「South America」の版間の差分

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(ページの作成:「==climate and vegitation== *tropical to temperate *much rain to dry *rain forest to desert *low to high altitude *mosquito to snake bite」)
 
 
(同じ利用者による、間の5版が非表示)
5行目: 5行目:
 
*low to high altitude
 
*low to high altitude
 
*mosquito to snake bite
 
*mosquito to snake bite
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 +
==HTLV-1 population offspring of Japanese immigrants==
 +
*related to stronglyoides
 +
 +
==Bartonella==
 +
*''Bartonella henselae''
 +
**cat flea
 +
**cat scratch disease
 +
*''B. quintana''
 +
**body lice
 +
**trench fever
 +
*''B. bacilliformis''
 +
**sandfly (female) - ''Lutzomyia'' spp.
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**Carrion's disease, Oroya fever
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**Colombia, Ecuador, Peru
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**obligate intracellular (intra RBC)
 +
**acute phase vs chronic phase
 +
***CFR in acute phase >80%
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***chronic: angioprolific cutaneous disease (warts)
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****veruga peruana
 +
 +
==Chagas disease==
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===pathogen===
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''Trypanosoma cruzi''
 +
 +
===transmission===
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*Triatomine insect (reduvid bug) borne
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**food contaminated with triatomine faeces
 +
**skin wound contamination with triatomine faeces, including sucking by triatomine
 +
*blood transfusion, organ transplant from chronic career
 +
 +
===disease===
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*acute disease only in 1% of infected
 +
**Romaña sign
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**chagoma
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*chronic
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**30-40% after 10-20 years
 +
**megacolon
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**RBBB in heart
 +
**cardiac aneurysm
 +
 +
===diagnosis===
 +
*serology IgM/IgG
 +
*culture in NNN media
 +
*blood smear
 +
 +
===treatment===
 +
*benznidazole
 +
*nifurtomox
 +
*cardiac treatment
 +
 +
===prevention===
 +
*insecticide spraying
 +
*bed net
 +
*blood screening
 +
*improving construction
 +
 +
==Leishmaniasis==
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===pathogen===
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*''Leischmania braziliensis''
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*''L. venezuelensis''
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*''L. amazonesis''
 +
*''L. peruviana''
 +
*''L. guyanensis''
 +
*''L. panamensis''
 +
 +
===vector===
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*sandfly
 +
 +
===disease===
 +
*mucocutaneous leishmaniasis
 +
**severe deformation of nose, lips and mouth
 +
*cutaneous lieshmaniasis
 +
**chiclero's ulcer
 +
***chiclero = a person who extracts gum from wild or cultivated trees
 +
 +
==Paracoccidiodomycosis==
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===pathogen===
 +
*''Paracoccidioides brasiliensis''
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*soil-transmitted fungus
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*dimorphic fungus
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**mould <28℃
 +
**yeast >37℃
 +
 +
===epidemiology===
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*confined to Latin America, esp. Brazil 80%
 +
*male vs female 14:1
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**most patients from tobacco/coffee crops
 +
**female hormone inhibit the transformation to yeast
 +
 +
===disease===
 +
*pneumonia
 +
**cough, sputum, hemoptysis, fever, weight loss
 +
*mimic pulmonary tuberculosis not only in history but also in imaging
 +
*skin and mucous membrane lesion
 +
**ulcer, painful
 +
**teeth loss
 +
*bone erosion
 +
 +
===diagnosis===
 +
*KOH microscopy of oral mucosa, skin lesion, sputum
 +
**Mickey Mouse or ship pilot wheel appearance of yeast form
 +
*histopathology
 +
**epithelioid granulomas
 +
**microabscess
 +
 +
===treatment===
 +
*co-trimoxazole
 +
*itraconazole
 +
 +
==Histoplasmosis==
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===pathogen===
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*''Histoplasma capsulatum'' var. ''capsulatum''
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*soil habitant fungus
 +
*dimorphic fungi
 +
 +
===transmission===
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*inhalation of fungus containing soil, bird excreta, bat guano
 +
 +
===risk===
 +
*occupational, building cleaning
 +
*cave exploration (spelunking)
 +
*cell-mediated immunocompromised
 +
**HIV
 +
**anti-TNF inhibitors
 +
**other immunosupression
 +
 +
===distribution===
 +
*Latin America
 +
*eastern part of north America
 +
*sub-Saharan Africa
 +
*Nepal - Bangradesh - Indochina peninsula
 +
 +
===disease===
 +
*acute pneumonia
 +
**disseminated consolidations in both lungs
 +
*mediastinal lymphadenopathy
 +
**DDx: TB, sarcoidosis, lymphoma
 +
*chronic lung cavity
 +
**associated with smoking/COPD
 +
**DDx: TB, aspergillosis
 +
*progressive disseminated histoplasmosis
 +
**risk at HIV CD4<150
 +
 +
===diagnosis===
 +
*culture on Sabouraud's agar
 +
**4-8 weeks
 +
*serology
 +
*antigen test in urine
 +
 +
===treatment===
 +
*liposomal amphotericin B
 +
*itraconazole

