Infectious diseases Flashcards
1
Q
What is dengue fever and what is it’s origin/ etiology?
A
Dengue fever is a viral infection that can progress to v_iral haemorrhagic fever_ (other examples include yellow fever, Lassa fever, Ebola).
- dengue virus is a RNA virus of the genus Flavivirus
- transmitted by the Aedes aegypti mosquito
- incubation period of 7 days
2
Q
What are symptoms of Dengue fever
A
- fever
- headache (often retro-orbital)
- myalgia, bone pain and arthralgia (‘break-bone fever’)
- pleuritic pain
- facial flushing (dengue)
- maculopapular rash
- haemorrhagic manifestations e.g. positive tourniquet test, petechiae, purpura/ecchymosis, epistaxis
- ‘warning signs’ include:
- abdominal pain
- hepatomegaly
- persistent vomiting
- clinical fluid accumulation (ascites, pleural effusion)
3
Q
What is Sever dengue/ Dengue Hemorrhagic fever?
A
- this is a form of disseminated intravascular coagulation (DIC) resulting in:
- thrombocytopenia
- spontaneous bleeding
- around 20-30% of these patients go on to develop dengue shock syndrome (DS
4
Q
What investigations in suspected Dengue fever?
A
- typically blood results
- leukopenia, thrombocytopenia, raised aminotransferases
- diagnostic tests
- serology
- nucleic acid amplification tests for viral RNA
- NS1 antigen test
5
Q
What is the treatment for gonorrhoea?
A
- ciprofloxacin used to be the treatment of choice. However, there is increased resistance to ciprofloxacin (around 36% in the UK) and therefore cephalosporins are now more widely used
- there was a change in the 2019 British Society for Sexual Health and HIV (BASHH) guidelines → first-line treatment is a single dose of IM ceftriaxone 1g (i.e. no longer add azithromycin). If sensitivities are known (and the organism is sensitive to ciprofloxacin) then a single dose of oral ciprofloxacin 500mg should be given
- if ceftriaxone is refused (e.g. needle-phobic) then oral cefixime 400mg (single dose) + oral azithromycin 2g (single dose) should be used
