Lecture 12 Travel Related Infection Flashcards
What is the vector for Malaria
Female anopheles mosquito
What is the 6 steps of the malaria cycle
- Mosquito bites human
- Takes blood and injects sporozoites (premature parasite)
- Sporozoites migrate to liver and infect liver cells
- Cells replicate to make Merozoites
- Merozoites rupture and invade and replicate in other red blood cells
- Mosquito take up red blood cells and take up Gametocytes which unit and form a zygote (7 days)
Name the 5 malaria species
- Plasmodium falciparum (potentially severe)
- Plasmodium vivax
- Plasmodium ovale
- Plasmodium malariae
- Plasmodium knowlesi
What are the symptoms of a malaria infection
- Fever
- Rigors
- Aching bones
- Abdomen pain
- Headache
- Dysuria
- Frequency
- Sore throat
- Cough
What are the signs of a malaria infection
- None
- Splenomegaly
- Hepatomegaly
- Mild jaundice
What are the complications of malaria
Cerebral malaria Blackwater fever Pulmonary oedema Jaundice Severe anaemia Algid malaria- gram negative septicaemia
How is malaria diagnosed
• Thick and thin blood films o Giemsa, Field’s stain • Quantitative buffy coat (QBC) o Centrifugation, UV microscopy • Rapid antigen tests o OptiMal o Parasight-F
How do you assess the severity of malaria
Severity Assessment: Complicated malaria =one or more of- • Impaired consciousness or seizures • Hypoglycaemia • Parasite count >2% • Haemoglobin <8mg/dL • Spontaneous bleeding/DIC • Haemoglobinuria • Renal impairment or PH<7.3 • Pulmonary oedema or ARDS • Shock (algid malaria)
Name 2 malaria drugs
- Quinine
* Artemisinins
What are the treatment options for uncomplicated P.falciparum
- Riamet (3 days)
- Eurartesim( 3 days)
- Malarone (3 days)
- Quinine (7 day)- plus oral doxycycline (or clindamycin)
What are the treatment options of complicated of severe P.falciparum malaria
- IV artesunate IV quinine- plus oral doxycycline (or clindamycin)
- When patient is stable & able to swallow, switch to oral treatments
What are the treatments of P. vivax, P. ovale, P. malariae, P. Knowlesi
- Chloroquine (3 days)
- Riamet (3 days)
- Add primaquine (14 days) in vivax and ovale to eradicate liver hypnozoites
What are the causative organisms of Typhoid (Enteric) Fever
- Salmonella typhi
* Salmonella paratyhphi
What are the clinical features of Typhoid fever during the 1st week
: fever, headache, abdomen discomfort, constipation, dry cough, relative bradycardia, neutrophilia, confusion
What are the clinical features of Typhoid fever during the 2nd week
fever peaks at 7-10 days, rose spots, diarrhoea begins, tachycardia, neutropenia