2021年4月16日 (金) 16:02時点における最新版

climate and vegitation

  • tropical to temperate
  • much rain to dry
  • rain forest to desert
  • low to high altitude
  • mosquito to snake bite

HTLV-1 population offspring of Japanese immigrants

  • related to stronglyoides

Bartonella

  • Bartonella henselae
    • cat flea
    • cat scratch disease
  • B. quintana
    • body lice
    • trench fever
  • B. bacilliformis
    • sandfly (female) - Lutzomyia spp.
    • Carrion's disease, Oroya fever
    • Colombia, Ecuador, Peru
    • obligate intracellular (intra RBC)
    • acute phase vs chronic phase
      • CFR in acute phase >80%
      • chronic: angioprolific cutaneous disease (warts)
        • veruga peruana

Chagas disease

pathogen

Trypanosoma cruzi

transmission

  • Triatomine insect (reduvid bug) borne
    • food contaminated with triatomine faeces
    • skin wound contamination with triatomine faeces, including sucking by triatomine
  • blood transfusion, organ transplant from chronic career

disease

  • acute disease only in 1% of infected
    • Romaña sign
    • chagoma
  • chronic
    • 30-40% after 10-20 years
    • megacolon
    • RBBB in heart
    • cardiac aneurysm

diagnosis

  • serology IgM/IgG
  • culture in NNN media
  • blood smear

treatment

  • benznidazole
  • nifurtomox
  • cardiac treatment

prevention

  • insecticide spraying
  • bed net
  • blood screening
  • improving construction

Leishmaniasis

pathogen

  • Leischmania braziliensis
  • L. venezuelensis
  • L. amazonesis
  • L. peruviana
  • L. guyanensis
  • L. panamensis

vector

  • sandfly

disease

  • mucocutaneous leishmaniasis
    • severe deformation of nose, lips and mouth
  • cutaneous lieshmaniasis
    • chiclero's ulcer
      • chiclero = a person who extracts gum from wild or cultivated trees

Paracoccidiodomycosis

pathogen

  • Paracoccidioides brasiliensis
  • soil-transmitted fungus
  • dimorphic fungus
    • mould <28℃
    • yeast >37℃

epidemiology

  • confined to Latin America, esp. Brazil 80%
  • male vs female 14:1
    • most patients from tobacco/coffee crops
    • female hormone inhibit the transformation to yeast

disease

  • pneumonia
    • cough, sputum, hemoptysis, fever, weight loss
  • mimic pulmonary tuberculosis not only in history but also in imaging
  • skin and mucous membrane lesion
    • ulcer, painful
    • teeth loss
  • bone erosion

diagnosis

  • KOH microscopy of oral mucosa, skin lesion, sputum
    • Mickey Mouse or ship pilot wheel appearance of yeast form
  • histopathology
    • epithelioid granulomas
    • microabscess

treatment

  • co-trimoxazole
  • itraconazole

Histoplasmosis

pathogen

  • Histoplasma capsulatum var. capsulatum
  • soil habitant fungus
  • dimorphic fungi

transmission

  • inhalation of fungus containing soil, bird excreta, bat guano

risk

  • occupational, building cleaning
  • cave exploration (spelunking)
  • cell-mediated immunocompromised
    • HIV
    • anti-TNF inhibitors
    • other immunosupression

distribution

  • Latin America
  • eastern part of north America
  • sub-Saharan Africa
  • Nepal - Bangradesh - Indochina peninsula

disease

  • acute pneumonia
    • disseminated consolidations in both lungs
  • mediastinal lymphadenopathy
    • DDx: TB, sarcoidosis, lymphoma
  • chronic lung cavity
    • associated with smoking/COPD
    • DDx: TB, aspergillosis
  • progressive disseminated histoplasmosis
    • risk at HIV CD4<150

diagnosis

  • culture on Sabouraud's agar
    • 4-8 weeks
  • serology
  • antigen test in urine

treatment

  • liposomal amphotericin B
  • itraconazole
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