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Week 6 - Clinical Microbiology & Infections 1 > Travel Related Infections > Flashcards

Travel Related Infections Flashcards

1
Q

What are the bacterial aetiologies of traveller’s diarrhoea? [10]

A
  1. Enterotoxigenic E.coli
  2. Enteroaggregative E.coli
  3. Campylobacter sp.
  4. Salmonella sp.
  5. Shigella sp.
  6. C. difficile
  7. Vibrio sp.
  8. Aeromonas
  9. Plesiomonas shigelloides
  10. Yersinia enterocolitica
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2
Q

What are the viral aetiologies of traveller’s diarrhoea? [3]

A
  1. Norovirus
  2. Rotavirus
  3. Enteric adenovirus
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3
Q

What are the parasitic aetiologies of traveller’s diarrhoea? [6]

A
  1. Giardia
  2. Cryptosporidium
  3. Cyclospora
  4. Microsporidia
  5. Isospora
  6. Entamoeba histolytica
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4
Q

How do you treat traveller’s diarrhoea? [3]

A
  1. Fluid replacement
  2. Antibiotics (reduce duration by 24hrs) - use only if required
    • Quinolones
    • Azithromycin
  3. Antimotility agents — CAUTION
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5
Q

What are the typical symptoms of traveller’s diarrhoea caused by ETEC? [7]

A
  1. anorexia
  2. malaise
  3. abdominal cramps
  4. watery diarrhoea (no blood)
  5. fever
  6. nausea
  7. vomiting
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6
Q

What investigations are used to diagnose malaria? [3]

A
  1. Antigen testing
  2. Blood films (thick & thin)
  3. PCR
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7
Q

What are the typical presenting signs & symptoms of malaria? [8]

A
  1. Fever
  2. Malaise
  3. Headache
  4. Myalgia (= pain in a muscle or group of muscles)
  5. Diarrhoea
  6. Anaemia
  7. Jaundice
  8. Renal impairment
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8
Q

What are the features of a severe malaria presentation? [8]

A
  1. Parasitaemia >2%
  2. Cerebral malaria
  3. Severe anaemia
  4. Renal failure
  5. Shock
  6. DIC (disseminated intravascular coagulation)
  7. Acidosis
  8. Pulmonary oedema
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9
Q

What is DIC (disseminated intravascular coagulation)? [1]

A

condition in which blood clots form throughout the body, blocking small blood vessels

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10
Q

What is the treatment for malaria? [3]

A
  1. artemether compounds (e.g. riamet)
  2. quinine
  3. doxycycline
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11
Q

What are the 2 methods to preventing malaria? [2]

A
  1. Bite avoidance
  2. Chemoprophylaxis
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12
Q

Name the 3 drugs used as prophylaxis for malaria, how often do you take them and what are their side effects/disadvantages? [9]

A
  1. Mefloquine
    • Once weekly
    • Psychiatric side effects
  2. Doxycycline
    • Daily
    • Photosensitisation
  3. Malarone
    • Minimal side effects
    • Costly
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13
Q

What are the causes of enteric fever? [4]

A
  1. typhoid = caused by salmonella (S.) typhi
  2. paratyphoid = caused by S. paratyphi
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14
Q

How is typhoid fever transmitted? [2]

A
  1. human-to-human transmission
  2. contaminated food/water
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15
Q

Describe the pathogenesis of enteric fever [3]

A
  1. Contaminated water/food (containing salmonella typhi/paratypi) is ingested
  2. S. typhi/paratypi invades through the Peyer’s patches in the small bowel and then infects the reticuloendothelial system (liver/spleen/lymph nodes)
  3. Eventually, after a period of time, you become bacteraemic (i.e. have a high fever)
    • So this is an illness that causes bacteraemia, not diarrhoea, not vomiting but bacteraemia
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16
Q

How long does it take for the symptoms of enteric fever to appear (what is the incubation period) and what is this dependent on? [5]

A
  • approx. 5 to 21 days
  • depending on:
    1. age
    2. gastric acidity
    3. immune status
    4. infectious load
17
Q

What are the GI symptoms of enteric fever? [4]

A
  1. diarrhoea or constipation
    • 50:50/diarrhoea more common in children
  2. abdominal pain
  3. rectal bleeding
  4. bowel perforation
    • due to hyperplasia
    • peyer’s patches
18
Q

What are the non-GI symptoms of enteric fever? [4]

A
  1. Neurological
    • Headache (44-94%)
    • Enteric encephalopathy
  2. Bacteraemia
    • due to metastatic infection
  3. Relative bradycardia
  4. Rose spots
19
Q

What are Rose spots? [1]

A

red macules 2-4mms in diameter occurring in patients with enteric fever

20
Q

How is enteric fever diagnosed? [4]

A
  1. Travel history
    • Area visited
    • Food and drink
    • Pre-travel vaccination/advice
  2. Blood culture
  3. Stool culture
  4. Serology
21
Q

What are the 3 antibiotics used to treat enteric fever? [3]

A
  1. Quinolones
  2. Cephalosporins
  3. Azithromycin
22
Q

How long is the incubation period for dengue fever? [1]

23
Q

What are the signs & symptoms of dengue fever? [9]

A
  1. Headache (often retro-orbital pain)
  2. Fever
  3. Arthralgia (pain in joints)
  4. Myalgia (pain in muscles)
  5. Rash (sunburn-like rash)
  6. Cough
  7. Sore throat
  8. Nausea
  9. Diarrhoea
24
Q

What are the typical laboratory findings in a patient with dengue fever? [3]

A
  1. Leucopenia (reduction in WBCs)
  2. Thrombocytopenia (reduction in platelets)
  3. Transaminitis (hepatitis)
25
Q

How do you manage dengue fever? [1]

A

symptomatic management

  • (patients tend to get better over time)
26
Q

What are the clinical features of dengue haemorrhagic fever? [4]

A
  1. ↑ increased vascular permeability
  2. Marked thrombocytopenia
  3. Significantly high fever
  4. Bleeding (through mucous membranes)
27
Q

What are the causes of viral haemorrhagic fever? [7]

A
  1. Lassa = spread by rats
  2. Ebola/Marburg = spread by giant fruit bat
  3. CCHF
  4. SAVHFs
  5. RVF
  6. DHF
  7. Yellow fever

Week 6 - Clinical Microbiology & Infections 1 (13 decks)

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