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Summary Essential Notes: Paediatrics: Infections
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UK Immunisation Viral infections Important bacterialSchedule Infection Features infections
Recommended
No. Of Primary infection by Varicella zoster virus Impetigo
Time vaccine
immunisations Shingles is reactivation of dormant virus in dorsal root ganglion Localised, highly contagious
s Fever initially
Chicken staph/strep infection most
0 months BCG (at risk)
2 pox
Itchy, rash starting on head/trunk before spreading (macular papular
(At birth) Hep B (at risk) vesicular), systemic upset is usually mild common in infant’s + young
Infectivity 4 days before rash, until 5 days after rash appeared children
1 month Hep B 1 Complications pneumonia, encephalitis, pancreatitis (rare)
‘6-in-1’ More common when there is a
(Diptheria, RNA Paramyxovirus pre-existing skin disease e.g.
Tetanus, Prodrome: irritable, conjunctivitis, fever
Pertussis, Polio, Measles Koplik spots: before rash (white spots on buccal mucosa, seen against bright red atopic eczema
2 months HiB, Hep B) 4 background) Face, neck + hands
Oral rotavirus Rash: discrete maculopapular, starts behind ears body Begin as erythematous macules
PCV RNA Paramyxovirus vesicular/popular bullous
Men B Respiratory tract parotid glands other tissues
‘6-in-1’ Mumps Infectivity 7 days before + 9 days after swelling (rupture leaves characteristic
3 months Rotavirus 2 Fever, malaise, muscular pain, parotitis, ‘ear pain’ (unilateral/bilateral (20%)) golden crust lesions)
‘6-in-1’ Complications Orchitis (50% in post-pubertal girls) Rx topical Fusidic acid (1st line)
4 PCV 3
months Togavirus Retapamulin (2nd line)
Men B
Infectivity 7 days before + 4 days after rash Extensive disease: Oral
Hep B (at risk) Rubella 1. Prodrome low grade fever
PCV 2. Rash Initially on face fades by 3-5 days
flucoxacillin
1 year Men B 4 3. Lymphadenopathy subocciptal + post auricular
HiB/MenC Scalded skin syndrome
MMR Bordetella Pertussis
Violent coughing spells= paroxysms Caused by exfoliative staph toxin,
Flu vaccine Air through swollen airways = ‘whooping sound’
which causes separation of
2-8 years 1 Whooping
Catarrhal nasal congestion, cough, low grade fever (very contagious 2 weeks)
(annual) cough
epidermal skin through the
Paroxysmal paroxysms + inspiratory ‘whooping’ noise. Vomiting, collapsed lung
‘4-in-1’ pre-
3 -4 school booster 2
apnoea granular cell layers
Convalescent Cough reduces, airway heals
years MMR ‘Slapped cheek syndrome’
Areas of epidermis separate on
HPV Transmission via respiratory/vertical transmission + transfusion of contaminated gentle pressure (Nikolsky sign)
12-13 vaccination 1 products Rx Anti-staph Abx, analgesia, fluid
years Parvoviru
Asymptomatic infection
for girls s B19
Erythema infectiosum balance monitoring
‘3-in-1’ Aplastic crisis
teenager Foetal disease
14 years booster 2 Peri-orbital cellulitis
Men ACWY HSV1= lip + skin lesions Fever + erythema + tenderness +
HSV2= genital lesions oedema of eyelid
* Since July 2016, Men C vaccine has been Asymptomatic (majority)
stopped no cases of Men C in the UK
Herpes
Gingivostomatitis vesicular lesions on the lips, gums, tongue + hard palate In young, unimmunised (HiB)
simplex
anymore Skin manifestations ‘cold sores’, eczema herpeticum, herpetic whitlows Aetiology local trauma, parasinus
Eye disease blepharitis/conjunctivitis
CNS diseases infection/dental abscess
Rx IV Abx
Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
Scarlet
Fever, malaise, tonsillitis, ‘Strawberry tongue, rash (fine punctuate erythema Orbital cellulitis
fever
sparing face) ‘sandpaper’ texture Proptosis, painful/limited ocular
movement + reduced visual
Hand & Coxsackie A16 virus acuity
Foot Mild systemic upset: sore throat, fever
disease Vesicles in the mouth and on the palms and soles of the feet
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