Infections in Travellers Flashcards
Why are travellers at greater risk of infection?
- Exposure to non-local infectious agents
- Poor sanitation
- Poor immunisations in the travelled areas
- Risk taking behaviour
- Sub-optimal notification and management programs
What is the gold standard for diagnosing parasitic infections?
Microscopy
What is an important principle for diagnosing parasitic infections?
one negative does not rule it out due to intermittent shedding
What are some symptoms of hook work infection?
-fatigue
-abdominal discomfort
-mild diarrhoea
-anaemia/nutritional deficiencies
(most often asymptomatic)
How do you diagnose hookworms via microscopy?
Iodine stained mount of faeces with egg present
When are symptoms usually seen in hook worm infections?
With increased worm load
How do you contract a hookworm infection?
Through your skin such as feet as they are in the soil
What is the lifecycle of hookworms?
- Eggs are passed out in faeces
- mature in the soil and hatch into larvae
- mature into infective form
- attach and penetrate skin
- lay eggs
How do you treat hookworms?
- Anti-helminths
- Iron supplements for anaemia
A patient that has recently returned from Indonesia has recurrent abdominal discomfort and transient biliary colic. X-ray shows no gall stones…who’s living inside her?
Ascarascaris lumbricoides
How is Ascarascaris lumbricoides diagnosed?
Thick shelled egg on microscopy
Why does the patient get biliary colic in Ascarascaris lumbricoides infection?
Blockage of bile duct by worms
How do you get an Ascarascaris lumbricoides infection?
Ingested eggs via contaminated food
What is the life cycle of Ascarascaris lumbricoides?
- Ingested then after ~ 3 weeks they hatch
- Invade intestinal mucosa
- Enter the portal system and then into systemic
- Crawl out into alveoli and up your trachea and are swallowed
- lay eggs and get all up in yo guts again
How is Ascarascaris lumbricoides treated?
Anti-helminiths eg Melbendazol or Albendazol
A patient presents with fever, splenomeagly mild anaemia and leucocytosis. Their blood films show trophozoites, with multiple rings per RBC. What is your diagnosis?
Plasmodium falciparaum
How is Plasmodium falciparaum contracted?
Bit of a mosquito which injects sporozoites
Another patient presents with fever, splenomeagly mild anaemia and leucocytosis after returning from PNG. Apart from malaria what other infections would you be concerned about?
- Srub typhis
- Japanese encephalitis
- Dengue fever
- T.B
A man complains of colickly abdominal pain and diarrhoea. He has recently begun treatment for CLL. His sample of faeces was iodine stained and a small worm was seen. What is the likely diagnosis?
Strongyloides-as too small to see with the eye, Ascarascaris lumbricoides can cause colic pain but is larger
How does a patient contract Strongyloides?
Penetration via infected soil or autoinfection (latent)
What is a complication of Strongyloides infection?
Septicaemia as bacteria can move into the blood when strongyloides invades
A girl presents with fever, anaemia and a fine, sparse maculopapular rash after returning from Bangladesh. What are some possible pathogens that would cause this presentation?
Malaria
Typhoid fever
What are the features of Salmonella typhi?
Gram -ve rods
How can you further characterise salmonella infections?
O and H antigens
