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CAUSED BY MYCOPLASMA PNEUMONEA
Pharyngitis (far-in-jī' tis) is a painful inflammation of the pharynx, and is
colloquially referred to as a sore throat. Infection of the tonsils, tonsillitis may
occur simultaneously.
The major cause is infection, of which 90% are viral, the remainder caused by
bacterial infection and rarely oral thrush (fungal candidiasis e.g. in babies). Some
cases of pharyngitis are caused by irritation from agents such as pollutants or
chemical substances.
Contagious bovine pleuropneumonia (CBPP - also known as lung plague), is a
contagious bacterial disease that afflicts the lungs of cattle, buffalo, zebu, and
yaks. Sheep, goats, camels, antelope, and wild bovids are resistant to the
disease. Humans are also unaffected.
It is caused by the bacteria Mycoplasma mycoides mycoides, and the symptoms
are pneumonia and inflammation of the lung membranes. The incubation period
is 20 to 123 days. It was particularly widespread in the United States in 1879,
affecting herds from several states. The outbreak was so severe that it resulted
in a trade embargo by the British government, blocking U.S. cattle exports to
Britain and Canada. This prompted the United States to the establish the Bureau
of Animal Industries, set up in 1884 solely to eradicate the disease, which it
succeeded in doing.
The bacteria is widespread in Africa, the Middle East, Southern Europe, as well
as parts of Asia. It is an airborne bacteria, and can travel up to several kilometres
in the right conditions.
M. pneumoniae infections can be differentiated from other types of pneumonia by
the relatively slow progression of symptoms, a positive blood test for coldhemaglutinins, lack of bacteria in a gram stained sputum sample, and a lack of
growth on blood agar. Mycoplasma atypical pneumonia can be complicated by
Stevens Johnson syndrome, hemolytic anemia , encephalitis or Guillain Barré
syndrome
Viral sore throats
These comprise about 90% of all infectious cases and can be a feature of many
different types of viral infections.
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Adenovirus - the most common of the viral causes. Typically the degree of neck
lymph node enlargement is modest and the throat often does not appear red,
although is very painful.
Orthomyxoviridae which cause influenza - present with rapid onset high
temperature, headache and generalised ache. A sore throat may be associated.
Infectious mononucleosis ("glandular fever") caused by the Epstein-Barr virus.
This may cause significant lymph gland swelling and an exudative tonsillitis with
marked redness and swelling of the throat. The heterophile test can be used if this
is suspected.
Herpes simplex virus can cause multiple mouth ulcers.
Measles
[edit] Bacterial sore throats
[edit] Group A Streptococcal
The most common bacterial agent is streptococcus. Unlike adenovirus, there
tends to be greater generalised symptoms and more signs to find. Typically
enlarged and tender lymph glands, with bright red inflamed and swollen throat,
the patient may have a high temperature, headache, and aching muscles
(myalgia) and joints (arthralgia).
Some immune-system meditated complications may occur:
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Scarlet fever with its vivid rash, although the milder disease seen after the 1950's
suggests that the bacteria may have mutated to less virulent illness and some
doctors now call this scarlatina (literally a 'little scarlet fever')
Historically the most important complication was of the generalised inflammatory
disorder of rheumatic fever which could later result in Rheumatic heart disease
affecting the valves of the heart. Antibiotics may reduce the incidence of this
complication to under a third.[1]However the incidence of rheumatic fever in
developed-regions of the world remains low even though the use of antibiotics has
been declining.[2][3]This may be a result of a change in the prevalence of various
strains of bacteria. In underdeveloped regions, untreated streptococcal infection
can still give rise to rheumatic heart disease and may be due to environmental
factors, or reflect a genetic predisposition of the patient to the disease.
