W12_09 pediatric infectious diseases 2 Flashcards
what’s the most common etiology of meningitis in children > 90 days
strep pneumo;
n.meningitidis
note: you can’t do nuchal rigidity testing in really young children because they’re often all over the place
ok;
if they “look” sick, consider LP
what’s the first line therapy for meningitis in neonates?
ampicillin + cefotaxime
what’s the first line therapy for meningitis in 1-3 mo children?
ampicillin + cefotaxime + vancomycin
what’s the first line therapy for meningitis in >3 mo children?
ceftriaxone + vancomycin (for strep pneumo resistance)
recall botulism
toxin inhibits acetylcholine release by binding to the presynaptic membrane
what are the three manifestations and etiologies of botulism?
food-borne, where the toxin is preformed;
wound botulism, where a wound gets spores;
infant botulism, where the baby ingests spores
note: the presentation of infant botulism is nonspecific.
floppy child is the most common. Diagnosis can be easily missed
can you use antibiotics for botulism in babies?
no, not helpful, and aminoglycosides will make it worse
what’s the pathogenesis of streptococcal toxic shock?
superantigen-mediated disease where there’s nonspecific activation of T cells, then cytokine storm
what’s the management for streptococcal toxic shock?
antibiotics (penicillin, clindamycin);
IVIg
what’s the most common congenital infection?
CMV infection (0.5-1%)
what does congenital CMV infection cause?
hearing loss;
microcephaly, CNS calcifications, mental retardation;
chorioretinitis;
hepatosplenomegaly, thrombocytopenia
how does congenital CMV typically occur?
mothers have two kids, one in daycare is infected with no symptoms. Passes it to mother, who also has no symptoms. Then mother passes it to the newborn
what’s the treatment for congenital CMV infection?
ganciclovir
