Infectious Diseases

Question 1

Dengue Fever

Answer 1

Can be self limiting or develop into Dengue haemorrhagic fever with shock
- risk increases for secondary rather than primary infection

Sx: Retro-orbital pain, headache, muscle+bone pain. Fevers 5-7 days.
Macular/maculopapular rash
Tourniquet test - pump cuff midway between systolic and diastolic. Leave for 5 min.
- positive if >10 petechiae are observed when cuff removed

Ix can show thrombocytopaenia

Warning signs for severe disease/haemorrhagic fever

• Abdo pain
• Vomiting
• Fluid accumulation including ascites + hepatomegaly
• Mucosal bleeding
• Increase in haematocrit

Question 2

Typhoid

Answer 2

Incubation 10-14 days

Clinical features:

• Insidious onset
• Profound headache
• Dry cough
• Abdo pain
• Fevers
• Constipation (early), diarrhoea (late)
• Splenomegaly possible

Typically clinical diagnosis
Blood/stool cultures can be helpful

Treat with Azithro 1g for 7/7 OR Ciprofloxacin 500mg BD 7-10 days
Stepladder fevers + Abdo pain + Relative bradycardia