Black Piedra
Black piedra is characterized by brown, black hard nodules on the hair shaft. Black piedra is caused by Piedraia hortae which infect the scalp of the hair. The mode of transmission may include sharing hair brushes and combs. Black piedra may be detected as dark pigmented nodules with dark septate hyphae on shaft of the hair while examining the hairs under direct microscopic examination in a potassium hydroxide preparation. The treatment of black piedra may include maintaing excellent personal hygiene and shaving the affected hair.
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Polio
Polio or poliomyelitis is caused by poliovirus. Poliovirus will infect the gastrointestinal tract and pharynx and later spread to the lymph nodes and finally into the central nervous system. There will be an invasion of the central nervous system which later lead to destruction and killing of the motor neurons in the anterior horn of the spinal cord. This may lead to paralysis. Poliovirus is transmitted via fecal oral routes. The laboratory investigations require to identify poliovirus may include RT- PCR, poliovirus specific antibody and culture. Polio may be asymptomatic. Poliomyelitis which present with symptoms and sign such as fever, sore throat, headache and nausea without neurological disturbance is known as abortive poliomyelitis. There are also non paralytic poliomyelitis and paralytic poliomyelitis. Paralytic poliomyelitis may present with asymmetrical flaccid paralysis while non paralytic poliomyelitis may present with aseptic meningitis ( fever, stiff neck and headache). Patient may suffer from post polio syndrome which may include symptoms such as muscle atrophy, muscle weakness, muscle pain and fatigue. Post polio syndrome may appear 30 years later after acute polio infection. Polio can be prevented either by killed vaccine or live attenuated vaccine. White Piedra
White Piedra is characterized by cream colored soft nodules on the hair shaft. White piedra is associated with Trichosporon asahii infection of the pubic hair, mustache, beard and scalp. White piedra is common in topical countries. Trichosporon asahii may lead to trichosporonosis in immunocompromised and neutropenic patient. The mode of transmission may include sharing hair brushes and combs. White piedra may be detected with white to light brown nodules and septate hyphae on the shaft of the hair while examining the hairs under the direct microscopic examination in a potassium hydroxide preparation. The treatment of white piedra may focus on maintaining excellent personal hygiene and shaving the affected hair. Norovirus infection.
Norovirus can be detected by polymerase chain reaction. Norovirus is part of the calicivirus family. Norovirus will destroy the enterocytes by infecting the small bowel. There will be malabsorption of nutrients and water which lead to reduction in motility of the gastric. Norovirus is associated with acute gastroenteritis. Patient may present with fever, abdominal cramp, nausea, vomiting and watery diarrhea. The common mode of transmission include fecal oral route. The incubation period of norovirus is approximately 1 day with the illness lasting for 1- 2 days. Norovirus may be spread by direct person to person contact or ingestion of contaminated water and food. Norovirus infection is prevented with proper hygiene such as hand washing.
Diphtheria is caused by corynebacterium diphtheriae. Diphtheria may lead to neurological disturbance and myocardium disturbance due to the effects of toxin. The toxin is originated from the pseudomembrane consists of fibrin, bacteria and necrotic cells. Besides that pseudomembrane will acts as a site for the growth of bacteria and production of toxin. Besides that diphtheria may also lead to obstruction of the airway which carry high risk of mortality. Corynebacterium diphtheriae will produce diphtheria toxin which is known as exotoxin. The toxin is an A-B toxin which effect the elongation factor 2. As a result there will be disruption of the protein synthesis and necrosis of the cell. The mode of transmission of corynebacterium diphtheriae is respiratory droplets. The treatment may include penicillin or erythromycin administration. Immunization against the toxin is also considered. Erythema infectiosum
Erythema infectiosum is also known as fifth disease. Erythema infectiosum is presented with slapped cheek appearance in children. The child may present with generalized erythematous rash on the face. Erythema infectiosum is caused by parvovirus B19. Parvovirus B 19 is detected via PCR detection and detection of the B-19 specific IgM antibody. In adult parvovirus B19 infection may lead to arthritis and arthralgia. Pregnant women who predispose to parvovirus B 19 may present with generalized fetal anemia and congestive heart failure or known as hydrops fetalis. Parvovirus B 19 will be transmitted via respiratory droplets. Parvovirus B 19 will lead to proliferation of the hematopoietic cells due to the infection of the erythroid precursors in the bone marrow. Parvovirus B 19 may cause anemia and suppression of the erythropoiesis due to parvovirus B 19 cytolytic properties on immature erythroid cells. Aplastic crisis is commonly present due to parvovirus B19 infection in sickle cell disease or hemolytic anemia patient. Atypical pneumonia
