Curriculum standards

Knowledge guides

LG13: Key infectious diseases and syndromes

Key presentations and conditions

Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.

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Epidemiology, pathophysiology, and clinical sciences

Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.

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Investigations, procedures, and clinical assessment tools

Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.

Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.

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Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.

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Presentations

Febrile illness:
- acute
- associated with:
  - arthritis
  - rash
- periodic
- without focus (unknown origin)
In immunosuppressed hosts, with:
- blunted or atypical clinical features
- fever
- risk of infection reactivation
- spectrum of pathogens they are susceptible to
- timing of diseases onset
Paradoxical reactions in the setting of immune reconstitution
Returned traveller:
- fever
- timing of exposure
Sepsis / Septic shock

Bloodstream infections

Including those caused by:
- enterococci
- gram-negative bacteria
- Staphylococcus aureus
- streptococci
- yeasts

Cardiovascular conditions

Device-related, such as:
- implantable devices
Endarteritis
Infective endocarditis
Myocarditis
Pericarditis
Rheumatic fever
Vascular foreign body infections, such as:
- vascular graft infection
Vasculitis

Central nervous system conditions

Abscess:
- cerebral
- epidural
Encephalitis:
- acute
- chronic
Guillain–Barre syndrome
Infections associated with prosthetic materials, such as:
- ventriculoperitoneal shunts
Meningitis, such as:
- aseptic
- bacterial
- fungal
- healthcare-associated / post-operative
- parasitic
- post-traumatic
- tuberculous
Myopathy with infectious causes

Emerging and remerging pathogens, such as flavivirus

Exposure to biowarfare agents, such as anthrax

Gastrointestinal, hepatobiliary, and intra-abdominal conditions

Abscess:
- intra-abdominal
- liver:
  - amoebiasis
  - pyogenic
Cholangitis
Colitis / Enteritis, infectious
Helicobacter pylori
Hepatitis, viral
Peritonitis:
- appendicitis
- catheter-related
- spontaneous

Head and neck conditions

Cellulitis:
- orbital
- post-septal
Ear:
- mastoiditis
- otitis externa, including:
  - malignant
- otitis media
Eye and orbit:
- conjunctivitis
- endophthalmitis
- keratitis
- peri-orbital infections
- retinitis
- uveitis
Mouth:
- infections, such as:
  - odontogenic
- osteomyelitis
Vincent’s angina

Infections involving multiple systems

Diphtheria
Human immunodeficiency virus (HIV)
Malaria
Polio
Rheumatic fever
Tetanus
Typhoid

Musculoskeletal conditions

Arthritis:
- reactive
- septic
- viral
Bursitis, septic
Infections in bones and joints related to prostheses
Osteomyelitis:
- acute
- chronic

Non-infectious diseases and syndromes that commonly mimic infection

Connective tissue diseases, such as:
- adult-onset Stills disease (AOSD)
- rheumatoid arthritis
- systemic lupus erythematosus
Haemophagocytic lymphohistiocytosis (HLH)
Haematological malignancies, such as:
- leukaemia
- lymphoma
Kikuchi disease
Pyoderma gangrenosum
Macrophage activating syndrome
Scurvy
Vasculitis

Pharynx and peripharyngeal space conditions

Abscess:
- peritonsillar
- retropharyngeal
Cervical lymphadenitis, such as:
- granulomatous
- lymphotropic virus
- toxoplasmosis
Lemierre syndrome
Ludwig angina
Mycobacterial
Pharyngitis
Thyroiditis:
- subacute
- suppurative
Tonsillitis, suppurative

Respiratory conditions

Lower respiratory, such as:
- abscess, lung
- bronchiectasis
- bronchiolitis
- bronchitis
- empyema
- pneumonia
Upper respiratory, such as:
- epiglottitis
- laryngitis
- laryngotracheobronchitis
- sinusitis

Severe communicable diseases, such as haemorrhagic fevers

Skin and soft tissue conditions

Abscess
Bites, such as:
- animal
- clenched fist
- human
Carbuncle
Cellulitis
Cutaneous involvement in infections:
- bacterial
- mycobacterial
- mycotic
- viral
Folliculitis
Furuncle
Gangrene:
- clostridial myonecrosis
- Fournier
Impetigo
Infections:
- subcutaneous tissue
- wound
Necrotising fasciitis
Scabies
Skin implantation injuries, such as:
- soil
- vegetation
- water

Urinary conditions

Abscess:
- kidney
Asymptomatic bacteriuria
Cystitis
Epididymitis
Infection associated with urinary tract prosthesis
Orchitis
Prostatitis
Pyelonephritis
Urethritis

Zoonotic infections, such as:

Bartonella
Brucellosis
Leptospirosis
Q fever
Toxoplasmosis

AIM

Genital conditions

Postoperative gynaecological infections, such as:
- infections post-termination of pregnancy
Proctitis
Urethritis (male)

Genital, pelvic, and sexually transmitted infections

Chlamydia
Genital:
- ulcers
- warts
Gonorrhoea
Infestations, such as:
- pubic lice
Lesions, genital
Mycoplasma genitalium
Pelvic infections, such as:
- chorioamnionitis
- endometritis
- pelvic inflammatory disease
- post-caesarean infection
- postpartum fever
- vaginal discharge
- vaginitis
- vaginosis
Syphilis
Vulvitis

Skin and soft tissue

Diabetic foot infection

PCH

Bronchiolitis
Infections:
- congenital
- perinatal
Kawasaki disease
Necrotising enterocolitis
Omphalitis
Sepsis, neonatal

Genital, pelvic, and sexually transmitted infections

Some knowledge of sexually transmitted and genital infections is expected in paediatric infectious diseases, but exposure is likely to be limited during training

Non-infectious diseases and syndromes that commonly mimic infection

Kawasaki disease
Paediatric inflammatory multisystem syndrome (PIMS-TS)

For each presentation and condition, Advanced Trainees will know how to:

Synthesise

recognise the clinical presentation
identify relevant epidemiology, prevalence, pathophysiology, and clinical science
take a comprehensive clinical history
conduct an appropriate examination
establish a differential diagnosis
plan and arrange appropriate investigations
consider the impact of illness and disease on patients and their quality of life when developing a management plan

Manage

provide evidence-based management
prescribe therapies tailored to patients’ needs and conditions
recognise potential complications of disease and its management, and initiate preventative strategies
involve multidisciplinary teams

Consider other factors

identify individual and social factors and the impact of these on diagnosis and management

Epidemiology of infectious diseases
Expected course of infectious diseases
Microbiology, including normal flora associated with organ systems
Pathogen endemicity
Pathophysiology / Pathogenesis of infectious diseases
Predisposing factors to infection
Unique aspects of infection presentations in special risk groups

Clinical sciences of infectious diseases

Bacteria:
- cell wall deficient
- gram:
  - negative
  - positive
- spirochaetes
Fungi:
- dimorphic
- moulds
- yeasts
Mycobacteria:
- non-tuberculous
- tuberculous
Parasites:
- ectoparasites
- helminths:
  - cestodes (tape worms)
  - nematodes (round worms)
  - trematodes (flukes)
- protozoa
Prions
Viruses:
- DNA
- ribonucleic acid (RNA)

PCH

Epidemiology across neonatal- and paediatric-aged spectrum to the conditions above

Diagnostic tests:
- biopsy
- medical imaging
- specimen tests
Examination and clinical assessment

Management of infectious diseases, such as:
- differences in management of paediatric and adult patients, such as bone and joint infection
- prevention and screening
- reporting procedures
- suppressive therapy