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What are corns and calluses? Causes,Treatment, Definition, Diagnosis,

What are corns and calluses?
Corns and calluses are annoying and potentially painful conditions that form thickened areas in the skin in areas of excessive pressure. The medical term for the thickened skin that forms corns and calluses is hyperkeratosis (plural=hyperkeratoses). A callus refers to a more diffuse, flattened area of thick skin, while a corn is a thick, localized area that usually has a popular, conical or circular shape. Corns, also known as helomas or clavi, sometimes have a dry, waxy, or translucent appearance. A callus is also known as a tyloma.

Corns and calluses occur on parts of the feet and sometimes the fingers. Corns are often painful, even when they are small. Common locations for corns are

On the bottom of the foot (sole or plantar surface), over the metatarsal arch (the “ball” of the foot);
On the outside of the fifth (small or “pinky”) toe, where it rubs against the shoe;
Between the fourth and fifth toes. Unlike other corns that are firm and flesh-colored, corns between the toes are often whitish and messy; this is sometimes called a “soft corn” (heloma molle), in contrast to the more common “hard corn” (heloma durum) found in other locations.
Corns are the result of mechanical trauma to the skin culminating in hyperplasia of the epidermis. Most commonly, friction and pressure between the bones of the foot and ill-fitting footwear cause a normal physiological response – the proliferation of the stratum corneum. One of the primary roles of the stratum corneum is to provide a barrier to mechanical injury.

Any insult compromising this barrier causes homeostatic changes and the release of cytokines into the epidermis, stimulating an increase in the synthesis of the stratum corneum. When the insult is chronic and the mechanical defect is not repaired, hyperplasia and inflammation are common.

With corns, external mechanical forces are focused on a localized area of the skin, ultimately leading to impaction of the stratum corneum and the formation of a hard keratin plug that presses painfully into the papillary dermis, which is known as a radix or nucleus.

The shape of the hands and feet are important in corn (clavus) formation. Specifically, the bony prominences of the metacarpophalangeal and metatarsophalangeal joints often are shaped in such a way as to induce overlying skin friction. As corn formation ensues, friction against the footwear is likely to perpetuate hyperkeratosis. Repetitive motion can produce callosities, as would be seen in musicians.

What causes corns and calluses?
The small bones of the toes and feet are broader and lumpier near to the small joints of the toes. If there is repeated friction or pressure on the skin overlying a small rough area of bone, this will cause the skin to thicken. This may lead to corns or calluses forming.

The common causes of rubbing and pressure are tight or ill-fitting shoes which tend to cause corns on the top of the toes and side of the little toe.

Also, too much walking or running which tends to cause calluses on the bottom of the feet (the soles). So if you do sports or activities that involve repeated pressure on your feet then this will increase your risk of developing a callus.

Corns and calluses are more likely to develop if you have very prominent bony toes, thin skin, or any deformities of the toes or feet which cause the skin to rub more easily inside shoes.

People with bunions are more likely to develop corns and calluses.

What are the Risk Factors for Corns and Calluses? 
Common risk factors associated with Corns and Calluses include:

Presence of bunions, hammertoes, clubfoot, or mallet toes
Congenital foot abnormalities
Advancing age
Farmers, rowers, or musical instrument players, who use hand tools or instruments, for long periods (without wearing suitable protective gloves/gear) exposing the skin to excessive friction
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

Signs and symptoms
Corns and calluses can make a person feel as if they are walking on stones.

The following signs or symptoms may indicate that there is a corn or callus:

A raised, hardened bump
A thick and rough area of skin
Skin that is flaky and dry or flaky and waxy
Pain or tenderness under the skin
If a corn or callus becomes very inflamed or painful, the patient should seek medical advice.

Patients with poor circulation, fragile skin, or nerve problems and numbness in the feet should talk to their doctors before treating corns and calluses at home.

People with diabetes, peripheral neuropathy, and peripheral arterial disease need to be particularly watchful.

What are the Complications of Corns and calluses?
Though corns appear to be a minor health problem, they can take a severe shape if not treated in due time. Experienced podiatrists have found neglected corns, later on, give rise to worsening conditions like:

Septic arthritis
How are Corns and Calluses Diagnosed?
Diagnostic methods that a physician may use to help diagnose Corns and Calluses include:

Physical examination: A thorough physical examination of the hands or feet is usually adequate, to diagnose Corns or Calluses. In addition to this, a complete medical history may aid in arriving at a definitive diagnosis

X-ray of the hand or foot: A physician may order an x-ray, to see if any underlying bony abnormalities are causing this condition
Biopsy of the hand or foot: Occasionally, a biopsy may be necessary to rule out the possibility of a viral wart, or an underlying cyst. The biopsy specimen is examined under the microscope, by a pathologist
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

Treatment for corns and calluses usually involves avoiding the repetitive actions that caused them to develop. You can help resolve them by wearing properly fitting shoes, using protective pads and taking other self-care measures.

If a corn or callus persists or becomes painful despite your self-care efforts, medical treatments can provide relief:

Trimming away excess skin. Your doctor can pare down thickened skin or trim a large corn with a scalpel, usually during an office visit. Don’t try this yourself because it could lead to an infection.

Callus-removing medication. Your doctor may also apply a patch containing 40 percent salicylic acid (Clear Away, MediPlast, others). Such patches are available without a prescription. Your doctor will let you know how often you need to replace this patch. He or she may recommend that you use a pumice stone, nail file or emery board to smooth away dead skin before applying a new patch. You can also get a prescription for salicylic acid in gel form to apply on larger areas.
Shoe inserts. If you have an underlying foot deformity, your doctor may prescribe custom-made padded shoe inserts (orthotics) to prevent recurring corns or calluses.
In rare instances, your doctor may recommend surgery to correct the alignment of a bone causing friction.
Lifestyle and home remedies
If you have diabetes or another condition that causes poor blood flow, consult your doctor before treating corn and callus on your own.

If you have no underlying health problems, try these suggestions to help clear up a corn or callus:

Use over-the-counter pads. Apply a pad to protect the area where corn or callus developed. Be careful using over-the-counter (nonprescription) liquid corn removers or medicated corn pads. These contain salicylic acid, which can irritate healthy skin and lead to infection, especially in people with diabetes or other conditions that cause poor blood flow.
Soak your hands or feet. Soaking your hands or feet in warm, soapy water softens corns and calluses. This can make it easier to remove the thickened skin.
Thin thickened skin. During or after bathing, rub corn or callus with a pumice stone, nail file, emery board or washcloth to help remove a layer of toughened skin. Don’t use a sharp object to trim the skin. Don’t use a pumice stone if you have diabetes.
Moisturize your skin. Apply moisturizer to your hands and feet to help keep the skin soft.
Wear comfortable shoes and socks. Stick to well-fitting, cushioned shoes, and socks until your corn or callus disappears.
How Can I Prevent Corns and Calluses?
Here are some suggestions for preventing corns and calluses:

To avoid corns and calluses on the feet, have both feet professionally measured at the shoe store and buy only properly fitting shoes.
Be sure both shoe width and length are correct — for each foot since feet may be slightly different sizes. Allow up to a half-inch between your longest toe and the front of the shoe. If you can’t wiggle your toes in your shoes, they’re too tight.
Shop for shoes at the end of the day when feet are typically most swollen.
Avoid shoes with sharply pointed toes and high heels. Women who must wear stylish shoes at work can take some of the pressure off their feet by walking to the office in well-fitting athletic shoes. Try to decrease heel height as much as possible.
Have shoes repaired regularly — or replace them. Worn soles give little protection from the shock of walking on hard surfaces and worn linings can chafe your skin and harbor bacteria.
Worn heels increase any uneven pressure on the heel bone. If the soles or heels of your shoes tend to wear unevenly, see an orthopedist or podiatrist about corrective shoes or insoles.
If you have hammertoes — toes that are buckled under — be sure that the shape of your shoes offers plenty of room to accommodate them.
Calluses can happen on hands, so wear protective gloves if you use tools.


Ciguatera fish poisoning- Origin,Definition,Causes,Diagnosis,Symptoms,Risk Factors,Prevention,Treatment…Ect..!

Overview – Ciguatera fish poisoning
Ciguatera fish poisoning (CFP) is a rare disorder that occurs because of the ingestion of certain contaminated tropical and subtropical fish. When ingested, the toxin (ciguatoxin), which is present at high levels in these contaminated fish, may affect the digestive, muscular, and/or neurological systems. More than 400 different species of fish have been implicated as a cause of ciguatera fish poisoning, including many that are otherwise considered edible (i.e., sea bass, snapper, and perch). These fish typically inhabit low-lying shore areas or coral reefs in tropical or subtropical areas. In the United States, ciguatera fish poisoning has occurred more frequently in the last decade perhaps as a result of a general increase in fish consumption.

