Serious Childhood Infections Flashcards
What is the treatment for cellulitis? What bugs does this empiric therapy target?
Penicillin G (or cloxacillin) targets S. Aureus and GAS (S. pyogenes). Antibiotics should be taken for 5-10 days.
What antibiotics cover community acquired MRSA?
Vancomycin/Septra/Clindamycin/Linezolid
A 7 year old boy presents with acute onset L arm pain. T38.0, no V/D. Mild redness is noted over the L arm and is more swollen than the R arm. The boy jumps off the bed if you try to touch the arm and appears to find palpation intensely painful. He had chicken pox about a week ago but has been otherwise healthy. What is at the top of your DDx? What is the management?
This is likely Necrotizing Fasciitis. The most likely pathogen is GAS or polymicrobial. A RF for NF is varicella in those less than 10 years of age. The key feature is severe localized pain out of proportion. There may also be a blue discolouration to the skin. Treatment is surgical - call plastics!
An 8 year old boy fell when playing soccer last week and now presents with a 2 day history of painful red R ankle and lower leg. He is unable to stand on the R leg. T38.0 and does not appear acutely unwell. PE is otherwise normal. What is at the top of the DDx? Investigations? Treatment?
This is a case of osteomyelitis. The most common pathogen is S. aureus. The most sensitive investigations are MRI or bone scan. Treat empirically with Cloxacillin for S. aureus coverage.
Which of the follow antibiotics is used to cover S. aureus in osteomyelitis? A. Ampicillin B. Cloxacillin C. Cefotaxime D. Vancomycin
B. Cloxacillin
Which of the following are the appropriate bugs and drugs implicated in cellulitis?
A. Penicillin G or Cloxacillin for GAS and S. aureus
B. Amoxicillin for S. pneumoniae
C. Ampicillin for Listeria monocytogenes
A.
An 8 year old boy was playing soccer when his foot punctured through his running shoe. He presents now with a 2 day history of painful R red foot. He is unable to stand on the R leg. T38.0 and does not appear acutely unwell. PE is otherwise normal. What is the most likely bug implicated in this injury?
Pseudomonas aeruginosa (Pointed out as an exam question in lecture…)
How does the treatment of neonates with meningitis differ from the treatment of children with meningitis?
Neonates are treated with ampicillin and cefotaxime (or gentamicin). The ampicillin covers Listeria. Do not give steroids (dex) to neonates. Children are treated with cefotaxime and vancomycin. They are also given dexamethasone to prevent hearing loss.
