Microbiology: Pyrexia of Unknown Origin & Fever in the returning traveler

Question 1

PUO & Fever in the returning traveller

What is the definition of Pyrexia of Unknown Origin?

Answer 1

Question 2

PUO & Fever in the returning traveller

• What is the approach to Neutropenic fever?
• What are the other key points to consider in PUO?

Answer 2

Question 3

PUO & Fever in the returning traveller

What are the main causes of fever in the returning traveller?

Answer 3

Question 4

PUO & Fever in the returning traveller

What are the symptoms, investigations and management options for Typhoid?

Answer 4

Antibiotics:

• Cotrimidazole, Chloramphenicol or ampicillin
• (Multi-drug resistance) >> 3rd gen cephalosporin or azithromycin

Question 5

PUO & Fever in the returning traveller

What insect carries malara?

Answer 5

Question 6

PUO & Fever in the returning traveller

What are the major features of sever or complicated Malaria?

Answer 6

IS PHARAOS:

• I: Impaired concoiusness/Seizures
• S: Shock
• P: Pulmonary oedema or ARDS
• H: Hypoglycaemia (<2.2mmol)/Haemoglobinueria
• A: Anaemia (Hb <8)
• R: Renal imapairement
• A: Acidosis (ph <7.3)
• O: Other indications
• S: Spontaneous bleeding/DIC

Question 7

PUO & Fever in the returning traveller

What are the investigations for P.Falciparum?

Answer 7

Question 8

PUO & Fever in the returning traveller

What is the treatment for P.Falciparum?

Answer 8

Question 9

PUO & Fever in the returning traveller

What are the common signs of P.Falciparum?

Answer 9

Question 10

PUO & Fever in the returning traveller

What are the symptoms of P.Falciparum?

Answer 10

Uncommon signs:

DDACC

• Diarrhoea
• Dark Urine
• Abdrominal pain
• Confusion
• Cough

Question 11

PUO & Fever in the returning traveller

What is the definition of Classical PUO and give some examples

Answer 11

PUO Definition:

>38.3⁰C fever on several occasions persisting >3/52 without diagnosis despite >1/52 of intensive Ix

Question 12

PUO & Fever in the returning traveller

What is the definition of Healthcare associated PUO and give some examples

Answer 12

Question 13

PUO & Fever in the returning traveller

What is the definition of Neutropenic PUO and give some examples

Answer 13

Question 14

PUO & Fever in the returning traveller

What is the definition of HIV Associated PUO and give some examples

Answer 14

Question 15

PUO & Fever in the returning traveller

What are the Severity & Liver stage, Length of Rhythm, Blood film and treatment of P.Falciparum

Answer 15

Question 16

PUO & Fever in the returning traveller

What are the Severity & Liver stage, Length of Rhythm, Blood film and treatment of P.Vivax

Answer 16

Question 17

PUO & Fever in the returning traveller

What are the Severity & Liver stage, Length of Rhythm, Blood film and treatment of P.Ovale

P.Malaria

Answer 17

Question 18

PUO & Fever in the returning traveller

What are the Severity & Liver stage, Length of Rhythm, Blood film and treatment of P.Malaria

Answer 18