Gambierdiscus toxicus is the dinoflagellate most notably responsible for the production of ciguatoxin precursors, although other species have been identified more recently. These dinoflagellates, which live on the surfaces of seaweeds and denuded corals, are a primary nutritional source for small herbivorous fish. In turn, these small fish become prey for larger carnivorous fish that are subsequently consumed by humans.

Ciguatoxin and other similar toxins are heat stable and lipid-soluble; they are unaffected by temperature, gastric acid, or cooking method. The presence of the toxin does not affect the odor, color, or taste of the fish. In humans who eat contaminated fish, the reported attack rate is 73-100%.

Chemists have successfully synthesized specific ciguatoxins, ensuring that a practical supply will be available for future biological applications. Although not completely reliable, an immunoassay and a mouse biologic assay are available for detection of ciguatoxin in affected fish.


Ciguatoxin produces toxic effects by activation of voltage-dependent sodium channels at the neuromuscular junction. Activation results in membrane hyperexcitability, spontaneous repetitive neurotransmitter release, blockage of synaptic transmission, and depletion of synaptic vesicles. Effects are most pronounced on neuronal, cardiac, and gastrointestinal tissues. Ciguatoxin causes an increase in parasympathetic tone and impairs sympathetic reflexes.

Which fish can be ciguatoxic? (Causes)
Ciguatoxin is produced initially by a microscopic alga and is stored in the tissues of fish species consuming these algae, increasing in concentration in large carnivorous fishes. Fishes from some reef areas may be toxic, while those from others may not be. The same species of fish that is ciguatoxic in one area may be safe in another.

By talking to local fishermen one can learn which areas to avoid and which fishes may be dangerous to eat. It is the location where a fish is caught, more than its species that determine whether a fish is ciguatoxic. Therefore, a comprehensive list of non-ciguatoxic fishes cannot be provided. Over 300 to 400 species of fish have been implicated in ciguatera fish poisoning. If no information is available, it is wise not to eat any large reef fishes, since such specimens may have accumulated sufficient toxin during their lifetimes to be. However, among the large reef fish only very few have been found to be poisonous.

Risk for Travelers
Over 50,000 cases of ciguatera poisoning occur every year.
The incidence in travelers to endemic areas has been estimated as high as 3/100.
Ciguatera is widespread in tropical and subtropical waters, usually between the latitudes of 35 degrees north and 35 degrees south; it is particularly common in the Pacific and Indian Oceans and the Caribbean Sea.
Fish that are most likely to cause ciguatera poisoning are carnivorous reef fish, including barracuda, grouper, moray eel, amberjack, sea bass, or sturgeon. Omnivorous and herbivorous fish such as parrotfish, surgeonfish, and red snapper can also be a risk.
Ciguatera Fish Poisoning (Toxin) Symptoms
Eating ciguatera toxin contaminated fish result in the following symptoms:

Symptoms generally begin 6 to 8 hours after eating the contaminated fish but can occur as early as 2 or as late as 24 hours after ingestion.
Symptoms include nausea, vomiting, diarrhea, muscle pain, numbness, tingling, abdominal pain, dizziness, and vertigo. The classic finding of hot and cold sensation reversal is actually a burning sensation on contact with cold (allodynia).
Teeth may feel loose and itching may be intense.
Severe cases of ciguatera poisoning may result in shortness of breath, salivation, tearing, chills, rashes, itching, and paralysis. Bradycardia, coma, and hypotension can occur. Death due to poisoning is rare (less than 0.5 %).
Complications of CFP
Death and serious cardiovascular complications are uncommon.

One bite of fish tainted with ciguatoxins can be enough to cause symptoms. The most common symptoms include stomach cramps, nausea, vomiting, and diarrhea. Other symptoms include itching; numbness of lips, tongue, and throat; blurred vision; low blood pressure; slowed heart rate; alternating hot and cold sensations; and coma. In severe cases, shock, muscular paralysis, and death can occur.

How to Diagnose Ciguatera Poisoning?
Ciguatera is reliably diagnosed by assessing the symptoms and determining if others who consumed the fish suffered from similar symptoms. Since the symptoms usually occur within a few hours of consumption of the fish, it is easy to trace back the source of poisoning.

A new method of diagnosis is the Visual Contrast Sensitivity (VCS). This study is based on the ability of an individual to discern the colors black, grey and white, which is usually impaired in patients affected by a neurotoxin. This test is inexpensive and portable, however, it is not specific only for ciguatera toxin but for all neurotoxins caused by dinoflagellate microorganisms.

Ciguatera poisoning could be misdiagnosed with other forms of neurotoxic poisoning like shellfish poisoning, pufferfish toxicity, botulism, pesticide poisoning, etc. For conclusive diagnosis, the fish can be subjected to laboratory testing to determine if it was infected with ciguatera. Though there are no diagnostic procedures for humans, there exist conclusive lab tests to determine the presence of ciguatera in fish.

How do you treat ciguatera?
Ciguatera food poisoning is treated based on the symptoms expressed by the patient. There is no specific antidote for this food-borne illness that is currently available in the market.

Earlier, ipecac was used to induce vomiting so that the ingested contaminated food is removed from the system. This is however no longer followed as this method resulted in excessive fluid loss. Instead, activated charcoal is administered within 3 to 4 hours of consumption of the contaminated food so that it prevents absorption of the toxin from the digestive tract.
Drugs for vomiting are administered to control vomiting and nausea while IV fluids help to replenish the fluid loss. It is important to keep the patient hydrated.
A good cold shower is recommended for patients with itching along with anti-histamine drugs
Low blood pressure is managed using IV fluids.
Vitamin B-12 intake has been found to alleviate a lot of symptoms of Ciguatera toxicity.
Mannitol is found to be effective when injected into the vein. It appears to act through multiple mechanisms. It should not be used in patients with dehydration unless the dehydration has been corrected.
Laser and Shenefeld in a case study published in the American Journal of Clinical Hypnosis in 2012 detail the symptoms of a patient with burning feet and hands who did not find relief using other methods but found relief after a single session of clinical hypnosis.
Inoue M and colleagues published their study in the Toxicon in June 2009 about the use of monoclonal antibodies in the treatment of ciguatera toxicity. This would help in the more effective management of the poisoning.
Prevention of ciguatera fish poisoning
Avoid consuming fish species commonly associated with ciguatera, including barracuda, grouper, snapper, parrotfish, moray eels, triggerfish and amberjacks. Ciguatoxin is odorless, tasteless and heat-resistant – it will not taste different, and cooking will not prevent intoxication.
While the whole fish will contain toxins, the highest concentrations are typically found in the liver, intestines, and gonads.

PNEUMONIA- Origin,Definition,Causes,Diagnosis,Symptoms,Risk Factors,Prevention,Treatment…Ect..!

Pneumonia is an infection in one or both lungs. It can be caused by bacteria, viruses, or fungi. Bacterial pneumonia is the most common type in adults. Pneumonia causes inflammation in the air sacs in your lungs, which are called alveoli. The alveoli fill with fluid or pus, making it difficult to breathe.

Normal air sacs and pneumonia affected air sacs

Pneumonia has been a common disease throughout human history. The word is from Greek πνεύμων (pneúmōn) meaning “lung”. The symptoms were described by Hippocrates (c. 460 BC – 370 BC). Edwin Klebs was the first to observe bacteria in the airways of persons having died of pneumonia in 1875.

Initial work identifying the two common bacterial causes, Streptococcus pneumoniae and Klebsiella pneumoniae, was performed by Carl Friedländer and Albert Fraenkel in 1882 and 1884, respectively.

Friedländer’s initial work introduced the Gram stain, a fundamental laboratory test still used today to identify and categorize bacteria. Christian Gram’s paper describing the procedure in 1884 helped to differentiate the two bacteria, and showed that pneumonia could be caused by more than one microorganism

One study estimated that nearly 4 million children died each year of acute respiratory infections in the period from 1980 to 1990. Because of this, the World Health Organization (WHO) set up the Child Health Epidemiology Reference Group (CHERG) to further study the incidence of childhood pneumonia.

CHERG performed systematic reviews to compile pneumonia statistics in children under age 5 for the year 2000. The group found that there were approximately 150 million new episodes of pneumonia in children under 5. Of these 150 million new cases, approximately 4 million occurred in developed countries, while the rest occurred in developing nations.

Types by location
Community-acquired pneumonia (CAP) as the name implies, develops outside of the hospital or health-care environment. It is more common than hospital-acquired pneumonia. CAP is most common in winter and affects about 4 million people a year in the U.S.

