Common Viral and Bacterial Diseases of Childhood PDF

Common Viral and Bacterial Diseases of Childhood Y2 BDS 2024-2025 Ness Avery, BDS-MSc (Micro) PGDip (Ortho) PGCert (ClinEd) AFHEA Learning Objectives  Understand how the most common viral infections have an effect on the systemic system and oral cavity in...

Common Viral and Bacterial Diseases of Childhood Y2 BDS 2024-2025 Ness Avery, BDS-MSc (Micro) PGDip (Ortho) PGCert (ClinEd) AFHEA Learning Objectives  Understand how the most common viral infections have an effect on the systemic system and oral cavity in children  Describe the mechanisms and signs and symptoms of common viral, bacterial and fungal diseases in children  Gain clinical knowledge of the systemic effects and treatments available for viral infections  Be aware of childhood vaccination schedules Remember your viral diseases plenary? Influenza Common Cold Covid 19 HPV Herpes Simplex Virus 1 and 2 – Human alphaherpesvirus 1 AKA cold sores, HSV 1 + HSV 2 Transmission: contact with herpetic lesions, mucosa surface and oral and genital secretions – in children can indicate sexual abuse Incubation: 4 days (2-12 range) Signs & symptoms: initial infection can include mild pyrexia, myalgia, anterior cervical lymphadenopathy. Difficulty eating (possibly dysphagia). Followed by painful recurring blisters or ulcers a few days after primary infection – vesicles on hard palate, fauces, herpetic lesions anterior part of the mouth. Treatment: +- 2 weeks to heal. Oral therapy with acyclovir, depending on symptoms. Prevention: avoiding contact with infected individuals, rescheduling patients with active lesions. Complications: immunodeficiencies see more severe symptoms and more frequent recurrences. Rarely meningoecenphalitis, encephalitis or keratitis. Severe neurological issues with neonates  Varicella Human alphaherpesvirus 3 AKA chicken pox Transmission: direct contact, broken blisters, droplets (airborne) Incubation: 10-20 days Signs & symptoms: rash (initially on face, scalp and back, eventually spreading), pruritus, oral unilateral vesicles followed by ulceration (may lead to devitalisation of teeth or even bone necrosis), mild pyrexia, Macules  papules  vesicles  crusts Treatment: calamine lotion, antipyretic, acyclovir for severe cases. Benzydamine spray/mouthwash for oral lesions Prevention: avoid contact with infected patient. vaccination Complications: bacterial infection of lesions, scarring, conjunctivitis, pneumonia, meningitis, encephalitis, myocarditis or Reye's syndrome Shingles  Infective mononucleosis Human gammaherpesvirus 4 AKA glandular fever, kissing disease, mono, EBV (Epstein Barr virus) Transmission: infected saliva. most common in teenagers Incubation: 4-7 weeks Signs & symptoms: exudative pharyngitis, tonsilitis, lymphadenopathy, pyrexia (high), cephalgia, myalgia, malaise, anorexia, hepatitis, enlarged spleen and liver. There can be a measles like rash, especially if taking amoxicillin. Treatment: symptom relief, antipyretic, fluid intake Prevention: avoiding contact with infected individuals Complications: spleen and liver enlargement, lymphoma, prolonged fatigue and malaise. Infects B lymphocytes -> cytotoxic T cells respond (CD8-positive) -> Epidemic parotitis Mumps orthorubulavirus AKA Mumps Transmission: droplets and secretions Incubation: 15-25 days Signs & symptoms: uni or bilateral parotitis, myalgia, anorexia, malaise, cephalgia, low-grade fever. Treatment: relieving symptoms, more serious if orchitis Prevention: vaccination Complications: orchitis (post-pubertal males), sterility (males), pancreatitis, facial paralysis, deafness, cerebellar ataxia and polyneuritis, Enteroviral vesicular stomatitis with exanthem Enterovirus spp AKA HFMD (hand foot and mouth disease) Transmission: droplets and faeces in a later stage Incubation: 6 days Signs & symptoms: pyrexia, sore throat, malaise, loss of appetite. Followed later by yellow/red oral lesions, oval vesicles hands and feet. Treatment: relieving symptoms, fluids Prevention: avoiding contact with infected individuals, good hand hygiene and surface disinfecting Complications: rare – viral meningitis, encephalitis, flaccid paralysis, fingernail and toenail loss  Measles Morbillivirus hominis Aka Rubeola, English Measles, Red measles Transmission: droplets Incubation: 10-12 days Signs & symptoms: pyrexia, conjunctivitis, lymphadenopathy, anorexia, kolpik’s spots (prodromic) – clustered white lesions molar area. Treatment: symptom relief, antibiotics if associated secondary bacterial infection Prevention: vaccination Complications: Otitis media, pneumonia, croup, convulsions and encephalitis, subacute sclerosing, encephalitis, death  Rubella Rubivirus rubellae (RuV) AKA German measles Transmission: direct contact or droplets Incubation: 10-20 days Signs & symptoms: can be asymptomatic. Rash