Friday, October 29, 2010

cases with thymus surgery

37 year old Nigerian man going to Nigeria for 3 weeks leaving in 5 days.
VFRs
history of Thymus Surgery
history of Seizures
no vaccince reccord
Allergy: itching after taking chloroquine(itching is not a alllergic action,it's just a common side effect)
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analysis: VFR, immune defect, allergy for chloroquine. short duration. stay with local people.
thymus surgery: yellow fever, typhoid oral, MMR, Varicella. should not get any live vaccine.
history of seizures, should not be given DTP and MMR(major in babies). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC320893/
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Vaccines:
routine: Tdap
recommendation: hepA,  flu, typhoid(ViCPS), MCV4, Rabies, IPV
required:no

malaria
High risk and chloroquine resistant area
Malarone (short duration)

Mefloquine is contraindicated for use by travelers with a known hypersensitivity to mefloquine or related compounds and in persons with active depression, a recent history of depression, generalized anxiety disorder, psychosis, schizophrenia, other major psychiatric disorder, or seizures.

Diarrhea
arithromycin
Ciprofloxacin

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