Peds Infectious Disease Flashcards
MC organisms causing brain abscess secondary to sinusitis
strep pneumo + other strep species H.flu staph aureus anaerobes
MCC of brain abscess
- direct extension - sinusitis, mastoiditis, ondontogenic 2. hematogenous - endocarditis, esp kids w/ CCHD 3. trauma 4. surgical procedures
Tx. brain abscess
broad spec abx x 6-8 weeks - if secondary to direct extension: Ceftriaxone + Vancomycin
child with cancer, develops fever during chemotherapy-induced neutropenia
- abx of choice?
- need coverage for gram (-), incl. pseudomonas and gram (+)
- Piperacillin-tazobactam
- Gentamicin
- MCC of central catheter related infections
- Treatment of catheter related infection
- When should you remove the catheter?
- Coag Neg Staph (CoNS) - creates biofilm
- Tx. Vancomycin
- either alone IV or in combo w/ “antibiotic lock” technique
-
Remove catheter when:
- severe sepsis
- suppurative thrombophlebitis
- endocarditis
- persistence of positive cultures > 72 hours after IV abx therapy
Side Effects: TMP-SMX (bactrim)
-
delayed cutaneous HS reaction (rash)
- 3.5% of pts develop isolated cutaneous reaction
- w/in 2 weeks of drug initiation
- MC lab finding = neutropenia (resolves w/ d/c of drug)
- anemia, thrombocytopenia
- transient rise in serum Cr
- hyperkalemia
- GI symptoms: NVD
- ** reactions are all usually dose dependent
Dengue Fever
- Clinical findings
- Lab findings
- Diagnosis
severe muscle/joint pains, headache, retro-orbital pain with acute febrile illness
-
assoc with:
- nonspecific rash
- NVD
- respiratory findings
Lab findings: leukopenia, thrombocytopenia, transaminitis
Diagnosis: dengue-specific IgM and IgG serology
Treatment: Pinworms (Enterobius vermicularis)
Albendazole
Pyrantel pamoate
- single dose, then repeated 2 weeks later
Infant born to HIV (+) mother, started on prophylaxis - best initial test to order to dx HIV?
- HIV DNA PCR
- 30-40% of infected infants will have (+) test in first 48 hours, 93% by 1 week, 95% by 2 weeks
- testing with the HIV DNA PCR assay is recommended at 14 to 21 days, 1 to 2 months, and 4 to 6 months of age. If 2 separate tests are positive, the infant is considered infected with HIV
Lyme Disease
- Initial screening test
- Confirmatory test
- EIA or IFA - not specific
- confirmatory = western blot for Lyme abs
Patient having recurrent episodes of Neisseria meningitis
- diagnosis?
- screening test?
- other conditions that p/w recurrent meningitis
-
terminal complement (C5-9) or properdin deficiency
- properdin deficient pts likely to have more fulminant and fatal disease
- Screening test: CH50 test (combined activity of terminal complements C1 to C9)
-
other:
- acquired defects: CLD, nephrotic syndrome, SLE
- structural mutations in the genes for mannose-binding lectin
- toll-like receptor 4 receptor deficiency
diagnosis: Acute hep B infection
- Hep B surface antigen
- Hep B core antibody
MCC of acute bacterial gastroenteritis
Campylobacter
- outbreaks common among children visiting farm/dairy sites or those who drink unpasteurized milk
- clinical findings:
- incubation 1 to 7 days –> acute diarrheal syndromewith visible or occult blood, fever, malaise, and abdominal pain. Recovery usually occurs within 1 week of onset, although up to 20% of patients experience either a relapse or a prolonged illness. Severe infection with bleeding may mimic IBD
Tx. campylobacter gastroenteritis
erythromycin or azithromycin
- eradicate the organism within 2 to 3 days
- shorten the duration of illness
- prevent relapse
MC complication associated with parvovirus B19 in children with sickle cell disease
Transient aplastic crisis
- severe anemia
- undetectable reticulocytosis
- normal WBC and platelet counts
