Session 8- Travel related infections Flashcards
Why is the travel history important
Recognise imported diseases
Infection prevention
- in the lab
- on the ward
Different strains of pathogen
- antigenically different
- impacts on protection/ detection
- antibiotic resistance
What other questions would you ask about travel history
• Any unwell travel companions /contacts?
• Pre-travel vaccinations / preventative
measures?
• Healthcare exposure?
What are the 5 main species of malaria
- falciparum
- vivax
- ovale
- malariae
- knowlesii
What is the vector for malaria
Female anopheles mosquito
Symptoms of malaria
Headache Fever Nausea Chills Dry cough Fatigue Back pain Enlarged spleen
How can severe malaria affect the blood
- Low/normal WCC
- Thrombocytopenia
- DIC
How many blood films should be taken in malaria
3
What investigations should be taken for malaria
Blood film x3 FBC U&Es LFTs Glucose Coagulation Head CT if neurological symptoms CXR
Prevention of malaria ABC
Assess risk
Bite prevention
Chemoprophylaxis
What is the mechanism for infection for typhoid and paratyphoid fever
Faecal-oral from contaminated food/water
Source is cases or carriers
What type of bacteria is salmonella typhi
Enterobacteriae Gram negative bacillus
Virulence of salmonella typhi
Fimbrae adhere to epithelium over ileal lymphoid tissues- peyer’s patches
Then they enter the RES/ blood
Then they reside within macrophages
Symptoms and signs of enteric fever
Fever, headache, abdominal discomfort, dry cough, relative bradycardia, intestinal haemorrhage an perforation, seeding
What would you discover after investigation of enteric fever
Moderate anaemia
Lymphopaenia
Raised LFTs
How do you treat enteric fever
Multi drug resistant
Fluoroquinolones may work
Usually treated with IV ceftriazone or azithromycin
What are bio films
Microbial communities attached to surfaces and encased in an extracellular matrix of microbial origin
What microorganisms are responsible for the frequent cases of hoptilisation-acquired infections
Staphylococci
Enterococci
What coagulase test do you use for bound
Slide
Negative- no clumps
Positive- clumps
What coagulase test do you use for free
Tube
Positive- clot
Negative- no clot
Why is there risks of infection of a bicuspid valve
They are at risk of developing endocarditis because of the abnormal flow of blood over the valve and the associated valve tissue
Patient is at greater risk of microbes in the blood sticking to the valve cusp
Biofilm hypothesis
1) bacterial adherence
2) biofilm growth and maturation
3) recalcitrant biofilm causing persistent inflammation, dispersion of biofilm fragments causing septic emboli at ion and a new biofilm formation
Clinical features of endocarditis
Fever
Heart murmur
Cardiac complications
Embolic features- small bits of vegetation that become loose and travel to small capillaries where they can block the capillary or cause local infection
Janeway lesions
These are haemorrhagic nodular lesions with an abnormal border they are associated with microabcess formation and localised necrosis
Splinter haemorrhages
Liner minute capillary engorgemtents usually in distal third of the nail bed
Roth spots in the eye
Linear haemorrhaging spots seen in the retina of the eye
Oslers nodes
Painful erythromatoous nodules on pads of fingers and toes
incubation period for malaria
4 weeks
blood test results for malaira
haemolysis- low Hb and high bilirubin
microoclusions- more sticky blood thus can damage kidneys/ brain- high urea and creatinine
treatment of salmonella
cephalosporin- ceftraixone
macrolide - azithromycin
is e coli gram positive or negatie
gram negative bacili
is salmonella gram + or -
gram - bacilus
what type of microbe is plasmodium
protozoa