Hospital-acquired pneumonia (HAP) is acquired when an individual is already hospitalized for another condition. HAP is generally more serious because it develops in ill patients already hospitalized or under medical care for another condition. Being on a ventilator for respiratory support increases the risk of acquiring HAP. Health-care-associated pneumonia is acquired from other health-care settings, like kidney dialysis centers, outpatient clinics, or nursing homes.

Types by germ
Pneumonia can be classified according to the organism that caused the infection.

Bacterial pneumonia: The most common cause of bacterial pneumonia is Streptococcus pneumoniae. Chlamydophila pneumonia and Legionella pneumophila can also cause bacterial pneumonia.

Viral pneumonia: Respiratory viruses are often the cause of pneumonia, especially in young children and older people. Viral pneumonia is usually not serious and lasts for a shorter time than bacterial pneumonia.

Mycoplasma pneumonia: Mycoplasma organisms are not viruses or bacteria, but they have traits common to both. Mycoplasmas generally cause mild cases of pneumonia, most often in older children and young adults.

Fungal pneumonia: Fungi from soil or bird droppings can cause pneumonia in people who inhale large amounts of the organisms. They can also cause pneumonia in people with chronic diseases or weakened immune systems.

Risk factors
Those most at risk include people who:

Are aged under 5 years or over 65years
Smoke tobacco, consume large amounts of alcohol, or both have underlying conditions such as cystic fibrosis, chronic obstructive pulmonary disorder (COPD), asthma, or conditions that affect the kidneys, heart, or liver
Have a weakened or impaired immune system, due, for example, to AIDS, HIV, or cancer
Take medicines forgastroesophageal reflux disease (GERD)
Have recently recovered from a cold or influenza infection
Experience malnutrition
Have been recently hospitalized in an intensive care unit
Have been exposed to certain chemicals or pollutants
Some groups are more prone than others to pneumonia, including Native Alaskan or certain Native American ethnicities.

Bacteria and viruses are the main causes of pneumonia. Pneumonia-causing germs can settle in the alveoli and multiply after a person breathes them in.
Pneumonia can be contagious. The bacteria and viruses that cause pneumonia are usually inhaled.
They can be passed on through coughing and sneezing, or spread onto shared objects through touch.
The body sends white blood cells to attack the infection. This is why the air sacs become inflamed. The bacteria and viruses fill the lung sacs with fluid and pus, causing pneumonia.
Pneumonia symptoms can be mild to life-threatening. The most common symptoms of pneumonia can include:

coughing that may produce phlegm (mucus)
fever, sweating, and chills
shortness of breath
chest pain
Other symptoms can vary according to the cause and severity of the infection, as well as the age and general health of the individual.

Symptoms by cause

Viral pneumoniamay start with flu-like symptoms, such as wheezing. A high fever may occur after 12–36 hours.
Bacterial pneumoniamay cause a fever as high as 105°F along with profuse sweating, bluish lips and nails, and confusion.
Symptoms by age

Children under 5 years of age may have fast breathing.
Infants may vomit, lack energy, or have trouble drinking or eating.
Older people may have a lower-than-normal body temperature.
Diagnosis and test
Typically, pneumonia can be diagnosed with the physical exam and the chest X-ray. But depending on the severity of your symptoms and your risk of complications, your doctor may also order one or more of these tests:

A blood test.This test can confirm an infection, but it may not be able to identify what’s causing it.
A sputum test.This test can provide a sample from your lungs that may identify the cause of the infection.
Pulse oximetry.An oxygen sensor placed on one of your fingers can indicate whether your lungs are moving enough oxygen through your bloodstream.
A urine test.This test can identify the bacteria Streptococcus pneumoniae and Legionella pneumophila.
A CT scan.This test provides a clearer and more detailed picture of your lungs.
A fluid sample.If your doctor suspects there is fluid in the pleural space of your chest, they may take fluid using a needle placed between your ribs. This test can help identify the cause of your infection.
A bronchoscopy. This test looks into the airways in your lungs. It does this using a camera on the end of a flexible tube that’s gently guided down your throat and into your lungs. Your doctor may do this test if your initial symptoms are severe, or if you’re hospitalized and your body is not responding well to antibiotics.
Treatment and medications
Your treatment will depend on the type of pneumonia you have, how severe it is, and your general health.

Prescribed treatment

Antibiotic, antiviral, and antifungal drugs are used to treat pneumonia, depending on the specific cause of the condition. Most cases of bacterial pneumonia can be treated at home with oral antibiotics, and most people respond to the antibiotics in one to three days.
Your doctor may also recommend over-the-counter (OTC) medication to relieve your pain and fever, as needed. These may include aspirin, ibuprofen(Advil, Motrin), and acetaminophen (Tylenol).
Your doctor may also recommend cough medicine to calm your cough so you can rest. However, coughing helps remove fluid from your lungs, so you don’t want to eliminate it entirely.
Home treatment

You can help your recovery and prevent a recurrence by:

Taking your drugs as prescribed
Getting a lot of rest
Drinking plenty of fluids
Not overdoing it by going back to school or work too soon

If your symptoms are very severe or you have other health problems, you may need to be hospitalized. At the hospital, doctors can keep track of your heart rate, temperature, and breathing. Treatment may include:

Intravenous antibiotics.These are injected into your vein.
Respiratory therapy.This therapy uses a variety of techniques, including delivering specific medications directly into the lungs. The respiratory therapist may also teach you or help you to perform breathing exercises to maximize your oxygenation.
Oxygen therapy.This treatment helps maintain the oxygen level in your bloodstream. You may receive oxygen through a nasal tube or a face mask. If your case is extreme, you may need a ventilator (a machine that supports breathing).
Dietary management for Pneumonia
Drink plenty of fluids and fresh juice of fruits and vegetables.
Consume hot vegetable soups – tomato, sweet corn, etc.
Add a pinch of turmeric to your diet as it has anti-inflammatory properties.
Initially, the diet should consist of fresh fruits and vegetables when better can start with grains and little of protein in diet.
Milk and milk products and sweets should be avoided to decrease mucus production.
Onion and garlic should be consumed it is beneficial.
Boil a mixture of Bishops weed (Ajwain), tea leaves and water and inhale the steam, helps to decongest. Do this at least 2-3 times a day.
Gargle with warm water, a pinch of salt and turmeric to soothe your throat.
Consume lots of vitamin A, maintains the integrity of the respiratory mucosa: Liver oils of fish like cod, shark, and halibut are richest source of vitamin A.
– Egg, milk and milk products, meat, fish, kidney and liver.
– Yellow orange-colored fruits and vegetables, dark green leafy vegetables.
Increase intake of vitamin C, it has the antioxidant property: foods of animal origin are poor in vitamin C.
– Citrus fruits, green vegetables.
Include zinc in your diet, it boosts up your immunity:
– Meat, poultry and milk, seafood – shellfish, crab, shrimp, and sea plants, etc.
– Plant foods are low in zinc, Whole wheat grains provide good amount of zinc.
Experts recommend immunization for children and adults. Children get the pneumococcal vaccine as part of their routine shots. Two different types of pneumococcal vaccines are recommended for people ages 65 and older. If you smoke, or you have a long-term health problem, it’s a good idea to get a pneumococcal vaccine. It may not keep you from getting pneumonia. But if you do get pneumonia, you probably won’t be as sick. You can also get an influenza vaccine to prevent the flu because sometimes people get pneumonia after having the flu.

You can also lower your chances of getting pneumonia by staying away from people who have a cold, measles, or chickenpox. You may get pneumonia after you have one of these illnesses. Wash your hands often. This helps prevent the spread of viruses and bacteria that may cause pneumonia.

SALMONELLA INFECTION (Salmonellosis) -Origin,Definition,Causes,Diagnosis,Symptoms,Risk Factors,Prevention,Treatment…Ect..!

Salmonella infection (salmonellosis) is a common bacterial disease that affects the intestinal tract. Salmonella bacteria typically live in animal and human intestines and are shed through feces. Humans become infected most frequently through contaminated water or food.

Salmonella is divided into two groups:

Typhoidal Salmonella, which is made up of bacterial strains that cause typhoid fever or paratyphoid fever, including Salmonella Typhi, Paratyphi A, Paratyphi B, and Paratyphi C
Non-typhoidal Salmonella, which includes all other Salmonella strains
The term Salmonella refers to a family of bacteria known for more than 100 years to cause foodborne illness in humans.   In 1885, a research assistant to veterinary surgeon Daniel Salmon discovered the first strain – Salmonella-Salmonella cholera suis – and Dr. Salmon got the credit.   Today, the number of known salmonella strains totals more than 2,300, and particular strains of salmonella are now resistant to traditional antibiotics.  Typically, none of the strains affects the taste, smell, or appearance of food.  Strains that cause no symptoms in animals can sicken people, and vice versa.

