Tags: Tetanus


Essentials of Diagnosis Intestinal nematodes: demonstration of characteristic eggs or parasites in stool. Bloodstream nematodes (filariasis): clinical diagnosis can be made; fresh blood smear may be confirmatory. Tissue nematodes: clinical diagnosis can be made; skin snip or other tissue examination may show organism. General Considerations Nematodes (roundworms) are nonsegmented, tapered, bilaterally symmetrical, cylindrical organisms that have complete digestive tracts and reproduce sexually. Although > 500,000 species of nematodes have been described, only a small number are commonly encountered as human parasites. Most nematodes have complex life cycles, sometimes involving several larval forms and intermediate hosts or free-living stages. The pathogenic nematodes may be categorized as primarily intestinal or extraintestinal tissue parasites […]


Essentials of Diagnosis History of a cat or dog bite or other exposure. Pain, erythema, swelling, and drainage at the bite site. Gram-negative bipolar bacilli on Gram stain of the drainage. Culture of the organism confirms the diagnosis. General Considerations Pasteurella multocida infection, a disease that primarily affects animals, may occasionally affect humans, causing a wide variety of infections ranging from soft tissue infection to bacteremia and endocarditis. Epidemiology Pasteurella multocida has been recovered from cultures of specimens from the nasopharynx and the gastrointestinal tract of a large number of asymptomatic wild and domestic animals. The highest carriage rates occur in cats (50%-90%), dogs or swine (50%), and rats (15%). Infections […]

Important Anaerobes

Essentials of Diagnosis Foul odor of draining purulence Presence of gas in tissues No organism growth on aerobic culture media Infection localized in the proximity of mucosal surface Presence of septic thrombophlebitis Tissue necrosis and abscess formation Association with malignancies (especially intestinal) Mixed organism morphologies on Gram stain General Considerations Epidemiology and Ecology Anaerobic bacteria are the predominant component of the normal microbial flora of the human body. The following sites harbor the vast majority of them: Skin Mostly gram-positive bacilli such as Propionibacterium acnes Gastrointestinal tract In the oral cavity Prevotella spp., Porphyromonas spp., Peptostreptococcus spp., microaerophillic streptococci, and Fusobacterium spp. are the most important anaerobes found; they significantly outnumber […]

Toxin-Mediated Infections

TETANUS Tetanus is a disease of global incidence produced by the toxin of Clostridium tetani. The risk of acquiring it increases in people > 60 years of age and in neonates, especially in Third World countries where poor sanitary conditions predispose to umbilical stump contamination. Immunization campaigns have played a crucial role in bringing about the observed decreasing incidence in the United States. The pathogenesis of tetanus involves the absorption of preformed toxin, or, less commonly, invasion of toxin-producing organisms from contaminated wounds; it may complicate surgical wounds colonized with C tetani. Incubation periods vary depending on the portal of entry. The toxin tetanospasmin blocks the transmission of inhibitory neurons, which […]

Haemophilus, Bordetella, & Branhamella Species

HAEMOPHILUS INFLUENZAE & OTHER HAEMOPHILUS SPECIES Essentials of Diagnosis Haemophilus influenzae is generally acquired via the aerosol route or by direct contact with respiratory secretions. The most common associated syndromes include otitis media, sinusitis, conjunctivitis, bronchitis, pneumonia, and, to a lesser extent, meningitis, epiglottitis, arthritis, and cellulitis. Gram stain shows pleomorphic gram-negative coccobacilli. In cases of meningitis, epiglottitis, arthritis, and cellulitis, organisms are typically recovered from blood, and type-b polysaccharide capsular material may be detected in the urine. Organisms and type-b polysaccharide capsule may also be present in other appropriate sterile body fluids, such as cerebrospinal fluid (CSF) in meningitis and joint fluid in arthritis. General Considerations Epidemiology Before 1990, strains […]

Bordetella Species: Clinical Syndrome

Classical pertussis occurs in three clinical stages: catarrhal, paroxysmal, and convalescent (Box 5). Clinical Findings Signs and Symptoms The catarrhal stage is characterized by nonspecific upper respiratory symptoms, including rhinorrhea, mild cough, and low-grade fever. During this stage, which typically lasts 1-2 weeks, the disease is highly communicable. The paroxysmal stage is marked by sudden attacks or paroxysms of severe, repetitive coughing, often culminating with the characteristic whoop and frequently followed by vomiting. A marked lymphocytosis usually accompanies this stage of the disease, with lymphocyte counts sometimes exceeding 50,000/mm3 and usually representing 70% or more of total circulating leukocytes. The paroxysmal stage typically lasts 1-4 weeks and can be associated with […]

Haemophilus Influenzae: Clinical Syndromes

H influenzae was first isolated during the 1892 influenza pandemic and was originally believed to be the causative agent of influenza. Although subsequent studies revealed the fallacy of this idea, H influenzae has proved to be a common cause of localized respiratory tract and systemic disease, including meningitis, epiglottitis, pneumonia, pyogenic arthritis, cellulitis, otitis media, and sinusitis, among others (Box 1). MENINGITIS Meningitis is the most common and serious form of invasive H influenzae type-b disease. In the mid-1980s, before the introduction of effective vaccines, ~ 10,000-12,000 cases of H influenzae type-b meningitis occurred in the United States each year, and 95% of cases involved children < 5 years old. Nowadays, […]

Order Chloroquine\Hydroxychloroquine (Aralen) No Prescription 250/500mg

Chloroquine/Hydroxychloroquine(US: Aralen): Drug-Drug Interactions Amlodipine Syncope occurred in a hypertensive 48-year-old man who took oral chloroquine sulfate (total 600 mg base) while also taking amlodipine 5 mg/day. Chloroquine and amlodipine both cause vasodilatation, perhaps by release of nitric oxide, and the syncope in this case was probably due to a synergistic mechanism. Malaria itself can also provoke orthostatic reactions, which may be why syncope is not a reported adverse effect of chloroquine. However, in this patient malaria had been excluded. Antibiotics Studies of chloroquine used in combination with antibiotics showed an antagonistic effect with penicillin but a synergistic effect with chlortetracycline. Urinary tests after single doses of ampicillin 1 g and […]

Anaerobic & Necrotizing Infections

Description of Medical Condition Gangrene is local death of soft tissues due to disease or injury and is associated with loss of blood supply. Anaerobic and necrotizing infections may be associated with gas. System(s) affected: Skin/Exocrine, Cardiovascular Genetics: N/A Incidence/Prevalence in USA: Rare Predominant age: Any Predominant sex: Male = Female Medical Symptoms and Signs of Disease Local pain Foul odor Abnormally dark skin and tissues under skin (dark green to black) Crepitation (gas) Fever Rapid pulse Fulminant course leading to death without treatment What Causes Disease? Local injury Superimposed infection (surface or deep; local or distant) Carcinoma of large intestine Hematologic malignancies Severe neutropenia, related or not related to chemotherapy […]

Vaccines, Toxoids, and other Immunobiologics

Definitions Immunization is the process of introducing an antigen into the body to induce protection against an infectious agent without causing disease. Vaccines are substances administered to generate a protective immune response. Toxoids are inactivated bacterial toxins. They retain the ability to stimulate the formation of antitoxin. Adjuvants are inert substances, such as aluminum salts (i.e., alum), which enhance vaccine antigenicity by prolonging antigen absorption. Immune sera are sterile solutions containing antibody derived from human (immune globulin) or equine (antitoxin) sources. Antitoxins contain antibodies that are made by immunizing animals with an antigen and then harvesting the antibodies from serum. Vaccine and toxoid recommendations In general, inactivated vaccines can be administered […]