Pediatric INfectious diseases

1. Infectious disease Flash cards
Danulka Vargas
Resources: PBR and Laughing your way to the Pediatric Boards

2. Clindamycin
• Clindamycin [cling 'da mice]
• Clings to 50S bacterial ribosome
• Effective against Gram (+) and
anaerobes [Violet Gram (+) and feces
with a snorkel on the tail]
• Good penetration into bone [bone in
mouth]
• Clostridium difficile [Closet] is resistant
• Rash is a side effect [Red rash spots]
• Eliminated in bile [green] and
urine [yellow]
NOT ACTIVE AGAINST ENTEROCOCCUS

3. CEPHALOSPORINS

4. FIRST GENERATION CEPHALOSPORINS
Cover Staph and Strep and
PEcK (Proteus, E. Coli and Klebsiella)
Cephalosporins - 1st generation [#1 flags]
Drug names start with "Cef/Cepha" [Cepha = head]
Generally effective against:
Proteus [Pee rot us skeleton]
Escherichia coli [Cherry colon]
Klebsiella [Kielbasa]
Mnemonic: [PEcK]
Cefazolin [Ce phase violin, has only 1 string for 1st generation]
Intravenous administration [Syringe]
Good penetration into bone [Bone at the end]
Also effective against Staphylococcus Aureus [Golden grapes]
Cephalexin [Cepha lexus, #1 generation flag]
Oral administration [Dropping pill]
Cefadroxil [Ce fat rock eat (French C'est = It is)]
Cephalothin [long & thin head]
Cephradine [Radiator head]
Cephapirin [Aspirin head]
• Cephalexin(Keflex PO)
• Cefazolin (Ancef IV)

5. SECOND GENERATION CEPHALOSPORINS
Better gram negative coverage
HEN (Haemophilus, Enterobacter and Neisseria)
PEcK (Proteus, E. Coli and Klebsiella)
• Cephalexin(Keflex PO)
• Cefazolin (Ancef IV)

6. Third generation Cephalosporins
CEFTAZIDIME COVERS PSEUDOMONAS
TAZ-MONAS DEVIL
BETTER GRAM NEGATIVE COVERAGE
HOSPITAL ACQUIRED AND CNS INFECTIONS
• Cephalosporins - 3rd generation [3 taxi wheels, 3 horns, 3 axes, 3
nipples, ears shaped in 3's ]
• Drug names start with "Cef/Cepha" [Cepha = head]
• Cefdinir [cefa-dinner]
• Cefixime [cefa-fix-chime] [hammer and square on head with a chiming
bell]
• Cefoperazone [cefa-opera-zone] [Opera lady]
• Causes hemorrhage [bloody tears]
• Disulfiram-like effect with alcohol [pouring wine]
• Eliminated in bile [melting in bile]
• Cefotaxime [cefa-taxi-chime]: Good CNS penetration [Taxi driving into
brain]
• Ceftibuten [cefa-boot]
• Ceftriaxone [3 axes]
• Hacks into bone and CNS
• Splits Neisseria
• Eliminated in bile
• Moxalactam [Moo ox lactating]
• Ceftizoxime [cefa-ox-tease-chime]

7. Gram positive organism

8. ENTEROCOCCUS
Gram positive diplococci
TX: Vancomycin, Linezolid or Ampicillin
(rifampin and quinolones)

9. Clostridium tetani
Anaerobic organism Tx: Debridement, Tetanus Immunoglob
and Metrodinazole or penicillin

10. Clostridium botulinum
Gram positive org
inhibits release of acetylcholine
Tx: Antitoxin if available and
supportive care
• Clues:
• Less than 6 m
• Progressive descending
weakness and ptosis

11. Corynebacterium diphteriae
Gram positive rod causes low grade fever
and URI symptoms, including sore throat
causes sensory prob loss of reflexes
Tx: Metrodinazole or Erythromycin

12. Streptococcal infections
Alpha hemolytic streptococcus: Strep viridans
and Strep pneumo
• https://www.youtube.com/watch?v=gj
o_GoJ03ps&feature=related
• Gram positive cocci in pairs and chains.
Gram stain will show blue.
Beta hemolytic streptococcus:
(Agalactiae and pyogenes)
• aBpA: Acute Bronchopulmonary
Aspergillosis
• aB: Agalactiae GBS: Baby
• pA: Pyogenes of group A: GAS =
Skin
• Inhaling GAS makes throat hurt.
Pharyngitis and oral abscesses.

