Tropical infections Flashcards
HIV transmission in children?
Mother to child transmission is most common (intrauterine, intrapartum, postpartum)
Diagnosis of HIV in children?
1) <18months (born to HIV infected mums) - have transplacental maternal IgG HIV antibodies (positive test indicated exposure to HIV but not infected)
- this age group - HIV DNA PCR.
- 2 negative HIV DNA PCR within first 3 months, 2 weeks after postnatal antiretroviral therapy indicate infant not infected
2) >18 months - antibodies to virus
Clinical features of HIV in children?
1) In first year - can progress to AIDS or be asymptomatic
2) Mild immunosuppression = lymphadenopathy or parotitis
3) Moderate immunosuppression = bacterial infections, candidiasis, chronic diarrhoea, lymphocytic interstitial pneumonitis
4) Severe AIDS = pneumocystis pneumonia, encephalopathy, severe failure to thrive
If persistent lymphadenopathy, hepatosplenomegaly, recurrent fever, parotid swelling, thrombocytopenia = test for HIV
Management of HIV in children?
1) Antiretroviral therapy - combination of 3 or 4 drugs
2) Infants that are HIV infected/older kids with low CD4 count = prophylaxis for pneumocystis pneumonia (co-trimoxazole)
3) Prevention:
- Immunization but NOT BCG (live vaccine can cause disseminated disease)
- MDT - survive into adulthood
- Complex issues with caregivers, family, and confidentiality
4) Reduction of vertical transmission:
- reduce breast feeding
- maternal antenatal, perinatal and postnatal antiretroviral drugs
- active labour and delivery management - avoid prolonged rupture of membranes or unnecessary instruments
- pre-labour c-section
What causes malaria?
Plasmodium falciparum
How does malaria present?
1) Fever
2) diarrhoea
3) vomiting
4) flu symptoma
5) anaemia
6) jaundice
7) thrombocytopenia
Diagnosis of malaria?
Consider malaria in febrile child returning from tropics!!
1) Thick blood film - species
2) falciparum, vivid, ovale, malaria confirmed on thin film
Treating malaria?
1) Quinine
2) Prevention - spray, nets, repellants
Typhoid presentation?
1) worsening headache
2) abdo pain
3) cough
4) headache
5) myalgia
6) GI sx in second week
Salmonella typhi or salmonella paratyphi
Complications with typhoid?
1) GI perforation
2) Nephritis
3) Hepatitis
4) Myocarditis
Treating typhoid?
3rd gen cephalosporin OR azithromycin
Dengue fever transmission method?
By infected mosquitos
Presentation of Dengue fever?
1) Fine erythematous rash
2) Myalgia
3) Arthralgia
4) High fever
Fluid resuscitation required
Complications of Dengue fever?
1) Dengue Shock syndrome - when child previously infected has another infection with a different strain of virus
2) Can present with severe capillary leak syndrome - leads to hypotension and haemorrhage problems
3) Not infectious/contagious
