Tropical Infections

Question 1

what infection is known as bilharzia

Answer 1

schistosomiasis

Question 2

how do people become infected with schistosomiasis

Answer 2

intermediate host are fresh water snails – release schistosoma as free swimming larvae which then penetrate human skin

Question 3

symptoms of acute schistosomiasis infection

Answer 3

usually asymptomatic

• can get a ‘swimmers itch’ a few days after exposure, typically on lower legs or feet
• in some patients can get katayama fever 1-2 months later: malaise, arthralgia, diarrhoea, hepatosplenomegaly, RUQ pain

Question 4

schistosomiasis can cause what type of cancer

Answer 4

bladder squamous cell carcinoma

Question 5

other chronic complications of schistosomiasis

Answer 5

portal hypertension
liver disease
splenomegaly

Question 6

treatment of schistosomiasis

Answer 6

praziquantel

Question 7

what areas are affected by dengue fever

Answer 7

Southeast Asia

Central + South America

Question 8

symptoms of dengue fever

Answer 8

fever
arthralgia + myalgia
rash
headache

Question 9

what is dengue haemorrhagic fever

Answer 9

PLT count <100

- haemorrhagic symptoms

Question 10

what areas are affected by Zika virus

Answer 10

Caribbean + Latin America

Question 11

symptoms of Zika virus

Answer 11

maculopapular itchy rash in 98% of cases
fever
arthralgia
conjunctivitis

Question 12

how is Zika virus spread

Answer 12

mosquito bites

sexual transmission

Question 13

what areas are affected by yellow fever

Answer 13

South America

Africa

Question 14

symptoms of Yellow Fever

Answer 14

fever, headache, myalgia, back pain – most patients go into remission after 3-4 days
- some then relapse into phase of fever, vomiting, epigastric pain, haemorrhage, multi-organ failure.

Question 15

what condition is known as enteric fever

Answer 15

Typhoid

Question 16

what bacteria causes typhoid

Answer 16

salmonella typhi

salmonella paratyphoid in paratyphoid fever

Question 17

what areas does typhoid affect

Answer 17

Asia (especially southeast)
Africa
South America

Question 18

presentation of Typhoid

Answer 18

fever
headache
malaise
constipation 
rose spots -- macule on chest/abdo
hepatosplenomegaly

Question 19

investigations for Typhoid

Answer 19

blood + stool cultures

Question 20

treatment for Typhoid

Answer 20

Azithromycin or ceftriaxone

Question 21

50 year old farmer with arthralgia in large joints, chronic diarrhoea, abdominal pain and weight loss.
Likely diagnosis?

Answer 21

Whipple’s disease

Question 22

presentation of Whipple’s disease

Answer 22

large joint arthralgia

chronic diarrhoea, colicky abdo pain, malabsorption, weight loss

Question 23

investigations for Whipple’s disease

Answer 23

PCR + acid schiff stain of tissue biopsy from small bowel

Question 24

treatment for Whipple’s disease

Answer 24

IV ceftriaxone for 2 weeks

then 3-12 months oral co-trimoxazole

Question 25

most common cause of gastroenteritis in returning traveller to UK

Answer 25

giardiasis

Question 26

how is giardiasis spread

Answer 26

faecal-oral

Question 27

presentation of giardiasis

Answer 27

diarrhoea – weight loss

abdo pain + bloating

Question 28

what is seen on stool microscopy in giardiasis

Answer 28

cysts

Question 29

treatment of giardiasis

Answer 29

oral metronidazole for 5 days