Travel Related Infection

Question 1

What is typhoid?

Answer 1

Infection associated with poor sanitation and unclean drinking water caused by salmonella typhi/paratyphi

Question 2

What is the most common cause of typhoid?

Answer 2

Salmonella typhi

Question 3

What is the incubation period of typhoid?

Answer 3

7 days-4 weeks

Question 4

How does typhoid present?

Answer 4

Fever, peaks at 7-10 days

Rose spots/patchy maculopapular rash on trunk, which blanch

Headache

Non bloody diarrhoea

Constipation

Bradycardia

Question 5

How is typhoid diagnosed?

Answer 5

Bone marrow aspirate and culture, most sensitive test

Question 6

What is the drug of choice for uncomplicated typhoid?

Answer 6

Oral Azithromycin

Question 7

What is the drug of choice for complicated typhoid?

Answer 7

IV Ceftriaxone

Question 8

What is malaria?

Answer 8

Infection common in tropical areas, transmitted via mosquito bites

Question 9

What pathogens cause malaria?

Answer 9

Plasmodium falciparum

Plasmodium vivax

Plasmodium ovale

Plasmodium knowlesi

Question 10

How does malaria present?

Answer 10

Fever on alternating days

Rigors

Musche aches

Abdominal pain

Jaundice

Headache

Hepatomegaly

Question 11

What investigations are used in malaria?

Answer 11

Thick and thin blood films, diagnostic test

FBC

• Anaemia

U&E

• Increased urea and creatinine, AKI

Raised LDH

Question 12

How is uncomplicated P.Falciparum malaria managed?

Answer 12

Riamet 3 days

Eurartesim 3 days

Malarone 3 days

Quinine 7 days plus oral doxycycline

Question 13

How is complicated or severe P.Falciparum malaria managed?

Answer 13

IV Artesunate

IV Quinine plus oral doxycycline

When patient is stable and able to swallow, switch to oral treatments

Question 14

How is malaria, not caused by P.Falciparum managed?

Answer 14

Chloroquine 3 days

Riamet 3 days

Add Primaquine 14 days in vivax and ovale to eradicate liver hypnozoites

Question 15

What is schistosomiasis?

Answer 15

Infection transmissioned via fresh water and freshwater snails

Question 16

What pathogens cause schistosomiasis?

Answer 16

S Haematobium

S Mansoni

S Japoncium

Question 17

What is the presentation of schistosomiasis?

Answer 17

Swimmers itch/itchy papular rash

Cough

Abdominal discomfort

Splenomegaly

Eosinophilia

Question 18

What investigations are used in Schistosomiasis diagnosis?

Answer 18

Antibody tests

Ova in stools and urine

Question 19

How is schistosomiasis managed?

Answer 19

Praziquantel 20mg/kg, two doses 6hrs apart, plus repeated treatment 2-3 months later to ensure all worms are destroyed

Prednisolone if severe

Question 20

What is dengue fever?

Answer 20

Infection caused by arbovirus that can progress to viral haemorrhagic fever

Question 21

How does dengue present?

Answer 21

Sudden fever

Severe headache, often retro-orbital pain

Maculopapular rash

Facial flushing/dengue

Pleuritic pain

Haemorrhagic signs/petechiae

Thrombocytopenia

Raised transaminases

Question 22

How does rickettsiosis present?

Answer 22

Abrupt onset swinging fever

Headache

Confusion

Rash

Question 23

How is Rickettsiosis managed?

Answer 23

Tetracycline

Question 24

How does toxoplasmosis present?

Answer 24

Asymptomatic

Usually resembles infective mononucleosis (sore throat, fever, lymphadenopathy)

Question 25

How is toxoplasmosis managed?

Answer 25

No treatment unless immunocompromised or severe infection

Question 26

What are the two types of trypanosomiasis?

Answer 26

African trypanosomiasis (sleeping sickness)

American trypanosomiasis (Chagas’ disease)