Peds Bacteria/Parasites Jones Flashcards
Brucella general
Etiology - small, aerobic, nonspore, nonmotile, G- coccobacillary
Epidemiology - handling infected goats, unpasteurized milk
Traveler
Brucella Clinical manifestations -
long inoculation perior
Classic Triad: Fever, Arthralgia/arthritis, HSM
Thrombocytopenia to pancytopenia
Brucella Dx
Serum agglutinin test
Brucella Tx
Doxycycline for children 8+
Bactrim for children under 8
Campylobacter jejuni general
Etiology - G-, curved, thin, non spore rods
Epidemiology - Ingestion of contaminated chicken/turkey or raw milk
Campylobacter jejuni Clinical manifestations
Gastroenteritis
Complications Reactive arthritis; Guillain-Barre syndrome
Campylobacter jejuni Dx
Stool culture
Campylobacter jejuni Tx
Supportive care: rehydration
Bartonella henselae general
Cat scratch disease
Etiology - small pleomorphic G- bacilli in LN
Epidemiology - inoculation from cat-scratch kittens to 6 months
Bartonella henselae Clinical manifestations
Papules to tender LAD to lymphadenitis w/ fever
NO I&D
Bartonella henselae Dx
Bartonella henselae Ab titer
Bartonella henselae Tx
Supportive care!
Amoxicillin-clavulinic acid for no staph
Clostridium botulinum general
Etiology - Acute, flaccid paralysis caused by neurotoxin
Epidemiology - infant foodborne/ wound
Clostridium botulinum Clinical manifestation
Infant: inability to feed, lethargy, weak cry,
diminished spontaneous movement; dysphagia, drooling
Clostridium botulinum Dx
Classic triad of botulism - acute onset of symmetric flaccid descending paralysis with sensorium, no fever, no paresthesias
Clostridium botulinum Tx
Human botulism Ig, given IB (BIG-IV)
C. diff general
Etiology: G+ anaerobic bacillus, spores
Epidemiology - preceding hospitalization or abx exposure
C. diff Clinical manifestation
pseudomembranous colitis (watery diarrhea)
C. diff Dx
C. diff toxin detection
Children under 3 y.o. is NORMAL
C. diff Tx
Oral Metronidazole
Oral Vancomycin for recalcitrant or recurrent infections
Enterococcus etiology
G+
Catalase neg
Facultative anaerobes that grow in pairs or short chains
Enterococcus Clinical manifestation
Neonates: sepsis
Children: Nosocomial UTIs, bacteremia
Enterococcus Tx
Amoxicillin/ampicillin
if simple UTI: Nitrofurantoin
E. coli Epidemiology
Enteric and UTIs
Sepsis and meningitis in Newborn
Bacteremia and sepsis in Immunocompromised pts
E. coli information
CM
Tx
6 major groups
EHEC well known for HUS - kidney failure
Clinical manifestations: mild diarrhea to hemorrhagic colitis
Abx can induce toxins - HUS
Fever in 1st week of life
Bactrim?
Haemophilus Etiology
Vaccine
Prophylaxis
Fastidioius
G-
Pleomorphic coccobacillus
Vacc: 12-15 months completed
Rifampin for children
Haemophilus Clinical manifestations
Meningitis Preseptal and orbital cellulitis epiglottitis Pneumonia OTITIS MEDIA Conjunctivitis, Sinusitis
Haemophilus Tx
OM: 80-90 mg/kg/day of Amoxicillin
Listeria monocytogenes Etiology
facultatively anaerobic
Nonspore, motile
G+
Catalase +
Perinatal infections from maternal infection
Foodborne outbreaks dair and contaminated vegetables
Listeria monocytogenes General info
Neonatal listeriosis -
Listeria monocytogenes Tx
Ampicillin
Borrelia burgdorferi General
Lyme disease
Epi- Outdoor occupation and leisure activities
Transmission - Ixodes genus
Borrelia burgdorferi Clinical manifestations
Erythema migrans and constitutional sx (bull’s eye
Multiple migrans
Neuritis
Meningitis, carditis, arthritis
Borrelia burgdorferi Diagnosis
Erythema migrans
Serology
Borrelia burgdorferi Treatment
Doxycycline
Amoxicillin under 8 y.o.
