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35 Cards in this Set
- Front
- Back
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? CFU on UC = treat
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10,000
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S. saphrophiticus is a cause of UTIs in what age group?
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adolescents
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What is the main cause of aseptic meningitis?
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Enteroviruses
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What unusual bacteria and nonviral agents can cause aseptic meningitis?
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Bartonella hensalae
Borrella burgdorferi TB also fungi, malignancy, hemorrhage |
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T/F Viral and bacterial meningitis patients are similarly toxic
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False; aseptic meningitis patients are typically less toxic
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What is the mortality rate of bacterial meningitis?
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10%
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Most common morbidities of bacterial meningitis
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hearing loss 30%
seizure 25% severe neuro complications 10-20% |
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Two foci of direct spread of meningitis (as opposed to hematologic spread)
What age group is this most likely in? |
otitis media
sinusitis < 1 year |
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What is paradoxical irritability?
What is it a sign of? |
increased irritability when held, rather than being comforted
meningitis |
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CSF finding in bacterial meningitis
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WBC usually > 1000 (but < 250 in 25%)
protein > 100 glucose < 30 gram stain + in > 70% |
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CSF findings in viral meningitis
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WBC 10 - 1000
protein normal glucose normal (2/3 of serum) gram stain negative |
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What is the empiric abx regimen for bacterial meningitis?
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ceftriaxone 100 mg/kg (high dose, twice that for PNA)
covers S pneu and Neisseria vanco 60 mg/kg QID covers resistance S pneu |
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What is unusual about the presentation of pneumonia in the young?
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Often has no respiratory signs on physical exam--only presentation is high fever, toxic appearance
Sometimes have misleading abdominal pain |
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Febrile child with WBC > 20,000 and no other signs on physical exam except malaise...think ?
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pneumonia, UTI
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pneumona with insidious onset is likely [viral, bacterial].
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viral
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Pneumonia in child with rales, retractions, respiratory distress is likely [viral, bacterial].
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viral
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Pneumonia in child with rapid onset is likely [viral, bacterial].
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bacterial
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Pneumonia in child with toxic presentationis likely [viral, bacterial].
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bacterial
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Pneumonia in child with wheezing is likely [viral, bacterial].
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viral
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Pneumonia in child with WBC > 15K is likely [viral, bacterial].
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bacterial
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Pneumonia in child with interstitial infiltrates is likely [viral, bacterial].
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viral
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Pneumonia in child with lobar consolidation is likely [viral, bacterial].
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bacterial
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Refusal to drink in child is often a sign of ?
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sore throat -- think abscess
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Prevertebral soft tissue should be how wide in relation to spine?
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half the width of spine
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What are two main causes of retropharyngeal abscess in kids?
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spread of pharyngitis infection to lymph nodes
penetrating trauma when child falls with popsicle stick or pencil in mouth |
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Main bacterial agents in retropharyngeal abscess
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Strep A or B
Staph aureus Anaerobes, especially bacterioides |
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Torticollis, drooling, stridor, respiratory distress...think
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retropharyngeal abscess
rule out epiglottitis, croup |
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Imaging for suspicion of retropharyngeal abscess
Tx of retropharyngeal abscess |
lateral neck xray as screen
CT neck is diagnostic Unasyn or clindamycin (staph, strep, anaerobes surgical drainage |
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Sx of peritonsillar abscess
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trismus
hot potato voice unilateral tonsil hypertrophy uvular deviation |
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Age of retropharyngeal vs peritonsillar abscess
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retropharyngeal usually 6 mo - 6 years
peritonsillar usually > 10 years |
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Epidemiology of Kawasaki disease
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< 5 years
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Sx of Kawasaki dz
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Fever of 5 days or more and 4 out of 5 clinical signs: CRASH:
cervical lymphadenopathy rash aortic aneurysm strawberry tongue hand/foot desquamation |
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What is the leading cause of acquired heart dz < 5 years old?
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Kawasaki
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What labs help to confirm Kawasaki's?
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elevated ESR/CRP
liver abnormalities: low albumin, elevated ALT elevated platelets, low Hgb |
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What is the treatment for Kawaski's?
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IVIG
aspirin serial echo for aneurysm check |