Post-streptococcal glomerulonephritis is an inflammation of the kidney. It is
disputed whether antibiotics might reduce[4] the small risk of this or not.[1]
Very rarely there may occur a secondary infection behind the tonsils which may
cause a life-threatening septicaemia (Lemierre's syndrome)
[edit] Diphtheria
Diphtheria is a potentially life threatening upper respiratory infection caused by
Corynebacterium diphtheriae which has been largely eradicated in developed
nations since the introduction of childhood vaccination programs, but is still
reported in the Third World and increasingly in some areas in Eastern Europe.
Antibiotics are effective in the early stages, but recovery is generally slow.
[edit] Treatment
The treatment of pharyngitis will vary according to the cause.
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Iodine compounds sold as Betadine or TCP can be gargled to shorten the duration
of the infection.[citation needed] These compounds are effective anti-viral agents.
Antibiotics are only helpful when a bacterial infection is the cause of the sore
throat. For viral sore throats, antibiotics have been shown to only affect the degree
of pain by day 4 and shorten the average natural duration by 16 hours overall (14
people need be treated for a week to reduce the duration by one day).[1]
[edit] Symptomatic
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Throat lozenges (cough medicine) are often used for short-term pain relief.
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Gargling with warm salty water is a popular household remedy, although there is
only anecdotal evidence this gives anything other than temporary relief and
likewise for the use of aspirin gargles.
Warm tea (true or herbal) or soup can help temporarily alleviate the pain of a sore
throat.
Analgesics such as NSAIDs can help reduce the pain associated with a sore
throat.
Cold beverages and popsicles numb the nerves of the throat somewhat, alleviating
the pain for a brief time.
Mouthwash (when gargled) reduces the pain but only for a brief time.
There have been some studies that show ingesting a solution high in protein can
have a profound relieving effect on sore throats, particularly if they are allergy
related.[citation needed]
Drinking heavy amounts of liquid reduces the pain for a short time.
Peppermint candy might help with some cases.[citation needed]
Raw juice of papaya leaves also helps to recover sore throat.[citation needed]
Yogurt has been shown to help alleviate the pain temporarily by coating the
affected area.[citation needed]
Pneumonia is an illness of the lungs and respiratory system in which the alveoli
(microscopic air-filled sacs of the lung responsible for absorbing oxygen from the
atmosphere) become inflamed and flooded with fluid. Pneumonia can result from
a variety of causes, including infection with bacteria, viruses, fungi, or parasites.
Pneumonia may also occur from chemical or physical injury to the lungs, or
indirectly due to another medical illness, such as lung cancer or alcohol abuse.
Typical symptoms associated with pneumonia include cough, chest pain, fever,
and difficulty in breathing. Diagnostic tools include x-rays and examination of the
sputum. Treatment depends on the cause of pneumonia; bacterial pneumonia is
treated with antibiotics.
Pneumonia is a common illness, occurs in all age groups, and is a leading cause
of death among the elderly and people who are chronically ill. Vaccines to
prevent certain types of pneumonia are available. The prognosis for an individual
depends on the type of pneumonia, the appropriate treatment, any complications,
and the person's underlying health.
Rabies (Latin, rabies, "madness, rage, fury") is a viral zoonotic disease that
causes acute encephalitis (brain swelling) in mammals. In non-vaccinated
humans, rabies is almost invariably fatal after neurological symptoms have
developed, but prompt post-exposure vaccination may prevent the virus from
progressing.
The virus is usually present in the blood and saliva of a symptomatic rabid
animal. The route of infection is usually, but not necessarily, by a bite, and in
many cases in animals, causes the victim to be exceptionally aggressive, attack
without provocation, and exhibit otherwise uncharacteristic behavior[1].
Transmission has occurred via an aerosol through mucous membranes;
transmission in this form may have happened in people exploring caves
populated by rabid bats. Transmission between humans is extremely rare,
although it can happen through transplant surgery (see below for recent cases),
or, even more rarely, through bites or kisses.
