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Pediatrics Chapter 8 Section 1 - Viral Infection
About Chapter 8 Section 1 of Pediatrics - Viral Infection Mind Map, about viral infections such as hand, foot and mouth disease, including common rash diseases, measles, Rubella etc.
Edited at 2023-12-03 10:36:21- bacteria
This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
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Pediatrics Chapter 8 Section 1 - Viral Infection
- bacteria
This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
- Plant asexual reproduction
This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
- Reproductive development of animals
This is a mind map about the reproductive development of animals, and its main contents include: insects, frogs, birds, sexual reproduction, and asexual reproduction. The summary is comprehensive and meticulous, suitable as review materials.
- Recommended to you
- Outline
Chapter 8 Section 1 - Virus Infection
syllabus
Leaflet (i.e. infectious mononucleosis, IM)
exanthematous disease
measles
rubella
Urgent rash in young children
chicken pox
Hand, foot and mouth disease
viral
scarlet fever
bacteria
Common rash diseases
measles
measles virus
"The rash is hot and intense" - when the rash breaks out, the body temperature is the highest and it is densely packed. Palpate behind the ears first.
rubella
rubella virus
"LN swelling in the neck", the rash is not obvious, and often merges into a wheal
Urgent rash in young children
human herpesvirus type 6
"The heat subsides and the rash appears"
chicken pox
Varicella-zoster virus
"Four generations under one roof" - macules, herpes, vesicles and scabs can appear at the same time
Hand, foot and mouth disease
Enterovirus (EV)
"Four no's" - no pain, no itching, no scabs, no scars
scarlet fever
Group A beta-hemolytic streptococci (pyogenic bacteria)
"Paaschein's lines/peeling", causing fever after suppurative tonsillitis
1. Measles
Pathogen: measles virus
Epidemiology
Source of infection: measles patients (carriers are not used as a source of infection)
Contagious: 5 days before and after the rash appears. If it is complicated by pneumonia, it will be delayed until 10 days after the rash appears.
complication
Most common: pneumonia, laryngitis, myocarditis, encephalitis, exacerbation of tuberculosis, malnutrition, vitamin A deficiency
Characteristics and patterns of rash
Incubation period: about 10 days
Prodromal period 3~4 days
fever
"Shangfei" symptoms, prominent eye symptoms
Measles mucosal spots (Koplik spots) - the main basis for early diagnosis before the rash occurs
The rash period lasts for 3 to 4 days
The order of the rash is: behind the ears, hairline, forehead, face, neck, trunk and limbs, and finally reaches the palms and soles of the feet
Symptoms of systemic poisoning worsen, body temperature rises suddenly to 40~40.5℃, cough worsens, irritability or lethargy, severe cases include delirium and convulsions (rash with excessive heat)
Recovery period 3~4 days
Systemic symptoms improved, and the rash began to subside in the order of onset.
After the rash subsides, the skin remains with bran-like desquamation and brown pigmentation (an important basis for later diagnosis)
Characteristics: runny nose and tears on face, high fever and crying but not talking, wear a hat and wear clothes when rash occurs, remember it in three to three days
treat
General treatment: rest, care, nutrition, hydration, vitamin A supplement
Symptomatic treatment
When treating high fever, use a small dose of antipyretic, and be careful not to reduce the fever too violently.
Supplement vitamin A
Treatment of complications
Complicated pneumonia - anti-infection
Concurrent febrile seizures—diazepam
prevention
Control sources of infection
Generally, patients are quarantined until 5 days after the onset of rash
If combined with pneumonia, the period will be extended to 10 days.
Susceptible persons exposed to measles should be quarantined for 3 weeks
Cut off transmission routes: Susceptible people should try to avoid going to public places as much as possible
Protect the vulnerable
Passive immunity: Immediate intramuscular injection of immune globulin within 5 days of exposure to measles can prevent measles
Active immunization: vaccination with live attenuated measles vaccine (8 months after birth)
2. Rubella
Pathogen: rubella virus
Epidemiology
Source of infection: rubella patients
way for spreading
droplet spread
Placental transmission – congenital rubella syndrome (can cause severe congenital malformations)
prevention
Isolate the patient until 5 to 7 days after the onset of rash
Rubella vaccination
Highly effective immunoglobulin
clinical manifestations
acquired rubella
Prodromal phase: short and inconspicuous, similar to symptoms of "shang flu" (not as virulent as measles virus)
Rash period
Rash appears on the second day of fever and appears all within one day
Order of rash: face, neck, trunk, limbs
The rash subsides and the body temperature returns to normal
3 to 4 days after the rash occurs, the lymph nodes behind the ears and on both sides of the neck become swollen.
congenital rubella syndrome
Pregnant women infected with rubella virus in early pregnancy can cause miscarriage and stillbirth; it can also cause organ malformations and tissue damage, such as congenital heart disease.
treat
No special treatment, only symptomatic treatment
Features: Rash on the day of fever, large lymph nodes behind the ears and behind the pillow. The general condition is not bad, but pregnant women are most afraid of it.
