wk 5 - 6 topical infection Flashcards
tropical infections can be divided into 3
returned travellers (acute,enteric fever, fever and jaundice) protozoan infections helminthic infections
questions to ask a returned traveller 10
where? rural/urban? accomodation? when? when did they return? when did they start feeling unwell? insect bites? symptoms? anyone else unwell? activities? precautions?
what is likely to be found in a returned traveller infection on examination
pyrexia rash hepatosplenomegaly lymphadenopathy insect bites wounds
associated diseases of a returned travellers fever 5
resp tract infectioin - pneumonia, flu diarrhoea malaria enteric fever (typhoid/paratyhpoid fever) arboviruses - dengue/chikungunya
most common bacteria causing acute travellers diarrhoea, name 3 others
enterotoxigenic E.Coli
campylobacter
salmonella
shigella
if the patient was on a cruise ship, what would be expected organism 2
noravirus
rotavirus
t/f dysentery (bloody diarrhoea) is caused by E.coli157
true
name for profuse watery diarrhoea
cholera
toxin mediated disease, associated with outbreaks
what 2 investigations would be carried out for acute travellrs diarrhoea
stool culture
stool wet prep - ameobic trophozoites
t/f a single dose of azithromycin can stop worsening in travellers diarrhoea
ffalse floroquinolone (ciproflaxin)
when would a macroslide begiven
if suspected pathogen is antibiotic resistant - v common in asia
which fever is most common in those returning from india/SE asia, and often due to people visiting family/friends
enteric fever ((typhoid/paratyphoid)
likely incubation period of enteric fever
7-18days (can be up to 60)
associated symptoms of enteric fever
fever
headache
constipation/diarrhoea
dry cough
what 2 organisms cause enteric fever q
salmonella tyhpi
parayphi
if enteric fever patient has severe sepsis, what is given
Iv ceftriaxone
-cephalosporin, bind to cell wall
t/f 70% of salmonella tyhpi/paratyphi are resistance to azithromycin
false
70% resistance to ciprofloxacin (floroquinolone)
investigation if malaria suspected
blood film and rapid antigen
amoebiasis is an infection of sml intestine by a parasite, causing diarrhoea with blood/mucus. what organism causes this
entamoeb histolytica
protozoa
associated symptoms of amoebic dysentry
ab pain
fever
blood diarrhoea/colitis - perforation
toxic and unwell, abd tenderness
3 investigations if ameobiasis is suspected
stool microscopy for trophozoites or cysts (determines E.histolytica from e.dispar)
AXR - toxic megacolon
Endoscopy for biopsy - if no evidence of toxic dilation
amoebiasis can be assymptomatic, what would be found in the stools which would identify this
sheds cysts in stoools
if a liver abscess develops from amoebiasis, can have subacute presentation for over 2–4weeks. Outline this presentation
fever,sweats upper ab pain sometimes history of GI hepatomegaly point tenderness over right lower ribs
associated investigations for amoebic liver abscess
abnormal LFTs CXR - raised hemi-diaphragm USS/CT scan serology stool microscopy - often -ve
pyogenic vs amoebic liver abscess
pyogenic - bacterial
amoebic - e.histolytica
giarhia intestinalis (lamblia) invades duodenum and proximal jejunum, how does it spread?
faecal-oral route
contaminated water most common
presentation of giardiasis
watery, smelly diarrhoea
bloating, flatulence
ab cramps
weight loss
investigations for giardiasis
stool microscopy for cysts
PCR
treatment for Giardiasis
metronidazole
drugs used to clear gut lumen of parasites
paramomycin
diloxanide
most common helminth infection
ascariasis - intestinal nematodes
outline the lifecycle of helminth infections
eggs injested hatch in sml intestines invade gut walls intovenous system via liver - heart - lungs break into alveoli ascend tracheobronchial tree swallowed and in gut develop into adult worms, producing eggs
chronic infection of trematodes can lead to
hepatomegaly
liver fibrosis
portal hypertension
cestodes (tapeworms) are acquired by eating undercooked meat containing cysts. name given if ingested by pork/beef
pork - taenia solium
beef - saginatum
t/f saginatum can cause seizures
false
taenia solium can
chagas disease is caused by Triatome (trypanasoma cruzi) and affects the colon and oesophagus by
parasympathetic denervation
megaoesophagus
