Microbiology 26: Fever In Returning Traveller Flashcards
List the 5 types of plasmodium that cause malaria ? Which is most common to cause malaria?
P.falciparum (MOST COMMON)
P.vivax
P.ovale
P.Malariae
P.knowlesi
What is the initial treatment for non-falciparum malaria ?
What do you give after 1st Tx?
Chloroquine: for 3 days
Primaquine: for 14 days
What must you test for before starting on primaquine?
What is a complication?
G6PD deficiency - primaquine can cause haemolysis
Splenic rupture
How is malaria diagnosed ?
- Thick smear: screen for parasites
- Thin smear: identify species and quantify parasitaemia
- Rapid antigen test:
List 3 side effects of quinine ?
- Cinchonism- dizzy, nauesues, vomiting
- Arrhythmias
- Hyperinsulinaemia
List 2 features on blood film suggestive of falciparum malaria ?
Headphone shaped parasites in red cells
Red cells with more than 1 parasite in it
What is the treatment of severe malaria (if around 20% parasitaemia)?
- IV artusanate (MAIN)
- (If not available then IV quinine)
- followed by artemisinin + lumefantrine
Which disease presents with arthralgia, myalgia, retro-orbital headache, fever and rash (erythrodermic), conjunctival injection ?
Dengue
Sphygmothermic dissociation is associated with which disease ? (When your Heart rate is relatively bradycardic for the high temperature)
Typhoid fever
NB give the high temp, you would expect a high HR, but in typhoid you have relative bradycardia (so it may be normal, but this is low/abnormal given the high temp)
Rose spots are pathognomonic of which disease ?
Typhoid fever
Which mosquito causes Dengue ?
AIDES
list diseases mosquitoes can cause (6)
- malaria
- encephalitis
- dengue
- yellow fever
- west nile virus
- zika virus
Features of malaria
- fevers: cyclical or continuous with spikes
- paroxysm- chills, high fever, sweats
- severe: end-organ damage
treatment for MILD falciparum malaria (lower parasitaemia) (3)
- oral malarone (atovaquone + proguanil)
- artermisinin combination therapy (artemesin + lumefantrine)
- oral quinine (with doxy/clindamycin)
hwta is the treatment of choice for severe malaria
IV artesunate
list clinical features of dengue fever
- fever
- headache
- myalgia
- erythrodermic rash
- bleeidng
- hepatitis
- if severe - encephalitis, myocarditis
- can progress to dengue haemorrhagic fever/ dengue shock
- inv = serology, PCR
- treatment: supportive
features of typhoid fever
- high fever, headache, rose spots, constipation, dry cough
- complications: GI bleeding, perforation, encephalopathy
treatment for typhoid fever
- empirical ceftriaxone
- azithromycin
features of infectious mononucleosis
- EBV/CMV
- tonsillar enlargement with exudates
- atypical lymphocytosis
- always consider HIV
Organism spreading malaria
Anopheles mosquito
Organism causing typhoid
Salmonella typhi or paratyphi
Gram -ve rod
Rickettsial Disease
Features
- intracellular bacteria
- Invades endothelial cells causing a vasculitis
- Spotted fevers: RMSF, MSF, African tick bite fever
- Fever
- Headache
- Myalgia
- +/- Eschar (dead tissue that sheds or falls off from the skin)
