Skin Infections & Viruses Flashcards

1
Q

What causes most surface infections in kids?

A
Step (mostly Pyogenes)
Or Staph (mostly Aureus)
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2
Q

How are strep & staph treated?

A

Penicillin for strep

Flucloxacillin for Staph

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3
Q

What causes Scarlet Fever?

A

Strep A (Strep Pyogenes) via exotoxins

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4
Q

What age group get scarlet fever?

A

2-10yrs

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5
Q

How would scarlet fever present?

A

Malaise, fever & Tonsilitis

Exanthema & Strawberry tongue

Late (1-2wks) squamation of hands/feet

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6
Q

How is Scarlet fever treated?

A

10 days penicillin

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7
Q

What non-infective diseases could cause fever and rashes like a strep/staph infection?

A

Kawasaki’s Disease

Henoch-Schonlein Purpura

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8
Q

What happens in Kawasaki’s Disease?

A

Self-limiting Vasculitis of medium sized arteries

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9
Q

How do you diagnose Kawasaki’s?

A

Fever for 5 days + 4 of:

  • Bilateral Conjunctival Injection
  • Cervical Lymphadenopathy
  • Polymorphous Rash
  • Extremities changes
  • Mucous membrane changes (e.g. strawberry tongue)

Can also get peripheral oedema & erythema + Periungual Desquamation

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10
Q

How can you test for Kawasaki’s?

A

You can’t its a clinical diagnose specifically but can do other non-specific tests e.g. FBC, ESR/CRP & maybe an Echo to look out for coronary artery vasculitis

Important to rule out Strep Pyogenes

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11
Q

How do you treat Kawasaki’s Disease?

A

It’s self limiting so you’re only trying to protect from complications e.g. Coronary Art Vasculitis:

  • Immunoglobulins
  • Aspirin
  • Immunosuppressants
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12
Q

List 4 things that cause an erythematous rash?

A

Meningitis
Scarlet Fever
Kawasaki’s
Henoch-Scholein Purpura

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13
Q

What is HSP?

A

Vasculitis of Skin, kidneys & ~GI tract

Present with persistant fever, red rash and purpura (may resemble meningococcal rash)

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14
Q

What things cause a vesicular rash?

A

Viruses e.g. VZV, HSV or Enteroviruses

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15
Q

Kid presents with malaise & fever but not really unwell

A disseminated exanthema with vesicles at various stages of crusting

Very itchy

Likely diagnosis?

A

Varicella Zoster Virus aka Chicken Pox

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16
Q

How can you determine the type of vesicular rash?

A

Clinical findings
Smear of vesicle + Tzanck test
PCR of fluids, CSF and/or blood
Serology (For past inf)

17
Q

How would you treat Chicken pox?

A

Mostly you don’t, except maybe symptomatically

Vaccinate

If it’s dangerous –> acyclovir

Watch out for secondary skin staph/strep inf from the vesicles/pustules

18
Q

What would be the warning signs that a chicken pox kid requires anti-virals?

A
Underlying immunodeficiency
>1yr old
High fever
Inflamed lesions
New lesions >10/day
General Malaise (i.e. unwell)
19
Q

What is Herpes Zoster?

A

Reactivation of latent VZV –> Dermatomal spread of vesicles & exanthema

Pretty much only in immunodeficient kids

20
Q

What are the main enteroviruses cause vesicular rashes?

A

Coxsackie A16

Enterovirus 71

21
Q

What would Enterovirus look like?

A

<10yrs
Unusual as it causes vesicles on soles/palms
Exanthema & Enanthema
Painful lesions

22
Q

How do you treat enterovirus?

A

Supportive, most will recover in 5-10days

23
Q

How do you spot HSV in kids?

A

Stomatitis

Recurrent cold sores

24
Q

How is HSV treated?

A

Mostly self-limiting but if needed with aciclovir

25
Q

How could you get neonatal HSV?

A

Usually from the birth canal or contact with mum’s sores

26
Q

Neonatal HSV is baaaad, what will it cause?

A

70-80% will get disseminated infection e.g. sepsis syndrome, meningoencephalitis or hepatitis

Other 20-30% will get SEM disease (skin, eye & mouth)

All in the first 1-3wks of life

27
Q

How do you treat a neonatal HSV case?

A

Aciclovir!