Body Systems, rashes and anything else Flashcards
What are the signs of Trachoma?
Trachomatous inflammation with follicles (TF)
Intense trachomatous inflammation (TI)
Trachomatous conjunctival scarring (TS)
Trachomatous trichiasis (TT) and
Corneal opacity because of trachoma (CO).
What causes Trachoma?
Chlamydia trachomatis,
What is the WHO SAFE strategy for elimination of Trachoma?
S Surgery for advanced cases.
A Antibiotic treatment. (azithromycin)
F Facial cleanliness to reduce transmission.
E Environmental improvement.
** WHO recommends 3 years of annual azithromycin as part of a trachoma control programme in communities where active trachoma is present in > 10% of children
3 causes of a purpuric rash
- Bacteria
– Neisseria meningitidis
– Staphylococcus aureus
– Pseudomonas aeruginosa - Other septicaemias
- Infective endocarditis
- Rickettsiae
- Dengue
- Enterovirus, parvovirus etc
- Drugs
- Vasculitis
- Henoch Schonlein purpura
What is Pellagra?
Vit B3 deficinecy –> diarrhoea, dementia, dermatitis
Rx with Niacine
What bacteria causes Buruli Ulcer?
Mycobacterium Ulcerans
Is buruli ulcer painful or painless?
painless –> likely due to local immunosuppression at ulcer site
How do people get Buruli ulcers?
Penetrating injury (may be minor) that causes inocculation of Mycobacterium ulcerans OR following infection of bugs
Person to person transmission is pretty unlikely
How does Buruli ulcer present?
Non ulceration –> ulceration
Can start as a papule, nodule, plaque or oedema
Usually a PAINLESS ulcer (causes delays in seeking healthcare )
Deeply undermined skin at the edge of the ulcer
Satellite lesions around the area
**adenitis and systemic symptoms are unusual unless other co-infection
What are complications of Buruli ulcer?
Tetanus
Osteomyeltis
Contractures
Nerve damage
How do you diagnose Buruli ulcer?
Micrscopy –> ZN stain might show AFB
PCR
Culture NOT worthwhile
How do you manage Buruli Ulcer?
Rifampicin + Streptomycin for at least 8/52
±surgical management
What are three causes of acute flaccid paralysis?
ACUTE HORN CELL DAMAGE
- Polio
- Enterovirus
- Japanese Encephalitis
IMMUNE MEDIATED
- Guillain Barre
- Chinese Paralytic Syndrome (Acute motor axonal neuropathy)
OTHER
- Tick paralysis (removal of tick eliminates symptoms)
- Botox consumption
- toxin exposure
- diptheria neuropathy
- rabies exposure
What is Polio?
Enterovirus which can cause CNS invasion leading to acute flaccid paralysis from destruction of anterior horn cell
Compara Polio presentation to GBS
Polio:
Paralysis is during or almost immediately after febrile illness
Symmetrical paralysis
2-3 days to reach max. weakness
No sensory involvement
CSF has raised lymphocytes
Limb pain
GBS:
Paralysis several weeks after illness
Symmetrical paralysis
Long duration to develop weakness (7-14 days)
Often sensory invovlemetn
CSF has high PROTEIN
Back pain
An outbreak of meningitis/septicaemia has occurred in the neonatal unit of a district hospital.
What is the possible diagnosis?
Escherichia coli; (common in neonatal units)
Gram –ve bacilli
(big and chunky rods) tends to have bipolar staining where ends stain better than middle.
An isolated case of neonatal sepsis in a patient from a
nomadic community
What is the likely diagnosis?
Listeria monocytogenes; (one of top 3 causes of neonatal
infection)
Gram +ve bacilli (small rods) a contaminant of soft cheeses, meat etc and an important zoonosis in herd animals.
What are the organisms that stain as Gram +ve Bacilli?
ABCD - L
Actinomyocytes
Bacillus Anthracus
Clostridium
Diptheria
Listeria
A case of bacterial meningitis in an HIV infected adult
What is the probable diagnosis?
Streptococcus (pneumococcus) pneumoniae;
Gram +ve diplococci (paired organisms) these patients are
more susceptible to invasive pneumococcus.
An isolated case of meningitis in a 4 year old child in West
Africa.
Could it have been prevented by immunisation?
Yes
Haemophilus influenzae; Gram –ve coccobacilli, a small and
delicate organism, some may appear as rods others as cocci.
A case of meningitis from an epidemic in Western Sudan
What is the probable diagnosis?
Neisseria meningiditis; (meningococcal meningitis) Gram -ve
diplococci (2 kidney-like organisms joined at centre)
What further bacteriological information would you want to
investigate the epidemic?
Need to know the serotype by growing the cells in central
reference lab
A 27yr old man with a 3 week history of headache and fever.
CSF examination shows lymphocytic meningitis.
What is the probable diagnosis?
Cryptococcal Meningitis