Infections

Cholera

An acute infectious disease caused by Vibrio cholerae (El Tor type is responsible for current epidemic, the other type, classic, is found only in Bangladesh). (New serotype now in Bangladesh, India (0139). Important because of lack of efficacy of standard vaccine.) Characteristics include severe diarrhea with extreme fluid and electrolyte depletion, and vomiting, muscle cramps and prostration.

Brucellosis

Systemic bacterial infection caused by Brucella species in infected animal products, or vaccine. Incubation period usually 5-60 days, but highly variable and may be several months.

Brain Abscess

Single or multiple abscesses within the brain, usually occurring secondary to a focus of infection outside the central nervous system. May mimic brain tumor but evolves more rapidly (days to a few weeks). It starts as a cerebritis, becomes necrotic, and subsequently becomes encapsulated.

Botulism

An intoxication producing paralytic disease caused by neurotoxins of Clostridium botulism and is the most toxic substances known to science. The toxin prevents acetylcholine release at presynaptic membranes, blocking neuromuscular transmission in cholinergic nerve fibers. Electro my ogram (EMG) shows characteristic brief, low voltage compound motor-unit, small amplitude, overly abundant action potentials (BSAPs), incremental response to repetitive stimulation. Findings not definitive for botulism.

Management of Bacterial Meningitis

Meningitis used to be a disease that occurred primarily in children younger than 12 years. The advent of a vaccine for Haemophilus influenzae has led to a marked change in the epidemiology of meningitis in developed countries.

Pelvic inflammatory disease (PID)

PID is a clinical syndrome caused by the ascent of microorganisms from the vagina and endocervix to the endometrium, fallopian tubes, ovaries, and contiguous structures. PID is a broad term that includes a variety of upper genital tract infections, unrelated to pregnancy or surgical procedures, such as salpingitis, salpingo-oophoritis, endometritis, tubo-ovarian inflammatory masses, and pelvic or diffuse peritonitis. The precise mechanism by which microorganisms ascend from the lower genital tract is not known. One possibility is that chlamydial or gono-coccal endocervicitis alters the defense mechanisms of the cervix allowing ascent of the vaginal flora with or without the original pathogen.

Osteomyelitis

Osteomyelitis is an acute or chronic infection of the bone and its structures caused most commonly by bacteria and rarely by other microorganisms. This infection may be acquired either by hematogenous, contiguous, or direct inoculation such as trauma or surgery.

Pneumonia, bacterial

An acute, bacterial infection of the lung parenchyma. Infection may be community-acquired or nosocomial (hospital acquired by an inpatient for at least 48 hours or inpatient in the previous 90 days). Most commonly, community-acquired disease is caused by Streptococcus pneumoniae or Mycoplasma pneumoniae. Hospital-acquired pneumonia is usually due to gram negative rods (60%, such as Pseudomonas) or Staphylococcus (30%).

Arthritis, infectious

Invasion of joints by live microorganisms or their fragments. One of the few curable causes of arthritis. May allow early recognition of systemic infection/disease. Limit activity or splint the joint initially.

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