Travel Related Infections Flashcards
What are the bacterial aetiologies of traveller’s diarrhoea? [10]
- Enterotoxigenic E.coli
- Enteroaggregative E.coli
- Campylobacter sp.
- Salmonella sp.
- Shigella sp.
- C. difficile
- Vibrio sp.
- Aeromonas
- Plesiomonas shigelloides
- Yersinia enterocolitica
What are the viral aetiologies of traveller’s diarrhoea? [3]
- Norovirus
- Rotavirus
- Enteric adenovirus
What are the parasitic aetiologies of traveller’s diarrhoea? [6]
- Giardia
- Cryptosporidium
- Cyclospora
- Microsporidia
- Isospora
- Entamoeba histolytica
How do you treat traveller’s diarrhoea? [3]
- Fluid replacement
- Antibiotics (reduce duration by 24hrs) - use only if required
- Quinolones
- Azithromycin
- Antimotility agents — CAUTION
What are the typical symptoms of traveller’s diarrhoea caused by ETEC? [7]
- anorexia
- malaise
- abdominal cramps
- watery diarrhoea (no blood)
- fever
- nausea
- vomiting
What investigations are used to diagnose malaria? [3]
- Antigen testing
- Blood films (thick & thin)
- PCR
What are the typical presenting signs & symptoms of malaria? [8]
- Fever
- Malaise
- Headache
- Myalgia (= pain in a muscle or group of muscles)
- Diarrhoea
- Anaemia
- Jaundice
- Renal impairment
What are the features of a severe malaria presentation? [8]
- Parasitaemia >2%
- Cerebral malaria
- Severe anaemia
- Renal failure
- Shock
- DIC (disseminated intravascular coagulation)
- Acidosis
- Pulmonary oedema
What is DIC (disseminated intravascular coagulation)? [1]
condition in which blood clots form throughout the body, blocking small blood vessels
What is the treatment for malaria? [3]
- artemether compounds (e.g. riamet)
- quinine
- doxycycline
What are the 2 methods to preventing malaria? [2]
- Bite avoidance
- Chemoprophylaxis
Name the 3 drugs used as prophylaxis for malaria, how often do you take them and what are their side effects/disadvantages? [9]
- Mefloquine
- Once weekly
- Psychiatric side effects
- Doxycycline
- Daily
- Photosensitisation
- Malarone
- Minimal side effects
- Costly
What are the causes of enteric fever? [4]
- typhoid = caused by salmonella (S.) typhi
- paratyphoid = caused by S. paratyphi
How is typhoid fever transmitted? [2]
- human-to-human transmission
- contaminated food/water
Describe the pathogenesis of enteric fever [3]
- Contaminated water/food (containing salmonella typhi/paratypi) is ingested
- S. typhi/paratypi invades through the Peyer’s patches in the small bowel and then infects the reticuloendothelial system (liver/spleen/lymph nodes)
- 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