UAskMe INFECTIEZIEKTEN - Klinisch eindexamen (2021GENGE3) - Samenvatting

15.
U ASK ME
INFECTIEZIEKTEN




KLINISCH EINDEXAMEN 2025-2026

,INHOUDSTAFEL
1. Polio(myelitis) ................................................................................................................................................ 3
2. Difterie ........................................................................................................................................................... 5
3. Tetanus .......................................................................................................................................................... 7
4. Pertussis ......................................................................................................................................................... 8
5. H. influenza B ............................................................................................................................................... 10
6. Rotavirus ...................................................................................................................................................... 11
7. Bof ................................................................................................................................................................ 12
8. HIV ............................................................................................................................................................... 13
9. Pseudomonas .............................................................................................................................................. 17
10. Legionella ................................................................................................................................................ 19
11. Clostridium difficile ................................................................................................................................. 21
12. Lyme ........................................................................................................................................................ 22
13. Pneumocystis .......................................................................................................................................... 25
14. Candida ................................................................................................................................................... 27
15. Aspergillus ............................................................................................................................................... 30
16. Toxoplasmose ......................................................................................................................................... 36
17. Leptospirose ............................................................................................................................................ 41
18. Cat scratch disease .................................................................................................................................. 46
19. Rabies ...................................................................................................................................................... 50
20. Brucellose ................................................................................................................................................ 55
21. Q-fever .................................................................................................................................................... 60
22. Malaria .................................................................................................................................................... 65
23. Worminfecties......................................................................................................................................... 67
24. Rickettsia ................................................................................................................................................. 77
25. Hospitaalinfecties.................................................................................................................................... 79
26. Sepsis ...................................................................................................................................................... 83
27. Vreemdlichaam-gerelateerde infecties................................................................................................... 88
Extra: antibiotica ................................................................................................................................................... 90




2

,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 à verspreiding via bloed à motorische voorhoorncellen
à schade motorneuronen
o Incubatieperiode: 6-20d

DIAGNOSTIEK

SYMPTOMEN

ð >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 paralyse
- 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




3

, BEHANDELING

- Curatief à Geen behandeling
- Preventief à 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)




4