Travel medicine Flashcards
Severe manifestations of falciparum malaria
- 3-7 after illness onset
-IV therapy and ICU, unable to tolerate oral therapy - Altered conscious state
- >5% parasitaemia
- Jaundice, oliguria, severe anaemia, hypoglycaemia, acidosis, ARDS
15-25% mortality - factors >5% parasitaemia, no chemoprophylaxis, splenectomy, delayed time to dx or Rx, pregnancy, extemities of age
Treatment of malaria
Uncomplicated
- First line - artemethe-lumefantrine -Riamet
- Second line -atovaquone-proguanil
Third line -quninine- doxy/clindamycin
Severe
IV artesunate
Presentation of fever and rash in returned traveller
dengue fever
chikungunya
rickettsia
leptospirosis
meningococcus
gonococuss
syphilis
HIV, EBV, CMV
measles
Presentation of fever and diarrhoea in returned traveller
Traveller’s diarrhoea
Malaria
Typhoid/paratyphoid
Fever and respiratory symptoms
Influenza
Simple URTI
Streptoccal URTI/pneumonia
Legionnares disease
Mycoplasma
Q fever
TB
Meloidosis
Paragonimiasis
Fever and lymphadenopathy
TB
Rickettsia
typanosomasis
tularaemia
Brucellosis
Fever and neurological symptoms
Malaria
Meningococcal meningitis
TB meningitis
Leptospirosis
Brucellosis
Lyme
Melioidosis
Schistosomiasis
Cysterocosis
Fever and jaundice
Hepatitis ABE
Malaria
Yellow fever
Dengue
amoebic fever
Q fever
Rickettsia
lepto
Live vaccines
MMR
Polio
BCG
Yellow fever
Varicella
Rotavirus
Oral typoid
Contraindications to live vaccines
>20mg prednisolone/day
HIV positive CD4 <200
on anti-TNF, mtx, azathioprine
