Fever in Returned Traveller Flashcards

1
Q

Main diagnosis of people coming back with fever?

A

Malaria
It represents about 70% of tropical infections

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2
Q

Main cause of fever if travelled to SS Africa
To Latin America?
To Asia?

A

Malaria
Leptospirosis for Latin America
Dengue for SE Asia

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3
Q

Pattern of fever helpful?

A

Continuous fever: malaria, Enteric fever, P knowelsi
Biphasic (saddleback)- Dengue, YF and Leptospirosis

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4
Q

What are the rule in signs?

A

Eschar: Rickettsiosis
Chancre: Syphillis, trypanosomiasis
Rose spot: Enteric fever
Symmetrical arthritis: Chicunguyna
Conjunctival suffusion: Leptospirosis
Rash and conjunctivitis: Zika
Rash (White island, dead sea): Dengue
Anosmia: COVID-19

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5
Q

Who are special groups of travellers?

A

Paeds (increased risk of diarrhoea and animal bites)
Elderly
Immunocompromised
Pregnant woman
Expats
VFR (often do not attend pre-travel consultation, local posture more important, more at risk of vaccine preventable infections)

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6
Q

When is initial screening in a person with fever as a returned traveller?

A

If any signs of severity including haemorrhagic conditions
qSOFA score >2
Transmissable infection?
Rpaidly progressive?
Severe malaria?

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7
Q

What should be included in your initial work up?

A

Blood cultures
Malaria tests
STI checks
Keep an acute serum
PCR resp viruses
Stool culture if you suspect Enteric fever

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8
Q

Empirical treatment for
-Bacterial sepsis
-P Falciparum
-Meloidosis
-Rickettsiosis

A

-Broad spec abx
-Artesunate
-carbapenem or ceftazidime
-doxycycline

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9
Q

Malaria back from endemic Country with undifferentiated fever

A

P Falciparum

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10
Q

Trip to India/Nepal/Pakistan/Bangladesh with high fever, Brady, abdo pain

A

Enteric fever

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11
Q

Fresh water exposure in Lake Malawi with fever, eosinophil and hepatomegaly

A

Schistosomiasis

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12
Q

Mosquito bite in urban area in tropical country with fever, headache, myalgia, retro orbital pai, Rash and thrombocytopenia

A

Dengue

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13
Q

Rafting in Thailand presents with fever, myalgia and Conjunctival icterus

A

Leptospirosis

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14
Q

European holiday trekking in woods presents with fever and confusion

A

Tick born encephalitis

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15
Q

Trip to South Africa, on safari

A

Rickettsiosis (tick borne)

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