Acute Febrile Illness Practice Flashcards

Comprehensive vocabulary flashcards covering the etiology, epidemiology, diagnosis, and treatment of malaria, typhoid fever, typhus, and relapsing fever based on the Nitsbin Bedside Oriented Internal Medicine 2nd Edition.

Malaria

A parasitic infectious disease caused by protozoan parasites of the genus Plasmodium, transmitted by mosquitoes and characterized by recurrent fever, chills, and body pain.

P. falciparum

The most common malaria species in Ethiopia, representing approximately $81\%$ of reported cases according to HMIS 2021.

Tertian cycle

The erythrocytic cycle of P. falciparum, P. vivax, and P. ovale which takes approximately $48$ hours.

Quartan cycle

The erythrocytic cycle associated with P. malariae infection which takes approximately $72$ hours.

Hypnozoites

A quiescent stage in the liver existing only in P. vivax and P. ovale infections that can cause relapsed disease months after initial infection.

Holoendemic

A category of malaria endemicity determined by palpable spleen rates in children $2$-$9$ years of age exceeding $75\%$.

Hemoglobinuria

Also known as cola-colored urine, it is a sign of severe malaria resulting from massive intravascular hemolysis.

Coartem

A combination of Artemether ($120\,mg$) and Lumefantrine ($20\,mg$) used as the first-line treatment for P. falciparum in Ethiopia.

Primaquine

A medication used for hepatic hypnozoite clearance in P. vivax/P. ovale ($14$-day course) or as a transmission blocker in P. falciparum (single dose).

Artesunate

The first-line parenteral treatment for severe malaria, administered at $2.4\,mg/kg$ ($3\,mg/kg$ for children under $20\,kg$) at $0$, $12$, and $24$ hours.

Enteric fever

An acute febrile illness caused by Salmonella enterica serotypes Typhi or Paratyphi A, B, and C.

Rose spots

Small ($1$ to $5\,mm$) erythematous, blanchable papules appearing in crops on the abdomen and chest during typhoid fever.

Widal test

An adjunctive serological diagnostic tool for typhoid fever that detects anti-S. Typhi antibodies (O and H antigens).

Ciprofloxacin

The first-line oral antibiotic for uncomplicated typhoid fever, typically dosed at $500\,mg$ BID for $7$ to $10$ days.

Epidemic typhus

A louse-borne disease caused by Rickettsia prowazekii, often associated with crowded and unhygienic environments.

Endemic typhus

A flea-borne disease caused by Rickettsia typhi, where fleas acquire the organism from rickettsemic rats.

Brill-Zinsser disease

A mild, recrudescent form of epidemic typhus that occurs years after the initial acute infection.

Weil-Felix test

A serology test used for the diagnosis of typhus through the demonstration of rising agglutination titers.

Louse-borne relapsing fever (LBRF)

An acute febrile illness caused by Borrelia recurrentis, which is endemic to the highlands of Ethiopia.

Crisis phenomenon

A feature of relapsing fever involving rigors and elevations in temperature, pulse, and blood pressure for $15$-$30$ minutes before the fever breaks.

Jarisch-Herxheimer reaction

A reaction following the first dose of antibiotics in relapsing fever patients, characterized by a 'chills phase' and a 'flush phase' due to rapid spirochete clearance.

Hyperreactive malarial splenomegaly (HMS)

An abnormal immune response to repeated malaria characterized by massive splenomegaly, elevated IgM, and hepatic sinusoidal lymphocytosis.

Algid malaria

A complication of severe malaria characterized by circulatory shock, hemodynamic disorders, and hypothermia.

Gray baby syndrome

A fatal condition in neonates characterized by cyanosis and vasomotor collapse caused by improper metabolism of Chloramphenicol (CAF).