Regions - The Americas

Question 1

Where has the highest prevalence of Chagas?

Answer 1

Bolivia

Question 2

Which viruses are commonly seen in latin America?

Answer 2

Dengue, zika, chik
Yellow fever (Brazil)
HIV
Hantavirus
Bolivian hemorrhagic fever

Question 3

Which parasites occur in latin america?

Answer 3

Chagas
MC leishmania

Question 4

Which helminths occur in latin america?

Answer 4

Amoebiasis
Fasciola
Giardia

Question 5

Which bacterial infections commonly occur in latin america?

Answer 5

TB - MDR Peru
Buruli Ulcer (Brazil)
Leprosy (Brazil)
Brucellosis
Bartonella

Question 6

Which mycoses commonly occur in Latin America?

Answer 6

Histoplasmosis
Coccidioidomycosis
Paracoccidioidomycosis

Question 7

What is Oroya fever?

Answer 7

2nd to Bartonella Bacilliformis - 1st phase
Fever, HSM, LN, jaundice
85% untreated mortality!

Question 8

Bartonella organism type

Answer 8

Gram negative intracellular bacteria

Cause of zoonotic infections

Question 9

3 types of Bartonella most related to human infections

Answer 9

Bartonella Henselae
Bartonella Quntana
Bartonella Bacilliformis

Question 10

What is Trench Fever?

Answer 10

b. quintana
5 day fever
First reported Europe soldiers
Transmitted by human body louse
Associated with endocarditis

Question 11

What is Oroya fever?

Answer 11

b. bacilliformis
Also known as Carrion disease
Railway line Lima to Oriya
Common mountainous Peru/SA

Orya fever and verruca peruana same disease

Question 12

What is cat scratch disease?

Answer 12

b. henselae

Most common bartonella infection
Cutaneous manifestation - vesicular, erythematous and papular phase
Lymhadenopathy
Occasional ocular neuropathy

Question 13

Stages of Bartonella bacciliformis disease?

Answer 13

Acute phase - Oriya fever

Chronic phase - eruptive cutaneous lesions that appear 2-8 weeks after acute phase

Question 14

Treatment of bartonella?

Answer 14

CSD - can be managed symptomatically without supportively (if local signs only) but one off abz (eg Azithro) limits symptoms

Trench fever - doxy
Oroya fever - cipro
Verrugana peruana - azitrho

Abx vary - ( azithro, cipro, gent, co trimox and rifampicin)

Question 15

Diagnosis of bartonella?

Answer 15

Serology or PCR

Difficult to culture - need long isolation times

Question 16

Chronic bartonella

Answer 16

Chronic eye problems
Bone marrow effects - bone pain
Classic symptom of pain soles of feet in morning - damaged blood vessels on soles
Anaemia
Neurological symptoms

Question 17

3 important bartonella, mode of acquisition and disease

Answer 17

Question 18

Valley fever

Answer 18

N America deserts/SA
Cocci immitis and cocci posadasii
Inhalation spores
Fever + cough
Erythema nods/multiforme possible
Dx - antibodies or culture

CXR - hilar adenopathy, infiltrates, cavitation

Question 19

Paracoccidiodomycosis

Answer 19

Farmers - tobacco/coffee crops
Inhalation spores
Lung - main target, mucosal involvement possible
Resp Symtpoms
Mickey Mouse/pilots wheel on micro with KOH

Treat - co-trimoxazoel or itraconoazole

Question 20

Histoplasmosis

Answer 20

Histo capitulum
Inhalation
Damp soil/guano
Caves
Acute pulmonary and disseminated possible
Culture = slow, urinary antigen test
Tx: Lip amp B or itraconazole

Question 21

Bolivian Hemorrhagic fever

Answer 21

Large vessel mouse - vector, virus shed in excretion
Human to human possible

Fever headache malaise
Haemorrgaic features - mucosal bleeding/petchia

Can develop severe haemorrhagic/neurological fealtures

Responds to Ribavirin

Death in 25%

Question 22

Where is hookworm endemic?

Answer 22

Haiti