Travel Related Infection Flashcards
Common infections worldwide
Influenza
Community-acquired pneumonia
Meningococcal disease
Sexually transmitted diseases
Climate or environment related health problems
Sunburn Heat exhaustion and heatstroke Fungal infections Bacterial skin infections Cold injury Altitude sickness
Water related infections
Schistosomiasis Leptospirosis Liver flukes Hookworms Guinea worms
Arthropod borne infections
Malaria (mosquitos) Dengue fever (mosquitos) Filariasis (mosquitoes: elephantiasis) Rickettsial infections (ticks: typhus) Leishmaniasis (sand flies: Kala-azar) Trypanosomiasis (tsetse fly: sleeping sickness)
Important tropical diseases
Malaria Typhoid Dengue Fever Schistosomiasis Rickettsiosis Viral haemorrhagic fevers Zika fever
Which species of malaria is potentially severe?
Plasmodium falciparum
Which species of malaria are “benign”
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Plasmodium knowlesi
Clinical features of malaria
NON SPECIFIC
Fever Rigors Aching bones Abdo pain Headache Dysuria Frequency Sore throat Cough Splenomegaly Hepatomegaly Mild jaundice
Complications of malaria
Cerebral malaria (encephalopathy) Blackwater fever Pulmonary oedema Jaundice Severe anaemia Algid malaria
What is complicated malaria?
One or more of:
Impaired consciousness or seizures
Hypoglycaemia
Parasite count >2%
Haemoglobin <8mg/dL
Spontaneous bleeding/DIC
Haemoglobinuria
Renal impairment or pH <7.3
Pulmonary oedema or ARDS
Shock (algid malaria)
Treatment of uncomplicated P. falciparum malaria
Riamet
Eurartesim
Malarone
=> 3 days
Quinine plus oral doxycycline
=> 7 days
Treatment of complicated or severe P. falciparum malaria
IV quinine plus oral doxycycline
Treatment of P. vivax, P. ovale, P. malariae, P. knowlesi
Chloroquine
Riamet
=> 3 days
Add primaquine (check for G6PD deficiency) in vivax and ovale to eradicate liver hypnozoites
Typhoid (enteric) fever causative organisms
Salmonella typhi
Salmonella paratyphi
From poor sanitation, unclean drinking water
Typhoid fever treatment
Oral Azithromycin (uncomplicated) IV Ceftriaxone (complicated)
Dengue fever clinical presentation
Sudden fever Severe headache, retro-orbital pain Severe myalgia and arthralgia Macular/maculopapular rash Haemorrhagic signs: petechiae, purpura, positive tourniquet test
Dengue diagnosis
Thrombocytopenia Leucopenia Elevated transaminases Positive tourniquet test PCR Serology
Clinical features of schistosomiasis
Swimmers Itch Invasive stage Katayama Fever Acute disease Chronic disease
Schistosomiasis diagnosis
Clinical diagnosis
Antibody tests
Ova in stools and urine
Rectal snip
Schistosomiasis treatment
Praziquantel
Prednisolone if severe
What is the commonest form of rickettsiosis in the UK?
Tick typhus (R. conorii, R. africae)
Clinical features of rickettsiosis
Abrupt onset swinging fever Headache Confusion Endovasculitis Rash (macular, petechial) Bleeding
Viral haemorrhagic fevers
Ebola
Congo-Crimea haemorrhagic fever
Lassa fever
Marburg disease
Viral haemorrhagic fevers treatment
Supportive
