Term
| average duration of typhoid fever? |
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Definition
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Term
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Definition
| nope, exclusively a human disease |
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Term
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Definition
good sanitation
WASH
vaccines contribute to prevention |
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Term
| why is early abx tx essential in typhoid? |
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Definition
| to prevent complications and to lower mortality rates |
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Term
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Definition
ceftriaxone
azithromycin in milder cases |
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Term
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Definition
| salmonella enterica serotype typhi |
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Term
| what type of bacteria causes typhoid? |
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Definition
| gram - bacilli salmonella enterica serotype typhi |
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Term
| what type of people does typhoid affect? |
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Definition
| mainly children and young children as adults are immunised from previous infection |
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Term
| what affect if any does immunosuppression and HIV have on typhoid? |
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Definition
| immunocompromised and HIV have no effect on incidence/severity of typhoid |
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Term
| what is the only resevir for typhoid? |
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Definition
| humans are the only resevoir |
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Term
| is there a vaccine for typhoid? |
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Definition
| yes, there is a vaccine for S typhi BUT there are other salmonella serotypes that are clinically indistinguishable from classical typhoid. |
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Term
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Definition
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Term
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Definition
systemic s+s secondary to bacteraemia.
it is not a D+V clinical picture |
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Term
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Definition
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Term
| incubation period of typhoid? |
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Definition
1-4 weeks. Symptoms will go on for weeks without rx
fever is usually constant |
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Term
| textbook typhoid symptoms? |
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Definition
constant fever
constipated then diarrhoea
relative bradycardia
rose spots on trunk
delirium (seeing through cloud) |
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Term
| for ever degree your temp increase how much does your HR increase by? |
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Definition
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Term
| complications of typhoid? |
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Definition
GI heamorrhage
bowel perforation (peyer's patches)
Typhoid encephalopathy
Abscesses |
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Term
| what do blood tests show in typhoid? |
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Definition
| derranged LFTs and mild pancytopenia |
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Term
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Definition
BC for S typhi - 60% are +ve
Bone marrow culture - most sensitive but not routinely used |
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Term
| what % of bc are +ve in s typhi infection? |
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Definition
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Term
| what is the most sensitive way to diagnose typhoid? |
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Definition
Bone marrow culture
BUT this is not routinely used |
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Term
| which tests can prove carrier status but not show acute infection? |
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Definition
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Term
| which test used to diagnose typhoid is dated, lacks sensitivity/specificity and is no longer used? |
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Definition
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Term
| typhoid and quinolones. whats the issue? |
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Definition
resistance.
suggest using 3rd gen cephlasporin e.g Ceftriaxone 2/52
Azithromycin 5/7 alternative in mild disease |
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Term
| what should pts with severe typhoid be given? |
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Definition
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Term
| can carriage be chronic, asymptomatic but yet infectious? |
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Definition
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Term
| where can infection sequester in chronic carriage? |
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Definition
in the gallbladder with faecal transmission
in the urinary tract with urinary transmission |
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Term
| how long does vaccination against typhoid last? |
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Definition
3 years
it has 60% efficacey. Should be used for prevention for endemic regions + outbreak controls |
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Term
| how many subtypes of paratyphi are there? |
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Definition
3
Parathphiy A,B and C
D+V may preceed septicaemia otherwise clinical features and mx is the same |
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Term
| do not confuse salmonella (non typhoidal) with typhoid (salmonella typhi) the former is a... |
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Definition
class food outbreak GI disease
The latter may not have any prominent GI symptoms |
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Term
| unlike typhoid salmonella which only has humans as resevoirs.. |
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Definition
| non typhoid salmonella have animal resevoirs too |
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Term
| how is severity for non typhoid salmonella in those with HIV + status? |
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Definition
It causes invasive disease, sepsis and death.
This is unlike typhoid salmonella which are unaffected by HIV status |
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Term
| dx and rx of non typhoid salmonella |
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Definition
Bc for dx
rX: ABX, screen for malaria, ART if HIV+ |
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Term
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Definition
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Term
| transit of typhoid in body |
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Definition
Faecal-oral spread.
Predominantly a bloodstream infection.
Bacteria enters via gut > blood and lymphatics via peyers patches > liver > reticuloendothelial systems > spleen etc |
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Term
| what did autopsy of Typhoid Mary show? |
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Definition
| Her gallbladder had salmonella Typhii in it |
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Term
| whats special about azithromycin and peyers patches? |
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Definition
| Azithromycin can penetrate peyers patches |
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Term
| in carrier state of typhoid which AB are raised? |
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Definition
| Vi Ab are persistantly raised |
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Term
| how many serovars of leptospirosis are there? how many are known to be pathogenia? |
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Definition
> 200 sevors
9 known to be pathogenic |
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Term
| what eye sign might you see that is distinctive to leptospirosis? |
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Definition
| Conjuctival suffusion or haemorrhage |
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Term
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Definition
Renal failure
Jaundice
Low platelets |
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Term
| described the biphasic illness of leptospirosis |
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Definition
initially bacteraemic phase
followed by immune mediated phase
incubation 10 days average |
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Term
when do rodents get infected with leptospirosis?
what type of bacteria is it?
how do humans get infected? |
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Definition
rodents infected early life. they shed bacteria in urine
spirochete bacteria. coiled structure with question mark sign on e microscopy
humans infected by water contact with broken skin or mucous membranes |
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Term
| gold standard for lepto dx? |
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Definition
MAT test
microscopic agglutination test
Note: Ab only appear after 5/7 so 2 samples are required 7 days apart |
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Term
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Definition
mild: doxycycline 7/7 alt: azithromycin
severe: IV pen or cephlasporin |
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Term
| Jarisch-Herxheimer Reaction |
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Definition
immune reaction to endotoxin when large qty bacteria killed
s+s: fever, agitation, tachycardia,sweating, shock,death |
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Term
| JHReactions are common with which types of bacteria? |
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Definition
| Spirochetes, lyme disease, syphillis and leptosporosis |
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Term
| prevention of leptospirosis? |
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Definition
clean water
rodent control
involve vet practitioners
prophylaxis in high risk personel e.g military |
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Term
gram - rod
yersinia pestis causes which diease? |
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Definition
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Term
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Definition
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Term
| what transmits the plague? |
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Definition
flea bite of Xenopsylla cheopis
eating infected meat
skinning contaminated hide
then it can be transmitted p2p if it is pneumonic plague |
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Term
| what are the 2 forms of plague? |
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Definition
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Term
| what can happen to bubonic plague to become pneumonic? |
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Definition
it can be seeded in lungs > pneumonic
Pneumonic plague can seed to CNS > meningitis |
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Term
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Definition
MC+S for gram - bacilli in blood/sputum/bubous/lymphnode
Serological Ag test available for field use |
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Term
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Definition
doxycycline
tetracycline
cipro
gent
strep |
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Term
| can bubonic plague be spread p2p? |
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Definition
No
But if it is seeded to lungs it causes pneumonic plague. This can be spread via respiratory droplets |
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Term
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Definition
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Term
| how does bacteria in flea cause increase in transmission |
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Definition
| bacteria multiply inside flea, stick together and form a plug that blocks the fleas stomach and causes it to starve. this increases the fleas feeding frequency |
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Term
| which form of plague is more common? |
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Definition
| bubonic plague more commmon |
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Term
| oriental rat flea latin name? |
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Definition
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