T6-L3: Childhood and Pregnancy Infections Flashcards
What particular teratogenic pathogens should we look for in pregnancy?
TORCH T - Taxoplasmosis O - Other such Syphilis, HIV, Hepatitis, Parovirus, Coxsackie virus and Varicella R - Rubella C - Cyclomegalovirus H - Herpes Simplex
If a developing fetus is infected by a TORCH agent, the outcome of the pregnancy may be miscarriage, stillbirth, delayed fetal growth and maturation (intrauterine growth retardation), or early delivery. In addition, newborns infected by any one of the TORCH agents may develop a spectrum of similar symptoms and findings.
For Chorioamnionitis, give the following: (a) Defintion (b) Causative agents (c) Clinical manifeston (d Risk factors
(a) “Chorioamnionitis” inflammation of the umbilical cord, amniotic membranes/fluid, placenta and has major causes of perinatal morbidity and mortality. It is more common in preterm labour (20-25%) and 1-2% in term pregnancies.
(b) - Group B Streptococcus
- Escherichia coli
- Genital Mycoplasma (Mycoplasma hominis & Ureaplasma urealyticum)
(c) - Maternal fever
- Tachycardia
- Purulent amniotic fluid
- Uterine tenderness
Can lead to sepsis and pneumonia and long terms neurodegenerative effects in the neonate.
(d) - Most common after prolonged rupture of membranes
- Other risk factors include: amniocentesis, cordocentesis, cervical cerclage, multiple vaginal examinations, ?Bacterial vaginosis
For Peurperal endometritis, give the following: (a) Defintion (b) Causative agents (c) Clinical manifeston (d Risk factors
(a) Uterine infection (lining of the womb) during puerperium affects ~5% of pregnancies
(b) E. coli, group B strep, and Anerobes
(c) - Fever
- Uterine tenderness
- Purulent, foul-smelling lochia (discharge from uterus after birth)
- Increased white cell count
- General malaise, abdominal pain
(d) Risk factors include caesarean section, prolonged labour, prolonged rupture of membranes, multiple vaginal examinations
What pathogen makes up a big portion of late onset neonatal sepsis?
Coagulase-negative staph
What pathogen makes up a big portion of early onset neonatal sepsis?
The organisms are similar to those in the female genital tract - GBS makes up almost half, other step, E.coli, enterococcus and S. aureus. It can manifest as pneumonia or multisystem involvement. High mortality especially in those who develop in the first 24 hours.
What is the most common symptom reported in early education setting?
Respiratory symptoms
What is the common cause of sore throat in childhood?
70-80% is viral.
In some we can get a group A step. This can cause a more severe pharyngitis.
What is Croup?
Inflammation and narrowing of the subglottic region of the larynx. It is most often caused by a viral infection.
Can lead to:
- Stridor
- Barking cough
- Hoarseness
- Respiratory distress +/- fever +/- coryza
It can be severe especially of they have severe respiratory distress.
UTI
What are common pathogenic causes of acute ortitis media?
- Strep. pneumoniae (35%)
- H. influenzae (25%)
- M. catarrhalis (14%)
- Strep. pyrogens (3%)
- Staph aureus (1%)
- Other
Can lead to symptoms such as:
- Unusual Irritability - Difficulty Sleeping - Tugging or Pulling At One Or Both Ears - Fever - Fluid Draining From The Ear - Loss Of Balance - Unresponsiveness To Quiet Sounds or Other Signs Of Hearing difficulty
What is the most common cause of lower respiratory tract infections in childhood?
RSV - Respiratory syncytial virus
They are not all viral but viral makes up a large group.
Describe the different phases of Pertussis infection.
- Occurs in 3 stages - Catarrhal, Paroxysmal and Convalescent phase
Catarrhal phase
- Cold-like (coryza, conjunctival irritation, occasionally a slight cough) - 7-10 days
Paroxysmal phase
- Long duration (2-6 weeks); No fever - a series of rapid, forced expirations, followed by gasping inhalation leading to the typical whooping sound - Post-tussive vomiting common - Very young infants may present with apnoea or cyanosis in the absence of cough
Convalescent phase - symptoms reduce
Whooping cough is a highly communicable acute respiratory infection caused by B. pertussis. It is spread via person-to-person transmission through aerosolised
What are the causative agents of bacterial meningitis in children?
Causative agents differ by the developing age of the child. Bacterial infections in the neonate causes include:
- Group B Streptococcus - Escherichia coli - Listeria monocytogenes
In ages 1 month - 5 years
- Streptococcus pneumoniae - Neisseria meningitidis
What is a characteristic sign of Meningococcaemia?
Rash
- Maculopapular rash common early in disease - Petechial rash seen in 50-60% The rash does not always fit the petechial rash picture early in the disease.
Other signs/symptoms include Fever, non-specific malaise, lethargy, vomiting, meningism, resp. distress, irritability, seizures.
What is the causative agents in most UTIs in children?
Bacterial cause:
Most UTIs in children are from ascending bacteria
- E. coli (60-80%), Proteus, Klebsiella, Enterococcus, and Staphylococcus saprophyticus
What is the epidemiology of UTIs in children?
Up to 7% of girls and 2% of boys experience a symptomatic culture-proven UTI prior to 6 years of age.
- Of febrile neonates, up to 7% have UTIs. - The overall prevalence of UTI is approximately 5% in febrile infants but varies widely by race and sex. - Caucasian children had a two- to fourfold higher prevalence of UTI as compared to African-American children - Females have a two- to fourfold higher prevalence of UTI than do circumcised males
