Infections Flashcards
Most common causes of travellers diarrhoea
Enterotoxic E. coli
Enteroinvasive E. coli
Enteroaggregate E. coli
Shigella
Salmonella
Campylobacter
Norovirus
Protozoa
Malaria features
Plasmodium falciparum causes most severe type
Spread by Anopheles mosquitos
Suspect in fever in returned traveller
Fever, malaise, HA, anorexia, vomiting, myalgia
May need recurrent blood draws for thick and thin films every 6-12 hours for 48 hours to rule it out completely
Can present a month or so after exposure
Should be hospitalised
Dengue features
Short incubation period 4-10 days
Spread by Aedes aegypti mosquitos
Fever + influenza like illness OR hemorrhagic complications eg epistaxis, prolonged periods
Diagnosis is clinical + some blood tests avail eg serology or PCR
Supportive treatment only
Typhoid fever features
Incubation period 3-60 days
Vaccination 70% successful only
Requires culture to diagnose, serology unhelpful
Fever + GI sx
Rickettsial disease
(usually from tick bites)
Fever + HA + myalgia
Rash may be present
Eschar may be present
Include Rocky Mountain Spotted fever, scrub typhus
Treat with doxycycline
Chikungunya/Zika features
Fever + arthralgia +/- myalgia + rash
Arthritis is bilateral and involves small joints in hands and feet
Meningitis immediate ABx pre-hospital
Neonate <3 months old benpen 50mg/kg
3m to 10yo ceftriaxone 100mg/kg (max 2g)
Adolescent/adult ceftriaxone 2g
Complicating factors of UTIs
Male
Catheterisation
Recent instrumentation
Pregnant
Immunosuppressed
Not improved on ABx in community
>3 in a year
?stone
Abnormal renal tract
Suspected pyelonephritis
Prev resistant organism
Common pathogens for encephalitis
Herpes simplex
Varicella
Measles
EBV
Toxoplasmosis
Enteroviruses
Adenoviruses
Autoimmune
Paraneoplastic
Acute demyelinating
Take a travel history
Where?
When? When returned?
How long?
Rural or urban?
Purpose of visit?
Hotel or family?
Exposures? - animals, activities eg swimming in lakes/SCUBA, mountaineering, caving, sexual, food, ticks/insects
Vaccinations?
Malaria prophylaxis? What? When? As directed? Still?
Travelling companions also unwell?
Ill while away?
PMH/meds etc
Meningitis organisms by age
Neonate: GBS, Listeria, E. coli, other gram negatives. HSV, Strep, HIB, Neisseria
Older: Neisseria, HIB, strep
Encephalitis causes
Infectious:
HSV (#1)
VZV, adenoviruses, measles, toxoplasmosis, EBV, post-travel mosquito/tick-borne
Non-infectious:
Immunologic eg acute demyelinating encephalitis, auto-immune, paraneoplastics
