Tropical Flashcards
Most common cestode infec
Hymnolepis Nana
Tenea solium
Undercooked pork
4 key findings in fasciola infection
Fever
Jaundice
Hepatomegaly
Hyperesinophilia
Water lily sign
U/S separation of germinal membrane of hydatid cyst
Complications of hydatid cyst rupture
- Anaphylaxis and allergy
- Dissamination
- Cholangitis
- Hemoptysis and secondary infection if bronchial
What is PAIR in percutanous drainage of Hydatid cyst larger than 5cm?
Done if pt is inoperable:
- Puncture
- Aspiration
- Installation of cysticidal then hypertonic saline/ ethanol for 5-10min
- Re-aspirate
Hydatid medical treatment
Albendazole 400mg x 2/day
If <5 cm for 6 months
As per drugs.com
28days cycle then 14days drug free interval, for a total of 3 cycles
Pyogenic liver abcess commonly caused by?
Polymicrobial most commonly Ecoli and K. Pneumonea
Diration of medical therapy after PAIR hydated
1 month albendazole and 4 days before
Most common site of pyogenic liver abcess
Biliary tract
Anchovy sauce
Amoebic liver abscess acellular debris
Infective stage of amoeba
Cyst
TTT pyogenic liver abcess
Medical ( 6 to 12 weeks) and surgical (or drain)
Mainstay of diagnosis in invasive amoebiasis
Detection of Ab (serology)
TTT of amoeba
Luminal:
1. Paromomycin 25mg/kg x 3/day for 10days, diloxanide 500mgx3x10
Tissue;
Metronidazole 800mgx3x10 (is luminal as well.
Tinidazole 2gm for 3 days
Abscess up to 10cm can be cured with metronidazole without drainage
Surgical indication for Amoebic liver abscess
- Possible pyogenic liver abscess
- Not responding to metronidazole 4days
- Large left sided abcess
- Severely ill patient
- Empyema from rupture
U/S for liver amoebiasis
Sensitive but not specific
Flask shaped ulcer
Intestinal amobiases
Serology in liver abscess
Mainstay Diagnostic but could have false negative in 1st week
Non infectious causes of chronic hepatitis
NASH
Alcoholic
Metabolic: hemosidrosis..
Drug induced: phenytoin INH Methyldopa macrodantin
Viral hepatitis in which fever fail to subside with icetric phase?
CMV