head to toe, lymphadenopathy, malaise, headache, conjunctivitis, pruritus. Forchheimer’s spots (20% patients. Prodromal) Treatment: symptom management Prevention: vaccination Complications: arthralgia, arthritis, encephalitis, thrombocytopaenic purpura, congenital rubella syndrome in neonates, deafness Similar intraoral signs… Nagayama spots  Respiratory Synsytial Virus – Orthopneumovirus hominis AKA RSV Transmission: droplets, direct contact, fomites Incubation: 2-8 days (3-5) Signs & symptoms: (common cold) nasal congestion, rhinorroea, sternutation, fatigue, mild pyrexia More serious symptoms can include prolongued apnoeas, loss of appetite, wheezing, difficulty breathing, chest wall retractions, conjunctivitis Treatment: hospitalisation, fluids, erythromycin, maintaining airway Prevention: vaccination (pregnancy, elderly) Complications: Pneumonia, Bronchiolitis, respiratory failure, bacterial pneumonia, lung hyperinflation, atelectasis, acute otitis media.  Scarlet fever Streptococcus pyogenes (Group A strep) AKA Scarlatina Transmission: normal flora of oropharynx. Associated with pharyngitis. Droplets Incubation: 12hours to 7 days Signs & symptoms: Pyrexia, Chills, Sore throat, cephalgia, vomiting, abdominal pain, pruritus, tachycardia, white coating on tongue that peels off a couple of days later, desquamated tongue (strawberry tongue), oedematous tonsils with white/yellow exudate and a red, fine, sandpaper rash Treatment: antipyretic, antibiotics (penicillin V) Prevention: long term antibiotics for at risk groups Complications: otitis media, sinusitis, peritonsillar abscess, pneumonia, septicaemia, meningitis, osteomyelitis, septic arthritis, rheumatic fever, acute renal failure Whooping cough – Bordetella pertussis AKA pertussis Transmission: droplets or direct contact Incubation: 7-10 days Signs & symptoms: similar to common cold, pyrexia (high), tachycardia, rapid breathing, malaise, dry cough that may last for more than 1 minute, extreme anxiety, vomiting. Classic paroxysm might be absent in infants Treatment: hospitalisation, fluids, erythromycin, maintaining airway Prevention: vaccination Complications: Pneumonia, Bronchiolitis, Convulsions, Atelectasis, Otitis Media, Weight loss and dehydration, Hernia, Prolapsed rectum. Newborns – encephalopathy and life Dermatophytosis Dermatophytes spp AKA tinea, dermatomycosis, ringworm Transmission: contact with infected soil or animals Types: scalp- Tinea Capitis, body- Tinea Corporis, feet- Tinea pedis (Athletes foot), face – tinea faciei Signs & symptoms: Round ring shaped, silvery and scaly lesion. Edge is raised and red. Ring spreads outwards and may blister and ooze. Scalp infections may cause some bald patches and lymphadenopathy. Treatment: topical corticosteroids, topical antifungal creams (miconazole), iodine shampoo and oral griseofulvin Prevention: check pets frequently, avoid sharing personal hygiene items, handwashing  Meningitis Cause by meningococcus, Neisseria meningitidis, streptococcus pneumoniae, heamophilus influenzae, streptococcus agalactia (group B strep) Transmission: respiratory secretions, droplets. Types: viral, bacterial, viral, fungal, parasitical, other causes Signs & symptoms: neck stiffness, pyrexia, vomiting, cephalgia, possible rash that doesn’t blanche (can initially blanche), photophobia, unresponsiveness or drowsiness, seizures, confusion/altered mental state, infants arching back Treatment: diagnosis usually requires lumbar puncture. Antibiotics, respiratory support, treating blood pressure, wound care/surgery to remove dead skin. Prevention: Vaccinations. Avoiding contact with infected individuals. Prophilactic antibiotics. Complications: limb loss, deafness, nervous system issues, brain damage  Sepsis Respiratory syncytial virus (RSV), Cytomegalovirus, listeria monocytogenes, herpes simplex virus, candida, E coli, …….. Transmission: not contagious. Evolving from ongoing infection More at risk: babies under 1 (especially if premature), over 75s, diabetes, immunocompromised, surgery recovery, recovering from serious illness, people who just delivered a baby Signs & symptoms: blue, pale, blotchy skin (lips, tongue)(soles of feet and palms of hands on darker skin), rash that doesn’t blanche, difficulty breathing, breathlessness, breathing very fast, weak and high pitched cry, abnormal response, no interest in feeding or normal activities, sleepier than normal, difficult to rouse, lack of urination, vomiting, pyrexia Treatment: ICU admission, ventilation, surgery to remove infected areas Prevention: vaccination, clean and address wounds properly, correctly take antibiotics, handwashing. Complications: septic shock, organ failure, gangrene, lung damage, brain damage,... Immunisations offered by NHS BCG Age Diseases protected against From birth Tuberculosis (at risk children)