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AHN 548 Unit 5 Pediatric Infectious Diseases And Rashes Questions And Answers
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AHN 548 Unit 5 Pediatric Infectious Diseases And Rashes Questions And Answers
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AHN 548 Unit 5 Pediatric Infectious Diseases AndRashes Questions And Answers
Common Cold: RHINOVIRUSES colder months ANS Respiratory syncytial virus,
parainfluenza viruses, human metapneumovirus, and influenza viruses
ENTEROVIRUSES cause.... ANS the "summer cold."
Treatment plan of the "common cold." ANS Oral antihistamines/decongestants/cough
suppressants: .conflicting evidence (not be used in children less than 2)
Topical decongestants temporary improvement in nasal symptoms. Vitamin C : no help.
Zinc therapy may be effective in adults, but uncertainty about dosing and some adverse effects.
Humidified air and garlic: no effect.
Adenoviruses: 57 types
● Multiple syndromes, most common <2 yo. ANS URI: (most notable is severe pharyngitis
with tonsillitis and cervical adenopathy), conjunctivitis, pneumonia, enteric adenoviruses cause
mild diarrheal illnesses, definitive dx by antigen detection, pcr, or culture.
Adenoviral Pharyngitis - ANS Pharyngitis is the most common adenoviral disease, and the
most common viral cause of severe pharyngitis in children. Fever and adenopathy are common.
Tonsillitis may be exudative. Rhinitis and an influenza-like systemic illness may be present.
Laryngo Tracheitis or bronchitis may accompany pharyngitis.
Adenoviral Pharyngoconjunctival Fever - ANS Conjunctivitis may occur alone and be
prolonged, but most often is associated with preauricular adenopathy, fever, pharyngitis, and
cervical adenopathy. Foreign body sensation in the eye and other symptoms last less than a week.
Lower respiratory symptoms are uncommon.
Adenoviral Epidemic Keratoconjunctivitis ANS severe conjunctivitis with punctate keratitis
and occasionally visual impairment. A foreign body sensation, photophobia, and swelling of
conjunctiva and eyelids are characteristic. Preauricular adenopathy and subconjunctival
hemorrhage are common.
,Adenoviral pneumonia: Symptoms persist for 2- 4 weeks. ANS especially common in (age <
3 years). Xray: bilateral peribronchial/patchy ground-glass interstitial infiltrates, can be
necrotizing and cause permanent lung damage like bronchiectasis. A pertussis-like syndrome
with typical cough and lymphocytosis can occur with lower respiratory tract infection. A new
variant of adenovirus serotype 14 can cause unusually severe, sometimes fatal pneumonia in
children and adults
Adenoviral Rash - ANS A diffuse morbilliform (rarely petechial) rash resembling measles,
rubella, or roseola may be present. Koplik spots are absent.
Koplik spots (also Koplik's sign) "grains of salt on a wet background" . ANS clustered, white
lesions on the buccal mucosa (opposite the lower 1st & 2nd molars) and are pathognomonic for
measles. The textbook description of Koplik spots is ulcerated mucosal lesions marked by
necrosis, neutrophilic exudate, and neovascularization
Enteric adenoviruses (types 40 and 41) ANS cause 3%- 5% of cases of short-lived diarrhea
in afebrile children, especially in those less than 4 years old.
Adenoviral Mesenteric Lymphadenitis ANS Fever and abdominal pain may mimic
appendicitis. Pharyngitis is often associated. Adenovirus-induced adenopathy may be a factor in
appendicitis and intussusception.
Other Adenoviral Syndromes - ANS Immunosuppressed patients, including neonates, may
develop severe or fatal pulmonary or gastrointestinal infections or multisystem disease.
Hemorrhagic cystitis,encephalitis, hepatitis, myocarditis, and the syndrome of idiopathic
myocardiopathy..
Specific Adenoviral Syndromes ANS A. Pharyngitis -
B. Pharyngoconjunctival Fever -
C. Epidemic Keratoconjunctivitis -
D. Pneumonia -
E. Rash -
,F. Diarrhea -
G. Mesenteric Lymphadenitis
H. Other Syndromes - Hemorrhagic cystitis can be a serious problem in immunocompromised
children, encephalitis, hepatitis, and myocarditis, idiopathic myocardiopathy..
The three main types of influenza viruses are type A (H1N1 and H3N2) and B ANS cause
most human epidemics. Spread by airborne respiratory secretions. The incubation period is 2- 7
days. late fall through mid-spring
Influenza infection in older children and adults produces a characteristic syndrome of ... ANS
sudden onset of high fever, severe myalgia, headache, and chills.
Common symptoms of influenza infection in in young children are ... ANS Fever, diarrhea,
vomiting, and abdominal pain
Infants may develop a ANS sepsis-like illness and apnea from an influenza infection.
Unusual clinical findings of influenza infection include ... ANS croup (most severe with type
A influenza), exacerbation of asthma, myositis (especially calf muscles), myocarditis, parotitis,
encephalopathy, nephritis, and a transient maculopapular rash. Acute illness lasts 2- 5 days.
Cough and fatigue may last several weeks. Viral shedding may persist for several weeks in
young children.
Antivirals are ANS benefitial if started within 48 hours after symptom onset. Treatment
duration is 5 days. markedly reduces the incidence of acute otitis media and antibiotic usage
during the flu season.
Parainfluenza viruses (types 1- 4) are ANS the most important cause of croup.
Parainfluenza
, S/S: Croup ... ANS barking cough, inspiratory stridor (especially when agitated), and
hoarseness. Fever, nasal congestion, sore throat, cough. Diagnosis is often based on clinical
findings. No specific therapy or vaccine is available.
Bronchiloitis
RSV is the most important cause of.... ANS lower respiratory tract illness in young children,
70% of cases of bronchiolitis and 40% of cases of pneumonia. infection in infancy may be an
important precursor to asthma. Epidemics in late fall to early spring (January- February peak).
RSV looks like URI initially but..... ANS The classic disease is bronchiolitis, characterized
by diffuse wheezing, variable fever, cough, tachypnea, difficulty feeding, and, in severe cases,
cyanosis.
Ribavirin is.... ANS the only licensed antiviral therapy used for RSV infection. It is given by
continuous aerosolization.
Human metapneumovirus (hMPV) is a common cause of.... ANS respiratory tract infections
similar to RSV, hMPV belongs to the paramyxovirus family like RSV, parainfluenza, mumps,
and measles. Humans are its only known reservoir.
S/S: The most common symptoms are
S/S of Human metapneumovirus (hMPV) infection include... ANS fever, cough, rhinorrhea,
and sore throat. Other manifestations include otitis, conjunctivitis, diarrhea, myalgia, and acute
wheezing
Enteroviruses are..... ANS a major cause of illness in young children. The multiple types,
identical syndromes, differ antigenically, vaccine development impractical and hindered
development of antigen detection and serologic tests.
Types of Enteroviruses..... ANS coxsackievirus, poliovirus, and echovirus
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