3. Urgent rash in young children
Pathogen: Human herpesvirus type 6
Epidemiology: Children between 6 and 18 months old, more common in spring and autumn
Clinical features
Incubation period: about 10 days
fever period
Acute, the body temperature suddenly rises to 39~40℃, lasting for 3~5 days, and there may be convulsions, but the general condition is good
Rash period
Heat-resistant rash—distributed on the trunk, neck, and upper limbs
recovery period
The rash subsided in 1 to 3 days, with no pigmentation, scaling, or peeling.
treat
Treat symptoms and isolate children
Featured tips: A baby with human herpes type 6 has a fever and a red throat. The most characteristic rash after fever is small papules on the chest and back
4. Chickenpox
Pathogen: Varicella-zoster virus
Epidemiology
It is highly contagious and is contagious from 1 to 2 days before the rash appears to about 7 to 8 days after all scabs have formed.
Long-lasting immunity is acquired after infection, but shingles can occur later
complication
Skin infections are most common
Severe cases can cause: chickenpox pneumonia, encephalitis, myocarditis, etc.
clinical manifestations
incubation period
10~21d
There was low-grade fever and slight discomfort the day before the rash occurred, and the systemic symptoms were mild.
classic chickenpox
Macules, papules, herpes and scabs can exist at the same time, "four generations live under one roof"
Centripetal distribution, that is, spreading from the head and trunk to the limbs
Severe itching, easy scratching leading to local infection
severe chickenpox
Occurs in patients with immune deficiencies or malignant diseases
High fever and rash with centrifugal distribution
treat
Antiviral (ribavirin, acyclovir)
Antibiotics for combined bacterial infections
Characteristics: maculopapular and vesicular rash, with a scab in the center of the belly button, very itchy for four generations, do not scratch it without leaving scars
5. Hand, foot and mouth disease
pathogen
Various enteroviruses (EVs)
Enterovirus 71 (EV71) often causes severe cases
Epidemiology
There are many ways of transmission and it is highly contagious and can cause outbreaks.
Digestive tract, respiratory tract, close contact transmission
It is common in preschoolers and is generally susceptible
Clinical features
Common cases
Acute onset, "shangfei" symptoms
Rash areas: hands, feet, mouth, buttocks
Rash characteristics: maculopapular rash and herpes
"Four Nos" - no pain, no itching, no scabs, and no scars
severe cases
Typical performance Meningitis, encephalomyelitis, brainstem encephalitis, myocarditis, neurogenic pulmonary edema, pulmonary hemorrhage and circulatory disorder
treat
Supportive, symptomatic, antiviral
Severely ill patients can receive intravenous gamma globulin
prevention
Isolation treatment and strengthened monitoring in daycare institutions
Characteristics: a large group of enteroviruses, type 71 is the most ferocious, four types of mild rash, severe encephalitis and myocarditis
6. Scarlet Fever
Pathogen: Group A B-hemolytic Streptococcus
Epidemiology
The incidence rate is high in winter and spring
Patients and carriers are sources of infection
Respiratory droplet transmission
complication
A few children may develop acute glomerulonephritis and rheumatic fever 1 to 5 weeks after onset.
Clinical features
prodromal stage
Sudden onset, high fever, headache
Sore throat, congestion and edema of tonsils, and purulent secretions
Rash period
Rash appears within 24 hours of onset and spreads throughout the body within 24 hours
Order: neck - armpit - groin - whole body
"Pale circles around the mouth", "Paaschein's lines", "no normal skin between rashes", "strawberry tongue"
recovery period
Body temperature drops and rash subsides in order of appearance
Peeling begins to appear 1 week after the rash subsides
Pityriasis-like peeling on the face and neck, and large patches of peeling on the trunk and limbs
treat
Penicillin is the first choice, intramuscular or intravenous injection for 7 to 10 days
If you are allergic to penicillin, you can choose erythromycin or cephalosporins
prevention
Isolate patient until recovery and throat swab culture is negative
Give long-acting penicillin to close contacts
Characteristics: Group A streptococcus B, this guy is very annoying. Acute infection of tonsils, pus and red rash, messing up the immune system, and playing a role in immune nephritis.
