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Showing posts with the label Infectious diseases

Emphysematous pyelonephritis - Review

  DEFINITION  Emphysematous pyelonephritis is an acute necrotizing infection characterized by gas formation. It is characterized by the presence of gas in and around the kidney.   ETIOLOGY   E. coli (58%) and K. pneumoniae (21%) are the organisms most commonly isolated. Clostridium and Enterobacter spp may also be responsible, 7% each.   RISK FACTORS   1) Diabetes mellitus (70-90%)- usually patients with poor glucose control. High levels of glucose in the urine serve as a substrate for these bacteria and large amounts of gas are generated through natural fermentation 2) Obstruction (25-40%)- it is another common predisposing factor for emphysematous pyelonephritis. For non-diabetics, protein fermentation is a proposed source of gas formation.  CLINICAL FEATURES  7% of cases may be asymptomatic. If symptomatic, patients may complain of pneumaturia, irritative lower tract voiding symptoms, flank pain or may present in a severe septic condition with an acute abdomen and hig

The common cold - definition, diagnosis and treatment

  DEFINITION   It is an upper respiratory tract illness that comprises of rhinorrhea and nasal obstruction as the main symptoms.   EPIDEMIOLOGY   5- 7 times/ year in children and 2-3 times/ year in adults. most commonly seen between the early fall and late spring in temperate climates. Transmission of the virus may occur via direct contact, large-particle aerosol, or small-particle aerosol.   MICROBIOLOGY   The rhinoviruses are usually responsible for the majority of cases. Coronavirus, respiratory syncytial virus and metapneumovirus may also be associated with the common cold syndrome.   DIAGNOSIS   The diagnosis of the common cold is a clinical diagnosis. Polymerase chain reaction assay can determine the responsible pathogen but this is rarely useful in the management of the patient.   THERAPY   Management is mainly directed towards the bothersome symptoms as no specific antiviral agents are useful in the treatment. First published on: 10 June 2016

A case of Mycobacterium marinum infection in a fisherman

Historically recognized as “swimming pool” or “fish tank” granuloma. Clinical features: Most infections occur 2 to 3 weeks after contact with contaminated water from one of these sources. The lesions are most often small violet papules on the hands and arms that may progress to shallow, crusty ulcerations and scar formation. Lesions are usually singular. However, multiple ascending lesions resembling sporotrichosis can occasionally occur. Most patients are clinically healthy with a previous local hand injury that becomes infected while cleaning a fish tank or patients may sustain scratches or puncture wounds from saltwater fish, shrimp, fins and other marine life contaminated with M. marinum. Swimming pools seem to be a risk only when non-chlorinated. Diagnosis: Diagnosis is made from culture and histologic examination of biopsy material, along with a compatible history of exposure. Treatment: No treatment of choice is recognized for M. marinum. However, successful treatmen