DOCSLIB.ORG

Infectious Syphilis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Infectious Syphilis Infectious Syphilis: The Return of the Great Imitator To Rhode Island Gail Skowron, MD, Xiaodan Wang, MD, and Ekta Gupta, MD SI N C E 2010, RHODE ISL A ND H A S SEEN A Asia. In the United States, syphilis cases CLINicaL MA N I FEST A T I ONS precipitous increase in the number of reached a peak during World War II, and Primary Syphilis cases of infectious syphilis, particularly declined steadily with the use of serologic The classic syphilitic chancre occurs at among HIV+ men who have sex with men testing and penicillin therapy until the late the site of inoculation of the spirochete, and (MSM). As clinicians, we are charged with 1980s and early 1990s, when an increase in may be seen as single or multiple genital, recognizing the protean manifestations of cases in heterosexual women and neonates perianal, or oral lesions.5 The chancre is this ancient disease, often called “the Great was linked to exchange of sex for drugs, characteristically indurated with a rolled Imitator,” a task made difficult by the low particularly crack cocaine.2 After declining edge and clean base, painless, and accompa- prevalence of syphilis during our training once again by 2000, a more recent rise in nied by regional lymphadenopathy. Lesions and practice. Entire textbooks have been cases has been noted in men who have sex may be inapparent to the patient. The me- devoted to the topic of syphilis; this article with men. In Rhode Island, the number of dian incubation period before appearance is designed as a clinical primer on infec- infectious syphilis cases per year rose from of the chancre is 21 days, with a range from tious syphilis for the practicing clinician 25 in 2008 to 61 in 2010. In 2010, 93% three to 90 days after acquisition.6 Syphilitic in primary care, emergency medicine, of cases were in MSM and half of those chancres are not reliably diagnosed by any dermatology, neurology, hepatology, and were HIV-infected. Factors associated with serologic test and, given the lack of ready nephrology. In order to contribute to syphilis infection included engagement in availability of dark-field microscopy, these public health efforts to reduce the spread anonymous sex and finding sexual partners must be diagnosed clinically and man- of syphilis (see accompanying article on the internet.3 This epidemiology neces- aged presumptively (treatment, reporting, “Interrupting Transmission of HIV and sitates all physicians to complete a com- follow-up and partner management).5 Other Sexually Transmitted Infections in prehensive assessment of sexual practices, Rhode Island”), emphasis is placed on the and testing for HIV infection and other Secondary Syphilis diagnosis of infectious syphilis (primary, sexually transmitted diseases.4 The clinical presentation of secondary secondary and early latent) in adults. Syphilis can be acquired by sexual syphilis is protean, as one would expect contact, transplacental transfer, kissing or from the wide dissemination of treponemes ET I OLOGY other close contact with an active lesion, throughout the body during the spiroche- Syphilis is caused by Treponema pal- transfusion of contaminated fresh human temia of early infection. (Table 1) The lidum, a slender, tightly coiled bacterium blood, or accidental direct inoculation presentation most easily remembered from that cannot be cultivated in vitro. The (needlestick).1 medical school is a rash with the classic genome of T. pallidum lacks apparent “palms and soles” distribution. (Figure 1) transposable elements, sug- gesting that the genome is Table 1. Multi-organ system manifestations of Secondary Syphilis extremely conserved and ������� ���������������������������������������������������������������������������������� !