Borrelia burgdorferi Complications
Jarisch-Herxheimer Reaction
after lysis of Borrelia
Neisseria meningitidis Epidemiology
close contact via aerosol droplets or exposure to respiratory secretions
Neisseria meningitidis Clinical manifestations
Fever -> Nucchal rigidity -> Petechiae -> septic shock rapid
Prominent petechiae then purpura then loss of circulation
Middle artery
Neisseria meningitidis Tx
Ceftriaxone
Prophylaxis Rifampin,
Cipro for 18+
Neisseria meningitidis Risk factors
Complement or properdin deficiencies increase risk
CH50 test for recurrent
Mycobacterium tuberculosis LTBI
Positive TST, neg CXR, no other evidence of TB disease
Children with LTBI - Isoniazid (w/ LFTs)
IFN-gamma little data
Pasteurella Multocida
Skin infection s/p animal bite
Sx present w/in 24hrs of bite
PCN
Amoxicillin-clavulanate adds
Azithromycin w/ PCN allergies
Bordetella pertussis Sx
Classic catarrhal, Paroxysmal, and Convalescent stages
Whoop -> lowering -> residual effects
Bordetella pertussis Dx
Clinical Picture
Deep nasopharyngeal aspirate
Bordetella pertussis Tx
Tx and Prophylaxis:
Azithromycin
Prophylaxis after significant exposure
Pseudomonas species Epidemiology
“swimmer’s ear”
Puncture wound through shoe
Nosocomial UTIs
Respiratory Infections in CF
Pseudomonas species Tx
Ceftazidime IV
Ciprofloxacin outpatient
Rickettsial diseases Clinical manifestations
Rocky Mountain spotted fever
ehrlichiosis
Clinical triad - Fever, HA, Rash
rose red blanching macules on extremities, wrists, ankles, lower legs
Spreads to entire body - Includes soles and palms
Petechial, purpura, hemorrhagic possible
Rickettsial diseases Tx
Doxycycline
Salmonella species Clinical manifestations
Enteritis
Bacteremia
Salmonella species Dx
Blood or Stool culture
Salmonella species Tx
Rehydration
Supportive care
Shigella species Epidemiology
Contaminated food (salad)
water
daycare centers
Shigella species Pathogenesis
Shiga toxin
Shigella species Clinical manifestations
dysentery - bloody diarrhea, fever, abd cramps, rectal pain, mucoid stools
Shigella species Dx
Stool culture
Shigella species Tx
Rehydration
Vit A, Zinc
ceftriaxone, but maybe not
Staphylococcus aureus Clinical manifestations
Skin
Respiratory - pneumonia, empyema
Sepsis
Osteomyelitis
TSS
Staphylococcus aureus Dx
Wound or blood culture
Staphylococcus aureus Tx
I&D
Vancomycin or Clindamycin
Streptococcus agalactiae Epidemiology
GBS
Neonatal sepsis: early onset 7 days
Streptococcus agalactiae Clinical manifestations
GBS
Early - signs and sx of sepsis
Late - sepsis, some meningitis
Streptococcus agalactiae Dx
GBS
Positive culture
Streptococcus agalactiae Tx
PCN G
Streptococcus pneumoniae Epidemiology
MCC of bacteremia
bacterial pneumonia
OM
bacterial meningitis in children
Streptococcus pneumoniae Prevention
Pneumococcal 13-valent vaccine - good immune
PCV 23 - immunocompromised, high risk
Streptococcus pyogenes Clinical manifestations
GAS Pharyngitis Impetigo, pyoderma Perianal cellulitis Endocarditis, pericarditis Scarlet fever and erysipelas Necrotizing fasciitis Rheumatic fever, acute glomerulonephritis
Streptococcus pyogenes Dx
GAS
Rapid Ag test
Throat culture
antistreptolysin O assay
anti=DNase B
Streptococcus pyogenes Tx
PCN and Cephalosporins
Streptococcus pyogenes Rheumatic fever
JONES criteria
prophylaxis criteria