1: Tropical diseases of the GI tract Flashcards
Patients who present with GI tract infections tend to have travelled ___ recently.
abroad
What will be seen on examination of a patient with an GI infection?
Fever - most common
Rash - particularly in HIV
Hepato/splenomegaly
Lymphadenopathy
Insect bites
Wounds
What “mundane” infection may cause fever in returning travellers?
Pneumonia / Influenza
What is the vector for malaria?
What family of organisms cause malaria?
Mosquitoes
Plasmodium spp.
Which organism causes enteric / typhoid fever?
Salmonella typhi
Which viruses cause dengue fever and chikungunya?
Arboviruses
Travellers with infectious GI diseases should be ___ until the cause is known.
isolated
What is acute traveller’s diarrhoea?
3 loose stools in 24h
Which organism typically causes acute traveller’s diarrhoea?
Enterotoxic E. coli
Other than E. coli, which organisms cause acute traveller’s diarrhoea?
Campylobacter
Salmonella
Shigella
Norovirus
Rotavirus
What is the main symptom of acute traveller’s diarrhoea?
Diarrhoea
:)
Which disease causes profuse watery diarrhoea?
Cholera - outbreaks, refugee camps
Which organism tends to cause dysentery?
Enterohaemorrhagic E. coli 0157
Shigella
How is acute traveller’s diarrhoea investigated?
Stool culture
How is acute traveller’s diarrhoea treated?
Fluid replacement (oral/IV)
Bloody diarrhoea/high fever would very rarely indicate the use of ___ to treat the underlying cause.
antibiotics
What are the two types of enteric fever?
Typhoid fever / paratyphoid fever
Which family of organisms cause enteric fever?
Salmonella spp.
Who tends to get enteric fever?
People visiting India / SE Asia
What is the incubation period of Salmonella in enteric fever?
1-3 weeks
What are some symptoms of enteric fever?
Fever
Headache
Constipation/diarrhoea
Dry cough
Which antibiotic would be tentatively used if an enteric fever patient was extremely ill?
IV Ceftriaxone
Which specific organisms cause typhoid and paratyphoid fever (enteric fever)?
Salmonella typhi
Salmonella paratyphi
Vaccination against enteric fever offers (complete / incomplete) protection.
incomplete
Which infectious disease causes haemolytic jaundice?
Malaria
Which disease occurs as a complication of diarrhoea related to E. colo 0157, Shigella infection?
HUS
What is a common post-hepatic cause of jaundice?
Gallstones
Helminth infection
What organism commonly causes amoebic dysentery?
Entamoeba histolytica
What are the symptoms of amoebic dysentery?
Abdominal pain
Fever
Bloody diarrhoea
leading to complications - colitis, perforation, peritonitis
What investigation is done to diagnose amoebic dysentery?
Stool microscopy
What is a longer-term presentation of E. histolytica infection?
Amoebic liver abscess
Which drug is used to treat ameobic infection of the GI tract?
Metronidazole
What should be done to an ameobic liver abscess before using a drug like metronidazole?
Drain abscess
What are helminths?
Wormy parasites
Which immune cell count is raised in helminth infection?
Eosinophils (eosinophilia)
remember that eosinophils fight parasites
How is helminth infection diagnosed?
Worm passed in faeces
or
Eggs found in stool