�" (modified from Mandell PPID)1 stable. This is the likely �#�� explanation of why T. pal- ���������$�������%������� � ������������������#&����������������������� lidum has remained exqui- � ��������������������&�������������&���������������� � ��������������'��'���������(������ sitely sensitive to penicillin ���������)��������������� � ����������������� for more than 70 years and � ��������&������&������&������*������������������������+��� that there are few differ- � ���������*���&������������ ����������������������� � ����������������� ences in DNA sequences � ���'��������&���������������������*������������������� among subspecies.1 � �������������&��������&����������������������� )���������������������� � ��*���������'��&��������&������������&�����������&������,��&�*����������&� ����������� HI STORY & ��������������� � ��������%��������������������������� � ����������������������������������������������������+����������������������� EP I DEM I OLOGY ��*������������������������������������� Syphilis has a long -��������� � )-����'��'���������������./0������������ � and storied past. Histori- � 1���������������������������������� 2�������������� � 3����������������������'�������������'�����&�������������&�'��������&����������&�����������&� ans have speculated that �������������#��������&�����������������������&����������������������� Columbus brought syphi- � ��������������������������������������������&���������������������&������������&� ��,����������&���������������&������������������������ ������������ lis back to Europe from 2������������ � �������������������'����������������������������&���������&�'������&����� the New World, perhaps ����+��������� 1������ � �������������#��������������������'��&���������������������������'����������� leading to the “Great Pox” ����������������������� epidemic in Europe and 4����� � �������������,�������������������&�*����������������������������������������� 245 VOLUME 95 NO. 8 AUGUST 2012 ������� ��������������5��������!�������������������� ������&���������������5�����������" 6����������7 � !��8��%������� ����������$�� .��9�,�� ���� ���������������������������� � ��,����������//�������8!��,��.����� � )������,��������!�����!:�;��,��/��.������� � 3%����������������������,��< �� �������������'�����������������������������������'�����������������(����������������*��� �� ����������������������� ��2������������(��������������������� ������������������������������� �� �����������������������*����������� ��)����������������������������������������������������� � ��#��1���� ����� � ����������������������������������������������������������������� � ��*������������������������=�1!:&����������&���������� � ����������������������������������������������1( �������������������������� � ����������������������������,�����������������&�)����,����������������������������������� � ��*����������������������������6 6������ � ��,������������������������������������������������������*����������������������<�������" skin, though the use of gloves is solved), or 3) a sex partner documented recommended when examining to have primary, secondary, or early latent any potentially infectious rash. syphilis.6 Late Latent syphilis is defined as Vesicular lesions occur only in asymptomatic seroreactivity in the absence congenital syphilis.1 of these conditions. Early latent syphilis is Two highly infectious skin considered “early” or “infectious” syphilis lesions are condylomata lata and and treatment recommendations are iden- mucous patches. Condylomata tical to primary and secondary syphilis. lata occur on warm, moist, in- tertriginous areas (perianal area, To LP or not to LP? vulva, scrotum, inner aspects of A common clinical dilemma is wheth- the thighs, skin under pendulous er to perform an LP on a patient presenting breasts, nasolabial folds, cleft of with early syphilis.8 This is particularly the chin, axillary and antecubital true for HIV-infected patients, in whom folds, webs of the fingers and an increased likelihood of progression toes) as painless, broad, moist, to symptomatic neurosyphilis has been grey-white to erythematous described.9 In HIV+ individuals, clinical plaques.1 Mucous membrane and CSF abnormalities consistent with lesions, termed mucous patches, neurosyphilis are associated with an RPR are silvery gray, superficial ero- titer > 1:32 and/or a CD4 cell count < sion with a red periphery, and 350 cells/µL.11-13 However, no studies have may occur on lips, mouth, phar- demonstrated a change in clinical outcome Figure 1. Lesions of secondary syphilis on the ynx, tonsils, vulva, vagina, glans if a lumbar puncture is performed and soles of the feet. penis, inner prepuce, cervix, and neurosyphilis is documented and treated.8,14 anal canal.1 Therefore, CDC does not recommend CSF Patients may ascribe the rash to another eti- Constitutional symptoms examination in HIV-infected or -unin- ology, and, though classically non-pruritic, may be prominent (or the presenting