T or F. Immune deficiencies are rare in children.
True, most who have infections are immunologically competent.
What is the most common Primary immune deficiency?
Selective IgA deficiency
What are some examples of relative immune deficiencies?
-DM, metabolic d/o, renal failure, malnutrition
T or F. Most newborns have all of the components of their immune system.
When do maternal IgG wane in babies?
reach nadir by 5 to 7 months
What is the average number of URIs in a normal child?
3-8 through age 5
What is the average number of GI infections for a normal child?
3 episodes per yr, first 3 years
List 3 presentations seen in a child with immune system defects.
- 1. Severe, deep tissue or life-threatening events
- 2. Recurrent or protracted infections
- 3. Infections with unusual organism
What are 4 reassuring features of children with recurrent illnesses?
- 1. Prior diagnosis are vague w/ unclear documentation
- 2. Lack of deep tissue infection
- 3. Presence of normal growth/development
- 4. General wellness
What oral symptoms are associated with immune?
thrust, mucosal lesions
What are 3 skin symptoms associated with underlying immune deficiency?
- 1. Eczema
- 2. Telangiectasia
- 3. Albinism
Features of specific conditions w/ recurrent infections:
2. Skin d/o
3. Neuro sx
4. Motor weakness
- 1. FTT--> HIV, T-cell disorders
- 2. Skind d/o--> Wiskott-Aldrich syndrome (eczema)
- 3. Neuro sx--> ataxia-telangiectasia
- 4. motor weakness--> recurrent aspiration pneumonia
What percentage of babies <3mo with fever can have a serious bacterial infection?
KNOW: What should you ALWAYS ask when a child presents with a fever and URI?
If a kid presents with diffuse petechiae and toxic appearance, what's your DD?
- 1. N Meningitides
- 2. Strep pneumoniae
- 3. H. Flu
- 4. Rocky MTN Spotted Fever
A neonate with petechiae presents, what is your DD? (2)
- 1. Disseminated CMV
- 2. Enterovirus
A kid presents with generalized erythroderma and peeling, what is your DD?
Toxic shock syndrome
What are the S/S of meningococcemia? (3)
- 1. Acute ill
- 2. Febrile
- 3. Rash
A baby presents with painful erythema, hemorrhagic bullae, crepitance, and dusky blotches, what's your DD?
What is the most common cause of severe, acute, disease in children?
T or F. Infants <2mo and those who are immunocompromised have ⇑ probability of bacterial infection and should be treated.
What are 3 sign of potential severe bacterial infection?
- 1. Fever in newborn < 2mo
- 2. Vascular instability (hypothermia, mottling, poor cap refill, unstable BP)
- 3. Skin rash (petechiae, eccymosis)
T or F. Diptheria is noted to have acute onset sore throat and high fever.
FALSE: insidious onset sore threat, malaise anorexia, NOTABLE absence of high fever
What are some s/s Diphtheria?
- -insidious sore throat, absence of high fever
- -Day 2-4, adherent gray, green, black membrane forms on mucosa w/ surrounding erythema
- -local adenopathy, bullneck
What is the txt for Diptheria?
- Horse antitoxin from CDC for system
- -PCN/ERTH if locat infection
How does Legionella present?
Acute pneumonia--> treat like it is, usually self-limiting
What is txt for Lyme Dx?
Amox, cefuroxime, doxy for at least 21 days
Which stage of Pertusis has non-specific URI?
Catarrhal stage 1
What is the diagnosis of Pertusis?
- 1. WBC 15-100,000
- 2. CXR- normal or perihilar infiltrate
- 3. PCR- or isolation of organism
T or F. Most nonspecific viruses are self-limiting and require no treatment