The period between infection and the first flu-like symptoms is normally three to
twelve weeks, but can be as long as two years. Soon after, the symptoms
expand to cerebral dysfunction, anxiety, insomnia, confusion, agitation, abnormal
behavior, hallucinations, progressing to delirium. The production of large
quantities of saliva and tears coupled with an inability to speak or swallow are
typical during the later stages of the disease; this can result in "hydrophobia".
Death almost invariably results two to ten days after the first symptoms; the few
humans who are known to have survived the disease were all left with severe
brain damage, with the recent exception of Jeanna Giese (see below).
In 2005, the case of Jeanna Giese, a girl of 15[2] who survived acute, unvaccinated rabies
was reported, indicating the successful treatment of rabies through induction of a coma.
This treatment approach was based on the theory that rabies' detrimental effects were
caused by temporary dysfunctions of the brain, and that the induction of a coma, by
producing a temporary partial stop in brain function, would protect the brain from
damage while the body built up an immune response to the virus. After thirty-one days of
isolation and seventy-six days of hospitalization, she was released from the hospital,
having survived rabies. Later attempts to use the same treatment have failed
Poliomyelitis, often called polio or infantile
paralysis, is a virally induced infectious disease which spreads via the fecal-oral
route.[1] It may proceed to the blood stream and into the central nervous system
causing muscle weakness and often paralysis.
The effects of a polio infection have been
known since prehistory. Egyptian paintings and carvings depict otherwise healthy
people with withered limbs, and children walking with canes at a young age.[6]
Pathogenesis
l. The incubation period of polio, from the time of first exposure to first symptoms,
is 2-20 days, with a range of 3 to 35 days. In individuals with a functioning
immune system, polio infection is often subclinical (there are no symptoms or
outward signs of the illness).[11] In approximately 1 in 100 to 1 in 1000 cases the
infection leads to paralytic disease, in which patients develop flaccid paralysis.
Depending on the site of paralysis, poliomyelitis can be classified as spinal,
bulbar, or spino-bulbar disease. Up to 0.2% of all polio patients (but 20% of
paralytic polio cases) require mechanical ventilation during the acute stage, and
permanent quadriplegia or respiratory paralysis occur in only 0.01% (1 in 10,000)
of all polio patients.
Non-paralytic polio
Approximately 4%–8% of polio infections consist of a minor, nonspecific illness
and may suffer upper respiratory tract infection (sore throat and fever),
gastrointestinal tract disturbances (nausea, vomiting, abdominal pain,
constipation or, rarely, diarrhea), and influenza-like illnesses. In some cases,
there may be no significant symptoms whatsoever
In 1935 Maurice Brodie, a research
assistant at New York University, had attempted to produce a polio vaccine,
procured from ground up monkey spinal cords, and killed by formaldehyde.
Brodie first tested the vaccine on himself and several of his assistants. He then
gave the vaccine to three thousand children, many developed allergic reactions,
but none developed immunity to polio.[24] Philadelphia pathologist John Kollmer
also claimed to have developed a vaccine that same year, but it too produced no
immunity and was blamed for causing a number of cases, some of them fatal.[25]
The development of two polio vaccines would lead to the first modern mass
inoculations. The last cases of paralytic poliomyelitis caused by endemic
transmission of wild virus in the United States were in 1979, when an outbreak
occurred among the Amish in several Midwest states. The disease was entirely
eradicated in the Americas by 1994. A small outbreak of vaccine-related polio
occurred in Haiti in 2002, where political strife and poverty have interfered with
vaccination efforts.[29]
Ascariasis is a human disease caused by the parasitic roundworm Ascaris
lumbricoides. Perhaps as many as one quarter of the world's people are
infected[1], and ascariasis is particularly prevalent in tropical regions and in areas
of poor hygiene. Other species of the genus Ascaris are parasitic and can cause
disease in domestic animals
Symptoms Patients can remain asymptomatic for very long periods of time. As
larval stages travel through the body, they may cause visceral damage,
peritonitis and inflammation, enlargement of the liver or spleen, toxicity, and
pneumonia. A heavy worm infestation may cause nutritional deficiency; other
complications, sometimes fatal, include obstruction of the bowel by a bolus of
worms (observed particularly in children) and obstruction of the bile or pancreatic
duct. More than 796 Ascaris lumbricoides worms weighing 550 g [19 ounces]
were recovered at autopsy from a 2-year-old South African girl. The worms had
caused torsion and gangrene of the ileum, which was interpreted as the cause of
death[7].