com- fected patients who lack neurologic signs or they may present with the common “gen- plaint), including fever, malaise, pharyngi- symptoms suggestive of neurosyphilis.6 In eralized pruritic rash” to their primary care tis, anorexia, weight loss, and arthralgias. clinical practice, therefore, a detailed history provider. (Figure 2) The lesions typically Generalized lymphadenopathy (particularly and physical examination to detect symp- begin as three to ten mm macules, sym- epitrochlear), hepatitis, and glomerulone- tomatic neurosyphilis must be performed metrically distributed first on the trunk and phritis may accompany other manifesta- in all patients diagnosed with syphilis. If upper extremities, that may progress to pap- tions. Seeding of the central nervous system clinical evidence of neurologic involvement ules, and less commonly, to pustules.1 A fine
Load more

Recommended publications
  • Tenfactsaboutld 2012
    Lyme Disease Lyme Disease Association, Inc. Top 10 Facts Lyme disease is caused by a spiral-shaped bacteria, Borrelia burgdorferi (Bb), or by newly discovered Borrelia mayonii. It is usually transmitted by the bite of an infected tick−Ixodes scapularis in the East, Ixodes pacificus in the West. The longer a tick is attached, the greater risk of disease transmission. Improper removal increases risk of infection. Go to www.LymeDiseaseAssociation.org for details. 1. Lyme is the most prevalent vector-borne disease in the USA. The ticks that cause Lyme are now found in 50% of US counties. It’s found in more than 80 countries worldwide. 2. According to the Centers for Disease Control & Prevention (CDC), only 10% of Lyme disease cases are reported each year. So in 2015, about 400,000 new cases of Lyme occurred in the USA. In 2009, CDC said the incidence of Lyme surpassed that of HIV. 3. One bite from Ixodes scapularis (western blacklegged/deer tick) can transmit one or more: Lyme, babesiosis, anaplasmosis, tularemia, ehrlichiosis, bartonellosis, Borrelia miyamotoi, tick paralysis, Powassan virus, clouding diagnostic/treatment picture. 4. Lyme disease is often called the "Great Imitator." It may be misdiagnosed as; multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), lupus, chronic fatigue, fibromyalgia, autism, Alzheimer’s, Parkinson’s disease and other conditions. 5. A bite from a tick that’s infected with Lyme disease bacteria can lead to neurologic, cardiac, arthritic and psychiatric manifestations in humans. It may cause death, sometimes cardiac related. 6. Children account for 30% of Lyme cases: ages 5-14 are at the highest risk.
    [Show full text]
  • LYME DISEASE “The Great Imitator”
    Rocky Mountain Tribal Leaders Council September 26, 2020 LYME DISEASE “The Great Imitator” Lyme disease - Basics • The most common vector- borne illness in the U.S. • Also known as Lyme borreliosis. • Transmitted to humans via ticks which are infected with a spirochete (spiral shape bacterium) called Borrelia burgdorferi. • Borrellia’s cork-screw shape allows it to burrow Classic Erythema Chronicum Migrans “bull’s eye” rash. into a variety of tissues, causing multi-system illness. Co-infection with Signs and symptoms of Lyme disease Babesia or Ehrlichia is common. • Symptoms of Lyme disease begin 3-30 days after a tick bite; average 7 days. Symptoms vary by disease stage. • Called The Great Imitator since its symptoms mimic • Stage 1: Occurs 1-30 days after the tick bite. Flu-like illness many other diseases. For (fever, chills, fatigue, malaise, muscle or joint pain), headache, red this reason, patients are expanding rash (bull’s eye rash, depicted above). The rash occurs often misdiagnosed with at or near the site of the tick bite and may persist for 2-3 weeks. chronic fatigue syndrome, • Stage 2: Early disseminated disease, 3-10 weeks after fibromyalgia, multiple inoculation. Musculoskeletal and neurologic symptoms, such as sclerosis, and various arthritis, facial muscle weakness or paralysis, meningitis, waxing psychiatric illnesses, and waning headache, neck pain/stiffness, fever, malaise, double including depression. or blurred vision, dizziness, heart palpitations, or chest pain. • Misdiagnosis leads to • Stage 3: Occurs months to years after the initial infection. unrestrained progression Arthritis of large joints, especially the knee, associated with of Lyme infection and warmth, swelling, and limited range of motion.
