MedUrgent

 ِBURULI ULCER   This is a chronic type of ulcers that is commonly seen in Uganda (Buruli County area), Sudan, West Africa, New Guinea, South East Asia, South America and Australia. The disease is caused by Mycobacterium ulcerans and transmitted via aquatic areas. Pathogenesis It starts as a painless subcutaneous nodule in any part of the body especially exposed areas. Infection of the subcutaneous fat leads to skin ulceration due to the toxin produced by the Mycobacterium ulcerans. In severe forms or super-infected ulcers, there is pain and fever. Ulceration heals by granulation leading to scarring and contractures. Investigations - Culture of a swab  - Ziehl-Neelsen stain - PCR Treatment - Rifampicin+ Streptomycin for 8 weeks (or clarithromycin) - Surgical excision - Local heat at 40 C Prevention - BCG vaccination

  YAWS Yaws is a non-venereal spirochaetal disease caused by treponema pertenue. The disease is transmitted by direct contact through skin abrasions. It is common in children (70% of cases) and adults in Africa, South America, South East Asia, South Pacific Islands and Australia, mostly in worm and humid areas. Clinical Picture The Primary lesion starts as a papule that ulcerates and increase in size and may get secondary infected, develop into secondary lesion or heals spontaneously. The Secondary lesion appears after weeks to years from the primary lesion. It may present as crops of papules, rounded framboesial granuloma, papilloma, ulcers, hyper-keratosis of palms and soles, osteitis, dermatitis and lymphadenopathy. The Tertiary lesions appear after a latent period and manifests as necrotic lesions of the skin and bones (saber tibia and boomerang leg), palatal destruction, bursitis and secondary infections. Goundou (boney thickness of the maxilla) and Gangosa (ulcerative...

 TRACHOMA (Greek: roughness)   Trachoma is a leading cause of blindness in the world. It is caused by the bacteria Chlamydia trachomatis. Pathogenesis: Chlamydia trachomatis is spread by flies and fomites through wet secretions from the eyes, nose and throat. A single attack may resolve spontaneously but repeated attacks end up with entropion, corneal ulceration and complete blindness. Clinical Incubation period is 5-7 days followed by conjunctival inflammation, appearance of conjunctival follicles in the under surface of the upper eye lid and watery discharge that may become purulent with secondary bacterial infection. The condition is associated with intense itching, eye discharge, photophobia and local lymphadenopathy. Cicatricial trachoma is a late manifestation that includes distortion of the eye lid (entropion), trichiasis (eye lid hair scratching the cornea), corneal ulceration, scarring and blindness. Treatment   -Azithromycin 20mg/kg once oral -Topi...

  PLAGUE Plague is a zoonotic infection of rodents which is caused by the gram negative coccobacillus Yersinia pestis. The disease is transmitted by fleas that feed on rats or through direct contact with infected tissues and body fluids. Incubation period is 2-8 days. Pathogenesis: After a flea bite or exposure through other methods, the bacteria migrate to the lymph nodes leading to lymphadenopathy (Buboes) and it may spread systemically leading to bacteremia or pneumonia. Clinical picture: Plague may present in any of the following forms: 1- Bubonic: This is the commonest form. Two to eight days after a flea bite, the inguinal lymph nodes enlarge and may be associated with fever, rigors, headache and prostration. Other lymph nodes e.g. axillary and cervical may also be involved. DIC, purpura, gangrene and death may soon follow. 2- Septicemia : This form may follow bubonic plague or results from direct contact with infected fluids and tissues. It presents with severe t...

VIRAL HAEMORRHAGIC FEVERS Viral Hemorrhagic Fever defines a syndrome caused by 4 different families of RNA viruses. Though they have constant features in common, yet there are particular clinical features associated with different viruses. They can cause disastrous epidemics with case fatality rate up to 50%. Classification 1. Arenaviruses e.g. Guanarito, Junin, Machupo and Lassa. They have rodent reservoir. Humans are infected by aerosols of rodent excreta or other close contacts with rodents. 2. Bunyaviruses e.g. Rift Valley, Criean-Congo and Hantaan. Transmission through mosquito bites, aerosols or contact with blood of domestic animals, tick bite and rodent excreta. 3. Filovirus e.g. Ebola and Marburg. Mode of transmission is by person to person through body fluids 4. Flaviviruses e.g. yellow fever, Dengue and Kyanasur forest disease. Mode of transmission is through mosquito and tick bites.  Clinical features After contracting the disease, the incubation period ...

  INTESTINAL HELMINTHS   Introduction Soil transmitted Helminthiasis includes Ascaris lumbricoides, Trichuris trichiura, Ancylostoma dudenale and Necator americanus. About one third of the global population is infected and it is an important cause of physical and intellectual retardation. It is most commonly seen in worm and moist climates and in areas where there is poor sanitation, poor hygiene and unsafe water supply. It is more prevalent in developing countries in Africa, South East Asia, China and South America. Morbidity depends on the heaviness of the infection.   ASCARIASIS  Life cycle Ascaris lumbricoides infection is acquired by swallowing of embryonated ova from soil contaminated by human faeces. After being swallowed, the ova penetrate the intestinal wall, passes to the liver and thence through the systemic circulation to the lungs. There, it penetrates the alveoli, passes up the respiratory system to be swallowed again and develop into adults that ...