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Systems: Paediatrics AB > Staph, Strep and Kawasaki Disease > Flashcards

Staph, Strep and Kawasaki Disease Flashcards

1
Q

What type of bacteria is streptococci?

A

Gram positive cocci

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2
Q

What type of bacteria is staphylococci?

A

Gram positive cocci

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3
Q

What antibiotic is usually used for strep infection?

A

Penicillin

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4
Q

What antibiotic is usually used for staph infection?

A

Flucloxacillin (synthetic penicillin resistant to B-lactamasese) due to resistance issues

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5
Q

What causes scarlet fever?

A

Group A B-haemolytic streptoccoci

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6
Q

Who is relatively protected from scarlet fever?

A
  • Children < 2 due to maternal antibodies

- Children > 10 due to natural protection

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7
Q

What are the virulence factors involved in scarlet fever?

A
  • M-protein

- Exotoxins

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8
Q

What are the possible complications of scarlet fever?

A
  • Erysipelas, cellulitis, impetigo
  • Streptococcal toxic shock syndrome
  • Rheumatic fever
  • Glomerulonephritis
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9
Q

How is scarlet fever treated?

A

Penicillin for 10 days

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10
Q

What is the incubation period for scarlet fever?

A

2-4 days

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11
Q

How does scarlet fever present?

A
  • Malaise and fever
  • Tonsillitis
  • Exanthema
  • Strawberry tongue
  • Squamation (hands and feet)
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12
Q

What is the epidemiology of scarlet fever?

A
  • Median age 4
  • 89% occur in <10 years
  • 5% occur in adults over 18
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13
Q

What is impetigo caused by?

A
  • Strep pyogenes

- Staph aureus

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14
Q

How does impetigo present?

A
  • Highly contagious
  • Sores and blisters
  • No systemic symptoms
  • Yellow-brown crusta
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15
Q

What is SSSS caused by?

A

Exotoxins of staph aureus

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16
Q

What is SSSS?

A

Staphylococcus Scalded Skin Syndrome

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17
Q

Who is usually affected by SSSS?

A

Children <5 (particularly new-borns)

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18
Q

How does SSSS present?

A
  • Fever
  • Widespread redness
  • Fluid-filled blister that rupture easily especially in the skin folds
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19
Q

What is the clinical presentation of Kawasaki disease?

A

Fever for at least 5 days with 4 or more:

  • Bilateral conjunctival injection
  • Changes of the mucous membranes
  • Cervical lymphadenopathy
  • Polymorphous rash
  • Changes of the extremities
  • Peripheral oedema
  • Peripheral erythema
  • Periungual desquamation
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20
Q

What is the pathophysiology of Kawasaki disease?

A
  • Self-limited vasculitis of medium-sized arteries

- Aetiology unknown but infectious cause suggested

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21
Q

How does prevalence of KD vary amongst individuals?

A
  • Reported in all racial and ethnic groups
  • Highest prevalence in Japan and Hawaii
  • Increased risk of siblings and twins
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22
Q

What is the aim of treatment of KD?

A

To prevent complciations like vasculitis of the coronary arteries

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23
Q

What is the treatment for KD?

A
  • Immunoglobulins
  • Aspirin
  • Other immunosuppressive agents
24
Q

How does Henoch-Schonlein purpura present?

A

Vasculitis of the skin, kidneys and more rarely GIT

25
Q

What is Henoch-Schonlein purpura associated with?

A

Previous aspecific viral illness

26
Q

What can cause eryhtmatous maculopapulous rashes?

A
  • Measles
  • Rubella
  • CMV
  • Enterovirus
  • Human herpesvirus 6
  • Human herpesvirus 7
  • Parovirus B19
  • EBV
27
Q

What can cause vesiculobullous rashes?

A
  • VZV
  • HSV
  • Enterovirus
28
Q

What can cause petechial and purpuric rashes?

A
  • Rubella (congenital)
  • Enterovirus
  • CMV (congenital)
29
Q

What is the incubation period for VZV infections?

A

14 days (10-21)

30
Q

How do VZV infections present?

