Page 243 - PJ MED OPS Handbook 8th Ed

21. Tropical Disease Reference Guide

NOTE: This reference is provided to develop situational awareness. Expertise in infectious
tropical diseases is beyond the scope of rescue medicine. Reliance on subject matter experts
and telemedicine when needed should be used.

Brucellosis Mexico, Peru, Fever chills depression, Doxy or Cipro
(undulating Mongolia neuropsychiatric, testicular pain, with rifampin or
fever) arthralgia, lower back pain, bone gentamycin
pain, lethargy
Travelers’ World wide Passage of 3 or more unformed Fluid replacement,
Diarrhea stools within 24hr, N/V abdominal Cipro, levofloxacin,
Bacterial, viral, pain, fever, blood or no blood azithromycin
parasitic in stools (except Asia)
No improvement:
Metronidazole
Bacterial World wide Fever >38.3, tender anterior azithromycin
Pharyngitis lymph nodes, exudates on tonsils
Group A, C, G
strep
Viral most
common
Cholera Africa, Middle Abdominal discomfort, vomiting, Oral hydration, azith
Vibrio cholera East diarrhea (rice water stool) mycin, or cipro
Giardia Central America, Diarrhea, cramping, abdominal metronidazole,
Flagellated South America, distention, wt. loss, fatigue tinidazole
protozoan Africa, Middle
East, Asia

Japanese South East Asia, Acute encephalitis, fever, Supportive care,
Encephalitis Western Pacific diarrhea, rigors, followed by control of ICP,
Vector: Mosquito headache, vomiting, generalized seizure control
weakness. Mental status changes,
focal neurologic deficiencies
(cranial nerve palsies)
TB Africa, Asia Commonly asymptomatic when Isoniazid, rifampin,
infected. Primary TB: Fever, pyrazinamide,
chest pain, retrosternal pain, ethambutol
dull intercostal pain, enlarged
bronchial lymph

Chapter 21. Tropical Disease Reference Guide n 241