Epidemiology at world wide
The incidence of salmonellosis has markedly increased in many countries; however, a paucity of good surveillance data exists. In 2000, approximately 21.6 million worldwide cases of typhoid fever caused 216,500 deaths. The incidence of typhoid fever in south-central Asia, Southeast Asia, and, possibly, southern Africa was high (>100 cases per 100,000 population per year). The rest of Asia, Africa, Latin America, and Oceania (except for Australia and New Zealand) typically see intermediate rates of typhoid fever (10-100 cases per 100,000 population), while the incidence is low in the other parts of the world (< 10 cases per 100,000 population). In countries where typhoid fever is endemic, most cases of the disease occur in children aged 5-19 years and young adults. Risk factors Since foods contaminated with Salmonella are not obvious, anyone may consume contaminated foods. Owning pets such as small rodents, chicks, ducklings, turtles and some other reptiles, and some birds may increase the risk of coming in contact with Salmonella bacteria. People who are exposed to many people, such as those living in group housing, may have an increased risk. Children under 5 years of age have the highest reported incidence of infection. People with medical conditions that lead to immune suppression are at risk for a more severe illness when they do become infected. Causes You can get salmonellosis by eating food contaminated with salmonella. This can happen in the following ways: Food may be contaminated during food processing or food handling. Food may become contaminated by the unwashed hands of an infected food handler. A frequent cause is a food handler who does not wash his or her hands with soap after using the bathroom. Salmonella may also be found in the feces of some pets, especially those with diarrhea. You can become infected if you do not wash your hands after contact with these feces. Reptiles, baby chicks and ducklings, and small rodents such as hamsters are particularly likely to carry Salmonella. You should always wash your hands immediately after handling one of these animals, even if the animal is healthy. Adults should also be careful that children wash their hands after handling reptiles, pet turtles, baby chicks or ducklings, or small rodents. Beef, poultry, milk, and eggs are most often infected with salmonella. But vegetables may also be contaminated. Contaminated foods usually look and smell normal. Causes of salmonellosis Symptoms Salmonella infection is usually caused by eating raw or under cooked meat, poultry, eggs or egg products. The incubation period ranges from several hours to two days. Most salmonella infections can be classified as stomach flu (gastroenteritis). Possible signs and symptoms include: Nausea Vomiting Abdominal cramps Diarrhoea Fever Chills Headache Blood in the stool Signs and symptoms of salmonella infection generally last two to seven days. Diarrhea may last up to 10 days, although it may take several months before bowels return to normal. A few varieties of salmonella bacteria result in typhoid fever, a sometimes deadly disease that is more common in developing countries. Diagnosis and test Salmonella infection can be detected by testing a sample of your stool. However, most people have recovered from their symptoms by the time the test results return. If your doctor suspects that you have a salmonella infection in your bloodstream, he or she may suggest testing a sample of your blood for the bacteria. Treatment and medications Salmonella-induced gastroenteritis treatment Usually, symptoms will last for about 1 week and will resolve without any treatment. It is important to monitor the hydration levels of the patient by making sure they have an adequate fluid intake. If the doctor suspects the bacteria have entered the bloodstream, or are likely to, they may prescribe antibiotics. Antimotility drugs (to stop diarrhoea) generally are discouraged, especially in people with bloody diarrhoea or diarrhoea complicated by a fever. Typhoid fever treatment The Salmonella bacteria that causes typhoid can be killed by antibiotics such as ciprofloxacin or ceftriaxone. However, some strains become resistant to antibiotics after long-term use, and antibiotics have known side effects. Additional treatments for typhoid include drinking fluid to prevent dehydration and eating a healthy diet to ensure the absorption of nutrients. Prevention Wash your hands with soap and warm water before preparing food, before eating food, after going to the toilet, after changing a baby’s diapers, after touching pets and other animals and after gardening. Do not keep cooked and raw foods next to each other In the fridge, place raw foods in the shelves below ready-to-eat foods Thoroughly wash raw fruits and vegetables before eating Cook food thoroughly, especially meats Keep all cooking utensils and work surfaces clean Regularly swap used dishcloths for clean ones Beware of drinking untreated water from streams, rivers and lakes Do not keep pet reptiles or amphibians inside the house if there are elderly people, pregnant women, very young children or people with weakened immune systems in the household If somebody in your household becomes infected with Salmonella, wash all dirty clothes, bedding and towels in the washing machine at the hottest setting possible. Thoroughly clean toilet seats, toilet bowls, all handles in the bathroom, basins and taps after use with a detergent and hot water, followed by a household disinfectant.

PLAGUE-Origin,Definition,Causes,Diagnosis,Symptoms,Risk Factors,Prevention,Treatment…Ect..!

Plague is an infectious disease caused by bacteria called Yersinia pestis. These bacteria are found mainly in rodents, particularly rats, and in the fleas that feed on them. Other animals and humans usually contract the bacteria from rodent or flea bites.

SEM image of Yersinia pestis
Historically, plague destroyed entire civilizations. In the 1300s, the “Black Death,” as it was called, killed approximately one-third (20 to 30 million) of Europe’s population. In the mid-1800s, it killed 12 million people in China. Today, thanks to better living conditions, antibiotics, and improved sanitation, current World Health Organization statistics show there were only 2,118 cases in 2003 worldwide.

Approximately 10 to 20 people in the United States develop plague each year from flea or rodent bites primarily from infected prairie dogs in rural areas of the southwestern United States. About 1 in 7 of those infected die from the disease. There has not been a case of person-to-person infection in the United States since 1924.

Most cases of plague reported are from developing countries such as Africa and Asia. During 1990-1995, a total of 12,998 cases of plague were reported to the World Health Organization (WHO), particularly from countries such as India, Zaire, Peru, Malawi, and Mozambique. The following countries reported more than 100 cases of plague: China, Congo, India, Madagascar, Mozambique, Myanmar, Peru, Tanzania, Uganda, Vietnam, and Zimbabwe. Several foci are located in the semi-arid regions of northeastern Brazil, and outbreaks have also been reported from Malawi and Zambia. Australia is the only continent that is considered free of plague. The largest enzootic plague area is in North America-the southwestern United States and the Pacific coastal area.

Types of plague
There are three basic forms of plague:

Bubonic plague
In bubonic plague, the most common form, bacteria infect the lymph system and become inflamed. (The lymph or lymphatic system is a major component of your body’s immune system. The organs within the lymphatic system are the tonsils, adenoids, spleen, and thymus). Bubonic plague is the most commonly occurring type of plague and is characterized by the appearance of buboes swollen, tender lymph nodes, typically found in the armpits and groin

It’s usually contracted when an infected rodent or flea bites you. In very rare cases, you can get the bacteria from material that has come into contact with an infected person. Bubonic plague infects your lymphatic system (the immune system), causing inflammation. Untreated, it can move into the blood and cause septicemic plague, or to the lungs, causing pneumonic plague.

Septicemic Plague
When the bacteria enter the bloodstream directly and multiply there, it’s known as septicemic plague. You usually get septicemic plague the same way as bubonic plague through a flea or rodent bite. You can also get septicemic plague if you had untreated bubonic or pneumonic plague. Symptoms include fever, chills, weakness, abdominal pain, shock, and bleeding underneath the skin or other organs. Buboes, however, do not develop.

Pneumonic Plague
When the bacteria spread to the lungs, you have pneumonic plague the most lethal form of the disease. When someone with pneumonic plague coughs, the bacteria from their lungs are expelled into the air. Other people who breathe that air can also develop this highly contagious form of plague, which can lead to an epidemic. Pneumonic plague is the only form of the plague that can be transmitted from person to person.

The plague bacteria, Yersinia pestis, is transmitted to humans when they are bitten by fleas that have previously fed on infected animals, such as:

Prairie dogs
The bacteria can also enter your body if you have a break in your skin that comes into contact with an infected animal’s blood. Domestic cats and dogs can become infected with plague from flea bites or from eating infected rodents.

Pneumonic plague, which affects the lungs, is spread by inhaling infectious droplets coughed into the air by a sick animal or person.

Risk factors
The risk of developing plague is very low. Worldwide, only a few thousand people develop plague each year. However, your risk of plague can be increased by where you live and travel, your occupation, and even by some of your hobbies.


Plague outbreaks are most common in rural and semirural areas characterized by overcrowding, poor sanitation and a high rodent population.


Veterinarians and their assistants have a higher risk of coming into contact with domestic cats and dogs that may have become infected with plague. Also at higher risk are people who work outdoors in areas where plague-infected animals are common.


Camping, hunting or hiking in areas where plague-infected animals reside can increase your risk of being bitten by an infected flea.

Signs and symptoms vary depending on the type of plague.

