Fever in returning traveller Flashcards
Symptoms
Resp: SOB + cough
GI: diarrhoea
CNS: photophobia, headache, meningism and encephalitis
Skin: rash + jaundice
What to ask in history:
Where When What symptoms How - Activities Unprotected sex
Rickettsia symptoms
○ Fever
○ Severe headache
○ Rash
○ Myalgia
Brucella epidemiology and how it’s acquired
North America
Drinking unpasteurised milk
Conditions
Cytomegalovirus Dengue HIV Meningococcus Rickettsia Typhoid fever Enteric fever
Dengue fever location
Dengue - Arbovirus
Location: Africa, Asia and south America
Dengue presentation
Asymptomatic
Non specific febrile illness
Lasts 1- 5 days
Improves 3 - 4 days after rash
Treatment of Dengue
Supportive
Re - infection of dengue
Dengue haemorrhagic fever
Dengue shock syndrome
Salmonella typhi organism
Salmonella - enterobacteriaceae
Aerobic
Gram negative rod
Virulence:
- Low infectious dose
- Survives gastric acid
- Fimbriae - adhere to Peyer’s patches
- resides within macrophages - liver, spleen and bone marrow
Organism that causes typhoid fever
Salmonella typhi
Typhoid fever presentation
Mild diarrhoea
Myalgia
Headache
Severe disseminated disease - multi-organ involvement
Can cause intra-intestinal bleeding and perforation
Mode of spread of typhoid fever
Faecal–oral route via contaminated food and water
Incubation of typhoid fever
1–3 weeks
Paratyphoid fever
Caused by salmonella paratyphi - clinically similar to typhoid fever but y less severe
No vaccine available to prevent paratyphoid infection
Tetanus
Clostridium tetani release tetanus toxin
Transport: Tetanus spores are present in soil or manure an dcan spread to human via wounds
Symptoms of tetanus
Muscle stiffness - usually involves the jaw (lockjaw) and neck - then becomes generalized
Complications :
- respiratory failure
- convulsions
- bone fractures
- cardiac problems
Yellow fever virus and spread
Flavivirus
Spread: spread by the bite of infected mosquitoes
Yellow fever symptoms
Fever
Mmalaise
Photophobia
Headache
Severe:
- Sudden onset fever
- vomiting
- prostration
- may progress to jaundice and haemorrhage
Treatment of yellow fever
no treatment
Enteric fever presentation
Fever Headache Abdominal discomfort Dry Cough Relative bradycardia
Intubation period of enteric fever
7 - 14 days
Complications of enteric fever
Intestinal haemorrhage + perforation
Investigations of enteric fever
Basic obs Bloods - FBC: - moderate anaemia - lymphopenia - CRP - LFTS - U+Es
Blood and stool culture
Amoebiasis
Caused by: Entamoeba Histolytica
Spread: feaco - oral
Presentations of Amoebiasis
Asymptomatic - 90%
Abdominal pain
Blood diarrhoea
Complications of Amoebiasis
Ulceration
Bowel perforation
Peritonitis
Liver or lung abscess
How to diagnose Amoebiasis
Stool x 3 microscopy - cysts
Serology
Treatment of Amoebiasis
Tissue invasion: Metronidazole tds - 10 days
Gut: Paromomycin
