ID-Travel Medicine Flashcards
How long can malaria incubate for?
12-35 days
Describe the pathology of malaria, what are the symptoms?
Parasitemia of 5-10% causes clotting and infarcts in small blood vessels, capillary leakage and organ dysfunction.
Complications include altered mental status, seizures, liver failure, DIC, intravascular hemolysis, kidney insufficiency, hemoglobinuria, and hypoglycemia
Develop anemia and splenomegaly, elevated LFTs, and thrombocytopenia
Malaria prophylaxis for chloroquine resistant P. falciparum?
atovaquone/proguanil (not for pregnancy)
mefloquin
doxycycline (not for pregnancy)
Malaria prophylaxis for chloroquine sensitive P. falciparum?
chloroquine
hydroxychloroquine
Malaria prophylaxis for areas endemic with P. vivax?
Primaquine (unless have G6PD)
chloroquine
hydroxychloroquine
prophylaxis for vivax or ovale
primaquine
What areas have… vivax? oval? falciparum? malariae? knowlesi?
vivax: topical and temperate areas
ovale: West Africa and southeast asia
malariae: tropical zones
falciparum: tropical and temperate zones
knowlesi: south and Southeast Asia
What causes typhoid fever?
Salmonella enterica
Incubation period and clinical symptoms of typhoid fever?
8-14 days. Fever, headache, arthralgia, pharyngitis, anorexia, abdominal pain and tenderness
Very high fevers to 104 can last for weeks
rose spots or blanching rash on body
hepatosplenomegaly, leukopenia, anemia, thrombocytopenia, abnormal liver chemistries
how diagnose typhoid fever
blood cultures, stool cultures, urine, or bone marrow
Treatment of typhoid fever
ceftriaxone, azithromycin, levo, cipro, moxi
Do you give antibiotic prophylaxis for traveler’s diarrhea?
NO! it is effective but it is not given due to the potential for adverse effects. do consider ppx in people with inflammatory bowel disease, immunocompromised, or significant comorbidities
What does prophylaxis include?
Bismuth 4x a day
cipro
What can you use for treatment of travelers diarrhea?
Fluid is the mainstay and generally resolves in 3-5 days on it’s own without antibiotics, but you can give…
Bismuth
Cipro for 3 days
Dengue fever, how is it transmitteD?
dengue virus, mosquitos!
What are the clinical features of dengue fever?
incubation period of 4-7 days
febrile illness with frontal headache, retro-orbital pain, myalgia, arthralgia, and sometimes spontaneous bleeding (purpura, melena, conjunctival injection), you also get a rash with dermatographism.
Pathognomic is the lumbosacral pain! It’s called the breakbone pain… Dengue has the saddle fever!
How do you vaccinate for hepatitis A?
give 1 month before travel, followed by a booster 6 to 12 months later
If someone doesn’t have time, can you provide an accelerated vaccination schedule for Hep B?
Yes, bc otherwise it takes 6 months
How does brucellosis occur?
unpasteurized dairy products or undercooked meat
Clinical presentation of brucellosis?
Myalgias, athralgias, fatigue, headache, night sweats, depression is frequent
HSM and LAD on physical examination
can also get bone infection around the joints
Disease relapse can occur if undertreated or a small focal area of infection
How do you diagnose brucellosis?
blood, bone marrow, body fluids, other tissue
Diagnostic is: 1:160, or a four fold increase from acute to convalescent titers
How is brucellosis treated?
doxycycline, rifampin, streptomycin (or gentamicin!)
How is yellow fever transmitted?
Aedes mosquito
Clinical features of yellow fever and where is it common?
South America and sub Saharan Africa
fever, headache, myalgias, backache, can get jaundice hemorrhage and shock
What are the travel recommendations for rabies?
Pre-exposure vaccine. Then if bitten they should get a post exposure vaccine
If previously unvaccinated then they should get the rabies toxin
Leptospirosis–caused by?
urine and feces from rodents
Clinical features of leptospirosis
fevers, headaches, myalgias (especially in the calf muscles and lower back), conjunctival injection, lower back pain, diarrhea, pharyngitis, pretibial rash
Q fever–where get it? clinical features?
inhalation of aerosols from the infected placenta of cattle, goats, and sheep
self limited febrile illness but can get an atypical pneumonia
Middle East and Africa
