12.08.29 Common infections

Rashes

Children with fever

Important diagnoses

• • Meningitis

    • Neck stiffness

    • Bulging fontanelle

    • Decreased level of consciousness

    • Convulsive status epilepticus

  • Meningococcal disease

    • Non-blanching rash, particularly with one or more of the following:

      • an ill-looking child

      • lesions larger than 2 mm in diameter (purpura)

      • CRT ≥ 3 seconds

      • neck stiffness

  • Herpes simplex encephalitis

    • Focal neurological signs

    • Focal seizures

    • Decreased level of consciousness

  • Pneumonia

    • Tachypnoea (depending on age)

    • Crackles

    • Nasal flaring +/- chest indrawing

    • Oxygen saturations < 95%

  • UTI (> 3 months)

    • Vomiting

    • Poor feeding

    • Lethargy

    • Irritability

    • Abdo pain or tenderness

    • Frequency or dysuria

    • Offensive urine or haematuria

  • Septic arthritis / Osteomyelitis

    • Swelling of limb or joint

    • Not using extremity

    • Non weight-bearing

Risk Factors for Neonatal Infection (in order of risk)

1. PROM >18 hours

2. Preterm delivery <37 weeks

3. Preterm delivery <35 weeks

4. Choramnionitis or Fever>38oC (or 37.5oC on 2 occasions separated by at least 1 hr)

5. Previous infant with invasive GBS disease