Systemic infections

Question 1

Streptococcus Pneumoniae

Answer 1

children < 5 years
OM, sinusitis, pneumonia, bacteraemia, meningitis

Dx: cultures NOT from nasopharynx
treatment: URTI - Amoxil

Meningitis - 3rd gen cephalosporin (resistance add vancomycin)

Prevention: Conjugate vaccine

Question 2

Diphtheria

Answer 2

Corynebacterium diphtheriae
sore throat, fever, toxaemia
white - grey membranes in nose or oropharynx (attempts remove result in bleeding)
cervical lymphadenopathy and periadenitis - bull neck
myocarditis
neuritis

Complications - pneumonia, thrombocytopenia and DIC, renal failure AIRWAY obstruction

Dx: Culture

Mx: Penicillin for 10 days
airway
antitoxin

Prevention - DTP vaccine

Question 3

AFP case definition

Answer 3

any case of AFP (sudden weakness in arms and legs) including GBS, that is not caused by injury
in a child less than 15 years of age

Question 4

Role of clinicians in AFP

Answer 4

notify all cases with sudden paralysis in children < 15 years
Investigate the case thoroughly
- completing investigation form
- recording accurate address info to facilitate tracing and f/u
- ensuring that 2 stool specimens are collected and shipped frozen to NICD in JHB