Travel Medicine

Question 0

Prophylaxis for travel

Answer 0

Malaria: atovaquone/proguanil, mefloquine

doxycycline if >8yo

Question 1

Vaccines before travel

Answer 1

Hep A: not for 1yo)

Typhoid: for trips >2wks, not for <2yo

Question 2

Plasmodium falciparum

Answer 2

Malaria
Sx: high fever, chills, rigors, sweats, HA
hemolysis&raquo_space; anemia, hyperbili
cerebral&raquo_space; increased ICP, seizure, coma
IV abx (vs po) if: AMS, severe anemia, AKI, pulm edema, ARDS, shock, DIC, spontaneous bleeding, acidosis, hemoglobinuria, jaundice seizures, parasitemia >5%

Question 3

Entamoeba histolytica

Answer 3

Gradual onset over 3wks

Question 4

Salmonella typhii

Answer 4

Typhoid Fever
Sx: fever, constitutional sx, significant abd pain, HSM, rose spots (subtle rash), AMS
Tx: ampicillin, bactrim, 3rd gen cephalo

Question 5

Dengue Fever

Answer 5

Arbovirus (arthropod-borne)
HA w/retro-orbital pain, fever
*severe musculoskeletal pain
tender hepatomegaly, mild high lft’s