13. Streptococcal Pharyngitis
Look for fever, LAD, Sore throat, erythematous or
exudate tonsils
Dx: Culture. Rapid Test + =Treat
TX: Penicillin or Amoxicillin. If allergic,
use erythromycin or Clindamycin
Antibiotics are given to prevent Rheum. fever

14. Streptococcal Glomerulonephritis
Low C3 and normal C4 +
renal impairment
Follow C3 until normal
TX: IVF and loop diuretics if HTN
Antibiotics are given to prevent Rheum. Fever but cannot
prevent PSGN.

15. Peritonsillar abscess
Due to GAS. Tx. Clindamycin and ampicillin-sulbactam .
Once the lesion has been drained and the
patient can swallow. Treat with Augmentin.

16. Retropharyngeal abscess
Less than 6y/o, fever, LAD, pain, difficulty
swallowing , drooling and hyperextension
of the neck.
Tx: requiring both surgical drainage (usually
performed via a transoral route) and
intravenous antibiotics

17. Scarlet Fever
Due to GAS, rash does not
hurt and is “sandpaper like”

19. Group B Strep SEpsis
Early onset
• First 3 days of life
• Pneumonia
• Tx: Penicillin G
• A band neutrophil ratio: >0.2
suggestive of infection
Late onset
• 1 week to 3 months.
• Meningitis

20. Staphylococcus
Aureus
Epidermidis
• Tx: Vancomycin
Tx: IV antibiotics and Echocardiogram to R/O
Endocarditis

22. Gram negative
Ella, ellla, ella, most like gram neg organisms

24. Ritcketssia ricketsii and RMSFStart treatment on clinical suspicion to all ages

26. Enterobacter
Hospital acquired bacteria resulting in
UTI or respiratory tract infections Tx: Cephalosporins or Carbapenems

27. Bartonella Henselae
Immunocompromised patients need
treatment with macrolides, cephalosporin,
doxycycline or TMP-SMX

28. Patient may be afebrile.

29. Chlamydia Trachomatis
Intracellular anaerobe intracytoplasmic
inclusion
Causes: Urethritis, Conjunctivitis and PID.
• PID can lead to ectopic pregnancy and
infertility.
• Conjunctivitis in a neonate should raise
concern of this due to vertical
transmission.
• DX: PCR of cells, secretions or urine.
• Tx: Azithromycin x 1 or Doxycycline x 7 d.
• In conjunctivitis: Tx. Oral erythromycin to
eradicate nasopharyngeal colonization
Lymphogranuloma venereum serovar
• Most common in tropical areas.
Small tender papules or shallow
ulcers that resolve. Then a
tender unilateral inguinal lymph
node appears.
Tx: Doxycycline or erythromycin

30. Chlamydia psitacci
• Psittacosis is an occupational disease of zoo
and pet-shop employees, poultry farmers,
and ranchers. It is an infection caused by
bacteria found in the droppings of birds. Birds
spread the infection to humans. Bird owners,
pet shop employees, persons who work in
poultry processing plants, and veterinarians
are at increased risk for this infection.
• Symptoms: Dry cough, Fatigue, Fever and
chills, Headache, Joint aches, sputum with
blood.
Treatment: The infection is treated with
antibiotics naamely Doxycycline, macrolides,
Fluoroquinolones or tetracyclines.

31. Mycoplasma Pneumonia
Atypical Pneumonia or bullous
myringitis
• Some get neurological
symptoms
• Dx: Serum IgM titers, not Cold
agglutinins because they only
help if positive.
• MMMM: Mycoplasma, IGM,
Macrolides, Myringitis, watch for
Meurologic symptoms

32. H. influenzae
Bacteremia, Pneumonia, Meningitis, Otitis
media , Epiglottitis, sinusitis and
conjunctivitis
Immigrants, asplenic patients and
immunized patients: severe disease.
• Pleomorphic organism
• Tx. Ceftriaxone

33. Bordetella Pertussis
HIGH WBC >20,000
Lymphocytosis
Dx. Nasopharyngeal
swab
Tx: Azithromycin <1y/o
then Erythromycin

35. Pseudomonas

36. Fungal and Atypical bacteria

37. Cryptococcus