    [Show full text]
  • Abdominal Tuberculosis Misdiagnosed As Acute Surgical Abdomen and Carcinomatosis [Version 2; Peer Review: 2 Approved]
    F1000Research 2021, 10:355 Last updated: 13 JUL 2021 CLINICAL PRACTICE ARTICLE Abdominal tuberculosis misdiagnosed as acute surgical abdomen and carcinomatosis [version 2; peer review: 2 approved] Edinson Dante Meregildo-Rodriguez 1,2, Rosita Claudia Tafur-Ramirez3, Walter Giovanny Espino-Saavedra4, Sonia Fiorella Angulo-Prentice4 1Universidad César Vallejo, Escuela de Medicina, Trujillo, La Libertad, Peru 2Department of Internal Medicine, Hospital Regional Lambayeque, Chiclayo, Lambayeque, 14007, Peru 3Department of Nephrology, Hospital Regional Lambayeque, Chiclayo, Lambayeque, 14007, Peru 4Department of Clinical Pathology, Hospital Regional Lambayeque, Chiclayo, Lambayeque, 14007, Peru v2 First published: 07 May 2021, 10:355 Open Peer Review https://doi.org/10.12688/f1000research.53036.1 Latest published: 12 Jul 2021, 10:355 https://doi.org/10.12688/f1000research.53036.2 Reviewer Status Invited Reviewers Abstract Tuberculosis is a major public health problem worldwide. Tuberculosis 1 2 can be confused with other diseases and its diagnosis is frequently delayed, especially in areas of low prevalence. Abdominal tuberculosis version 2 includes involvement of the gastrointestinal tract, peritoneum, lymph (revision) nodes, and/or solid organs; and accounts for 5% of all cases of 12 Jul 2021 tuberculosis. We report two cases of young patients who presented preoperatively as acute abdomen due to acute appendicitis. During version 1 surgery, these cases were misdiagnosed as “carcinomatosis”, and in 07 May 2021 report report the postoperative period these cases were complicated with septic shock. In both cases, histopathology showed caseating 1. Uzair Yaqoob , Dow University of Health granulomas which suggested tuberculous peritonitis and enteritis. Subsequently, RT-PCR in peritoneal fluid confirmed Mycobacterium Sciences, Karachi, Pakistan tuberculosis.
    [Show full text]
  • Secondary Syphilis: the Great Imitator Can't Be Forgotten
    SECONDARYIMAGE SYPHILIS: TINHE GREA MEDICINET IMITATOR CAN’T BE FORGOttEN Secondary syphilis: The great imitator can’t be forgotten CLARISSA PRIETO HERMAN REINEHR1*, CÉLIA LUIZA PETERSEN VITELLO KALIL2, VINÍCIUS PRIETO HERMAN REINEHR3 1MD, Dermatologist, Member of the Brazilian Society of Dermatology, Master’s Student at the Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil 2Dermatologist, Member of the Brazilian Society of Dermatology, Porto Alegre, RS, Brazil 3MD, General Practitioner, Porto Alegre, RS, Brazil SUMMARY Study conducted at Clínica Dermatológica Célia Kalil, Porto Alegre, RS, Brazil Syphilis is an infection caused by Treponema pallidum, mainly transmitted by sexual contact. Since 2001, primary and secondary syphilis rates started to rise, Article received: 11/7/2016 Accepted for publication: 12/4/2016 with an epidemic resurgence. The authors describe an exuberant case of second- ary syphilis, presenting with annular and lichen planus-like lesions, as well as *Correspondence: Address: Rua Félix da Cunha, 1.009, one mucocutaneous lesion. Physicians must be aware of syphilis in daily practice, conj. 401 since the vast spectrum of its cutaneous manifestations is rising worldwide. Porto Alegre, RS – Brazil Postal code: 90570-001 [email protected] Keywords: cutaneous syphilis, sexually transmitted disease, benzathine penicil- lin G, Treponema pallidum. http://dx.doi.org/10.1590/1806-9282.63.06.481 INTRODUCTION firmed and the patient was treated with three weekly in- Syphilis is an infection caused by Treponema pallidum, a spi- tramuscular injections of benzathine penicillin G 2.4×106 rochete bacterium transmitted mostly by sexual contact. IU.4 The patient was advised to contact his sexual partners Spirochetes penetrate skin or mucosa in areas of micro- so that they could seek medical evaluation.
