Less Common Infections Flashcards

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1
Q

What is tetanus?

A

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

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2
Q

What is the presentation of tetanus?

A

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

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3
Q

What is the management of tetanus?

A
  • Ventilatory support and muscle relaxants,
  • IM human tetanus immunoglobulins for high risk wounds,
  • Metronidazole is first line abx
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4
Q

What is Dysentery?

A
  • Infection of the intestines which causes diarrhoea with blood and mucus.
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5
Q

What are the two types of dysentery?

A
  • Bacillary dysentery or shigellosis (caused by shigella)
  • Amoebic dysentery
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6
Q

Describe features of amoebiasis

A

It is caused by entamoeba histolytica. It presents with profuse, bloody diarrhoea. Stool microscopy can show trophozotes. Treatment is with metronidazole.

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7
Q

What are features of amoebic liver disease

A

It presents as a single mass which results in fever, RUQ pain, malaise and hepatomegaly. Diagnose with ultrasound and treat with metronidazole

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8
Q

Describe features of cholera

A
  • 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
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9
Q

What is leprosy?

A

Granulomatous disease affecting the peripheral nerves caused by mycobacterium leprae.

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10
Q

What are the symptoms of leprosy?

A
  • 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
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11
Q

What are the examples of viral haemorrhagic fever?

A

Dengue, Ebola, lassa, marburg, yellow fever

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12
Q

What are the signs and symptoms of viral haemorrhagic fever?

A
  • Fever, fatigue, Myalgia, arthralgia,
  • Nausea, vomiting and diarrhoea,
  • Bleeding from eyes, ears, mouth and internally
  • Delirium, coma, organ failure
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13
Q

Describe features of Rabies?

A

Viral disease which causes acute encephalitis. Majority are caused by dog bites bbut can also be transmitted by bat, raccoon and skunk bites

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14
Q

What are the symptoms of rabies?

A
  • Prodrome: Headache, fever and agitation, abnormal behaviour, limb paralysis
  • Hydrophotbia = water provoking spasms
  • Hypersalivation
  • Negri bodies (cytoplasmic inclusion bodies found in infected neurons
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15
Q

What is the initial management of a person with an animal bite in a high risk area?

A
  • 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
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16
Q

What is ascariasis?

A

A roundworm infection. It is transmitted via faecal-oral route (ingestion of eggs)

17
Q

What are the symptoms of ascariasis

A

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

18
Q

What are the investigations and treatment for ascariasis/roundworm?

A
  • Stool microscopy,
  • Chest X -ray
  • Abdo x-ray
  • Can be treated with antihelminth eg, albendazole
19
Q

What are the signs and symptoms of a tapeworm?

A
  • Worm segments in stool,
  • Neurocysticerosis: Raised ICP, seziures.
  • Hepatomegaly if cysts in liver
  • Cough and haemoptysis if cysts in lungs
20
Q

What is toxoplasmosis?

A

Protozoan infection called toxoplasma gondii. It enters the body via GI tract, lungs or broken skin

21
Q

What are the symptoms of toxoplasmosis?

A
  • 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
22
Q

What is measles and its symptoms?

A
  • 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.
23
Q

What are the investigations and managment of measels?

A
  • IgM antibodies against measels virus.
  • Management is mainly supportive but it is a notifiable disease
23
Q

What are the complications of measels?

A
  • Otitis media (most common)
  • Pneumonia
  • Encephalitis
  • Subacute sclerosing panencephalitis,
  • Febrile convulsions,
  • Keratoconjunctivitis, corneal ulceration,
  • Diarrhoea,
  • Appendicitis
  • Myocarditis
24
Q

describe features of mumps and its presentation

A
  • RNA paramyxovirus which is spread by droplets.
  • It presents with fever, malaise, muscular pain, parotiditis
25
Q

What is the prevention, management and complications of mumps?

A

Prevention - MMR vaccine
Management - rest and paracetamol. Notifiable disease
Complications - Orchtiis, hearing loss (usually transient), meningoencephalitis, pancreatitis

26
Q

What organism is most commonly isolated from animal bites?

A

Pasturella multocida

27
Q

What organisms are found in human bites?

A
  • Streptococci,
  • S. aureus,
  • Fusobacterium,
  • Prevotella
28
Q

What is cryptosporidium and its features

A

Parasite infection which causes watery diarrhoea, Abdo pain, fever.
Diagnosis via Ziehl Neelsen stain which shows red cysts