Bubonic plague: Buboes may be:

Situated in the groin, armpit or neck
About the size of a chicken egg
Tender and warm to the touch
Other signs and symptoms may include:
Sudden onset of fever and chills
Fatigue or malaise
Muscle aches
Septicemic plague: Signs and symptoms include:

Fever and chills
Extreme weakness
Abdominal pain, diarrhea and vomiting
Bleeding from your mouth, nose or rectum, or under your skin
Blackening and death of tissue (gangrene) in your extremities, most commonly your fingers, toes and nose
Pneumonic plague Signs and symptoms can begin within a few hours after infection, and may include:

Cough, with bloody sputum
Difficulty breathing
Nausea and vomiting
High fever
Complications of plague may include:

Most people who receive prompt antibiotic treatment survive bubonic plague. Untreated plague has a high fatality rate.
Blood clots in the tiny blood vessels of your fingers and toes can disrupt the flow of blood and cause that tissue to die. The portions of your fingers and toes that have died may need to be amputated.

Rarely, plague may cause inflammation of the membranes surrounding your brain and spinal cord (meningitis).
Doctor performs certain blood tests such as cultures (growing the bacteria in the lab from samples of blood, sputum, and fluid from the bubo). Cultures require more than 48 hours to produce definitive results.
A doctor may order an X-ray film of the chest, especially to see if plague has infected the lungs.
Treatment and management
Treatment usually involves strong and effective antibiotics, intravenous fluids, oxygen, and sometimes breathing support. People with pneumonic plague must be isolated from other patients. Medical personnel and caregivers must take strict precautions to avoid getting or spreading plague.

As soon as your doctor suspects that you have plague, you’ll need to be admitted to a hospital. There, you’ll receive powerful antibiotics, such as:

Doxycycline (Vibramycin)
Ciprofloxacin (Cipro)
Levofloxacin (Levaquin)

BRUCELLOSIS – Origin,Definition,Causes,Diagnosis,Symptoms,Risk Factors,Prevention,Treatment…Ect..!

Brucellosis is an infectious disease caused by a type of bacteria called Brucella. The bacteria can spread from animals to humans. There are several different strains of Brucella bacteria. Some types are seen in cows. Others occur in dogs, pigs, sheep, goats, and camels. Recently, scientists have seen new strains in the red fox and certain marine animals, including seals.

Brucella organisms, which are small aerobic intracellular coccobacilli, localize in the reproductive organs of host animals, causing abortions and sterility. They are shed in large numbers of animal’s urine, milk, placental fluid, and other fluids.

Magnified view of Brucella abortus
To date, 8 species have been identified, named primarily for the source animal or features of infection. Of these, the following 4 have moderate-to-significant human pathogenicity:

Brucella melitensis (from sheep; highest pathogenicity)
Brucella suis (from pigs; high pathogenicity)
Brucella abortus (from cattle; moderate pathogenicity)
Brucella canis (from dogs; moderate pathogenicity)

Origin of Brucella organisms from different sources
Brucellosis is a disease that is thought to have existed since ancient times, as it was first described more than 2,000 years ago by the Romans and Hippocrates. It was not until 1887 that a British physician, Dr. David Bruce, isolated the organism that causes brucellosis from several deceased patients from the island of Malta. This disease has had several names throughout its history, including Mediterranean fever, Malta fever, Crimean fever, Bang’s disease, and undulant fever (because of the relapsing nature of the fever associated with the disease).

In the mid-20th century, the Brucella bacteria was also developed for use as a biological weapon by the United States. The use of brucellosis for biological warfare purposes was later banned in 1969 by President Nixon.

Different species of Brucella tend to affect certain animal hosts and are more common in specific geographical locations.

Worldwide, B melitensis is the most common species to infect humans, although some studies have suggested that up to 73% of cases of brucellosis in certain areas of the US may be due to B abortus. The majority of cases reported in the US between 1979 and 2002 were in California and Texas, particularly among the Hispanic population and those travelling to and from Mexico.

Brucellosis tends to be an occupational disease predominantly affecting farmers, animal handlers, abattoir workers, and veterinarians. It may also occur in laboratory personnel working with cultures. Between 1979 and 1999, approximately 8% of laboratory-acquired infections in the US were due to Brucella species. Brucellosis continues to be a hazard in the laboratory in both endemic and non-endemic countries.

Brucellosis in humans occurs when a person comes into contact with an animal or animal product infected with the Brucella bacteria.
Very rarely, the bacteria may spread from person to person. Breastfeeding moms with brucellosis may pass the bacteria to their baby. Brucella may also be spread through sexual contact.
The bacteria can enter into the body:

Through a cut or scratch in the skin
When you breathe in contaminated air (rare)
When you eat or drink something contaminated with the bacteria, such as unpasteurized milk or undercooked meat
Risk factors of Brucellosis
Eating or drinking unpasteurized dairy products from cows, goats, or other animals that are infected with the bacteria
Eating other unpasteurized cheeses called “village cheeses.” These come from high-risk regions, including the Mediterranean
Traveling to areas where Brucella is common
Working in a meat-processing plant or slaughterhouse
Working in a farm
Signs and symptoms
Symptoms in humans are similar to having the flu. The symptoms may include:

Continuous or intermittent fever
Profuse sweats
Joint pains
Weight loss
The infection can affect the liver and spleen, and may last for days or months, and sometimes for a year or more if not treated
Joint complications and involvement of the testes and epididymis (storage tubes for sperm that are on top of the testes) are common. Recovery is usual but relapses can occur.
Death can occur from inflammation of the lining of the heart (endocarditis) but this is very rare.
If treatment isn’t successful, brucellosis can cause complications. These may include:

Encephalitis (inflammation of the brain)
Lesions on the bones and joints
Endocarditis (infection of the heart’s inner lining)
Meningitis (inflammation of the membranes around your brain)

Brucellosis arthritis
Diagnosis and Test
Testing may include:

Blood culture
Urine culture
Bone marrow culture
Cerebrospinal fluid testing
Testing for antibodies to brucellosis
Other imaging studies and procedures may also be performed, depending on the individual’s signs and symptoms. These tests may include:

CT scan
MRI Scan
Lumbar puncture (spinal tap),
Joint aspiration
Electrocardiogram (ECG).
The cornerstone of treatment for brucellosis is antibiotics. Because of the high relapse rate associated with the disease, the use of a multidrug (two or more) antibiotic regimen is recommended. The antimicrobials most commonly used include:

Doxycycline (Vibramycin)
Rifampin (Rifadin)
Ciprofloxacin or ofloxacin
Gentamicin (Garamycin)
Trimethoprim-sulfamethoxazole (Bactrim, Septra)
The combination of antibiotics used will vary based on disease severity, age and pregnancy.

Exclusion from work is not necessary.
A vaccine is not available for use in humans.
Control is best achieved by eliminating the disease in animals.
Avoid drinking raw or unpasteurized milk and products made from raw or unpasteurized milk.
Educate farmers, abattoir workers and other occupational at risk groups on how to prevent infection when handling potentially infected animal products:
Cover open cuts and sores with dressings
Wear gloves, overalls and face masks when slaughtering animals or handling animal products
Thoroughly wash hands and arms after handling animals or their products
Take special care when handling animal birth products
Thoroughly clean all working areas

TRACHOMA – Origin,Definition,Causes,Diagnosis,Symptoms,Risk Factors,Prevention,Treatment…Ect..!

Trachoma is a contagious bacterial infection which affects the conjunctival covering of the eye, the cornea, and the eyelids. It is often associated with poverty and lack of proper hygiene. Trachoma is caused by the Chlamydia trachomatis bacteria and is essentially totally preventable and curable. It is the leading infectious cause of blindness in the world.

Trachoma eye
The disease is one of the earliest known eye afflictions, having been identified in Egypt as early as 15 B.C. Its presence was also recorded in ancient China and Mesopotamia. Trachoma became a problem as people moved into crowded settlements or towns where hygiene was poor. It became a particular problem in Europe in the 19th century. After the Egyptian Campaign (1798–1802) and the Napoleonic Wars (1798–1815), trachoma was rampant in the army barracks of Europe and spread to those living in towns as troops returned home. Stringent control measures were introduced and by the early 20th century, trachoma was essentially controlled in Europe, although cases were reported up until the 1950s. Today, most victims of trachoma live in underdeveloped and poverty-stricken countries in Africa, the Middle East, and Asia.

Trachoma is endemic in parts of Africa, Asia, the Middle East, Latin America, the Pacific Islands, and aboriginal communities in Australia.Worldwide, an estimated 229 million people in 53 countries live in trachoma-endemic areas. In hyperendemic areas, most members of nearly all families may have active disease. When the overall community prevalence decreases to around 20%, active disease is clearly seen to cluster in families. In 1 of 5 families, most children have active trachoma (as opposed to 1 in 5 children in most families). This clustering becomes more apparent in communities as the prevalence decreases.