    [Show full text]
  • CLINICAL UPDATE UPDATE Coeliac Disease: the Great Imitator
    CLINICAL UPDATE UPDATE Coeliac disease: the great imitator John M Duggan “Know syphilis in all its manifestations and all other things ABSTRACT clinical will be added unto you.”1 ■ Coeliac disease (CD) is caused by a complex immunological WHEN THE SUPREME CLINICIAN William Osler wrote this, response provoked by grain protein in susceptible people. he was drawing attention to the ubiquity of syphilis and the remarkable range of its late-stage manifestations, today ■ The majority of people with CD are symptom-free adults; virtuallyThe unknown.Medical Journal However, of Australia I argue ISSN: that 0025-729X its place has been the remainder are prone to a bewildering variety of signs taken17 by May coeliac 2004 180disease 10 524-526 (CD), another great imitator. As a and symptoms, ranging from infertility to type 1 diabetes. diagnostic©The challenge,Medical JournalCD is ofthe Australia“syphilis” 2004 of the 21st ■ Many patients with undiagnosed CD spend years seeking century.www.mja.com.au Clinical Update help for complaints such as chronic tiredness or mild Western civilisation owes much of its foundation to a abdominal symptoms. strange molecular rearrangement of the chromosomes of wild grasses in the Middle East to produce a high-protein, ■ In primary care, an appropriate target group to test for CD is high-yielding grain — wheat — with six sets of chromo- people with anaemia (especially women), chronic tiredness, somes. This enabled the nomads to settle down with some non-specific abdominal symptoms (including so-called assurance of a regular food supply and time to think and “irritable bowel syndrome”), or a family history of CD.
    [Show full text]
  • Unraveling the Tuskegee Study of Untreated Syphilis
    COMMENTARY Unraveling the Tuskegee Study of Untreated Syphilis ODAY WE repeatedly and public health in relation to and/ that contributed to the genesis of the hear about the or concurrent with the TSUS. This in- TSUS will be briefly described. Tuskegee Study of cludesactivitiesbythegovernmentand In the early 1930s, the Rosen- Untreated Syphilis nongovernment entities. If Americans wald Memorial Fund, a Chicago- (TSUS) in the media. do not understand the historical con- based philanthropic foundation, TThe TSUS was the 1932 through text and the successes and failures of undertook what had not been per- 1972 US Public Health Service past public health policy and medical formed before in America—a study (USPHS) study involving approxi- practices,wemayrepeatsimilarerrors. of the prevalence of syphilis among mately 400 African American men A historically correct, empiri- African Americans. The study was with syphilis who were found un- cally based analysis of the TSUS is performed with the cooperation of treated in rural Alabama and were ob- presented in this article. This is im- the USPHS. The purpose of the study served to autopsy. As a control, there portant given the impact that pre- was to determine the practicability was also a comparable group of 200 vious interpretations (ie, racism, and effectiveness of measures for African American men without syphi- genocide, and conspiracy) of the mass control of syphilis. Macon lis who were observed to autopsy.1 TSUS have had on present-day re- County, Alabama, was one of 6 ru- The TSUS is a topic the domain search, medical practice, and race re- ral counties chosen for study; the of which includes not only medicine lations.
    [Show full text]
  • County's Lyme Disease Cases on the Rise
    OOONNNEEEIIIDDDAAA CCCOOOUUUNNNTTTYYY HHHEEEAAALLLTTTHHH DDDEEEPPPAAARRRTTTMMMEEENNNTTT Adirondack Bank Building, 5th Floor, 185 Genesee St., Utica, NY 13501 ANTHONY J. PICENTE, JR. PHYLLIS D. ELLIS, BSN, MS, F.A.C.H.E ONEIDA CO UNTY EXECUTIVE DIRECTOR OF HEALTH AAADDDMMMIIINNNIIISSSTTTRRRAAATTTIIIOOONNN Phone: (315) 798-6400 Fax: (315) 266-6138 NNNEEEWWWSSSRRREEELLLEEEAAASSSEEE August 28, 2013 For Immediate Release County’s Lyme Disease Cases On the Rise Health Department Warns Against Tick Bites Health Department officials say 56 cases of Lyme disease have been confirmed in Oneida County so far this year, with more than thirty cases being reported in the month of July. “We’re definitely seeing a sharp increase in the number of confirmed cases of Lyme disease in 2013,” Phyllis Ellis, Director of the Oneida County Health Department said. She added, “Last year only saw a total of fourteen cases of the tick‐borne illness throughout the County.” Lyme disease is caused by bacteria transmitted by the deer tick. Ticks will perch on grass or low‐hanging vegetation, usually 18 to 24 inches above the ground, before attaching themselves to a host and inserting a small piercing element into the skin through which they ingest blood. Lyme disease is often called ‘The Great Imitator’ because its symptoms mimic many other illnesses such as Fibromyalgia, Multiple Sclerosis, Chronic Fatigue Syndrome or Amyotrophic Lateral Sclerosis (ALS). The most recognizable sign of Lyme disease is a bulls‐eye rash that sometimes develops around the sight of the bite, although not in 100% of cases. Early stage of the disease is marked by chills, fever, headache, stiff neck, muscle and joint pain and swollen glands.
