Sepsis & Meningitis Flashcards

1
Q

Define Sepsis?

A

Bacteraemi + SIRS:

  • Tachypnoea
  • Tachycardia
  • Fever/Hypothermia
  • Leucocytosis/Leucocytopenia
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2
Q

What organisms cause sepsis?

A

Neonates:
- Group B Strep, E. Coli & Listeria Monocytogenes

Children:
- Pneumococcus, Meningococcus, Group A strep & Staph Aureus

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3
Q

At what age is sepsis most common?

A

In neonates, gets progressively less from there

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4
Q

How might sepsis look in a kid?

A

Fever/hypothermia
Chills & rigors

Cold hands/feet + Slow cap refill

Muscle weakness & muscle/joint ache

Rash

Low UO, vomiting & diarrhoea

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5
Q

Sepsis 6 in kids is a bit different, what criteria do we use to spot it?

A
  • Hypotension
  • Fever/Hypothermia
  • Tachycardia
  • Tachypnoea
  • Alt Mental Status
  • Slow cap refill / poor perfusion / mottled peripheries
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6
Q

Sepsis 6 is a bit different in kids, what are the 6 actions?

A
  • Take Blood cultures
  • Give IV resus
  • Give IV Abx
  • Give Inotropes
  • Give O2

Get Senior Help

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7
Q

Meningitis in kids often comes secondary to sepsis, what organisms cause it?

A

0-6 months: (Same as sepsis)

  • Group B Strep
  • E. Coli
  • Listeria Monocytogenes

6 months - 6 years:

  • Meningococcus
  • Pneumococcus
  • H. Influenzae

6 -60:

  • Meningococcus
  • Pneumococcus
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8
Q

How would meningitis present in a kid?

A

Older kids will show classic signs such as depressed consciousness, seizures,. focal neuro signs, headaches & photophobia

Neonates will be lethargic, irritable have a bulging fontanelle & “Nappy Pain”

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9
Q

What blood tests would you do in a septic/meningeal child?

A
FBC
CRP
Coagulation study
Blood gas
Glc
U&Es + Creatinine
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10
Q

What non-blood tests would you do for septicaemia/meningitis?

A

LP with antigen testing & PCR

Culture blood, CSF, Urine & skin

Urinalysis

Head CT

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11
Q

What would you expect to see after testing a septic/meningeal child?

A
FBC - Leucocytosis & thrombocytopenia
CRP - Elevated
Coag Study - Low due to DIC
Blood Gas - Metabolic Acidosis
Glc - Hypoglycaemia

CSF - Pleocytosis, high protein & low Glc

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12
Q

How do you treat a child with meningitis?

A

ABCD & G (glc)

Broad spec Abx - Specifically:

  • < 3 months = IV cefotaxime* & amoxicillin
  • > 3 months = IV cefotaxime*

+/- CCS (dexamethasone)

(*ceftriaxone alternative to cefotaxime)

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13
Q

How can we prevent Meningitis?

A

With vaccines for:

  • Pneumococcus
  • Meningococcus
  • H. Influenzae
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14
Q

List 3 major complications of pneumococcal meningitis?

A

Brain damage hearing loss & hydrocephalus

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15
Q

Where can pneumococcal infections occur in the body and what is likely to precede them?

A

Viral inf tends to predispose to invasive pneumococcal disease.

Can be found:

  • Pneumonia
  • Meningitis
  • Septicaemia
  • Otitis Media
  • Sinusitis
  • Arthritis
  • OM
  • Peritonitis
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16
Q

Are pneumococcus & H influenzae Gram -ve or +ve?

A

Pneumoccous is gram +ve

Haemophilus is Gram -ve

17
Q

Other than the brain where might you find H influenzae infection?

A

Septicaemia
Pneumonia
Epiglottitis

18
Q

What’s special about meningococcal infection?

A

Its very very fast. Once it hits the blood stream you get:

  • septic shock within 12hrs
  • Meningitis within 18-36hrs

Also can cause meningococcal rash

19
Q

List 5 major complications of meningococcal infection?

A

Skin Scarring
Amputation

Cognitive impairment
Epilepsy
Hearing Loss