Tropical Medicine: Fever in the Returning Traveller Flashcards
(39 cards)
Name one cause of fever and rash
Dengue Chikungunya Ricketsia Enteric Fever acute HIV Measles
Name one cause of fever and abdo pain
Enteric Fever
Amoebic Liver abscess
Name one cause of fever and normal or low blood count
Dengue Malaria Ricketsia Enteric Fever Chikungunya
Name one cause of fever and haemorrhage
VHF
Meningococcaemia
Leptospirosis
Ricketsia
Name one cause of fever and eosinophilia
Acute schistosomiasis
Drug hypersensitivity
Fascioliasis
Other parasite
Name one cause of fever and pulmonary infiltrates
Bacterial/ Viral pathogens
Legionellosis
Acute Schistosoiasis
Q fever (Coxiella Burnetti)
Name one cause of fever and altered mental status
Cerebral Malaria
Encephalitis of any cause
Trypanosomiasis
Name one cause of mononucleosis syndrome
EBV
CMV
Toxoplasma
Acute HIV
Name one cause of fever persisting for more than 2 weeks
Malaria Enteric fever EBV CMV Toxoplasmosis acute HIV acute schistosomiasis Brucellosis TB Q fever Vixceral lesihmanisis
Name one cause of fever with onset over 6 weeks
Vivax malaria
Acute hepatitis
TB
Amoebic liver abscess
What diseases are mosquitos responsible for?
Malaria (Anopheles) Dengue (Aedes) West Nile virus Lymphatic Filariasis Yellow Fever Zika Virus
How many cases a year of malaria are there in the UK?
1500
What are the 5 Plasmodium species?
Falciparum Vivax Ovale Malariae Knowlesi
What are the features of falciparum?
Invades erythrocytes
Double dotted rings
What is the blood film appearance of Vivax?
Schaffner dots
What is the blood film appearance of Ovale?
Enlarged red cells
Schaffner dots
comet forms
What is the blood film appearance of Malariae?
Daisy head appearance
Square ring forms
What is the life cycle of malaria?
o Within humans, there is an erythrocytic stage and an exo-erythrocytic stage
o Malaria breaks down red cells -> haemolysis
o There is also a liver stage (where the parasite lies dormant in the liver)
How do we prevent malaria?
o Awareness of risk
o Bite prevention
o Chemoprophylaxis
o Diagnose promptly and treat without delay
What are the clinical features of malaria?
Cyclical fevers or continuous without spikes
Malaria paroxysm
What are the complications of severe malaria?
ARDS Hepatic failure Altered consciousness Circulatory collapse Renal failure
Biochemical changes:
Metabolic acidosis, severe anaemia, haemoglobinuria, coagulopathy, DIC, hypoglycaemia
How do you diagnose malaria?
3 thick (parasites) and thin (species and quantity) blood films using fields or Giemsa stain
Malaria antigen detection tests (Paracheck PF or optiMAL-IT)
What is the treatment of mild F malaria?
Adult - Malarone (Atovaquone and proguanil)
Child- (Artemisinin Combination Therapy Artemisinin + lumefantrine)
Oral quinine/ Doxycycline
What is the treatment of severe F malaria?
IV artesunate (+/- quinine) Glucose and hydration support