Acute trachoma

It is frequently found in children who are dirty, dusty and unhealthy. The symptoms include painful eyes, swollen eyelids, watery discharge from the eyes and itching of the eyes with ear, nose and throat infection. It usually affects one eye and gradually spreads to both the eyes.

Recurring trachoma

If poor hygiene persists the person gets affected again and again.

Chronic Trachoma

It causes inward turning of the eyelid such that the eye lashes rub against the cornea .Gradually the symptoms persist and instead of resolving lead to chronic trachoma and leads to blindness between the age of 30 to 40 years if left untreated. If it does not lead to blindness, it leads to scarring of the of the cornea of the eye.

Risk factors
Factors that increase your risk of contracting trachoma include:

Poverty. Trachoma is primarily a disease of extremely poor populations in developing countries.

Crowded living conditions. People living in close contact are at greater risk of spreading infection.

Poor sanitation. Poor sanitary conditions and lack of hygiene, such as unclean faces or hands, help spread the disease.

Age. In areas where the disease is active, it’s most common in children ages 4 to 6.

Sex. In some areas, women’s rate of contracting the disease is two to six times higher than that of men.

Flies. People living in areas with problems controlling the fly population may be more susceptible to infection.

Lack of latrines. Populations without access to working latrines — a type of communal toilet — have a higher incidence of the disease.

Trachoma is caused by certain subtypes of Chlamydia trachomatis, a bacterium that can also cause the sexually transmitted infection chlamydia.
Trachoma spreads through contact with discharge from the eyes or nose of an infected person. Hands, clothing, towels and insects can all be routes for transmission. In developing countries, eye-seeking flies also are a means of transmission.
The major symptoms or signs of the initial stages of trachoma consist of:

Irritation and mild itching of the eyelids or eyes
Drainage from the eyes contains pus or mucus
As this disease progresses, trachoma symptoms begin to include:
Blurred vision
Marked sensitivity to light referred to as photophobia
Pain in the eye
Young children are most susceptible to this disease but the infection normally advances gradually and the most painful signs or symptoms normally will not develop until adult hood.

What are complications of trachoma?
Trachoma causes irritation of the eye, starting with simple redness of the eye and lids, progressing to inward turning of the lids and irritation and scarring of the cornea, which may then progress to an opaque cornea resulting in blindness. These complications are avoidable with adequate diagnosis and treatment.
With development of the later stages of trachoma with scarring of the lids and conjunctiva, vision is often decreased to the point where the individual is no longer able to work, resulting in disruption of the family. Children drop out of school to take care of a parent with blindness and the family may have severe economic problems.
Because of profound visual disturbance or blindness, there may be an increased number of related injuries or even accidental death.
Diagnosis and test
Although there are bacteriologic and other tests available, trachoma is commonly diagnosed by examining the eyes and eyelids of the patient. In the rare cases seen in developed countries, the diagnosis is usually by the ophthalmologist.
Sample of bacteria from your eyes to a laboratory for testing. But lab tests aren’t always available in places where trachoma is common.
However, in the third world, ancillary personnel are very capable of being trained to make this diagnosis. Trachoma should be suspected from the history and symptoms. It then can be confirmed by an examination which can be performed within the community without the aid of sophisticated office equipment.
If equipment is available, the vision is measured and the eye is inspected with a slit lamp (bio microscope), with which characteristic changes in the lids, tear film, conjunctiva, and cornea can more easily be seen.
Treatment and medications
The treatment is relatively simple. A single oral dose of antibiotic is the preferred treatment, plus making safe water available and teaching simple cleanliness. Because of cultural differences and widespread poverty in endemic areas, this regimen is difficult to implement on a universal scale.
The World Health Organization (WHO) developed the SAFE strategy.
                                                      S = surgical care

                                                      A = antibiotics

                                                      F = facial cleanliness

                                                      E = environmental improvement

Treatment involves screening communities for the presence of trachoma in children 1-9 years of age. When over 10 % are found to have clinical disease, the entire community is treated with antibiotics. In areas with less disease, only targeted groups are treated.
Due to the contagiousness of trachoma, it is necessary to treat all who might be in contact with the infected individuals.
The actual treatment is the onetime use of use of azithromycin (Zithromax) pills (currently the treatment of choice) or the topical use of 1% tetracycline (Achromycin) ointment.
When trachoma has progressed to inward-turning of the lashes, surgery is necessary to correct this and prevent the lashes from scarring the cornea. Performance of this surgery can be taught to nurses or other medical personnel.
If significant corneal scarring already exists, corneal transplantation surgery may be required, which should be performed by an ophthalmologist.
Can trachoma be prevented?
Maintaining good hygiene and sanitation are essential to prevent this disease of the developing countries which has been eradicated from the developed countries. The steps include:

Avoid physical contact with a person suffering from trachoma
Personal cleanliness, especially of face and hands is important.
Washing hands and face frequently with soap and water is important even in children who are already infected to prevent re-infection.
Keep separate towels, handkerchiefs and linens for each member of the family.
Wash hands after handling domestic animals.
Keep the food covered and use latrines and toilets for defecation to prevent breeding of flies.
Avoid crowded places.

LYME DISEASE-Origin,Definition,Causes,Diagnosis,Symptoms,Risk Factors,Prevention,Treatment…Ect..!

Lyme disease is caused by a bacteria, Borrelia burgdorferi, that’s transmitted to humans through a bite from an infected black-legged or deer tick. Symptoms can occur anywhere from 3 to 30 days after the bite, and symptoms can be wide-ranging, depending on the stage of the infection.

Lyme disease
The chances you might get Lyme disease from a tick bite depend on the kind of tick, where you were when the bite occurred, and how long the tick was attached to you, according to the CDC. Black-legged ticks must be attached to you for at least 24 hours to transmit Lyme disease.

Interestingly, the disease only became apparent in 1975 when mothers of a group of children who lived near each other in Lyme, Conn., made researchers aware that their children had all been diagnosed with rheumatoid arthritis. This unusual grouping of illness that appeared “rheumatoid” eventually led researchers to the identification of the bacterial cause of the children’s condition, what was then named “Lyme disease” in 1982.

The only vector for Lyme disease in the U.S. is the black-legged tick, or deer tick, known as Ixodes scapularis. These ticks are carriers of the Lyme disease spirochete in their stomachs; Ixodes ticks may also transmit Powassan virus. The ticks then are vectors that can transmit the bacterium to humans with a tick bite. The number of cases of the tick-borne illness in an area depends on the number of ticks present and how often the ticks are infected with the bacteria. In certain areas of New York, where Lyme disease is common, over half of the ticks are infected. Lyme disease has been reported most often in the northeastern United States, but it has been reported in all 50 states, as well as China, Europe, Japan, Australia, and parts of the former Soviet Union. In the United States, it is primarily contracted in the Northeast in the states from Maine to Maryland, in the Midwest in Minnesota and Wisconsin, and in the West in Oregon and Northern California.

Lyme disease is endemic in North America, Europe, and Asia, and the distribution of the vectors directly affects the incidence of the disease. Ixodes scapularis is the principal vector found in the Northeast and Central United States and Canada, whereas Ixodes pacificus is more common on the Pacific coast. Ixodes ricinus is the principal vector in Europe. The vector in Asia is the taiga tick, Ixodes persulcatus.

United States statistics

Lyme disease is the most common vector-borne illness in the United States. Approximately 30,000 cases of Lyme disease are reported to the US Centers for Disease Control and Prevention (CDC) each year. In 2014, 33,461 cases of Lyme disease were reported, 25,359 confirmed and 8102 probable.

From 2008 (when the national surveillance case definition was revised to include probable cases) to 2012, the incidence ranged from 9.86-12.71 cases per 100,000 population in the United States. In 2014, Lyme disease was the fifth most common nationally notifiable disease.

Risk factors
Lyme disease occurs most frequently in children 5-14 years of age and adults 40-50 years of age.
The most substantial risk factor for Lyme disease is exposure to the ticks located in the high-risk areas of the country listed above, particularly in the New England states, as well as Minnesota and Wisconsin.
Additional risk factors include recreational and occupational exposure to ticks and outdoor activities, including gardening, in woods, and fields in the high-risk areas.
No transplacental transmission (congenital infection) of Lyme disease from the mother to the unborn child has ever been described. Again, Lyme disease is not contagious from one person to another.
Lyme disease is caused by Borrelia burgdorferi and Borrelia mayonii bacteria, carried primarily by blacklegged or deer ticks. The ticks are brown and, when young, often no bigger than a poppy seed, which can make them nearly impossible to spot.

