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Infection > Viral Exanthema > Flashcards

Viral Exanthema Flashcards

1
Q

What pathogens can cause sepsis in neonates?

A

Group B Streptococci

Escherichia Coli

Listeria Monocytogenes

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2
Q

What pathogens can cause sepsis in children?

A

Streptococcus Pneumoniae

Meningococci

Group A Streptococci

Staphylococcus Aureus

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3
Q

What is the most common cause of community aquired sepsis in children?

A

Neisseria Meningitis

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4
Q

What antibiotics are used in sepsis management for neonates?

A

Gentamicin and penicillin

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5
Q

What antibiotics are used in sepsis management for children?

A

Ceftriaxone and amoxicillin

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6
Q

What is scarlet fever

A

Infection caused by an exotoxin produced by group A streptococci

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7
Q

What is the incubation period of strep A

A

2-4 days

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8
Q

How does scarlet fever present?

A

Red/pink blotchy macular rash with rough sandpaper skin that starts on the trunk and spreads out

Strawberry tongue

Tonsilitis/sore throat

Flushed face

Lymphadenopathy

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9
Q

How is scarlet fever managed?

A

10 days phenoxymethylpenicillin

Notifiable disease

Children should be kept off school until 24 hours after starting antibiotics

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10
Q

What is rheumatic fever?

A

Untreated scarlet fever

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11
Q

How does rheumatic fever present?

A

Fever, not always present

Joint pain/swollen joints

New murmur

Raised rash over trunk

Involuntary movements of arm

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12
Q

How is rheumatic fever managed?

A

Benzylpenicillin

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13
Q

What is Kawasaki disease?

A

Immune mediated vasculitis leading to coronary aneurysms, common in Japan

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14
Q

How does Kawsaki disease present?

A

Red eyes, red extremities, red membranes

Fever, for at least 5 days +4/5

Bilateral conjunctival injection

Changes to mucous membranes

  • Strawberry tongue
  • Cracked lips
  • Red pharynx

Cervical lymphadenopathy

Widespread blanching polymorphous rash

Changes to extremities, painful to hold things in hand and stand on feet/desquamation

Inflammation of BCG scar is also associated

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15
Q

How is Kawsaki disease managed?

A

Immunoglobulins

  • Give within 10 days of symptom onset to minimise aneurysm risk

Aspirin

  • Prevent coronary artery aneurysm

Other immunosuppressive agents

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16
Q

What organism causes glandular fever/infectious mononucleosis?

A

Epstein Barr Virus

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17
Q

How does glandular fever present?

A

Classic triad of fever, sore throat and cervical lymphadenopathy, usually lasting 2 weeks

Erythematous tonsils

Coryzal/URTI symptoms

Splenomegaly

Hepatitis

Platal petichae

Lymphocytosis

Haemolytic anaemia

Rash post amoxicillin

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18
Q

How is glandular fever diagnosed?

A

Heterophil antibody test (Monospot test) in the 2nd week of the illness

Blood film

  • Atypical lymphocytes
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19
Q

When do symptoms of glandular fever usually resolve?

A

2-4 weeks

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20
Q

How is glandular fever managed?

A

Supportive

Avoid alcohol and contact sports

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21
Q

Give complications of glandular fever

A

Splenic rupture, avoid contact sports for 8 weeks

Maculopapular pruritic rash develops in around 99% of patients who take amoxicillin whilst they have infectious mononucleosis

Idiopathic thrombocytpenic purpura

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22
Q

Wha is Henoch–Schönlein Purpura?

A

Paediatric vasculitis commonly occuring after a viral URTI

23
Q

Give features of Henoch–Schönlein Purpura

A

Tetrad of rash, abdominal pain, arthralgia and glomerulonephritis

Large joint arthralgia

Rash

  • Urticarial to purpuric
  • Purple
  • Buttock and thighs

Intusception

Abdominal pain

Renal involvement

  • Hypertension
  • Nephrotic syndrome
24
Q

How is Henoch–Schönlein Purpura managed?

A

NSAIDS

Supportive treatment

25
Q

What is slapped cheek?

A

Parovirus infection

26
Q

What is the incubation period of parovirus?

