17
July
2008
West nile virus notes: 1st isolated in West Nile province of Uganda in 1937. reappeared USA ’99 and found across most of the nation. Arbovirus goes from bird to mosquito to bird.
1/150 result in meningitis or encephalitis. <10% people are infected during outbreaks. Peaks late summer and early fall. 60 varieties of Mosquito gives to humans. Blood is screened before transfusions. Incubation 2-14d.
Most asx. 20% will have sx: 6d fever, headache malaise, back pain, anorexia. +/- eye pain (chorioretinitis and vitritis), sore throat, n/v/d, abd pain (hepatitis, pancreatitis), maculopapular rash. Central DI. Myocarditis.
Neuro: enceph, meningitis, and/or flaccid paralysis (anterior horn cell process). CN palsies. Possible guillain-barre syndrome.
Once infected, prob lifelong immunity.
drjohnhong 
infection 
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9
July
2008
Food Poisoning occurs about 76 million times a year in Americans, leading to over 300,000 hospitalizations and 5,000 deaths. Ones most hurt by food poisoning are the elderly, immunocompromised, and young kids. Food poisoning is usually from bacteria, but also viruses and chemical ingestion. Incubation time most c/w: <1 hr chemical ingestion, 1-7 hrs toxins from staph aureus or bacillus cereus, 8-14 hours bacteria, and 15 or more hrs viruses.
For outbreaks, Salmonella is #1. Though Listeria account for like 0.2% cases, it is the #1 cause of death from food poison outbreaks. #2 is viruses, in particular norovirus. Chemical ingestion and then parasites follow.
drjohnhong infection, GI Comments (0) » |
9
January
2008
What meds are used for the common cold?
drjohnhong Uncategorized, infection Comments (0) » |
15
August
2007
Acute Pharyngitis is the medical term for new onset of sore throat. Only 10% of patients who see the doctor for a sore throat have Group A Streptococcus (GAS) – which is #1 treatable bacterial infection. Other strept infections are Group C and Group G. STD bugs N. gonorrhoeae and Chlamydia can cause sore throats. Mycoplasma (which causes walking pneumonia) is an atypical bacteria. So these bacteria just named consist of only 15-30% cases seen by doctors that will respond to antibiotics. C. diphtheriae is pretty rare because tetanus-diphtheriae vaccines. The rest of infections don’t respond to antibiotics – in particular viruses, which consist of 50% of cases of sore throats in a doctor’s office.
Pharyngitis caused by a virus will not be cured with antibiotics. Virus include Epstein-Barr virus (mononucleosis) and HIV acute infection. Other viruses include rhinovirus (common cold), adenovirus, parainfluenza, coxsackievirus (hand, foot and mouth disease), coronavirus, echovirus, CMV (mono as well), and herpes simplex. Influenza can be treated with Tamiflu.
30% cases a pathogen is not found on throat culture.
Clinical: Sore throat comes on pretty quickly. Tonsils are swollen with exudate (pus or discharge) + Lymph nodes in neck + Fever make the triad for strept throat + lack of cough. If there are other symptoms like stuffy runny nose, sneezing, ear congestion, and coughing then it is likely a virus infection and not strept.
But still studies show doctors often don’t know which patients will have a positive throat culture for GAS if they have the classic signs of strept throat. On the other hand, if 3/4 signs are negative for strept, then about 80% of the time the patient doesn’t have strept throat.
So the rapid strept test is used because the strept culture takes 24-48 hours. But the rapid strept test isn’t perfect: only 80% sensitive. A blood test called ASO can aide in diagnosis but that takes a day as well.
GAS needs to be treated with antibiotics to help prevent acute rheumatic fever, which can cause heart valve damage and kidney damage. Also early treatment with antibiotics can help prevent an abscess forming.
Worst case scenarios for sore throat include an abscess, swollen epiglottis, or parapharyngeal space infections. It might be a bad sign to have drooling, dysphagia (difficulty swallowing) and neck swelling and might require emergency treatment
Symptoms can be reduced with common things like: warm salt water gargles, Listerine, herbal teat with licorice root. NSAIDs like Tylenol (if no liver problems) and ibuprofen (risk of higher blood pressure and stomach ulcers)
drjohnhong Uncategorized, infection Comments (0) » |
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