Treatment
Native Americans have traditionally used epazote (Chenopodium ambrisioides)
for treatment, which was not as powerful as pharmaceutical compounds, but
spontaneous passage of Ascarids provided some proof of efficacy [citation needed].
Some recent studies exist in the medical literature suggesting that sun-dried
papaya and watermelon seeds may reduce infections by a large factor. The adult
dosage is one tablespoon of the seed powder in a glass of sugar water once a
week for two weeks. The sugar makes the bitter taste palatable and acts as a
laxative
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Sleeping sickness or African trypanosomiasis is a parasitic disease in people
and in animals. Caused by protozoa of genus Trypanosoma and transmitted by the
tsetse fly, the disease is endemic in certain regions of Sub-Saharan Africa,
covering about
36 countries and 60 million people. In addition to the bite of the tsetse fly, the
disease is contractible in the following ways:
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Mother to child infection: the trypanosome can cross the placenta and infect the
fetus, causing perinatal death.
Laboratories: accidental infections, for example, through the handling of blood of
an infected person and organ transplantation, although this is uncommon.
Symptoms begin with fever, headaches, and joint pains. As the parasites enter
through both the blood and lymph systems, lymph nodes often swell up to
tremendous sizes. Winterbottom's sign, the telltale swollen lymph glands along
the back of the neck may appear. If untreated, the disease slowly overcomes the
defenses of the infected person, and symptoms spread to include anemia,
endocrine, cardiac, and kidney diseases and disorders. The disease then enters
a neurological phase when the parasite passes through the blood-brain barrier.
The symptoms of the second phase give the disease its name; besides confusion
and reduced coordination, the sleep cycle is disturbed with bouts of fatigue
punctuated with manic periods progressing to daytime slumber and nighttime
insomnia. Without treatment, the disease is fatal, with progressive mental
deterioration leading to coma and death. Damage caused in the neurological
phase can be irreversible. The current standard treatment for first stage disease
is:
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Intravenous pentamidine (for T.b. gambiense); or
Intravenous suramin (for T.b. rhodesiense)
The current standard treatment for second stage (late stage) disease is:
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Intravenous melarsoprol 2.2 mg/kg daily for 10 consecutive days.[6]
Alternative first line therapies include:
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Intravenous melarsoprol 0.6 mg/kg on day 1, 1.2 mg/kg iv melarsoprol on day 2,
and 1.2 mg/kg/day iv melarsoprol combined with oral 7.5 mg/kg nifurtimox twice
a day on days 3 to 10;[7] or
Itravenous eflornithine 50 mg/kd every six hours for 14 days.[8]
In areas with melarsoprol resistance or in patients who have relapsed after
melarsoprol monotherapy, the treatment should be:
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melarsoprol and nifurtimox, or
eflornithine
The following traditional regimens should no longer be used:
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(old "standard" 26-day melarsoprol therapy) Intravenous melarsoprol therapy (3
series of 3.6 mg/kg/day intravenously for 3 days, with 7-day breaks between the
series) (this regimen is less convenient and patients are less likely to complete
therapy)[9];
(incremental melarsoprol therapy) 10-day incremental-dose melarsoprol therapy
(0.6 mg/kg iv on day 1, 1.2 mg/kg iv on day 2, and 1.8 mg/kg iv on days 3–10)
(previously thought to reduce the risk of treatment-induced encephalopathy, but
now known to be associated with an increased risk of relapse and a higher
incidence of encephalopathy)[7][9];
All patients should be follow-up for two years with lumbar punctures every six
months to look for relapse