria, measles, HIV, mono (EBV/CMV), histo, toxo
Non-infectious causes of difuse lymphadenopathy?
leukemia, lymphoma, histiocytosis, metastatic neuroblastoma, rhabdomyosarcoma
Cat scratch dz illness script?
Infections caused by the bacterium Bartonella henselae can be asymptomatic or symptomatic. The infection usually is introduced by a scratch from a cat or kitten, with subsequent infection of the node or nodes draining that site. The site that is involved most commonly is the axilla, followed by cervical, submandibular, and inguinal areas. This is usually a self-limited disease, with regression of the lymph node in four to six weeks.
Bacterial cervical adenitis illness script?
This is typically seen in children ages one to five years with a history of a recent upper respiratory tract infection. Staphylococcus aureus and Streptococcus pyogenes are the organisms most commonly identified. Patients may have high fevers and a toxic appearance. Overlying cellulitis and development of fluctuance are common.
Strawberry tongue ddx?
strep pharyngitis, Kawasaki dz, and toxic shock syn; (also mono but usually d/t concomittant strep phar)