Atypical pneumonia may present with bronchitis, pharyngitis and productive cough. Atypical pneumonia mostly is caused by chlamydophila pneumonia, legionella pneumophila and mycoplasma pneumonia. Chlamydophila pneumonia is detected by serology analysis. Chalmydophila pneumonia is a gram negative bacteria. Chlamydophila cell wall is lacking of the peptidoglycan component. Chlamydophila pneumonia consists of reticulate bodies which are the metabolic intracellular active form while elementary body which is the extracellular infectious form. Chlamydophila is also known as obligate intracellular bacteria. Chlamydophila pneumonia is transmitted via respiratory droplets. The common medication needed to treat chlamydophila pneumonia causing atypical pneumonia may include erythromycin and tetracycline. Measles
Measles is caused by measles virus. measles virus will infects the respiratory cells. Measles virus later will multiple in the lymph nodes. Measles virus then disseminated to the mucosa and skin. Measles virus is a form of paramyxovirus with a single serotypes. Measles virus may present with fever,conjunctivitis, cough and coryza. Koplik spots or white spot on inflamed buccal mucosa may appear in the cheek. This is follow later by maculopapular rash which occur due to cell mediated immune attack on the vascular endothelial cells which is infected by virus in the skin. The maculopapular rash present on the head, trunk and extremities. Patient is predisposed to secondary infection due to depression of the immune response by infection of the T cells and B cells. The complication of measles may include subacute sclerosing pan encephalitis,otitis media, encephalitis and virus induced giant cell pneumonia. Measles virus is transmitted via respiratory droplets. The common laboratory technique may include serology analysis of the virus specific antibody of the measles. Measles is prevented by administrating live attenuated measles virus vaccine with mumps vaccine and rubella vaccine. Rabies
Rabies is caused by rabies virus. Rabies virus is a rhabdovirus family member. Rabies may lead to viral zoonotic infection. The natural reservoir of rabies may include bat, foxes, dogs, skunks or coyotes. The RNA of rabies virus may be detected with PCR of the saliva.Rabies may also be diagnosed based on the immunochemical detection of the viral antigen which present on the brain tissue at autopsy, the cytological detection of cytoplasmic inclusion bodies ( Negri bodies) in the neurons and immunocytochemistry biopsy of the skin or scraping of the cornea. Rabies virus will be transmitted via bite of a rabid animal from the infectious saliva, or from recipient of organ transplants from the rabies infected donor. Any aerosol / droplets contact with mucous membrane may also lead to rabies. Rabies virus will multiply at the sites of bites. Rabies virus will attach to the acetylcholine receptor and infect the sensory neurons. Rabies virus will later enter the central nervous system and replicates in the gray matter. The virus then enter the peripheral nerves to the skin and salivary gland. Cytomegalovirus infection
Cytomegalovirus is an opportunistic pathogen mostly affecting patient with HIV / AIDS or organ transplant recipient. Cytomegalovirus in this cases may present with colitis, encephalitis and retinitis as well as graft failure in transplant recipient. Cytomegalovirus may present with mononucleosis like syndrome. Congenital cytomegalovirus infection may also occur which presented with growth retardation, petechiae, jaundice, hepatosplenomegaly and neurological disturbance. There are a few laboratory investigations that can be performed to identify cytomegalovirus infection such as PCR and CMV - specific antibody. Cytomegalovirus may be transmitted via direct contact of blood, semen, breast milk, saliva and cervical secretions. Cytomegalovirus is initiated with infection of the oropharynx which later spread to the lymphatic tissue and affecting organs such as lung, kidney, spleen and livers. Cytomegalovirus will remain latent in the mononuclear cells. Cytomegalovirus will only be activated in cases of immunosuppressed patients ( organ transplant recipient, HIV / AIDS patient). The treatment of cytomegalovirus infection may focus on ganciclovir or foscarnet in cases of ganciclovir resistant infection. Other alternatives include the prodrug valaganciclovir. |
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