African Trypanosomiasis

Descripción

MBBS Tropical Medicine Mapa Mental sobre African Trypanosomiasis, creado por Amirul Aiman el 04/07/2018.
Amirul Aiman
Mapa Mental por Amirul Aiman, actualizado hace más de 1 año
Amirul Aiman
Creado por Amirul Aiman hace casi 6 años
10
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Resumen del Recurso

African Trypanosomiasis
  1. Summary
    1. Sleeping sickness
      1. T brucei group
        1. Gambiense TbG
          1. West + Central
            1. Gradual
              1. Human- Human
            2. rhodesiense TbR
              1. East + South
                1. Rapid
                  1. Reservoir
                    1. Game
                      1. Cattle
                2. Vector (transmission)
                  1. Tsetse fly
                    1. Painful bite
                      1. Rural woodlands + forest
                      2. Rarely
                        1. Bloodborne
                          1. Congenital
                        2. Locality
                          1. Sub Saharan
                            1. DR of Congo
                              1. South Sudan
                                1. Central African Rebuplic
                              2. Negelected Tropical Disease
                                1. misdiagnosis as psychosis after travel
                                2. Vector
                                  1. Tsetse fly
                                    1. warm+ Shaded
                                      1. 1-6 mo
                                        1. Low infctn rate
                                          1. 2-3 per1000
                                      2. Life cycle
                                        1. 1. Fly bite + injects parasite
                                          1. 2. Metacyclic trypomastigotes → BS trypomastigotes
                                            1. 3. Multiply via binary fission
                                              1. 4. Trypomastigotes in blood
                                                1. 5. Fly bite + ingest parasite
                                                  1. 6. BS parasite→ procylic parasite@ tsetse fly midgut
                                                    1. multiply via binary fission
                                                      1. 7. Procyclic parasite leave midgut→ epimastigotes
                                                        1. 8. multiply @ salivary glands epi→ metacyclic
                                                  2. Human Stages
                                                2. Tsetse fly Stages
                                              2. Signs and Symptoms
                                                1. Signs
                                                  1. Chancre
                                                    1. localised erythema
                                                      1. Indurated
                                                        1. Tender
                                                          1. Lymphadenopathy
                                                            1. trypanosome move to nearby nodes → lymphadenitis
                                                              1. painless
                                                                1. soft
                                                                  1. mobile nodes
                                                                    1. Common in TbG
                                                                      1. @ posterior cervical "Winterbottom's Sign"
                                                                      2. Onset in days
                                                                        1. up to 3 weeks
                                                                        2. Common in TbR
                                                                        3. Hepatosplenomegaly
                                                                          1. Anaemia
                                                                            1. abnormal LFT
                                                                          2. Symptoms
                                                                            1. Parasitaemia
                                                                              1. Myalgia
                                                                                1. Fever
                                                                                  1. Headache
                                                                                    1. Weightloss
                                                                                      1. Rash
                                                                                        1. Itch
                                                                                      2. Complications
                                                                                        1. CVS
                                                                                          1. Myocardits
                                                                                            1. Effusions
                                                                                            2. Endocrince
                                                                                              1. Hypothyroidism
                                                                                                1. Hypoadrenalism
                                                                                                2. CNS
                                                                                                  1. Psychosis
                                                                                                    1. Convulsions
                                                                                                      1. Insomnia/somnalence
                                                                                                        1. Hyper/Para thenesia
                                                                                                          1. Tremors/Ataxia/Focal signs
                                                                                                          2. General
                                                                                                            1. Wasting
                                                                                                              1. Malnutrition
                                                                                                                1. Infections
                                                                                                            2. Dx
                                                                                                              1. Demonstration of Parasite
                                                                                                                1. Aspiration of chancre
                                                                                                                  1. Blood Film
                                                                                                                    1. blood concentration technique
                                                                                                                      1. Quantitative Buffy coat
                                                                                                                        1. QBC
                                                                                                                      2. Bone marrow
                                                                                                                        1. CSF
                                                                                                                          1. Mandatory
                                                                                                                            1. xclude CNS
                                                                                                                              1. Microscopy for trypanosomes
                                                                                                                                1. WCC > 5
                                                                                                                                  1. Morula cells of Mott
                                                                                                                                    1. Big Eosinophillic Plasma cell contain IgM
                                                                                                                                  2. Serology
                                                                                                                                    1. Population screening
                                                                                                                                      1. CATT (Card Agglutination Test)
                                                                                                                                    2. Ddx
                                                                                                                                      1. HIV
                                                                                                                                        1. Toxoplasmosis in HIV
                                                                                                                                          1. CD<400
                                                                                                                                        2. TB
                                                                                                                                          1. Meningitis
                                                                                                                                            1. Lymphoma
                                                                                                                                              1. CNS vasculitis
                                                                                                                                                1. Psychiatric illness
                                                                                                                                                2. Prognosis
                                                                                                                                                  1. Fatal without Tx
                                                                                                                                                3. Staging
                                                                                                                                                  1. Stage 1 (Early)
                                                                                                                                                    1. No CNS involvements
                                                                                                                                                      1. Haemolymphatics
                                                                                                                                                      2. Stage 2 (Late)
                                                                                                                                                        1. CNS involvements
                                                                                                                                                      3. Tx
                                                                                                                                                        1. TbG
                                                                                                                                                          1. S1- Pentamidine
                                                                                                                                                            1. S2 - Eflornithine / ±Nifurtimox
                                                                                                                                                            2. TbR
                                                                                                                                                              1. S1- Suramin
                                                                                                                                                                1. S2- Melarsoprol
                                                                                                                                                                2. Steroids often used
                                                                                                                                                                  1. SE common
                                                                                                                                                                    1. 1-3 weeks
                                                                                                                                                                    2. Control
                                                                                                                                                                      1. Vector control
                                                                                                                                                                        1. Population screening
                                                                                                                                                                          1. Minimise contact
                                                                                                                                                                            1. Prevention
                                                                                                                                                                              1. aerial insecticide
                                                                                                                                                                                1. Tsetse fly trap
                                                                                                                                                                                  1. insectiside impregnated screen
                                                                                                                                                                                    1. wild animal pop reduction
                                                                                                                                                                                      1. removal of woody vegetaion
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