5 key points on enteric fever (lecture notes)

• potentially fatal infection caused by bacteria in the Salmonella Typhi group
• diarrhoea is uncommon in its early stages
• a rare infection where personal & community hygiene is of a high standard
• diagnosis is best confirmed in early infection by blood culture
• resistance to commonly used antibiotics is common

If you missed this week’s Tropical Medicine Breakfast, here are the notes. An illustrated version of the Clinical Parasitology unit will appear later when the enteric infection module is complete.

• Enteric fever
• Enteropathogenic protozoa

And here is the other FACTM pt 1 teaching unit you may have missed last Tuesday. It deals with Schistosoma species; the group of blood flukes that cause a range of clinical syndromes including swimmer’s itch, Katayama fever and urinary schistosomiasis. You can find additional information on the Priobe Net.

Download (PDF, 398.96KB)

For those following the FACTM pt 1 series, the next instalment is just around the corner, if you’re planning your diary for next week. The face-to-face session will take place at the later time of  7:30am next Tuesday (25th May) in the ED seminar room at Sir Charles Gairdner Hospital, and will run for an hour in its usual two topic format.

Next week’s session is open to junior medical staff and there will be a light breakfast as usual. The MicroGnome apologises for not having the unit notes ready in time for this post, owing to an encounter with arboviruses in Queensland earlier this week. He assures you that the lecture material will meet the usual standard, and was inspired by recent fieldwork in tropical Australia.

Tuesday’s units will cover Leptospirosis, Melioidosis and Scrub Typhus; three infections prevalent in the Australian tropics. Reading for this unit includes:

• Leptospirosis – Oxford Handbook of Tropical Medicine p694
• Manson’s Tropical Diseases p1161 ff;
• Melioidosis – Oxford Handbook p700, Manson p1127 ff
• Scrub Typhus – Oxford Handbook p687, Manson p 885 ff.

The satirist, Jonathan Swift (1667-1745) wrote in 1733 that “Hobbes clearly proves, that every creature lives in a state of war by nature.” While the arboviruses and their mosquito vectors can hardly be described as leviathans, they continue to have an impact on the health of many millions living in the tropics.

The Arbovirus Infections unit for FACTM pt 1 study is now complete. Lecture notes for both modules (FACTM Arbo 1, and FACTM Arbo 2) can be found via this site. The live version takes place in the Emergency Department seminar room, Sir Charles Gairdner Hospital,  at 06:50hr next Tuesday (11th May, 2010). Further details on the Calendar function of this site (right hand contents bar). Sources of supplementary information on arbovirus infections can be found on the Priobe Net.

Oxford Handbook of Tropical Medicine. Eddlestone M et al. 3rd edn. Oxford University Press, 2008. ISBN 978-0-19-920409-0

42 contributors. 22 chapters. 843 pages

This small textbook has been recommended by the Australasian College of Tropical Medicine as an essential core text for those studying towards the Part 1 Fellowship exam. There is good reason for this recommendation. This small, easily portable volume provides a comprehensive and authoritative guide to this area of clinical medicine. Its contents go well beyond the inner circle of tropical infectious diseases, envenomations and nutritional disorders to include tropical paediatrics, mental health, multisystem diseases and covers topics relevant to other areas of general medicine, obstetrics and gynaecology.

Guidance is practical and details of drug administration and other key aspects of acute patient management are plentiful.

This is the third edition, and contains a series of updates to the previous editions including new material on non-infective conditions such as heat stroke and altitude sickness. There is quite a bit of integration through cross-referencing and supplementary coverage in other chapters. For instance, the well-crafted chapter on Malaria (Ch 2) might have the last word on the infection, but there is also a well-made reminder about malaria in the chapter on multi-system infections (Ch 18: p668). Indexes can serve this function if you have the time to be methodical, but any busy clinician will tell you that pressure of work will rarely allow you that luxury. Well thought out contents and information layout are at the heart of a useful clinical handbook. As always, the proof of the pudding is in the eating, and in this case the Oxford Handbook stays on my desk, close to the phone. It gets used most days; more often than the authoritative Manson’s Tropical Diseases.

But no textbook is perfect. If I were asked to make any recommendations for the fourth edition I’d bring the contents list forward. Page ix buries the all-important contents between acknowledgements and a list of colour plates. Unfortunately the grey page markers do not line up with the contents list on p ix or the back cover. But these are cosmetic criticisms. The heart of this book is made of gold.

Oxford Handbook of Tropical Medicine, 3rd edn