Travel Related Infection Flashcards
What is typhoid?
Infection associated with poor sanitation and unclean drinking water caused by salmonella typhi/paratyphi
What is the most common cause of typhoid?
Salmonella typhi
What is the incubation period of typhoid?
7 days-4 weeks
How does typhoid present?
Fever, peaks at 7-10 days
Rose spots/patchy maculopapular rash on trunk, which blanch
Headache
Non bloody diarrhoea
Constipation
Bradycardia
How is typhoid diagnosed?
Bone marrow aspirate and culture, most sensitive test
What is the drug of choice for uncomplicated typhoid?
Oral Azithromycin
What is the drug of choice for complicated typhoid?
IV Ceftriaxone
What is malaria?
Infection common in tropical areas, transmitted via mosquito bites
What pathogens cause malaria?
Plasmodium falciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium knowlesi
How does malaria present?
Fever on alternating days
Rigors
Musche aches
Abdominal pain
Jaundice
Headache
Hepatomegaly
What investigations are used in malaria?
Thick and thin blood films, diagnostic test
FBC
- Anaemia
U&E
- Increased urea and creatinine, AKI
Raised LDH
How is uncomplicated P.Falciparum malaria managed?
Riamet 3 days
Eurartesim 3 days
Malarone 3 days
Quinine 7 days plus oral doxycycline
How is complicated or severe P.Falciparum malaria managed?
IV Artesunate
IV Quinine plus oral doxycycline
When patient is stable and able to swallow, switch to oral treatments
How is malaria, not caused by P.Falciparum managed?
Chloroquine 3 days
Riamet 3 days
Add Primaquine 14 days in vivax and ovale to eradicate liver hypnozoites
What is schistosomiasis?
Infection transmissioned via fresh water and freshwater snails
What pathogens cause schistosomiasis?
S Haematobium
S Mansoni
S Japoncium
What is the presentation of schistosomiasis?
Swimmers itch/itchy papular rash
Cough
Abdominal discomfort
Splenomegaly
Eosinophilia
What investigations are used in Schistosomiasis diagnosis?
Antibody tests
Ova in stools and urine
How is schistosomiasis managed?
Praziquantel 20mg/kg, two doses 6hrs apart, plus repeated treatment 2-3 months later to ensure all worms are destroyed
Prednisolone if severe
What is dengue fever?
Infection caused by arbovirus that can progress to viral haemorrhagic fever
How does dengue present?
Sudden fever
Severe headache, often retro-orbital pain
Maculopapular rash
Facial flushing/dengue
Pleuritic pain
Haemorrhagic signs/petechiae
Thrombocytopenia
Raised transaminases
How does rickettsiosis present?
Abrupt onset swinging fever
Headache
Confusion
Rash
How is Rickettsiosis managed?
Tetracycline
How does toxoplasmosis present?
Asymptomatic
Usually resembles infective mononucleosis (sore throat, fever, lymphadenopathy)
