Paediatrics & Child Health: Infectious Diseases

Presentations

• Fever without a focus
• Lymphadenopathy

Conditions

• Gastrointestinal infections, such as infectious diarrhoea
• Meningitis and encephalitis
• Ophthalmological infections, such as blepharitis, conjunctivitis, trachoma, and orbital or periorbital cellulitis
• Osteomyelitis and septic arthritis
• Perinatal and congenital infections
• Respiratory tract infections, upper and lower, including otitis media, tonsillitis, and pneumonia
• Septicaemia and toxic shock syndromes
• Skin and soft tissue infections
• Urinary tract and genitourinary infections
• Vaccine preventable diseases
• Viral infections, including those with dermatological manifestations

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

Synthesise

• recognise the clinical presentation
• identify relevant epidemiology, pathophysiology, and clinical science
• take a relevant clinical history
• conduct an appropriate examination
• establish a differential diagnosis
• plan and arrange appropriate investigations
• consider the impact of illness and disease on patients¹ and their quality of life

Manage

• provide evidence-based management
  For less common or more complex presentations and conditions the trainee must also seek expert opinions
• 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

Presentations

• Fever in the returning traveller

Conditions

• Dengue fever
• Emerging or less common viral infections, such as parechovirus and enterovirus 71
• Fungal infections
• Hepatitis viruses
• HIV
• Infections with antibiotic-resistant organisms
• Infective endocarditis
• Malaria
• Mycobacterial infections
• Parasitic infections, such as head lice and scabies
• Sexually transmissible infections, such as chlamydia
• Tuberculosis
• Typhoid fever

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

Synthesise

• recognise the clinical presentation
• identify relevant epidemiology, pathophysiology, and clinical science
• take a relevant clinical history
• conduct an appropriate examination
• establish a differential diagnosis
• plan and arrange appropriate investigations
• consider the impact of illness and disease on patients¹ and their quality of life

Manage

• provide evidence-based management
  For less common or more complex presentations and conditions the trainee must also seek expert opinions
• 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

• Antimicrobial resistance and strategies for management and prevention, including antimicrobial stewardship
• Biology of common and important pathogens
• Epidemiology of common and important infectious diseases
• Host response to infection
• Pharmacology of major antimicrobial medication classes used
• Principles of infection control, including hand hygiene
• Principles of passive and active immunisation
• Principles underlying laboratory testing for infectious diseases
• Role of immunisation in preventing infectious diseases

Investigations

• Blood tests:
  
  • bacterial and viral polymerase chain reaction (PCR)
  • bacterial and viral serology
  • bacterial microscopy, culture, and antimicrobial susceptibility
  • blood culture, including anaerobic and mycobacterial culture
  • C-reactive protein (CRP)
  • erythrocyte sedimentation rate (ESR)
  • full blood count (FBC)
  • liver function tests (LFT)
• Imaging
  
  • bone scan
  • chest x-ray
  • CT
  • MRI
  • ultrasound
• Microbiological tests:
  
  • bronchoalveolar lavage (BAL)
  • cerebrospinal fluid (CSF)
  • nasopharyngeal aspirate
  • pus samples
  • stool samples
  • swabs from sterile and non-sterile sites
  • urine

• Application of preventative strategies, such as immunisation and public health management of contacts
• Broader considerations at patient and community levels for management of antibiotic-resistant organisms and vaccine-preventable diseases
• Infections associated with medical devices
• Infections in the immunocompromised patient
• Risks of needle-stick injuries and non-occupational exposure, and the need for post-exposure prophylaxis and follow up
• Immunisation:
  
  • administration of common vaccines, including consent and delivery, and the importance of cold chain management
  • counselling for families regarding benefits and risks of immunisation
• Notifiable diseases, planning for and implementing patient isolation
• Potential complications of infectious disease and its management, particularly as relates to the use of antimicrobial therapy
• Potential routes of infection, infection compared with disease, routes of transmission, and secondary sites of infection
• Role of bone scintigraphy in assessing musculoskeletal infection, metabolic bone diseases, and arthritis
• Role of nuclear medicine in assessment of infection and inflammatory conditions