MEDI7305 Lecture Notes - Lecture 13: Chancroid, Eosinophilia, Mycobacterium Ulcerans
M4e - Zoonoses & Tropical Diseases in Rural Setting
Other rural and tropical diseases
Melioidosis Burkholderia pseudomallei
Average cases/yr in QLD
Average 28 cases per yr (QLD 2010-2014)
3 fatal cases in SEQ (2 Ipswich, 1 Gatton)
Cases as % Aus cases - 70% total Aus cases
Notifiable disease - YES in QLD, NT, WA
At risk groups - occupational, travel, contact
Geography of infection
Hot, wet, tropical QLD (also rest of Nth Australia, SE Asia)
Transmission - source, contact, vector, route
Direct contact with contaminated soil
Incubation - usually few days but can lay dormant up to 25yrs
Symptoms + signs
Uncommon bacterial infection, most people in contact with organism
don't develop clinical illness
2/3 patients with melioidosis have underlying condition
oExcessive alcohol consumption, poorly controlled diabetes,
chronic renal failure, chronic lung disease, advanced age, impaired immunity
Clinical presentation
oPneumonia +/- septicaemia
oAbscesses - skin, joint, bone, spleen, kidney, liver, brain
oIt can be rapidly fatal
Diagnostic tests
Culture using special medium
Management
Abscess drainage
AB therapy
oIntensive IV therapy - 2wks ceftazidime/ meropenem/ imipenem
+/- additional oral sulfamethoxazole-trimethoprim
oOral eradication therapy - 3-6mths sulfamethoxazole-
trimethoprim OR doxycycline OR amoxicillin-clavulanic acid
Relapse - 10% patients relapse even after 20wks AB treatment
Hendra virus Importance
Severe respiratory illness of horses identified in Brisbane (1994), which
has high case fatality rate amongst humans (despite rarity) - 4/7 infected humans have
died + 90 horses have died since discovery
At risk groups - occupational, travel, contact
Occupational and recreational exposure to horses
Geography of infection
Orange dots - Hendra virus outbreak
North of blue line - Flying fox distribution
Transmission - source, contact, vector, route
Virus shed in respiratory secretions via close contact
Reservoir - flying foxes
find more resources at oneclass.com
find more resources at oneclass.com
