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