fever in returned traveller Flashcards
approach to fever in returned traveller (5)
- pre-travel prep
- itinerary
- epi and exposure Hx
- history and physical
- lab tests
3 aspects of travel preps to ask about
- immunizations
- malaria prophylaxis
- other meds
1 immunization that’s not great
typhoid
what is important about incubation period
short = dengue long = malaria
***if over 7 days, what can be ruled out
dengue
what to pay attention to on physical
derm rashes
*** 4 common infections seen
- malaria
- dengue
- typhoid
- ricketssiosis
where are malaria and rickessiosis seen
africa
where is typhoid seen
india
*** WHAT IS FEVER FROM TROPICS UNTIL OTHER WISE
malaria
2 most common malarias and which is dangerous
- falciparum - anger
2. vivax
which is most likely to present ealier
falciparum
why assume malaria
kills fast - can’t distiguish clinically
2 tests for malaria
- bloods
2. dip stick
2 blood tests and adv/dis
thick - sensitive
thin - species ID
adv of dip stick
fast and easy, sensitive
4 things we need to know for malaria
- species
- load
- chloroquine resisiance
- severe?
treatment of simple and severe malaria
simple - chloroquine and malorine
severe artesunate
*** key to dengue
short incubation
Sx of dengue
- cap leakage
- fever - often self limited
- rash
*** cause of typhoid
Gr - Baccillus
- fecal oral
features of typhoid
- often only prolonged fever
- Gr- baccilli
***feature of rickettsiosis
- fever - self-limiting
- tache noir -cigarette burn
what to remember about flu
year round in the tropics
3 tests for undifferentiated fever
- think and thin bloods
- blood cultures
- CXR
