Infectious Disease Flashcards
- Febrile returning traveller (onset at 3-6mo)
- Fever cycles
- Anaemia
- Jaundice
- +/- Haemoglobinuria
Malaria
- Febrile returning traveller
- mild haemorrhage (bruising, gum bleed, faecal losses)
viral haemorrhagic fever
viral haemorrhagic fever: causal pathogens
- Dengue
- Yellow fever
- Congo-Crimean fever
- No-arboviruses (Lassa, Ebola, Marburg)
- Febrile returning traveller (duration <1wk)
- High fevers and rigors
- Viral haemorrhagic fever (mild bleeding)
- Jaundice
- Haematemesis
- Oliguria
- N&V
Yellow Fever
Malaria: management
Artemisinin combination therapy first-line
Quinine plus doxycycline second-line
IV artesunate in severe diseas
- Febrile returning traveller
- Abdominal pain
- Constipation and/or non-bloody yellow-green diarrhoea
- ‘Rose Spots’ around the umbilicus
- Bradycardia and cough
Typhoid fever
typhoid fever: management
Ciprofloxacin first-line
- traveller’s diarrhoea (risks: swimming, MSM)
- non-bloody diarrhoea with steatorrhoea
- bloating and abdominal pain
- lethargy and weight loss
- secondary lactose intolerance
Giardiasis
Giardiasis: investigation and management
- stool microscopy (trophozoites and cysts)
- metronidazole
- febrile returning traveller
- intermittent fever
- posterior cervical lymphadenopathy
- Chancre at the site of infection
- progresses to CNS involvement (somnolence, HA, mood Sx)
African Sleeping Sickness
(African trypanosomiasis)
African Sleeping Sickness (African trypanosomiasis): management
IV pentamidine or suramin
For CNS disease: IV melarsoprol
- often asymptomatically initially
- chancre at the site of infection
- myocarditis and dilated cardiomyopathy
- GI disease (megaoesophagus, megacolon, sigmoid volvulus)
Chagas Disease
(American Trypanosomiasis)
Chagas Disease (American Trypanosomiasis): management
In acute phase: benznidaole or nifurtimox
In chronic phase: supportive
- febrile returning traveller (risks: farm work, sewage works)
- early fever, flu-like symptoms
- subconjunctival haemorrhage
- progresses to AKI, hepatitis, aseptic meningitis
Leptospirosis (Weil’s Disease)
Leptospirosis (Weil’s Disease): management
benzylpenicillin or doxycycline
if icteric symptoms (CNS): ceftriaxone
viral gastroenteritis: causal pathogens
- rotavirus
- adenovirus
- astrovirus
- calcivirus
- incubation period 2-5 days
- gastroenteritis in a non-traveller (meat, milk, cheese)
- prodrome illness
- bloody diarrhoea
Campylobacter jejuni
Campylobacter jejuni: complications
Guillain Barre Syndrome
- traveller’s gastroenteritis (most common cause)
- watery OR bloody diarrhoea
- can cause HUS (AKI, haemolytic anaemia, thrombocytopenia)
E coli
E coli gastroenteritis: management
supportive
(PLEX for severe HUS)
Campylobacter jejuni: management
clarithromycin
- incubation period 12-48hours
- gastroenteritis (risk: eggs and poultry) +/- sepsis
Salmonella or Shigella
Salmonella or Shigella gastroenteritis: management
ciprofloxacin
- traveller’s diarrhoea (risk: unclean water source)
- watery “rice water stool”
- rapid onset (toxin-mediated)
Vibrio cholerae gastroenteritis
Cholera: management
supportive, hydration
toxin-mediated gastroenteritis
S aureus (undercooked meat and rice)
Clostridrium (undercooked meat and canned foods –> botulism)
Baccilus cereus (rice)
- traveller’s diarrhoea (long incubation period)
- RUQ pain (liver abscess)
Entamoeba histolytica (Amoebiasis)
Entamoeba histolytica (Amoebiasis): investigation and management
hot stool microscopy
metronidazole
- traveller’s diarrhoea (risk: water sources)
- watery diarrhoea
- protozoa on microscopy
cryptosporidium