A

7-10 days

27
Q

How does parovirus present?

A

Viral prodrome

Headache

Erythematous rash

  • Occurring on cheeks initially and becoming a lace like network rash on trunk and limbs
  • Can take 6 weeks to fully fade
28
Q

How is parovirus managed?

A

Supporitve

29
Q

What organisms cause hand, foot and mouth disease?

A

Coxsackie virus A16

  • Most common

Enterovirus 71

30
Q

How long do patients take to recover from hand, foot and mouth disease?

A

5-10 days

31
Q

How does hand, foot and mouth disease present?

A

Vesicular rash on hands and feet, followed by mouth ulcers

Viral symptoms

  • Fever
  • Drooling
  • Irritable
32
Q

How is hand, foot and mouth disease managed?

A

Self limiting, so supportive treatment

  • Antipyretics
  • Fluids

Does not require home exclusion

33
Q

What is the incubation period of varicella zoster virus?

A

10-21 days

34
Q

What organism causes chicken pox?

A

Human herpes virus 3/varicella virus

35
Q

How long is chicken pox contagious for?

A

Contagious 1-2 days before rash appears and until lesions have crusted

36
Q

How does chicken pox present?

A

Red, itchy papules/small bumps progressing to vesicles/blisters, often starting on the trunk

Mild malaise and fever, children don’t tend to be sick

37
Q

How is chicken pox managed?

A

Self limiting

38
Q

Give complications of chicken pox

A

Disseminated haemorrhagic chickenpox

Secondary bacterial infection

Encephalitis

Pneumonia

39
Q

What is the incubation period of mumps?

A

14-25 days

40
Q

What is mumps?

A

Self limiting viral infection, most common in childhood, spread by respiratory droplets

41
Q

How does mumps present?

A

Flu like prodrome, occuring for a few days before

Parotid gland swelling with associated pain that can be unilateral or bilateral

Signs of complications

42
Q

Give complications of mumps

A

Pancreatitis

Orchitis

Meningitis

Sensorineural hearing loss

43
Q

How is mumps diagnosed?

A

PCR testing on saliva swab

Antibodies to mumps virus

Notifiable disease

44
Q

How is mumps managed?

A

Supportive

MMR vaccine

45
Q

What is measles?

A

Highly contagious infection caused by measles virus spread via respiratory droplets

46
Q

How does measles present

A

Symptoms start 10-12 days after infection

Flu like prodrome with fever, coryza

Koplik spots, greyish white spots on the buccal mucosa appearing 2 days after the fever

Erythematous rash that starts behind ear and spreads all over body

Conjunctivitis

Always consider in an incomplete or uncertain vaccination history

47
Q

How is measles managed?

A

Supportive/self resolving after 7-10 days of symptoms

Children should be isolated until 4 days after their symptoms resolve

Notifiable disease

MMR vaccine

48
Q

Give complications of measles

A

Acute otitis media, most common complication

49
Q

What is rubella?

A

Also known as german measles, highly contagious infection caused by rubella virus spread via respiratory droplets

50
Q

How does rubella present?

A

Milder erythematous macular rash compared to measles, starting on the face and spreading to the rest of the body, lasting 3 days

Mild fever

Joint pain

Sore throat

Lymphadenopathy

51
Q

How is rubella managed?

A

Supportive

Notifiable disease

Children should stay off school for at least 5 days after rash appears

Avoid pregnant women

52
Q

What is roseola infantum?

A

Common disease of infancy caused by human herpes virus 6, typically affecting children aged 6 months-2 years

53
Q

Give features of roseola infantum

A

High fever lasting a few days followed by maculopapular rash

Nagayama spots around uvula and soft palate

Febrile convulsions

Diarrhoea and cough

School exclusion not required

54
Q

Differentiate between the main paediatric rashes

A

Roseola

  • Fever before, rash after

Scarlet fever

  • Sore throat, sandpaper rash, strawberry tongue (S’s)

Measles

  • Cough, conjunctivitis, coryza (C’s)

Kawasaki

  • 5 day fever

Rubella

  • 3 day fever, 3 day prodrome, 3 days rash

Infection (9 decks)

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