Vector-Borne Diseases Flashcards

1
Q

Give examples of non-mosquito vectors.

A

Ticks

Bugs/Flies

Snails

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2
Q

What is Lyme Disease?

A

Also called Lyme borreliosis

It is a tick-borne multisystem disease caused by the spirochaete Borrelia burgdorferi.

It is mainly northern hemisphere - Europe and US.

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3
Q

Presentation of Lyme Disease.

A

Around 75% will remember the tick bite.

Peak infection is withing 48-72h of attachment.

Then follows stages;

Early localised - 3-30d after bite with erythema migrans, pain/pruritus, lymphadenopathy +/- constitutional symptoms like fever, malaise and headaches.

Early disseminated - Weeks to months after bite with borrelial lymphocytoma and neuroborreliosis + carditis.

Late disseminated - Months to years after bites. Acrodermatitis chronic atrophicans and lyme arthritis.

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4
Q

Explain lymphocytoma in in Lyme disease.

A

Bluish-red plaque/nodule where you should check earlobes, nipples and genitals.

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5
Q

Explain neuroborreliosis in Lyme disease.

A

Lymphocytic meningitis

Ataxia

manesia

Facial/cranial nerve palsies

Neuropathy

Encephalomyelitis

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6
Q

Diagnosis of Lyme disease.

A

Clinical with erythema migrans + known exposure.

Borrelia culture, PCR.

Two-tier serology due to false-positive reaction with other spriochaete infection.

Enzyme immunoassay/immunofluoresecence + immunoblot.

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7
Q

Treatment of Lyme Disease.

A

Doxycycline for erythema migrans. Can also give amoxicillin, phenoxymethylpenicillin, azithromycin.

Ceftriaxone or IV benzylpenicllin or doxycycline in Neuroborreliosis.

Doxyciline or amoxicillin or ceftriaxone if arthritis or carditis.

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8
Q

Prevention of Lyme Disease.

A

Keep limbs covered.

Use insect repellent

Inspect skin and remove ticks.

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9
Q

What is Rickettsial disease?

A

Rickettsiae are obligate, intracellular coccobacillary forms lying between bacteria and viruses.

It is gram-negative.

Mammals and arthropods are natural hosts.

More common in camping, hiking, hunting etc…

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10
Q

What is Rickettsial diease divided into?

A

Spotted fevers

Typhus

etc…

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11
Q

Presentation of Rickettsial disease.

A

INcubation 1-2 weeks.

Fever

Headache

Malaise

Rash

N+V

Myalgia

There might be lymphadenopathy and an eschar at the site of the bite.

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12
Q

Diagnosis of Rickettsial disease.

A

Clinical fever + rash + travel to endemic area

Serology, culture/PCR of blood/skin biopsy.

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13
Q

Treatment of Rickettsial disease.

A

Doxycycline, azithromycin, chloramphenicol.

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14
Q

What is Chaga’s disease?

A

A life-threatening illness due to protozoan Trypanosoma crusi which is transmitted by triatomine bugs.

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15
Q

Where is Chagas’ disease endemic?

A

Latin America

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16
Q

Presentation of Chagas’s disease.

A

Acute phase - 2 months with skin lesions (chagoma), fever, headache, myalgia, lymphadenopathy, unilateral conjunctivitis, periorbital oedema that can lead to closing of the eye (Romana’s sign), myocarditis, meningoencephalitis.

Chronic phase - years with dilated cardiomyopathy, mega-oesophagus, mega-colon and CNS symptoms.

17
Q

Diagnosis of Chagas’ disease.

A

Acute - trypomastigotes in blood, CSF and node aspirate.

Chronic with serology - Chagas’ IgG ELISA.

18
Q

Treatment of Chagas’ disease.

A

Benznidazole, nifurtimox.