S13C156 - World Travelers Flashcards
5 causes of rash in returning traveler:
- dengue
- typhus
- syphilis
- gonorrhea
- ebola
- brucellosis
- chikungunya
- HIV
Infections spread by fleas
- typhus
- plague
Infxn spread by tse tse flies
-african sleeping sickness
Infxn from sandflies
-leishmanisiasis
2 Infxn spread from barefeet exposure
-strongyloidiasis, hook worm
5 causes Jaundice in returning traveller
-hepatitis, malaria, yellow fever, leptospirosis, relapsing fever
3 causes of hepatomegaly in returning traveler
- amebiasis
- malaria
- typhoid
- hepatitis
- leptospirosis
3 causes of eschar’s in travellers:
- typhus
- borrelliosis
- crimean-congo hemorrhagic fever
- anthrax
Infections of africa:
- malaria
- hookworm/tapeworm/roundworm
- yellow fever
- relapsing fever
- tick typhus
- filariasis
- schistosomiasis
Infections of South America
- malaria
- relapsing fever
- dengue
- filariasis
- schistosomiasis,
- chagas
- typus
Infectiosn of Mexico/Caribbean
- dengue
- hookworm
- malaria
- cysteicercosis
- amebiasis
Infections of australia/nz
- dengue
- q fever
- murray valley encephalitis
- japanese encephalitis
Infections of china and east asia
- dengue
- hookworm
- malaria
- strongyloidiasis
- hemorrhagic fever
- japanese encephalitis
Causes of fever with incubation >14d
-malaria, typhoid, HAV, HEV, schistosomiasis, amebic liver dz, leptospirosis, q fever, trypanosomiasis
Causes of fever with incubation >6w
-malaria, TB, HBV, leishmaniasis, filariasis, schistosomiasis, rabies, amebic liver abscess, african trypanosomiasis
Yellow Fever
- flavivirus
- monkey reservoir, mosquito vector
- south/central america and africa
- flu-like illness, hemorrhagic fever, conjunctival injxn, abod pain, faical flushing, prostration, bradycardia, bleeding diathesis
- incubation 3-6d
- classic triad: jaundice, black emesis, albuminuria
- tx: supportive
Lass Fever
- arenavirus, west africa
- viral syndrome, fever, h/a, sore throat, retrosternal c/p, multi-organ failure, bleeding in 1/3 of pts
- dx: ELISA serology, Cx
5 tropical dz causes of severe h/a and fever:
- malaria
- rickettsia
- dengue
- typhoid
- human african trypanosomiasis
Japanese Encephalitis
- flavivirus
- rural rice paddy fields, Asia, western pacific
- sudden high fever, h/a, nuchal rigidity, vomiting, Sz
- Dx: clinical, CSF for virus
- tx: supportive
Cysticercosis
- pork tapewarm, taenia solium
- mexico, latin america, sub-saharan africa, india, east asia
- ingestion from food, soil, undercooked pork
- neurocysticercosis: seizures, obstructive hydrocephalus, meningoencephalitis, stroke, h/a,
African sleeping sickness
- human african trypanosomiasis
- protozoans via tse tse fly
- painless chancre x2-3 after bite, then intermittent fever, malaise, rash, wasting, CNS involvement, encephalits, coma, hemolysis, anemia, pancarditis, meningoencephalitis
- dx: blood smears
- tx: suramin, eflornithine, melarsoprol
American trypanosomiasis (Chagas dz)
- protozoan
- kissing bug
- unilateral periorbital edema, painful cutaneous edema (chagoma), LA, HSM, depressed cardiac and GI fxn over months, myocarditis, dysrhythmias, CM, CHF
- dx: blood smear, serology if chronic
- tx: nifurtimox
Leishmaniasis
- intracellular protozoan, via sandflies
- africa, asia, mediterranean basin, central/south am.
- visceral leishmaniasis: most lethal, TB, pna, dysentery, pentad of fever, wt loss, HSM, pancytopenia, hypergammaglobulinemia
- cutaneous
- mucocutaneous: chronic, relentless
- diffuse cutaneous
- dx: bone marrow bx or LN bx
- tx:
visceral: sodium stibogluconate
Schistosomiasis
- blood fluke, AFrica, middle east, SA, Asia
- GI Sx, freshwater exposure, penetrate wet skin or are ingested
- pruritic dermatitis, fever, h/a, cough, urticaria, diarrhea, HSM, hyperesoinophilia, Sz, paralysis, acute transverse myelitis, hematuria, SCC,
- dx: eosinophlia, microscopy or bx, serology
- tx: praziquantel
4 causes of diarrhea with blood AND fever
- bacillary dysentery
- campylobacter enterocolitis
- salmonella enterocolitis
- e coli
4 causes of bloody diarrhea with no fever
- amebiasis
- blantidium coli
- schistosoma
- trichuris
Amebiasis
-entamoeba histolytica, Asia, Africa, latin america
-alternating constipation/diarrhea x3w, abdo pain, fever, dehydration, wt loss, hepatic abascess
-dx: stool o+p
-tx:
asymptomatic - iodoquinol or paromomycin
-symptomatic: flagyl
Giardia
- flagellated protozoan, infects small intestine and biliary tree
- cramping, flatulence, foul-smelling watery diarrhea +/- blood/mucus, wt loss, anemia
- dx: stool o+p, giardia antigen test in stool
- tx: flagyl
Cholera
- SA
- bacteria: vibrio cholerae
- fecal contamination of water/food
- incubation 2-3d, sodium pump inhibition in GIT by toxin
- profuse, painless watery diarrhea (rice water stools), dehydration, vomiting, leg cramps, fever
- tx: PO rehydration
- tetracyline, septra
Worms
- ascariasis (Roundworm): fecal oral, dry cough, pna, bowel obstruction, hepatic abscess, pancreatitis, appendicitis
- enterobiasis (pinworm): fecal-oral, children sharing toys/utensils/bedding, perianal itching
- trichuris: whipworm, contaminated soil/veggies
- hookworm: chronic, severe anemia, cutaneous form, skin contact with soil with feces, penetrate skin
- cestodes: tapeworm, undercooked pork, fish, beef, n/v, h/a, abdo pain, pruritus, constipation, diarrhea, obstruction, cysticercosis
- strongyloides: small intestine, pna, wheeze, bloody diarrhea
- tx: mebemdazole 100mg BID x3d
- tapeworm: praziquantel
- strongyloides: albendazole
Infectious causes of petechiae, hemorrhage
- meningococcemia
- dengue fever
- viral hemorrhagic fefvers
- yellow fever
- RMSF
- louse-borne typhus
- leptospirosis
