Microbiology 24 - Fever in the Returning Traveller

Question 1

Recall some differentials for fever and rash in the returning traveller

Answer 1

Viral: dengue, chickungunya, measles
Bacterial: typhoid (look for rose spots)

Question 2

Recall some differentials for fever and abdo pain in the returning traveller

Answer 2

Typhoid fever

Amoebic liver abscess

Question 3

Recall some differentials for fever and cytopaenias in the returning traveller

Answer 3

Dengue, chickungunya, typhoid, malaria

Question 4

Recall some differentials for fever and haemorrhage in the returning traveller

Answer 4

Viral haemorrhagic fevers (dengue/ ebola)

Meningococcaemia

Question 5

Recall a differential for fever and eosinophilia in the returning traveller

Answer 5

Schistosomiasis

Question 6

Recall some differentials for fever > 6 weeks post-travel in the returning traveller

Answer 6

Vivax malaria
Acute hepatitis
TB
Amoebic liver abscess

Question 7

What % of parasitaemia constitutes a severe malaria?

Answer 7

> 2%

Question 8

What is the treatment for falciparum malaria?

Answer 8

IV Artesunate

Question 9

What type of mosquito carries malaria?

Answer 9

Female Anopheles

Question 10

Recall the different types of malaria

Answer 10

Falciparum
Vivax
Ovale
Malariae
Knowelsi

Question 11

What acid base abnormality may be seen in malaria?

Answer 11

Metabolic acidosis

Question 12

Why is malaria sometimes known as ‘blackwater fever’?

Answer 12

Due to the haemaglobinuria

Question 13

What is the gold standard test for malaria?

Answer 13

Thick and thin blood films

Question 14

What are the treatments for non-falciparum malaria?

Answer 14

Primaquine and chloroquine

Question 15

What type of mosquito is a vector for dengue virus?

Answer 15

Aedes

Question 16

What are the symptoms of dengue?

Answer 16

Fever
Headache
Myalgia
BLANCHING RASH

Question 17

What cytopaenias are expected in dengue infection?

Answer 17

Thrombocytopaenia

Neutropaenia

Question 18

What are the possible causative organisms in typhoid (enteric) fever?

Answer 18

Salmonella typhi/ paratyphi

Question 19

What is the phrase “himalaya peak fevers” pathognemonic for?

Answer 19

Typhoid fever

Question 20

What is the treatment of typhoid fever?

Answer 20

Ceftriaxone then azithromycin