To contract Lyme disease, an infected deer tick must bite you. The bacteria enter your skin through the bite and eventually make their way into your bloodstream. In most cases, to transmit Lyme disease, a deer tick must be attached for 36 to 48 hours. If you find an attached tick looks swollen, it may have fed long enough to transmit bacteria. Removing the tick as soon as possible may prevent infection.

Early symptoms

Perhaps the most well-known symptom of Lyme disease is a rash that looks like a bull’s-eye. The scientific name for this rash is erythema migrans. It occurs in 70-80 percent of people infected by a tick bite. The area directly around the tick bite may be red and raised and look like a normal bug bite. The rash often spreads in a circular pattern that’s lighter in the center and darker on the outer ring. However, not everyone who gets Lyme disease gets the target-shaped rash.

Lyme disease symptoms
Classic signs of early Lyme disease include:

Muscle aches
Symptoms can start at any time between three and 30 days after infection. The incubation period can also lead to confusion about your symptoms. If you don’t remember being bitten, you may think you have the flu and you may not connect the tick bite and your symptoms.

Advanced symptoms

Some people with Lyme disease experience other, more advanced symptoms of the illness. Joint pain, especially in the knees, and a stiff neck may occur in the early-symptom stage or several months after your tick bite. Severe headaches and shooting pain in your body may keep you up at night. Dizziness and changes in your heart rate or rhythm are also advanced symptoms of Lyme disease.

Lyme disease that isn’t treated for several months can lead to more serious problems, including those that affect the nervous system. Bell’s palsy, the loss of muscle function in your face, is a neurological complication of Lyme disease. People with Bell’s palsy sometimes look like they’ve had a stroke because they can’t move the muscles on one side of their face. Movement problems, especially in the arms and legs, can also occur. Heart problems and inflammation of the eyes and liver are rare but possible in late-stage Lyme disease.

Diagnosis and test
The diagnosis of Lyme disease begins with an assessment of your health history and a physical exam. Blood tests are most reliable a few weeks after the initial infection, when antibodies are present. Your doctor may order the following tests:

ELISA (enzyme-linked immunosorbent assay) is used to detect antibodies against B. burgdorferi.
Western blot can be used to confirm a positive ELISA test. It checks for the presence of antibodies to specific B. burgdorferi proteins.
Polymerase chain reaction (PCR) is used to evaluate people with persistent Lyme arthritis or nervous system symptoms. It is performed on joint fluid or spinal fluid.
Treatment and medications
Antibiotics are used to treat Lyme disease. In general, recovery will be quicker and more complete the sooner treatment begins.

Oral antibiotics: These are the standard treatment for early-stage Lyme disease. These usually include doxycycline for adults and children older than 8, or amoxicillin or cefuroxime for adults, younger children, and pregnant or breast-feeding women. A 14- to 21-day course of antibiotics is usually recommended, but some studies suggest that courses lasting 10 to 14 days are equally effective.

Intravenous antibiotics: If the disease involves the central nervous system, your doctor might recommend treatment with an intravenous antibiotic for 14 to 28 days. This is effective in eliminating infection, although it may take you some time to recover from your symptoms. Intravenous antibiotics can cause various side effects, including a lower white blood cell count, mild to severe diarrhea, or colonization or infection with other antibiotic-resistant organisms unrelated to Lyme.

After treatment, a small number of people still have some symptoms, such as muscle aches and fatigue. The cause of these continuing symptoms, known as post-treatment Lyme disease syndrome, is unknown, and treating with more antibiotics doesn’t help. Some experts believe that certain people who get Lyme disease are predisposed to develop an autoimmune response that contributes to their symptoms. More research is needed.

Lyme disease prevention mostly involves decreasing your risk of experiencing a tick bite. Take the following steps to prevent tick bites:

Wear long pants and long-sleeve shirts when in the outdoors.
Make your yard unfriendly to ticks by clearing wooded areas, keeping underbrush to a minimum, and putting woodpiles in areas with lots of sun.
Use insect repellent. Insect repellent with 10 percent DEET will protect you for a period of about two hours. Don’t use more DEET than what is required for the time you’ll be outside, and don’t use DEET on the hands of young children or on the faces of children less than 2 months old. Oil of lemon eucalyptus gives the same protection as DEET when used in similar concentrations. It shouldn’t be used on children under the age of 3.
Be vigilant. Check your children, pets, and yourself for ticks. Don’t assume you can’t be infected again; people can get Lyme disease more than once.
Remove ticks with tweezers. Apply the tweezers near the head or the mouth and pull gently. Check to be certain that all tick parts have been removed. Contact your doctor whenever a tick bites you or your loved ones.


CELLULITIS – Origin,Definition,Causes,Diagnosis,Symptoms,Risk Factors,Prevention,Treatment…Ect..!

Cellulitis is a bacterial infection that affects the skin as well as the soft tissues under the surface of the skin. This kind of an infection usually occurs when bacteria enter normal or broken skin and start spreading under the skin into the soft tissues. This causes inflammation and infection in the affected parts of the skin. Cellulitis can either be caused by exogenous bacteria or even by the normal flora of the skin. Cracks in the skin, bruises, cuts, open wounds, surgical wounds, insect bites, burns, and blisters are common sites where such infections develop. Although cellulitis may affect any part of the body, usually the skin on the legs and face are primarily affected by this disease.

When cellulitis was first identified in 1860 it was just considered an inflammatory condition and there was no treatment given. Around 1865 the condition was recognized as a bacterial infection. The type of bacteria that was causing the infection would eventually be identified, which allowed doctors to prescribe the most effective antibiotics. When the infection didn’t respond to commonly prescribed antibiotics, MRSA was suspected and MRSA cellulitis was identified. Currently when diagnosing this bacterial infection, a medical history will be taken.

Cellulitis is a common condition; a general practice with approximately 2000 people will have about 30 consultations for ‘cellulitis and abscess’ each year. Many more people present to emergency departments; in 2003 to 2004, cellulitis or erysipelas accounted for approximately 49,500 hospital admissions in England (0.4%). According to data collected from community hospitals in the US in 2005, cellulitis was the 27th most common primary diagnosis among adults at discharge. A population-based study in the Netherlands found that, in 2001, approximately 28,000 patients presented with cellulitis or erysipelas of the leg. Of these patients, 2200 were hospitalised, with the average cost per hospitalisation of 5346 euros. This accumulated to more than 14 million euros in 2001. Among patients presenting to acute care facilities, men outnumbered women and the lower extremity predominated as the site of involvement. However, some forms of cellulitis are unique to women. Another study of US hospital data showed an increase in visits for skin infection during the emergence of community-associated MRSA; however, further analysis concluded this was mostly due to abscesses rather than cellulitis.

Most commonly, cellulitis affects body parts like the arms, hands, legs, and feet and is therefore known as cellulitis of the extremities. Some of the other types of cellulitis include:

Orbital Cellulitis: This refers to a cellulitis infection inside the socket of the eye and is usually treated as a medical emergency. Some of the factors which increase the chances of orbital cellulitis include eye injuries, infections in the middle ear, teeth, or face, and sinus infections.

Perianal Cellulitis: This is a type of cellulitis infection that affects the anal region. This type of infection is quite common in children and usually more common in boys than in girls. Those suffering from perianal cellulitis usually do not experience symptoms like fatigue, fever, and body aches which are common symptoms in other types of cellulitis. However they may experience other symptoms like painful bowels, bloody stools, anal itching, and tenderness.

Periorbital Cellulitis: This type of cellulitis develops around the eyelids and is more common in children than adults. People suffering from eye injuries, insect bites, and upper respiratory tract infections are more prone to developing periorbital cellulitis. Fever, eyelid redness, redness inside the eye, and inflammation are common symptoms of periorbital cellulitis.

Facial Cellulitis: This facial infection affects people of all ages and may cause serious complications if left untreated. Some of the risk factors which increase the chances of developing this infection include middle ear or tooth infections, upper respiratory tract infections, and lymphatic system problems.

Breast Cellulitis: As the name suggest, this type of cellulitis affects the skin on the breasts. Women suffering from breast cancer and those with a history of lumpectomy are more prone to developing this type of cellulitis.

Risk factors
The following risk factors increase the likelihood of cellulitis.

Leg swelling (edema): This raises the chances of developing cellulitis.

Weakened immune system: Including people who are undergoing chemotherapy or radiotherapy, those with HIV or AIDS, and older adults.

Diabetes: If the diabetes is not properly treated or controlled, a person’s immune system can be weaker, or they may have circulatory problems, which can lead to skin ulcers.

Blood circulation problems: People with circulation issues may develop skin infections.

Other skin infections: Conditions, such as chicken pox and shingles may cause skin blisters. If the blisters break, they can become ideal routes for bacteria to get into the skin.

Lymphedema: This condition causes swollen skin that is more likely to crack. Cracks in the skin may become perfect entry routes for bacteria.

