infectious

Question 1

Leptospirosis

Answer 1

Farms / Animal urines (rat, cattle, pigs)

C/F :
Headache
fever
light-sensitive conjunctivitis

Ix:
PCR or serology

Treatment
doxycycline 100mg BD PO for 7 days

Question 2

Q fever (Coxiella Burnetii)

Answer 2

farm/animal

C/F
Fever
Atpical pneumonia - dry cough
rash
abdominal pain

Treatment:
Doxycycline 100mg BD for 14 days

Tx in pregnancy

• Bactrim (Trimethoprim + sulfamethaxazole) 160+800 BD
• Folic acid 5mg daily

Question 3

Listeriosis

Answer 3

seafood, unwashed vegetables, unpasteurised milk

c/F

• meningitis
• flu-like symptoms
• N/V/D
• pneumonia

Ix:
stool microscopy and isolation
serology

Treatment:
Amoxycillin 1g PO , TDS

Question 4

Pertussis- Clinical features

Answer 4

whooping cough

post-cough vomiting

Question 5

Pertussis- investigation

Answer 5

< 4 weeks: NPS for pertussis PCR and culture

> 4 weeks: Pertussis serology

Question 6

Pertussis- treatment

Answer 6

Azitrhomycin 500mg D1 then 250mg daily for 4 days (total of 5 days)

Question 7

Pertussis-prophylaxis

Answer 7

anyone defined as contact (in contact within <1 meter and for > 1 hour)- consider prophylactic treatment especially the following

1. neonate < 6 months
2. children < 2 years with no immunisation (no UTD immunisation)
3. pregnant lady in the last month of pregnancy
4. anyone who is in contact with the above 3 scenarios such as household member and childcare teachers.

Prophylaxis
Azithromycin 500mg D1 then 250mg Daily for 4 days