Bacterial - Typhoid, Cholera, Leptospirosis

Question 1

Typhoid
-causative organism
-presentation
-investigations
-management

Answer 1

Typhoid - salmonella typhi
Paratyphoid - salmonella paratyphi
Fecal-oral transmission - ASIA

Systemic upset - headache, fever, joint pain
-bradycardia
-abdo pain, CONSTIPATION (but could be diarrhoea)
-ROSE SPOTS
-splenomegaly

Can lead to
-osteomyelitis
-GI bleeds/perforation
-meningitis
-cholecystitis

Cefotaxime
-alt azithromycin

Question 2

Cholera
-causative organism
-presentation
-investigations
-management

Answer 2

Vibrio cholerae
-fecal-oral route
Areas with poor sanitation and overcrowding

Profuse rice water diarrhoea => dehydration, hypoglycemia

Stool culture

ORT
Doxy/cipro

Question 3

Leptospirosis
-causative organism
-presentation
-investigations
-management

Answer 3

Leptospira interrogans
-tropics
-sewage workers, farmers, vets, abattoirs

Early - subclinical/mild - LEGS + EYES + Pyrexia
-fever + fluey + subconjunctival hemorrhage

2nd immune phase - Weil’s disease
-AKI + hepatitis (jaundice, hepatomegaly) + aseptic meningitis
-HEPATORENAL FAILURE

Serology - AB at D7
Blood and CSF culture - positive for 1st 10 days
Urine culture - positive during 2nd week

Mild/moderate - doxy/azithromycin
Severe - IV benpen