Less Common Infections Flashcards
What is tetanus?
It is a condition caused by the exotoxin released from clostridium tetani. Spores are present in soil and may be introduced into the wound. It can be seen in IVDU
What is the presentation of tetanus?
It is caused by the exotoxin preventing release of GABA.
- Prodrome fever, lethargy and headache
- Trismus (locked jaw),
- Risus sardonicus (facial spams),
- Opisthotonus (arched back and hyper-extended neck)
- Spasms
What is the management of tetanus?
- Ventilatory support and muscle relaxants,
- IM human tetanus immunoglobulins for high risk wounds,
- Metronidazole is first line abx
What is Dysentery?
- Infection of the intestines which causes diarrhoea with blood and mucus.
What are the two types of dysentery?
- Bacillary dysentery or shigellosis (caused by shigella)
- Amoebic dysentery
Describe features of amoebiasis
It is caused by entamoeba histolytica. It presents with profuse, bloody diarrhoea. Stool microscopy can show trophozotes. Treatment is with metronidazole.
What are features of amoebic liver disease
It presents as a single mass which results in fever, RUQ pain, malaise and hepatomegaly. Diagnose with ultrasound and treat with metronidazole
Describe features of cholera
- Caused by vibro cholerae.
- Presents with profuse, rice water diarrhoea, dehydration, crampy abdominal pain and hypoglycaemia.
- Investigated via stool culture (gold standard)
- Management is with oral rehydration therapy.
- Can treat with doxycycline or co-trimoxazole
What is leprosy?
Granulomatous disease affecting the peripheral nerves caused by mycobacterium leprae.
What are the symptoms of leprosy?
- Low degree of cell mediated immunity: Extensive skin involvement and symmetrical nerve involvement.
- High cell mediated immunity: Limited skin disease, asymmetrical nerve involvement and hair loss
What are the examples of viral haemorrhagic fever?
Dengue, Ebola, lassa, marburg, yellow fever
What are the signs and symptoms of viral haemorrhagic fever?
- Fever, fatigue, Myalgia, arthralgia,
- Nausea, vomiting and diarrhoea,
- Bleeding from eyes, ears, mouth and internally
- Delirium, coma, organ failure
Describe features of Rabies?
Viral disease which causes acute encephalitis. Majority are caused by dog bites bbut can also be transmitted by bat, raccoon and skunk bites
What are the symptoms of rabies?
- Prodrome: Headache, fever and agitation, abnormal behaviour, limb paralysis
- Hydrophotbia = water provoking spasms
- Hypersalivation
- Negri bodies (cytoplasmic inclusion bodies found in infected neurons
What is the initial management of a person with an animal bite in a high risk area?
- Wound requires washout
- 4 doses of rabies vaccine on days 1,3,7 and 21. If already immunised then just give extra 2 doses.
- If not previously immunised then administer human rabies immunoglobulin around the wound
What is ascariasis?
A roundworm infection. It is transmitted via faecal-oral route (ingestion of eggs)
What are the symptoms of ascariasis
Often is asymptomatic but can present with abdominal discomfort, GI symptoms. It can cause eosinophilic pneumonitis which can present with cough, wheezing, dyspnoea. It can also cause hepatobiliary ascariasis
What are the investigations and treatment for ascariasis/roundworm?
- Stool microscopy,
- Chest X -ray
- Abdo x-ray
- Can be treated with antihelminth eg, albendazole
What are the signs and symptoms of a tapeworm?
- Worm segments in stool,
- Neurocysticerosis: Raised ICP, seziures.
- Hepatomegaly if cysts in liver
- Cough and haemoptysis if cysts in lungs
What is toxoplasmosis?
Protozoan infection called toxoplasma gondii. It enters the body via GI tract, lungs or broken skin
What are the symptoms of toxoplasmosis?
- Immunocompotent: asymptomatic but can present with symptoms resembling infectious mono (headaches, myalgia, pharyngitis, hepatosplenomegaly). Can occasionally get pneumonitis, myocarditis, pericarditis, encephalitis.
- Immunosuppressed: Constitutional symptoms, headaches, confusion and drowsiness.
- Cervical lymphadenopathy is the most common symptoms
What is measles and its symptoms?
- RNA paramyxovirus which spreads via aerosol. It presents with the following:
- Prodromal phase: irritable, fever and conjunctivitis
- Koplik spots: White spots (‘grain of salt’) on buccal mucosa
- Rash: starts behind ears then across whole body. Maculopapular rash which desquamates.
What are the investigations and managment of measels?
- IgM antibodies against measels virus.
- Management is mainly supportive but it is a notifiable disease
What are the complications of measels?
- Otitis media (most common)
- Pneumonia
- Encephalitis
- Subacute sclerosing panencephalitis,
- Febrile convulsions,
- Keratoconjunctivitis, corneal ulceration,
- Diarrhoea,
- Appendicitis
- Myocarditis
describe features of mumps and its presentation
- RNA paramyxovirus which is spread by droplets.
- It presents with fever, malaise, muscular pain, parotiditis
What is the prevention, management and complications of mumps?
Prevention - MMR vaccine
Management - rest and paracetamol. Notifiable disease
Complications - Orchtiis, hearing loss (usually transient), meningoencephalitis, pancreatitis
What organism is most commonly isolated from animal bites?
Pasturella multocida
What organisms are found in human bites?
- Streptococci,
- S. aureus,
- Fusobacterium,
- Prevotella
What is cryptosporidium and its features
Parasite infection which causes watery diarrhoea, Abdo pain, fever.
Diagnosis via Ziehl Neelsen stain which shows red cysts