    [Show full text]
  • Colorado State University-Pueblo Student Health Services 2200 Bonforte Blvd Pueblo, CO 81001 (719)549-2830 Syphilis Patient Teaching Sheet
    Colorado State University-Pueblo Student Health Services 2200 Bonforte Blvd Pueblo, CO 81001 (719)549-2830 Syphilis Patient Teaching Sheet Definition: Syphilis is a sexually transmitted disease that is caused by the bacteria Troponema pallidum. It can infect the genital area, lips, mouth, throat, or anus of both men and women. Syphilis has been called “The great imitator” because its signs and symptoms are similar to other infectious diseases. Syphilis occurs in three stages: primary, secondary, and tertiary. Statistics of Syphilis In the United States, the Center for Disease Control, reported 32,000 cases of syphilis in 2002. Most of those cases occurred in patients between the ages of 35-39 years of age. Between the years 2001-2002, the numbers of reported cases of syphilis have increased approximately 12%. It was found that men who have unprotected sex with other men are 3.5 times more likely to catch syphilis. Stages of Syphilis a. Primary-This stage of Syphilis begins with a non-painful lesion called a chancre. A chancre is a round, firm, small painless lesion that appears where syphilis entered the body and lasts about 3-6 weeks. It will heal without treatment. If a patient ignores the chancre and does not seek medical attention, syphilis will progress to the second stage. b. Secondary-a patient who has progressed to the second stage of syphilis will develop a skin rash and lesions on the mucous membrane. A syphilitic rash appears as rough, red, or with reddish brown spots on the palms of the hands and the bottom of the feet.
    [Show full text]
  • Syphilis Facts
    SYPHILIS What is syphilis? Syphilis is a complex sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. It is often called "the great imitator" because many of its signs and symptoms resemble those of other diseases. How do people get syphilis? Syphilis is passed from person to person through direct contact with a syphilis sore. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth which means that it can also be spread by kissing someone with a sore in their mouth or on their lips. Transmission of the organism occurs during vaginal, anal, or oral sex. Pregnant women with the disease can pass it to the babies they are carrying. What are the signs and symptoms of syphilis in adults? Primary Stage The time between infection with syphilis and the start of the first symptom can range from 10-90 days (average 21 days). The primary stage of syphilis is usually marked by the appearance of a single sore (called a chancre), but there may be multiple sores. The chancre is usually firm, round, small, and painless. It appears at the spot where syphilis entered the body. The chancre lasts 3-6 weeks, and it will heal on its own. If adequate treatment is not administered, the infection progresses to the secondary stage. Secondary Stage The second stage starts when one or more areas of the skin break into a rash that usually does not itch. Rashes can appear as the chancre is fading or can be delayed for weeks.
