Lecture 12 Travel Related Infection Flashcards
What is the vector for Malaria
Female anopheles mosquito
What is the 6 steps of the malaria cycle
- Mosquito bites human
- Takes blood and injects sporozoites (premature parasite)
- Sporozoites migrate to liver and infect liver cells
- Cells replicate to make Merozoites
- Merozoites rupture and invade and replicate in other red blood cells
- Mosquito take up red blood cells and take up Gametocytes which unit and form a zygote (7 days)
Name the 5 malaria species
- Plasmodium falciparum (potentially severe)
- Plasmodium vivax
- Plasmodium ovale
- Plasmodium malariae
- Plasmodium knowlesi
What are the symptoms of a malaria infection
- Fever
- Rigors
- Aching bones
- Abdomen pain
- Headache
- Dysuria
- Frequency
- Sore throat
- Cough
What are the signs of a malaria infection
- None
- Splenomegaly
- Hepatomegaly
- Mild jaundice
What are the complications of malaria
Cerebral malaria Blackwater fever Pulmonary oedema Jaundice Severe anaemia Algid malaria- gram negative septicaemia
How is malaria diagnosed
• Thick and thin blood films o Giemsa, Field’s stain • Quantitative buffy coat (QBC) o Centrifugation, UV microscopy • Rapid antigen tests o OptiMal o Parasight-F
How do you assess the severity of malaria
Severity Assessment: Complicated malaria =one or more of- • Impaired consciousness or seizures • Hypoglycaemia • Parasite count >2% • Haemoglobin <8mg/dL • Spontaneous bleeding/DIC • Haemoglobinuria • Renal impairment or PH<7.3 • Pulmonary oedema or ARDS • Shock (algid malaria)
Name 2 malaria drugs
- Quinine
* Artemisinins
What are the treatment options for uncomplicated P.falciparum
- Riamet (3 days)
- Eurartesim( 3 days)
- Malarone (3 days)
- Quinine (7 day)- plus oral doxycycline (or clindamycin)
What are the treatment options of complicated of severe P.falciparum malaria
- IV artesunate IV quinine- plus oral doxycycline (or clindamycin)
- When patient is stable & able to swallow, switch to oral treatments
What are the treatments of P. vivax, P. ovale, P. malariae, P. Knowlesi
- Chloroquine (3 days)
- Riamet (3 days)
- Add primaquine (14 days) in vivax and ovale to eradicate liver hypnozoites
What are the causative organisms of Typhoid (Enteric) Fever
- Salmonella typhi
* Salmonella paratyhphi
What are the clinical features of Typhoid fever during the 1st week
: fever, headache, abdomen discomfort, constipation, dry cough, relative bradycardia, neutrophilia, confusion
What are the clinical features of Typhoid fever during the 2nd week
fever peaks at 7-10 days, rose spots, diarrhoea begins, tachycardia, neutropenia
What are the clinical features of Typhoid fever during the 3rd week
complications): intestinal bleeding, perforation, peritonism, metastatic infections
What are the clinical features of Typhoid fever during the 4th week
Recovery
How is Typhoid fever diagnosed
Culture blood, urine and stool
Culture bone marrow
How is typhoid fever treated
Oral azithromycin IV ceftriaxone (if complicated)
What is the transmission vector of dengue fever
Aedes aegypti
What are the clinical features of dengue fever
- Sudden fever
- Severe headache, retro-orbital pain
- Severe myalgia and arthralgia
- Macular/maculopapular rash
- Haemorrhagic signs: petechiae, purpura, positive tourniquet tests
How is dengue fever diagnosed clinically
o Thrombocytopenia
o Leukopenia
o Elevated transaminases
o Positive tourniquet test
How is dengue fever diagnosed in the laboratory
PCR, serology
How is Dengue fever managed
No specific therapeutic agents
