Other Travel-related infections Flashcards

1
Q

Other than malaria the main travel related infections are?

A
Typhoid
Dengue Fever
Schistosomiasis
Typhus
Viral Haemorrhagic fevers e.g. ebola or lassa fever
Zika
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2
Q

What causes Typhoid?

A
Salmonella Typhi
Salmonella Paratyphi (paratyphoid)
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3
Q

How does typhoid first present?

A

In the 1st week you get:

  • High fever, Malaise & Neutrophilia
  • Bradycardia
  • Headache & CNS issues e.g. confusion
  • Constipation &aAbdo Pain
  • Cough
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4
Q

How does Typhoid progress?

A
In week 2:
The fever peaks & rose spots appear on the patient's trunk
Constipation -> Diarrhoea
Bradycardia --> Tachycardia
Neutrophilia --> Neutropenia

By week 3 the patient develops intestinal bleeds, perforation, peritonism and metastatic infections

By wk 4 they either recover or relapse

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5
Q

How do we test for Typhoid?

A

Blood Cultures
Marrow Cultures
Later urine and stool cultures

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6
Q

How do you treat typhoid?

A

Supportive care

Either Oral Azithromycin (uncomplicated) or IV ceftriaxone for complicated.

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7
Q

How are typhoid and dengue spread?

A

Typhoid - Faecal-oral

Dengue Fever - Aedes Aegypti Mosquitos

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8
Q

How does Dengue Fever present?

A

A sudden fever + Macular/maculopapular rash
Can develop a headache, myalgia or arthralgia
As well as some haemorrhagic signs including petechial rash, +ve tourniquet test & Purpura

If the fever lasts more than 2 wks or its been more than 2 wks since potential exposure its not dengue

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9
Q

How do we test for dengue fever?

A

PCR & Serology

A clinical diagnosis can be made with:

  • +ve tourniquet test
  • Elevated transaminases
  • Luecopenia
  • Thrombocytopenia
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10
Q

How do you treat dengue fever?

A

Supportive - Fluids, fresh frozen plasma and platelets

Prevention with Dengvaxia vaccine

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11
Q

What causes Schistosomiasis?

A

S. Haematobium (Africa)

S. Japonicum (Far East)

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12
Q

How is schistosomiasis transmitted?

A

Fresh Water & Freshwater Snails

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13
Q

Describe the progression of schistosomiasis?

A

Swimmers itch within the first few hours

24hrs later- invasive stage: cough, abdominal discomfort , splenomegaly, eosonophilia

15-20 days later they develop katayama fever (acute) which includes fever, urticaria, diarrhoea, abdo pain, splenomegaly, eosinophilia & lymphadenopathy

6-8 wks later they develop the chronic phase of the disease depending on the location the eggs grow:

  • Intestinal –> Dysentery, portal HTN & varices
  • Urinary –> Cystitis, haematuria etc
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14
Q

How do we test for schistosomiasis?

A

Clinical diagnosis is possible

Antibody tests
Rectal Biopsy
Ova in the stool or urine

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15
Q

How do we treat schistosomiasis?

A

Praziquantel

add Prednisalone if its severe

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16
Q

What causes Typhus

A

Rickettsia Conorii
Rickettsia Africae

They are parasitic bacteria

17
Q

How does typhus present?

A

Think in anyone with exposure and septicaemia + -ve blood cultures

Abrupt fever/ headache
-confusion
- jaundice
-rash (mostly macular or petechial)
As well as bleeds and thrombosis
18
Q

How do you test for and treat Typhus?

A

Clinical diagnosis + serology to confirm

Treat with tetracycline

19
Q

What are the main viral haemorrhagic fevers?

A

Ebola and Lassa Fever

20
Q

How do Viral Haemorrhagic fevers present?

A

Sudden onset:

  • Headache
  • Pleuritic Pain
  • Backache
  • Myalgia
  • Conjunctivitis
  • Prostration
  • Dehydration
  • Fever

Then insane bleeding

21
Q

How do we prevent and treat viral haemorrhagic fevers?

A

High security infection unit to isolate patients

Most treatments are supportive

22
Q

What spreads Zika?

A

Aedes Mosquito
Sex
Blood Transfusion

23
Q

What spreads typhus?

A

Ticks

24
Q

What is the presentation of Zika?

A

None or mild symptoms e.g.:

  • Headache
  • Rash
  • Fever
  • Malaise
  • Conjunctivitis
  • Joint Pain

Possibly Guillain-barre

The main feature is microcephaly in babies