Lecture 41 - Returned Traveller Flashcards
Exposure to new infections?
air, food and water (salmonella, HepA, campylobacter), vectors (malaria), people (HIV)
History Q’s?
where have you been and what did you do (risk factors), how long were you there ad when did you get sick (incubation period)
Malaria types?
plasmodium falciparum (potentially fatal) and plasmodium vivax (benign) (from anopheles mosquitos)
Malaria process?
infected female anopheles feeds on blood and injects saliva containing sporozoites, these invade liver cells and replicate to form merozoites, released from liver and infect RBC, replicate and rupture RBC causing fever, form male and female gameotcytes that combine in a new mosquito to form sporozoites
Malaria diagnosis?
residence in malarious area, fevers rigors malaise headache and coma, blood film and blood antigen test +
P. falciparum>
infects any RBC, high parasite load, infected protein causes RBC to adhere to capillary, sequestration leading to death from com and renal failure
P. Vivax?
only infects young RBC, low parasite load, doesn’t cause sequestration, no risk of severe disease but relapse due to repeated release of liver hypnozoites
P.falciparum - treatment?
quinine and doxcycline (kill merozoites in RBC)
P. vivax - treatment?
chloroquine (to kill merozoites in RBC) and primaquine (kill hypnozoites in liver)
Prevention?
avoid areas, mosquito control, clothing, doxycycline
Typhoid fever?
salmonella typhi: from people, infects Peyer’s patches of terminal ilequm, -> bacteraemia, septicaemia -> fever, confusion (sometimes diarrhorea) -> risk of peritonitis, haemorrhages or death
Salmonella enteriditis?
from animals (not people), infects colonic mucosa -> gastroenteritis
Typhoid fever - treatment?
ceftriaxone IV or ciprofloxacin oral
