Lichen- Planus
- Purple, Pruritic, Papular, Polygonal rash
- On flexor surfaces
- Wickham's striae over surface
- Oral involvement common
- Sclerosus
- Itchy white spots typically seen on the vulva of elderly women
Septic six- Blood cultures
- Before antibioitics are administered
- Antibiotics
- Mortality is reduced by 50% in severe sepsis if these are given within an hour of diagnosis
- Oxygen -
- Even if they are not desaturating
- If they are severe sepsis, give 100% at 15L/m via a non-rebreath mask
- Fluids
- They are highly likely to develop hypovoloemia
- Lactate
- A lactate above 2 means ITU involvement
- Catheterise
- You need to monitor urine output
Childhood infections
| Infection | Features | | Chickenpox | Fever initially
Itchy, rash starting on head/trunk before spreading. Initially macular then papular then vesicular
Systemic upset is usually mild | | Measles | Prodrome: irritable, conjunctivitis, fever
Koplik spots: white spots ('grain of salt') on buccal mucosa
Rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent | | Mumps | Fever, malaise, muscular pain
Parotitis ('earache', 'pain on eating'): unilateral initially then becomes bilateral in 70% | | Rubella | Rash: pink maculopapular, initially on face before spreading to whole body, usually fades by the 3-5 day
Lymphadenopathy: suboccipital and postauricular | | Erythema infectiosum | Also known as fifth disease or 'slapped-cheek syndrome'
Caused by parvovirus B19
Lethargy, fever, headache
'Slapped-cheek' rash spreading to proximal arms and extensor surfaces | | Scarlet fever | Reaction to erythrogenic toxins produced by Group A haemolytic streptococci
Fever, malaise, tonsillitis
'Strawberry' tongue
Rash - fine punctate erythema sparing face | | Hand, foot and mouth disease | Caused by the coxsackie A16 virus
Mild systemic upset: sore throat, fever
Vesicles in the mouth and on the palms and soles of the feet |
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