Flashcards in Hemorrhagic Fevers and Malaria Deck (32):
What is the vector for Dengue fever?
- Aedes aegypti (mosquito)= DAYTIME biter
**** What is the clinical presentation of Dengue fever?
- ISLANDS of WHITE in a SEA of RED.
- retro-orbital pain
*** What is the Dengue Hemorrhagic fever Triad?
- plasma leakage
What are the clinical manifestations of the FEBRILE PHASE of Dengue fever?
- macular or maculopapular rash
- petechiae, ecchymosis, epistaxis, or hematuria.
What are the clinical manifestations of the CRITICAL PHASE of Dengue fever?
- pleural effusion
- severe abdominal pain
What is Antibody-Dependent Enhancement (ADE) associated with Dengue fever?
- disease-enhancing activity of cross-reacting antibodies elicited by previous infections by heterologous viruses.
**** What is Chikengunya virus?
- an epidemic arbovirosis that causes acute febrile illness, rash, and SEVERE relapsing ARTHRALGIA.
*vector is asian tiger mosquito (bright white stripes).
What should be on your DDX for chikengunya?
- dengue, malaria, parvovirus B19
What are the characteristics of viral hemorrhagic fever?
- bleeding from the skin, mucous membranes, vene-puncture sites, and fever.
*highly contagious and spread by body fluids.
What is the main virus that causes hemorrhagic fever?
- Ebola virus
*WEST AFRICA is epicenter.
How is Ebola transmitted?
- zoonotic virus (bats most likely) via direct contact through broken skin or unprotected mucous membranes. with an EVD-infected patient's blood or body fluids.
What is the classical appearance of Ebola infection?
- deep-set eyes, ghost-like, expressionless face, extreme lethargy along with a stooped walk and extreme cachexia.
- skin sloughing, hair loss, and neuro-psychiatric illness.
What happened in 2014 with Ebola?
- WHO declared Ebola a Public Health Emergency of International Concern (PHEIC).
How does Ebola virus kill?
- hypovolemia and vascular collapse from electrolyte abnormalities, multi-organ failure, septic shock, or DIC.
What symptom may also be associated with Ebola?
- hiccups (dry rope in the throat).
What laboratory findings will be seen with Ebola?
- elevated LFTs (AST greater than ALT)
- electrolyte abnormalities
- prolonged PT and PTT
- proteinuria, increased creatinine
How contagious is Ebola?
*requires biosafety level 4 laboratory.
How does Malaria present?
- fever, chills, diarrhea (don't let this one fool you), headaches, dark urine, renal failure, server anemia, and icterus.
What causes Malaria?
- plasmodium sp. (parasite) transmitted via mosquito (anopheles).
*vector must bite twice.
What 2 areas does malaria affect?
1. LIVER (hepatocytes rupture releasing merozoites).
2. RBCs (rupture releasing gametocytes).
What will you see on blood smear with malaria? (always do thick and thin smear)
- ROSETTING (RBCs stick together).
- will see plasmodium species in RBCs as well.
What is the fever pattern with malaria?
- comes and goes (intermittent).
*opposed to typhoid fever which is continuous.
Do you develop immunity to malaria following infection and treatment?
- it is patchy and incomplete.
What are the 3 intra-erythrocytic organisms?
Which plasmodium species is the most lethal?
What are some other symptoms of malaria?
- pale skin
- severe anemia
- nephrotic syndrome
- splenomegaly or rupture.
- gingival bleeding
What drug is used for relapsing malaria?
With what disease should you be careful when using primaquine to treat malaria?
- G6PD deficiency causing hemolysis.
What is important for malaria prevention?
- mosquito nets and DDT spray
What is yellow fever?
- mosquito born hemorrhagic fever causing hepatitis, renal failure, shock, and death.
*found mostly in the tropics (but also seen in philadelphia in the 1700s).
Is yellow fever seen in Asia?