Fever in returned traveller Flashcards
(21 cards)
Lifecycle of Malaria
Anopheline mosquito –> human
- -> Sporozoites in blood
- -> Sporozoites in the liver
- -> multiply in hepatocytes
- -> hepatocytes burst releasing merozoites into circulation
- -> merozoites infect RBCs
- -> Asexual division into schizonts
- -> release of daughter merozoites when RBCs burst
Features of P. falciparium
Incubation 7-28 days Multiple infected RBCs on blood film Causes adhesion of RBCs to endothelium --> organ dysfunction Cerebral malaria Renal failure
Features of P. Malariae
Persistant - difficult to treat
Features of P. Vivax
Dormant liver stages = needs primaquine treatment
Chemoprophylaxis for malaria?
Chloroquine sensitive = chloroquine
Chloroquine resistant = Doxycycline
Treatment of malaria?
Uncomplicated PF:
- Artemether and lumefantrine
Severe PF:
- Artesunate or quinine IV
PV, PM or PO = chloroquine and primaquine
Features of Typhoid?
S. Typhi and Paratyphi
Faecal-oral transmission - water bourne
Fever, abdominal pain, hepatosplenomegaly, neuropsychiatric changes, bradycardia, rose spots
Complications of Typhoid?
GIT perforation Endocarditis and pericarditis Splenic or liver abscess Endovascular Chronic carriage --> carcinoma of gallbladder
Treatment of typhoid?
Africa = Ciprofloxicin Asia = Ceftriaxone and azithromycin
Features of Dengue fever?
Aedes aegyptii mosquito
Fever, severe headache, MSK pain, rash
Leukopenia, neutropenia, thrombocytopenia
Complications of dengue fever?
Dengue haemorrhagic fever
Dengue shock syndrome
Treatment of dengue?
Supportive
Features of Amoebiasis?
Entamoeba Histolytica
Ingestion –> excystation in SI –> trophozoite –> infection of LI
GIT = Dysentery, colitis, perforation, megacolon
Extra GIT = Liver abscess, lung abscess, brain abscess, GU disease
Treatment of Amoebiasis?
Metronidazole
Features and treatment of hepatitis A
Acute self limiting hepatitis
Faecal-oral transmission
Highly contagious
Supportive treatment
Vaccination
Common causes of acute diarrhoea in travellers?
E. coli Shigella Salmonella Campylobacter jejuni Vibrio Entamoeba Crypto Viruses
Most common cause of chronic diarrhea in returned travellers?
Giardia Lamblia
Treatment of travellers diarrhoea?
Azithromycin 1gm or norfloxacin 800mg
Loperamide
Features of Ebola?
Virus - filovirus family
70% mortality
Transmission from infected bodily fluids
Supportive management
Features of Zika virus?
Flavivirus
Mosquito bourne transmission, sexual transmission and vertical transmission
In children - mild illness
Adults = Acute febrile illness - fevers, rash, arthragias, CONJUNCTIVITIS
Fetal = microcephaly
Treatment = supportive
Vaccinations for travellers?
ADT HBV HAV Meningococcal Polio Typhoid Cholera Yellow fever Japanese B encephalitis Rabies
