Traveller's Infection Flashcards
Common symptoms in traveller’s infection.
GI - D+V
Jaundice
Lymphadenopathy and hepatosplenomegaly
Resp - cough and SOB
Rash
Most common tropical infections in the UK.
Malaria
Dengue fever
Typhoid
History of traveller’s infection.
Geographic region of travel within 12 last months
Dates of travel and duration of stay to identify incubation period
Careful documentation of time of onset and nature of various signs and symptoms.
Types of accommodations + rural vs urban stay.
Recreational activities and exposures. (Insects?, animals?, freshwater lakes and streams?, well/canal water?)
Type of food and water consumed
Sexual history
PMH
Common infections with incubation of 0-10 days.
Dengue
Rickettsia
Viral like EBV
GI bacteria and amoeba (gastroenteritis)
Chikungunya
Common infections with incubation of 10-21 days.
Malaria
Typhoid
Primary HIV infection
Brucellosis
Enteric fever
Leptospirosis
Melioidosis
Q-fever
VHF
Chagas’
Common infections with incubation of >21 days.
Malaria
Chronic bacterial infections like brucella, coxiella, endocarditis and bone and joint infections.
TB
Parasitic infection of helminths or protozoa like Schistosomiasis and visceral leishmaniasis
Viral hepatitis
Pre-travel immunisation and chemoprophylaxis.
Vaccination against Hep A, hep B, typhoid, tetanus, childhood infections like MMR, yellow fever and rabies.
If travel was to malarious areas give malaria chemoprophylaxis and advice about insect repellents and bed-net use.
What is a slow pulse rate for the degree of fever suggestive of?
Typhoid fever
What is a maculopapular rash suggestive of?
Dengue
Leptospirosis
Rickettsia
Mono by EBV or CMV
Rubella
Parvovirus B19
Prim HIV
Chikungunya
VHF
What are rose spots suggestive of?
Pink macules 2-3mm in diameter on chest or abdomen is suggestive of Typhoid fever
What are black necrotic ulcer with erythematous margins suggestive of?
Rickettsia due to tick exposure
What is a purpuric rash suggestive of?
Dengue
Meningococcal infection
Plague
DIC
VHF
What are petechiae, ecchymoses or haemorrhagic lesions suggestive of?
Dengue fever
Meningococcaemia
Viral haemorrhagic fever
What is conjunctivial suffusion suggestive of?
Leptospirosis
What is hepatosplenomegaly suggestive of?
Mono
Malaria
Visceral leishmaniasis
Typhoid
Brucellosis
Viral hepatitis
HIV
Enteric fever
Leptospirosis
What are neurological symptoms suggestive of?
Cerebral malaria
Japanese encephalitis
West Nile Virus encephalitis
HIV
Syphilis
Lyme disease
Leptospirosis
Brucellosis
Tick-borne encephalitis
Investigations in Traveller’s infection.
FBC
LFTs
U&Es
Malaria smears +/- antigen detection dipstick
Blood cultures x2
Urinalysis
Stool culture +/- stool for ova, cysts and parasites
CXR
HIV, Hep B, Hep C and Syphillis serology
Infections common in Sub-Saharan Africa.
Malaria
HIV
Rickettsia
Schisto
Ameobiasis
Brucellosis
Dengue
Enteric fever
Meningococcus
VHF
Infections common in South-East Asia.
Malaria
Chikungunya
Dengue
Enteric fever
Leptospirosis
Japanese encephalitis
Infections common in South and Central Asia.
Malaria
Dengue
Enteric Fever
Chikungunya
VHF
Japanese encephalitis
Infections common in Middle East, Mediterranean and North Africa.
Brucellosis
Q-fever
Zika
Infections common in South America and the Carribean.
Malaria
Dengue
Enteric Fever
Brucellosis
Leptospirosis
Zika
Yellow fever
Infections common in Eastern Europa and Scandinavia.
Lyme disease
Hanta virus
Tick-borne encephalitis
Infections common in Australia.
Dengue
Q fever
Ricketssia
Infections common in North America
Lyme Disease
Rickettsia
What is jaundice suggestive of?
Viral hepatitis
Severe falciparum malaria
Enteric fever
Leptospirosis
Relapsing fever
Typhus
VHF