A
  • Mild malaise and fever
  • Exanthema
  • Itching
31
Q

What is the progression of exanthema in VSV infections?

A
  • Papules
  • Vesicles
  • Pustules
  • Crustae
  • Scarring
32
Q

What are the possible complications of VZV infections?

A
  • Secondary staph/strep skin infections

- Meningoencephalitis, cerebellitis, arthrtitis

33
Q

How is VZV infection prevented?

A

Vaccination

34
Q

How is VZV infection treated?

A
  • Self-limiting

- (Val) acyclovir if new lesions after 10 days

35
Q

How can VSV infection manifest?

A
  • Primary infection (varicella, chickenpox)

- Recurrent infection (Zoster)

36
Q

Who is at risk of complicated VSV infection?

A
  • Fatal varicella (2 : 100.000)
  • < 1 year of age (8 : 100.000)
  • T-cell deficiencies (7-10% mortality)
37
Q

What are the warning signs for VZV complicated infection?

A
  • High fever
  • new lesions >10 days
  • Inflammed lesions
  • General malaise
38
Q

What are the 2 types of HSV infection?

A
  • HSV1 (oral)

- HSV2 (genital)

39
Q

How can HSV infections present clinically?

A
  • Stomatitis (primary infection)

- Recurrent cold sores

40
Q

What complications of HSV are there?

A
  • (Kerato) conjunctivitis
  • Encephalitis
  • Systemic neonatal infections
  • Immunocompromised children
41
Q

What is the therapy for HSV infection?

A
  • Self-limiting

- (Val) acyclovir

42
Q

How can neonates contract HSV infection?

A
  • Birth canal

- Direct contact with mothers infected lesions

43
Q

When does HSV infection present in neonates?

A

DOL 4-21

44
Q

How does HSV infection present in neonates?

A

70-80’% disseminated/CNS infections

  • Sepsis
  • Meningoencaphilitis
  • Hepatitis (jaundice and bleeding)

20-30% skin/eye/mouth disease

45
Q

What is the incidence of HSV infection in neonates?

A

2-3 per 100,000

46
Q

What is the mortality rate of HSV infection in neonates?

A
  • Without acyclovir >50%

- With acyclovir 20-30%

47
Q

What is the seroprevalence of VZV?

A
  • 20% at 1 year old
  • > 90% at 5 years old
  • 95% of adults
48
Q

What is the seroprevalence of HSV-1?

A
  • 20-30% at 5 years old
  • 40-50% of adolescents
  • 60-80% of adults
49
Q

What is the seroprevalence of HSV-2?

A
  • <5% of children under 10

- 10-15% of adults

50
Q

What is the cause of hand-foot-mouth disease?

A

Enteroviruses

  • Coxsackie A16
  • Enterovirus 71
51
Q

What is the incubation period for hand-foot-mouth disease?

A

3-6 days

52
Q

Who is usually affected by hand-foo-mouth disease?

A

Children under 10

53
Q

When is hand-foot-mouth disease most prevalent?

A

Summer and early autumn

54
Q

What is the clinical presentation of hand-foot-mouth disease?

A
  • Exanthema and enanthema
  • Painful lesions
  • Recovery in 5 to 10 days
55
Q

What mild infections can enteroviral disease manifest as?

A
  • Fever +/- rash
  • Hand, foot, mouth syndrome
  • Herpangina
  • Pleurodynia
  • Pharyngitis
  • Conjunctivitis
  • Croup
56
Q

What potentially serious infections can enteroviral disease manifest as?

A
  • Meningitis
  • Encephalitis
  • Acute paralysis
  • Neonatal sepsis
  • Myocarditis/pericarditis
  • Hepatitis
  • Chronic infection in immunocompromised patients
57
Q

How are vesicular rashes diagnosed?

A
  • Clinical diagnosis
  • Smear of vesicle from ulcer base (Tzanck test, cannot differentiate HSV/VZV)
  • PCR of fluids, CSF and bloods
  • Serology for past infections

Systems: Paediatrics AB (31 decks)

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