Infectious mononucleosis (IM)
Definition: IM is a proliferative disease of the monocyte-macrophage system caused by Epstein-Barr virus
Epidemiology
Source of infection: patients and carriers
Transmission route: Transmitted through oral close contact, so it is also called the "kissing disease"
Susceptible groups: older children and adolescents
Characteristics: This disease is a benign, self-limiting disease with a good prognosis in most cases. A small number of serious complications such as hemophagocytosis syndrome and spleen rupture occur
clinical manifestations
Incubation period 30~50d
The main symptoms
main performance
Fever - 90% to 100% of children have fever, which can last for about 1 week in mild cases and 2 weeks or more in severe cases.
Angina - 50% of pharyngeal tonsils have gray-white purulent secretions
Lymphadenopathy - Superficial lymphadenopathy occurs in 80% to 95% of cases. Lymph nodes throughout the body can be affected, with cervical lymph node enlargement being the most common.
"Triad"
secondary performance
Hepatosplenomegaly - the incidence of hepatomegaly is 45% to 70%, and the incidence of splenomegaly is 35% to 50%
Eyelid edema - 15% to 25% of cases may have eyelid edema
Skin rash - the incidence rate is 15% to 20%, which can be erythema, urticaria, maculopapular rash or papule, and the manifestations are diverse
Complications (not important)
1. Nervous system
Encephalitis, meningitis, transverse cerebrospinal meningitis and Guillain-Barré syndrome can occur. Most of them can be recovered, but they are the leading cause of death from this disease.
2. Blood system
Autoimmune hemolysis and thrombocytopenia may occur, and in severe cases, hemophagocytic syndrome may occur
3. Spleen rupture
Although rare, the consequences are serious
4. Others
Nephritis, nephrotic syndrome, interstitial pneumonia, myocarditis, mumps, orchitis, otitis media, hemolytic-uremic syndrome, etc.
i.e. leaflet is a systemic disease
diagnosis
clinical diagnosis
Meet any 3 of the clinical indicators and the 4th item of the laboratory indicators
Laboratory confirmed
Meet any 3 of the clinical indicators and any one of 1 to 3 of the laboratory indicators
Differential diagnosis
Differentiation from infectious mononucleosis caused by other viruses such as Toxoplasma gondii, cytomegalovirus, rubella virus and other infections
Tonsillitis caused by Streptococcus
viral hepatitis
treat
This disease is a benign, self-limiting disease with a good prognosis in most cases, and symptomatic treatment is the mainstay.
1. Rest
Rest during acute phase
People with abnormal liver function should stay in bed and be treated as viral hepatitis.
2. Application of glucocorticoids
In severe cases and patients with complications, glucocorticoids can significantly reduce symptoms. For short-term use of about 3 to 7 days, prednisone tablets are commonly used at 1 mg/(kg·d), and the maximum daily dose does not exceed 60 mg.
3. Antiviral treatment
In the early stages of the disease, acyclovir, valacyclovir, or cyclovir may be used. ●Note: Antiviral treatment cannot reduce the severity of the disease, shorten the course of the disease, or reduce the incidence of complications.
4. Antibiotic treatment
If combined with bacterial infection, sensitive antibiotics can be given accordingly. ●Note: Avoid using ampicillin and amoxicillin to avoid hypersensitivity reactions and aggravating the condition.
5. Prevent and treat spleen rupture
Avoid any movement that squeezes or bumps the spleen. ① Limit or avoid exercise: strenuous exercise should be allowed 2 to 3 months or even 6 months after symptoms improve; ②The movements should be gentle when palpating the abdomen; ③Pay attention to dealing with constipation; ④ Aspirin should be used as little as possible to cool down, as it can cause splenic rupture and thrombocytopenia, increasing the risk of severe illness.
Characteristics
Epstein-Barr virus 250, transmitted through mouth, caused fever and sore throat due to anger, pinched the swollen lymph nodes, punched out the swollen eyelids, kicked out hepatosplenomegaly, and transformed the lymph in the blood.