Previous cellulitis: A person who has had cellulitis before has a higher risk than others of developing it again.

Intravenous drug users: Drug addicts who do not have access to a regular supply of clean needles are more likely suffer from infections deep inside the skin.

Cellulitis occurs when bacteria, most commonly streptococcus and staphylococcus, enter through a crack or break in your skin. The incidence of a more serious staphylococcus infection called methicillin-resistant Staphylococcus aureus (MRSA) is increasing.
Although cellulitis can occur anywhere on your body, the most common location is the lower leg. Bacteria is most likely to enter disrupted areas of skin, such as where you’ve had recent surgery, cuts, puncture wounds, an ulcer, athlete’s foot or dermatitis.
Certain types of insect or spider bites also can transmit the bacteria that start the infection. Bacteria can also enter through areas of dry, flaky skin or swollen skin.

Bacteria causes’ cellulitis
Although symptoms may appear in any part of the body, the legs are most commonly affected. The affected area will become:

Some people may develop blisters, skin dimpling, or spots. They might also experience a fever, chills, nausea, and shivering.

Lymph glands may swell and become tender. If the cellulitis has affected the person’s leg, the lymph glands in their groin may also be swollen or tender.

Symptoms of cellulitis
Sometimes cellulitis can spread throughout the body, entering the lymph nodes and bloodstream. In rare cases, it can enter into deeper layers of tissue. Potential complications that can occur are:

A blood infection
A bone infection
An inflammation of your lymph vessels
Tissue death, or gangrene
Diagnosis and test
Your doctor can usually diagnose cellulitis on sight, but they’ll perform a physical exam to determine the extent of your condition. This exam might reveal:

Swelling of the skin
Redness and warmth of the affected area
Swollen glands
Depending on the severity of your symptoms, your doctor may want to monitor the affected area for a few days to see if redness or swelling spread. In some cases, your doctor may perform a blood test or a culture of the wound to test for the presence of bacteria.

Treatment and medications
The aim of the treatments for cellulitis is to reduce the intensity of the infection, relieve pain and other cellulitis symptoms, heal the skin, speed up the recovery process, and prevent the infection from reoccurring. Treatment for children suffering from cellulitis depends on their age and the type of cellulitis they are suffering from. In general, some of the common treatments for cellulitis include:

Oral Antibiotics: Doctors usually recommend oral antibiotics to treat this infection, especially is it is restricted to a smaller area. If the infection is widespread or the recovery rate is slow, antibiotics may be injected or used intravenously to combat the infection.

Topical Antibiotics: Mild cases of cellulitis may even be treated with the help of topical antibiotics.

Limb Elevation: In the case of cellulitis of the extremities, doctors recommend elevating the affected limb to reduce the inflammation and swelling.

Hospitalization: This is usually recommended when the cellulitis is severe or causes other complications. Such patients need constant medical attention and it is therefore best for them to be hospitalized.

Although some cases of cellulitis are not preventable, there are things that people can do to reduce their chances of developing it:

Treat cuts and grazes: If the skin is broken because of a cut, bite, or graze, it should be kept clean to reduce risk of infection.

Reduce the likelihood of scratching and infecting the skin: The risk of the skin being damaged by scratching will be greatly reduced if fingernails are kept short and clean.

Take good care of the skin: If the skin is dry, use moisturizers to prevent skin from cracking. Individuals with greasy skin will not need to do this. Moisturizers will not help if the skin is already infected.

Protect the skin: Wear gloves and long sleeves when gardening; do not wear shorts if there is a likelihood of grazing the skin of the legs.

Lose weight if you are obese: Obesity may raise the risk of developing cellulitis.

NOCARDIOSIS – Origin,Definition,Causes,Diagnosis,Symptoms,Risk Factors,Prevention,Treatment…Ect..!

Nocardiosis is a rare infection caused by the Nocardia asteroides bacterium. This type of bacteria can be found in the soil and water of regions around the world. People may become infected with this bacteria when they inhale it or when the bacteria enter an open wound. The infection can’t be spread from one person to another.

Microscopic view of Nocardia asteroides
Nocardiosis most commonly occurs in the lungs, but it may spread to other areas of the body, such as the:

Digestive system
Earlier reports estimated the incidence of nocardiosis in the US at 500 to 1000 cases per year. However, due to the increase in the number of immunosuppressed patients during recent decades, the incidence of nocardiosis is also increasing. Nocardiosis has been reported worldwide in all ages and races, and it is 2 to 3 times more common in men than in women. Pulmonary disease is the most frequent clinical presentation (approximately 50% of cases), and most of the infective organisms are from the former Nocardia asteroides complex. Approximately one third of patients with pulmonary nocardiosis will develop disseminated disease. The frequency of Nocardia infections in recipients of solid organ transplants varies between 0.4% and 3%, and the infections have mostly been reported in heart, kidney, liver, and lung transplant recipients. The incidence of nocardiosis is approximately 340-fold higher among bone marrow transplant recipients than in general populations. Primary cutaneous nocardiosis is a rare disease associated with direct inoculation in immunocompetent patients, frequently caused by N. brasiliensis.

Risk factors
Predisposing factors include
Lymphoreticular cancers
Organ transplantation
High-dose corticosteroid or other immunosuppressive therapy
Underlying pulmonary disease
However, about one half of patients have no preexisting disease or condition.
Nocardiosis is also an opportunistic infection in patients with advanced HIV infection.
The Nocardia spp is found in soil and enters the human body mainly through breathing. The bacteria initially lead to pneumonia, which may cause sepsis or blood poisoning. In this way, the infection may gradually spread to other areas of the body such as skin and brain. The condition is referred to as disseminated Nocardiosis when it occurs in this manner.

Sometimes, the infection may be introduced through a skin lesion, puncture, cut or wound that may occur while working outdoors. This type of skin infection can take various forms and is known as Cutaneous Nocardiosis. Individuals with occupations or hobbies that involve exposure to soil, such as farming, gardening, landscaping and other field works, are more at risk of being affected by this infection.

Cutaneous Nocardiosis
The symptoms of nocardiosis vary depending on which part of your body is affected.

Nocardiosis most commonly occurs in the lungs. If your lungs are infected, you can experience:

Weight loss
Night sweats
Chest pain
When lung infections occur, the infection can spread to the brain. If your central nervous system (brain and spinal cord) is infected, you can experience:

Skin infections can occur when soil containing Nocardia species gets into open wounds or cuts. Farming or gardening without gloves and protective clothing increases the risk of cuts, thorn pricks, or other minor injuries. If your skin is infected, you can develop:

Skin ulcers (shallow wound on the surface of the skin)
Nodules, sometimes draining, with the infection spreading along lymph nodes
What Are the Complications Associated with Nocardiosis?
A number of complications can arise from this infection. These vary depending on the area of the body that has become infected:

A lung infection might lead to scarring or long-term shortness of breath.
A skin infection might lead to disfigurement or scarring.
A brain infection might lead to the loss of certain brain functions.
Diagnosis and test
Your doctor can diagnose this infection by performing various tests that check for the presence of N. asteroides bacteria. These tests may include the following:

A chest X-ray is an imaging test that produces detailed images of the lungs.
A bronchoscopy is a test in which your doctor uses a thin tube with an attached camera to view the lungs.
A brain biopsy is a procedure that involves removing a small sample of abnormal brain tissue.
A lung biopsy is a procedure that involves removing a small sample of abnormal lung tissue.
A skin biopsy is a procedure that involves removing a small sample of abnormal skin cells.
A sputum culture is a procedure that involves taking a small sample of mucus.
Treatment and medications
Nocardia organisms are usually resistant to penicillin. Sulfonamide drugs may be prescribed. However, since most cases respond slowly, treatment with sulfonamide drugs must be continued for several months. Trimethoprim-sulfamethoxazole is often prescribed for immunosuppressed patients. Recurrent infection is common.
Other drugs sometimes prescribed are Imipenem and cilastatin (Primaxin), Meropenem (Merrem IV), Cefotaxime (Claforan), Ceftriaxone (Rocephin) ampicillin, minocycline, and amikacin. Without treatment the disease can be fatal, so proper and prompt diagnosis is essential.
If infection occurs and spreads, surgery may be needed to remove and/or drain the infected areas.
There are no specific ways to prevent infection. People who have weakened immune systems should wear shoes as well as clothing covering the skin, open wounds, and cuts when they are working in the soil. This could prevent skin infections.
People who have an organ transplant might be given antibiotics to prevent bacterial infections. Some studies have shown that this might prevent nocardiosis.
Outbreaks of nocardiosis in hospitals are rare. A few outbreaks have been linked to other patients, healthcare workers, and the release of bacteria in the air during hospital construction work. Hospitals should maintain strong infection control practices to avoid outbreaks of nocardiosis.