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CSP1 > Fever in the Returning Traveller > Flashcards

Fever in the Returning Traveller Flashcards

1
Q

Examples of VHF

A

Ebola

Lassa

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2
Q

What spreads Crimean congo haemorrhagic fever

A

ticks

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3
Q

What causes rickettsiae?

A

African tick-bite fever

Scrub typhus

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4
Q

What is enteric fever

A

Typhoid

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5
Q

What type of microorganism is histoplasma?

A

Fungus

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6
Q

What is dengue and chikungunya?

A

Both viruses

Different but carried by the same mosquitoes

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7
Q

What microorganism is rickettsiae?

A

Gram negative bacteria

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8
Q

What microorganism is shistosomiasis?

A

Parasitic worm

Also known as snail fever and bilharzia

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9
Q

Cause of amoebic liver abscess

A

Amebiasis = infection of intestine with parasite entamoeba histolytica

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10
Q

What microorganism is meningococcus?

A

Gram negative bacterium

Can cause meningococcemia = life threatening sepsis

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11
Q

Example of gram positive cocci

A

Staphylococci

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12
Q

Cause of brucellosis

A

Gram negative bacteria - Brucella

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13
Q

Main example of a retrovirus

A

HIV

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14
Q

Main example of arbovirus

A

Yellow Fever

- commonest are dengue and chik

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15
Q

What is trypanosomiasis

A

Protozoan

Spread by African Tsetse fly

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16
Q

What is leishmaniasis

A

Protozoan
Sandfly transmits
Can be visceral, cutaneous or mucocutaneous

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17
Q

What features of malaria indicate a serious infection

A
  • cerebral involvement (seizures, impaired consciousness)
  • respiratory involvement (ARDS, pulmonary oedema)
  • shock
  • bleeding
  • parasitaemia >10%
  • platelets <20
  • anaemia Hb>8
  • hypoglycaemia <2.2mmol/L
  • renal failure = oliguria
  • creatinine >265 mol/L
  • haemoglobinuria
  • acidosis ph<7.3
18
Q

Features of Dengue and presentation

A

3-14 day incubation
can range from primary mild to 2ndry haemorrhagic/shock
transmitted by mosquitoes
symptoms = headache, myalgia, arthralgia, rash
rash goes from erythrodermic than petechial

19
Q

Warning signs in dengue

A

Severe if organs damaged and plasma leakage

- ab pains, persistent vomiting, lethargic, hepatomegaly

20
Q

Treatment of dengue

A

analgesia
no NSAIDs
monitor fluid balance

21
Q

Diagnosis of dengue

A

serum, EDTA blood for kidney function, RDTs, FBCs

22
Q

Features of chikungunya

A

1-12 day incubation

  • fever and arthralgia and develop arthritis
  • East Africa first then South and East Asia, Europe, South America/Caribbean
23
Q

Diagnosis of chikungunya

A

PCR or IgM

24
Q

Treatment of chikungunya

A

Steroids for arthritis

Symptomatic relief

25
Q

Features of enteric fever

A
  • salmonella typhoid/parathyphi
  • 1-3 weeks incubation
  • fever!!!
  • non specific symptoms = headache, constipation, diarrhoea, dry cough
26
Q

Complications of enteric fever

A

GI bleed, intestinal perforation, encephalopathy

27
Q

Treatment for enteric fever

A

Vaccinations only partially effective and not against paratyphoid
IV ceftriaxone while waiting sensitivity results
- oral ciprofloxacin treats sensitive organisms
- azithromycin for non complicated disease
- isolated in hospital and notify PH

28
Q

Features of rickettsia

A
  • game parks in South Africa, tick typhus
  • 5-10 day incubation
  • fever, headache, rash, myalgia
  • lymphadenitis less common
29
Q

treatment of rickettsia

A

Doxycycline if no contraindication

- azithromycin is alternative

30
Q

What is ZIka

A
  • aedes mosquito-borne flavivirus
  • Similar to Dengue/Chik
  • sexual transmission
  • linked to Guillian Barre & microcephaly
31
Q

What may lymphopenia indicate?

A

Dengue, HIV, Typhoid

32
Q

What may low-normal WBC indicate?

A

Malaria, Typhoid, Rickettsia

33
Q

What may neutrophilia indicate?

A

Bacterial, Amoebic

34
Q

What may thrombocytopenia indicate?

A

Malaria, dengue, typhoid, sepsis

35
Q

What may eosinophilia indicate?

A

Schisto
fasciola
FIlaria
Drug Reaction/Allergy

36
Q

What to consider if severe malaria?

A

ICU admission

37
Q

Microorganism for malaria

A

Plasmodium falciparum

38
Q

Malaria Management

A
  • fluid resus
  • lactate elevated
  • pulmonary oedema risk
  • aim for 1-2 ml/kg/hr of crystalloid
39
Q

treatment for severe malaria

A 
- IV artesunate 
OR
- IV quinine
- oral therapy when becomes improved
- check blood film daily
40
Q

indications for IV therapy for malaria

A
  • severe/complicated
  • parasitaemia >2% for presence of schizonts
  • vomiting
  • pregnancy
41
Q

Treatment for uncomplicated malaria

A
  • oral therapy with malarone/riamet/quinine and doxy or clinda
42
Q

Treatment for non-falciparum malaria

A
  • chloroquine followed by primaquine

- check G6PD status

CSP1 (20 decks)

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