Samenvatting Klinisch eindexamen UA UAskMe - INFECTIEZIEKTEN

U ASK ME
INFECTIEZIEKTEN




KLINISCH EINDEXAMEN
2025-2026

,1. Polio(myelitis) .............................................................................................................................2
2. Difterie........................................................................................................................................4
3. Tetanus .......................................................................................................................................6
4. Pertussis .....................................................................................................................................7
5. H. influenza B ..............................................................................................................................9
6. Rotavirus .................................................................................................................................. 10
7. Bof............................................................................................................................................ 11
8. HIV ........................................................................................................................................... 12
9. Pseudomonas ........................................................................................................................... 16
10. Legionella ............................................................................................................................. 18
11. Clostridium difficile ............................................................................................................... 20
12. Lyme .................................................................................................................................... 21
13. Pneumocystis ....................................................................................................................... 24
14. Candida ................................................................................................................................ 26
15. Aspergillus ............................................................................................................................ 29
16. Toxoplasmose ....................................................................................................................... 35
17. Leptospirose ......................................................................................................................... 40
18. Cat scratch disease ............................................................................................................... 45
19. Rabies .................................................................................................................................. 49
20. Brucellose ............................................................................................................................ 54
21. Q-fever ................................................................................................................................. 59
22. Malaria ................................................................................................................................. 64
23. Worminfecties ...................................................................................................................... 66
24. Rickettsia.............................................................................................................................. 76
25. Hospitaalinfecties ................................................................................................................. 78
26. Sepsis .................................................................................................................................. 82
27. Vreemdlichaam-gerelateerde infecties ................................................................................... 87
Extra: antibiotica ................................................................................................................................ 89




1

,1. POLIO(MYELITIS)
ALGEMEEN

- Definitie
o PicoRNAvirus > enterovirus > poliovirus type 1-2-3
o Enkel type 1 en cVDPV (zie infra) zijn nog in circulatie
- Epidemiologie
o Prevalenter bij: kids, slechte hygiëne
o 3 endemische landen
▪ Afghanistan
▪ Nigeria
▪ Pakistan
- Pathofysiologie
o Transmissie faeco-oraal, transplacentair, perinataal (congenitale polio)
o Replicatie in farynx, LN → verspreiding via bloed → motorische voorhoorncellen
→ schade motorneuronen
o Incubatieperiode: 6-20d

DIAGNOSTIEK

SYMPTOMEN

➔ >99% is asymptomatisch!
- Meningitis met bijkomend acute slappe paralyse bij 1/200
o Kids: onderste ledematen
o Volwassenen: AH-spieren
- Lichte GI-infectie bij ~25%
- Viremie met koorts

KLINISCH BEELD

- Acute slappe parallyse
- Vermoeden +++ indien endemische regio

CONFIRMATIE

- Virusisolatie uit
o faeces
o CSV
o farynx

DD

- Acute slappe myelitis (AFM) tgv andere enterovirussen
- West Nile virus
- Guillain-Barrésyndroom




2

, BEHANDELING

- Curatief → Geen behandeling
- Preventief → vaccinatie
o Geïndustrialiseerde gebieden: geïnactiveerd IM vaccin
▪ Zit in basisvaccinatieschema
▪ Pro: geen risico op vaccine-associated polio
▪ Contra: duurder, geen/beperkte intestinale immuniteit
o Ontwikkelingsgebieden: levend afgezwakt PO vaccin
▪ Is trivalent, dwz tegen type 1-2-3
▪ Pro: goedkoper, makkelijk toe te dienen, effect op vlak van groepsimmuniteit én
indirect (vaccin-Ag in faeces)
▪ Contra: risico op vaccine-associated polio (1/1.000.000) en circulating vaccine-
derived polio virus (cVDPV)

COMPLICATIES

- Mortaliteit
o 2-5% kids, 15-30% volwassenen
- Respiratoir falen
- Igv bulbaire betrekking
o BD-fluctuaties, circulatoire collaps, autonome dysfunctie
- Post-polio syndroom
o = nieuwe/progressieve spierzwakte decennia na initiële ziekte
o bij ~50% van overlevenden met slappe paralyse
- Mors in utero
- (schizofrenie)




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