Malaria & Tick Schoenwald Flashcards
This disease is mosquito borne-anopholes
Malaria
What is the most common mode of malaria transmission?
Mosquito
How to precent malaria?
- insect repellent
- mosquito netting
______ is contained in clothes, tents and other equipment that repells mosquitos
Permethrin
What is a medication for malaria chemoprophylaxis but has resistance issues and is used for Central America?
Chloroquine
*used primarily for central america
What is a medication for malaria chemoprophylaxis that has no resistance?
Atovaquone/Proguanil (Malarone)
What is a medication for malaria chemoprophylaxis that has sun sensitivity?
Doxycycline
What is a medication for malaria chemoprophylaxis used in Cambodia, Laos, and Burma?
Mefloquine (Lariam)
What malaria chemoprophylaxis med is only approved for pregnancy?
Mefloquine (Lariam)
What are side effects of Mefloquine (Lariam)?
depression, confusion, night terrors, hallucinations
When taking doxy, what should you caution patients?
sun sensitivity
This malaria chemoprophylaxis med is used for prophylaxis and antirelapse therapy and is used in combo with another antimalaria agent?
Primaquine
You need to check for _______ prior to primaquine administration due to potential for fatal hemolysis
G6PD
What malaria chemoprophylaxis med should NOT be used in G6PD and is a new agent?
Tafenoquine (Arakoda, Krintafel)
Signs and symptoms of malaria are ____
cyclical
-Fever, chills, HA, myalgias
What is the gold standard test for diagnosing malaria?
Blood smear (PCR only tells you if malaria is present and blood smear can tell you the species)
A blood smear for malaria is best done if during when?
During an episode of fever
What is the treatment for malaria in the US?
Atovaquone/Proguanil (Malarone)
-4 tablets PO qday x 3 days
What two malaria meds are approved for prophylaxis?
Chloriquine or mefloquine
What malaria med is contraindicated in pregnancy?
doxycycline
“bone break fever”
Dengue fever
These are symptoms of what?
Fatigue, fever, extreme muscle and body aches
Dengue fever
What is the treatment for Dengue fever?
Supportive
What med should be avoided in Dengue fever?
NSAIDs
These are symptoms of what?
headache, mental status changes, fever, body aches, sometimes rash (about 1 in 150 infected develop serious illness) meningitis, flaccid paralysis unique
West nile virus
How do you dx west nile virus?
Diagnose with serologies IgG and IgM in blood or spinal fluid
Treatment for west nile?
supportive
What are the three tick borne illnesses?
- Lyme disease
- Rickettsia
- Babesia
This disease is caused by spirochete borrelia burgdorferi
Lyme disease
Tick Ixodes ricinus “deer tick”
Lyme disease
What ages are at risk for Lyme disease ?
All ages at risk
This disease can cause dermatologic, rheumatologic, neurologic or cardiac abnormalities specifically erythema migrans rash
Lyme disease
erythema migrans rash
Lyme disease
What stage of lyme disease is this? (1, 2, 3)
- Erythema migrans present
- (75%) Fever, myalgias, fatigue
1
What stage of lyme disease is this? (1, 2, 3)
-Conduction abnormalities (5% some sort of AV block
2
What stage of lyme disease is this? (1, 2, 3)
-Persistent infection, arthritis type symptoms, usually not previously treated
3
What are the tests used to diagnose lyme disease?
ELISA followed by western blot
**serologic testing often negative in first few weeks of infection
Treatment for lyme disease?
Doxycycline 100 mg PO BID x 21 days
What is the treatment for lyme disease for children <8 or pregnant women?
Amoxicillin 50 mg/kg/day divided into 3
doses (q 8 hour dosing) x 14-21 days
These are symptoms of what disease?
-Symptoms include hemolytic anemia with fatigue, body aches, fever (may be abscent), splenomegaly and hepatomegaly
babesia
On labs for this disease you may find maltese cross formation in rbc
babesia
Treatment for babesia?
Atovaquone AND Azithromycin
Rocky Mountain Spotted fever in southeastern US
spotted fever
This disease causes a maculopapular rash on hands and feet that spreads to the body and progresses to petechiae?
spotted fever
How to dx spotted fever?
PCR
-Then acute (when sick) and convalescent sera (4 wks later)
Treatment for spotted fever ?
Doxy for everyone! (regular tx, kids & adults)
If you see morulae, think?
anaplasma & ehrilchia
anaplasma & ehrilchia are diagnosed by…
serology
treatment for anaplasma & ehrilchia?
doxy
In this disease, symptoms include Fever, rash, headache, pain behind eyes, **low platelets (key finding)
colorado tick fever
treatment for colorado tick fever?
supportive
What type of virus is zika?
flavi (an rna virus that can infect humans)
testing for zika?
PCR on serum and/or urine, igM serum
treatment for zika?
none
Men should wait ___ months to have intercourse if zika but most current recommendations say ____ months of abstinence after traveling in zika zone
6, 3
What is the main risk of zika virus?
Microcephaly
This virus is Transmitted by Aedes aegypti mosquito
Yellow fever
**think of egyptian pyramid is yellow
Symptoms of this disease are Acute onset fever, myalgias, headache, backache, nausea and vomiting and 15% can relapse and worsen
Yellow fever
Treatment for yellow fever?
symptomatic care only
What should you avoid in yellow fever and why?
Avoid NSAIDs as increased risk of hemorrhage
Can you get a yellow fever vaccine in pregnancy?
no
Who should we be cautious in giving the yellow fever vaccine to?
precaution in age >60 because you can get yellow fever from the actual vaccine
