Description
In the case of an acute ill patient with a tropical illness, prompt and accurate diagnosis is crucial to ensure appropriate treatment and prevent further complications. The patient's travel history and symptoms should be carefully evaluated, and laboratory tests may be necessary to confirm the diagnosis. Depending on the specific illness, treatment may include antiviral or antibiotic medications, intravenous fluids, and supportive care such as oxygen therapy. It is important to monitor the patient's condition closely and address any potential complications that may arise. In addition to medical care, patient education is also essential, including information on how to prevent the spread of the illness and avoid future exposure. Collaborative care among healthcare providers and specialists is necessary to provide comprehensive and effective treatment for patients with tropical illnesses, especially in areas where these illnesses are endemic. Close monitoring of vital signs and symptoms is essential to identify any changes in the patient's condition and adjust treatment as necessary. In severe cases, hospitalization and intensive care may be required.
Résumé
- The presentation focuses on tropical illnesses prevalent in India, highlighting the changing paradigms due to globalization and rainfall patterns. The mortality, incidence, and morbidity associated with these illnesses vary each decade, posing challenges in diagnosis and management. Intensive care unit (ICU) settings face specific difficulties in handling tropical illnesses like leptospirosis, scrub typhus, and typhoid fever due to atypical presentations and delays in diagnosis.
- A key approach to managing tropical infections involves categorizing patients based on acute undifferentiated fever, fever with rash, thrombocytopenia, or multi-organ dysfunction. Specific diseases are associated with each category. Common diagnostic challenges include overlapping clinical profiles, masking of symptoms due to prior medication use, and reliance on empirical treatment. The sensitivity and specificity of diagnostic tests also pose challenges.
- Indian data reveals that the incidence of tropical illnesses varies over time. Studies show shifts in the prevalence of scrub typhus, malaria, enteric fever, and dengue fever. The clinical disease profiles of tropical illnesses can overlap with other febrile illnesses. Classical symptoms are often masked due to prior medication use. Empirical treatment is frequently necessary due to diagnostic limitations.
- Leptospirosis management involves understanding the acute and immune phases of the disease. The leptospiral infection can manifest as fever, jaundice, decreased urine output, and generalized edema. Leptospirosis is often transmitted via urine-contaminated water, impacting farmers and sewage workers. Diagnosing leptospirosis can be challenging due to the limited sensitivity and specificity of available tests.
- Scrub typhus is another significant cause of undifferentiated fever in Southeast Asia. Clinical signs include lymphadenopathy, eschars, and a maculopapular rash. Severe illness is often characterized by relative bradycardia, encephalitis, and multi-organ involvement. Combination therapy with intravenous doxycycline and azithromycin shows better therapeutic results than monotherapy.
- Typhoid fever presents with abdominal pain, right iliac fossa pain, and neurological symptoms. Typhoid fever in older patients often presents with typhoid encephalopathy. Blood culture remains the gold standard for diagnosis. Extended-drug resistant (XDR) typhoid is treated with meropenem, particularly in cases involving ileal perforation, and dexamethasone is used to address associated encephalopathy.
- Dengue management requires understanding the different phases of the illness. Capillary leakage, shock, and bleeding can occur in the critical phase. The platelet count is monitored, and transfusions are given when platelets fall below 10,000.
Exemple de certificat
À propos des intervenants
Dr Manjunath Thimmappa
MD Anesthésiologie, FNB Soins intensifs, EDIC (Dublin), PGDMLE – NLSIU, (MBA – HHCM) Consultant, Médecine de soins intensifs @Manipal Hospital, Whitefield, BENGALURU, INDE
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