T4 malaria / tick illness Flashcards
Which mosquito most often carries Malaria?
Female Anopholes
What are the 5 forms of malaria protozoa?
Plasmodium:
- falciparum (Africa)
- vivax (India and S. america)
- ovale
- malariae
- knowlesi (SE asia-Malaysia)
Deaths from malaria occur most often in which age group?
Children
Areas of concern for malaria?
Central america
South america
india
africa
Other modes of transmission for Malaria besides mosquito?
Transfusion
organ transplant
needle sharing
mother to fetus
Mosquito bite prevention?
- Insect repellent
- anopheles nocturnal feeders
- mosquito netting
- permethrin clothes
- chemoprophylaxis
______is a medication for malaria chemoprophylaxis. Used primarily for central america.
Chloroquine
Timeframe needed to take chloroquine?
Weekly dosing through 4 weeks after return
Other chemoprophylaxis used for malaria which has no resistance to date?
Atovaquone / Proguanil (Malarone)
Timeframe needed to take Atovaquone?
Daily dosing to continue through 7 days after return
Which chemoprophylaxis can cause SE including depression, confusion, night terrors, hallucinations?
Mefloquine (Lariam)
Weekly dosing to continue through 4 weeks after return
Which chemoprophylaxis is the only one approved in pregnancy?
Mefloquine (Lariam)
or
chloroquine
Which chemoprophylaxis has some resistance in Cambodia, Laos, Burma?
Mefloquine (Lariam)
Doxycycline can be used as chemoprophylaxis for malaria. What should you be cautious about?
Sun sensitivity
T/F: Primaquine is used alone as a prophylaxis for Ovale.
False: it is not used as single agent.
used for vivax
Which med(s) should not be given to G6PD deficiency patients?
Primaquine
Tafenoquine
Typical s/sx of malaira?
Cyclical:
Fever, chills, HA, myalgias
S/Sx of severe cases of malaria?
Seizures confusion RF ARDS Coma death
Gold standard test for Malaria?
Thick and thin blood smears
Standard treatment in the US for malaria/
Atovaquone/Proquanil
4 tablets PO qd x 3 days
Referred to as “bone break fever”?
Dengue Fever
T/F: dengue fever is a mosquito borne virus?
True
S/Sx of dengue fever
fatigue
fever
EXTREME muscle and body aches
Areas that have Dengue fever
asia
central A.
South A.
Africa
Tx for dengue fever
Supportive
Avoid NSAIDs
Mosquito known to carry West Nile Virus
Culex mosquito
S/Sx of West nile
HA, AMS, fever, body aches, sometimes rash, meningitis, FLACCID PARALYSIS
Dx for west nile
IgG and IgM serologies in blood os CSF
Tx for West Nile
supportive
Spirochete Borrelia burgdorferi causes what disease
Lyme disease
Ixodes ricinus is also called the
Deer tick and carries lyme
Incubation of lyme disease
3-32 days
Name the characteristic rash in lyme
erythema migrans (bullseye rash)
How many stages of lyme disease are there.
3
Stage 1 of lyme is early infection. What S/Sx would you see.
Erythema migrans
fever, myalgias, fatigue
Stage 2 of lyme you would see what?
Conduction abnormalities (AV block)
Stage 3 of lyme is persistent infection. What type of sx would you see.
Arthritis type sx
Tx of Lyme disease
Doxycycline 100mg PO bid x 21 days kids /prego Amoxicillin 50mg/kg/day (q 8 hr dosing) x14-21 days
Babesia is carried by what kind of tick
Ixodes scapularis
S/Sx of Babesia
hemolytic anemia and fatigue body aches \+/- fever splenomegaly hepatomegaly
Dx of babesia is made by seeing what is RBCs
Maltese cross formation in RBC
Tx for Babesia
Atovaquone 750mg PO BID
AND
Azithromycin 500-1000mg qd x7-10 days
Rickettsia ricketsi from tick or fleas causes what illness?
Spotted fever
S/Sx of spotted fever?
Fever
HA
abd pain
MACULOPAPULAR RASH progressing to petechiae (hands/feet then body)
Dx of Spotted fever?
PCR
Acute and convalescent sera (wait 4 weeks for dx)
Tx of Spotted fever?
Doxycycline
100mg PO BID x14d
Tx of Spotted fever in pregnant women /kids?
Doxycycline
100mg PO BIDx14d
(chloramphenicol also considered for prego)
Anaplasma and ehrlichia are both _____ borne illnesses
tick
In anaplasma and ehrlichia what would you see in the WBC?
Morulae (inclusions in WBC)
Dx of Anaplasma and Ehrlichia?
Serology
Tx for anaplasma and Ehrlichia?
Doxycycline
Colorado Tick fever is a _______ infection carried by ______ or ______?
Viral infection
Fleas and ticks
What states is CTF found in?
Colorado and Idaho
S/Sx of CTF?
Fever Rash HA, pain behind eyes Low platelets increased liver enzymes
Tx for CTF?
Self limiting
Supportive
How long should men wait to have intercourse after being in a zika area?
3-6 months
What are cross reactants with testing for zika virus?
West nile
Dengue
Testing for zika?
Serum / urine PCR
Serum IgM
Main risks from Zika?
Congenital birth defects
Microcephaly
Yellow fever is caused by _______ virus carried by what kind of mosquito
Flavivirus
Aedes aegypti
Incubation time for yellow fever?
3-6 days
Acute sx of yellow fever?
acute fever myalgias HA Backache N/V
Progression sx of yellow fever?
jaundice hemorrhagic sx shock multiorgan failure Death 50% of cases
Dx of yellow fever?
Mainly clinical due to problems with serolgy and Nucleic acid testing
Tx for yellow fever?
None
avoid NSAIDS - increased risk of hemorrhage
Prevention of yellow fever?
Live virus vaccine (avoid in prego, immuno comp, biologics, chemo)
Caution in age>60