Tropical Gastroenterology Flashcards
What should you look for in a returned traveller when doing an examination?
Fever Rash Hepatosplenomegaly Lymphadenopathy Insect bites Wounds
What might fever in a returned traveller be indicative of?
Resp tract infections - pneumonia/influenza
Travellers diarrhoea
Malaria
Enteric fever (typhoid etc)
Arboviruses
Describe acute travellers diarrhoea?
Typically Enterotoxigenic E.coli
Can also be camplyobacter, salmonella, shigella
Cruise ships - Noro/rotavirus
What might be the cause of travellers diarrhoea on cruise ships?
Noro/rotavirus
What would profuse watery diarrhoea indicate?
Cholera - toxin mediated disease often associated with outbreaks - refugee camps
What investigations would you do for acute travellers diarrhoea?
Stool culture
What would the treatment for actor travellers diarrhoea be?
Supportive - rehydration
What is enteric fever?
Typhoid or parathyroid fever
What is enteric fever most common in?
Those returning from indian subcontinent and SE asia
What is the incubation period for enteric fever (typhoid)?
7-18days
can be up to 60 days
What are the symptoms for enteric fever (typhoid)?
Fever
Non-specific
Headache
Constipation or diarrhoea
Dry cough
What are the complications of enteric fever (typhoid)?
Complications GI bleeding GI perforation Encephalopathy Bone and joint infection
What is enteric fever (typhoid) caused by?
Salmonella
What are some causes of fever and jaundice (pre hepatic - haemolytic)?
Malaria
HUS as complication of E.coli
Sickle cell crisis triggered by infection
What are some causes of fever and jaundice (hepatic)?
Hepatitis A and E – acute (occasionally Hepatitis B)
Leptospirosis – Weils diseases (Icteric, haemorrhagic and renal failure)
Malaria
Enteric fever
Typhus
Viral haemorrhagic fever
What are some causes of fever and jaundice (post-hepatic)?
Ascending cholangitis
helminths
What is amoebic liver abscess?
A amoebic liver abscess is a type of liver abscess caused by amebiasis. It is the involvement of liver tissue by trophozoites of the organism Entamoeba histolytica and of is abscess due to necrosis.
What is the presentation of amoebic liver abscess?
Incubation period 8-20 weeks
Fever, cough, aching abdo pain etc - usually male
What is the management of amoebic liver abscess?
Metronidazole
What are helminth infections?
Soil-transmitted helminth infections are caused by different species of parasitic worms. They are transmitted by eggs present in human faeces, which contaminate the soil in areas where sanitation is poor.
(worms and parasites etc)
What are some protozoan infections?
Guardia lamblia - cysts or parasits in the stool, treat metronidazole
Trypanosome cruzi (chagas’ disease)
