Having been asked by junior doctors to help them diagnose fever in returned travellers, I thought I’d blog. Essentially most microbiologists follow the British Infection Society’s 2009 recommendations for fever in returned travellers. This document is very detailed, however it is not really a handy aid for the ward based doctor, so something simpler, based upon travel destination could be used.
According to the WHO about 3.3 billion people (half of the world's population) are at risk of malaria; globally there are over 200 million cases a year with an estimated 660,000 deaths.
In the UK, there are on average 1,600 cases and 7 deaths per year. It is not particularly common therefore it is easily missed. Any patient/returned traveller who has visited an endemic country (see map) who presents with a fever and flu-like symptoms should have malaria on the differential diagnosis for what might be causing their illness.
I am often asked “how can doctors remember the different
antibiotic spectrums of activity”? This is a difficult task as there are so many. Personally I have never found lists of medical information that helpful, I would much rather come up with a mnemonic. However, I’m stumped for a mnemonic to remember antibiotic spectrum of activity, so a list it must be. What I have done though is reduce a very long list into six short related lists, which I hope are easier to remember.
Many medical students I teach are desperate to know how
antibiotics work and how resistance to these antibiotics occurs. I try to reassure them that this knowledge is not really necessary for being a good doctor, unless you want to become a Microbiologist; I can only assume this question is asked a lot in medical school exams.
First, a quick reminder of the anatomy of bacteria. The flagella and plasmid have no role in antibiotic mechanisms of action or how bacteria mount resistance.