    [Show full text]
  • Chagas Disease
    Chagas Disease Ancient, Exotic, Endemic, Deadly My Experience with Chagas Disease Simon Bolivar Visiting Professor, National University, Caracas, Venezuela 1970 Additional Experience Progress in Cardiovascular Diseases 1970 Uncommon Causes of Heart Failure (With a Section on Chagas Disease) Joseph K. Perloff, Keith M. Lindgren and Bertron M. Groves Osler called syphilis the great imitator because the signs and symptoms were similar to so many other diseases. Another Great Imitator: South American Trypanasomiasis, (Trypanosoma Cruzi). How Ancient is Ancient ? Chagas disease began millions of years ago as an enzootic (non-human) disease of wild animals. DNA evidence of Trypanosoma Cruzi has been found in 4000 year old South American mummies. Exotic Caused by a hemoflagelate that enters the bloodstream after a bite of the reduvid sandfly. Endemic & Deadly Chagas disease is endemic In Mexico, Central and South America. Annual death toll is 50,000. 18 million are already infected, and 100 million--25% of the population--are at risk of acquiring the infection. Types of Trypanosomiasis: African Trypanosomiasis Sleeping Sickness American Trypanasomiasis Chagas Disease African Trypanosomiasis Caused by the parasite Trypanosoma brucei that enters the bloodstream after a bite by the Tsetse fly. American Trypanasomiasis Chagas Disease Animal -to-human and human-to human transmission by a blood sucking reduvid bug---the phlebotomine sandfly. Upper left--circulating flagellates. Upper right--pseudocysts light blue Lower left--myocardial fibrosis. Lower right--dilated cardiomyopathy. Who Was Chagas? Carlos Justiniano Rubiero Chagas Was 29 years old when he described the parasite in the blood stream, the cycle of the vector in the digestive tract, cultivation in agar-blood, and transmission to vertebrates by the bite of the infected reduvid sandfly.
    [Show full text]
  • Lyme Disease Information
    Stop Ticking Around... Lyme Disease Information Hamilton County Health Department Health Education Division www.hamiltoncounty.in.gov Disclaimer.. • This presentation is intended for educational purposes only. • If you think you have any symptoms that are in this presentation, you need to contact your health care provider as soon as possible. • Follow the Hamilton County Health Department on Social Media. The Reader Will Be Able To.. • Name two species of ticks that can transmit Lyme disease. • Explain two ways people become infected with Lyme disease. • Identify two symptoms of Lyme disease. • Recall how Lyme disease affects the body. • Discuss how to remove a tick. • List three ways to prevent Lyme disease. What is Lyme Disease? • Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged tick or deer ticks. • It is the most common tickborne infectious disease in the United States. • Although people may think of Lyme as an East Coast disease, it is found throughout the United States, as well as in more than sixty other countries. • Lyme disease is called “The Great Imitator,” because its symptoms mimic many other Borrelia burgdorferi bacterium diseases. Source: CDC Borrelia burgdorferi Bacterium… • Borrelia burgdorferi bacterium lives in mice, squirrels and other small animals. • The bacterium is spread among these animals – and to humans – through the bites of some ticks that are infected. Types Of Ticks… • The blacklegged tick (or deer tick, Ixodes scapularis) spreads the disease in the northeastern, mid- Atlantic, and north-central United States. • The western blacklegged tick (Ixodes pacificus) spreads the disease on the Pacific Coast.
    [Show full text]
  • Pdf 1.46 MB Guidelines on the Diagnosis and Treatment of Malaria
    Foreword Malaria is still a major cause of sickness and death in Zambia. Children under five years of age and pregnant women are at risk of serious illness, but malaria affects all levels of society. The Ministry of Health (MoH) is absolutely dedicated to ensuring that this disease is addressed at all levels and on all fronts. The MoH approach to ensure maximum impact on malaria focuses on the integration of the most effective prevention and treatment tools. Both indoor residual spraying (IRS) of insecticides and large-scale use of long-lasting insecticide-treated nets (LLINs) will be promoted to have the most rapid and sizable impact on the transmission of the disease. The importance attached to the management of malaria at the community level, availability of the most effective medicines at all levels of the health system, and use of the newest diagnostic tools including rapid diagnostic tests to ensure proper diagnosis at lower health facilities and at the community level are all key approaches to ensure the highest possible quality of case management. With this combination of approaches, the MoH aims to have a dramatic impact on the level of malaria in the country. It is with this background that I sincerely welcome the revisions made in the Guidelines for the Diagnosis and Treatment of Malaria in Zambia to reflect the updated policy recommendations. These fourth edition guidelines are intended to provide useful updated information to all health Guidelines for the Diagnosis and Treatment of Malaria in Zambia ii workers on the diagnosis and management of malaria at all levels of the health care system.
    [Show full text]