「South America」の版間の差分
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| 81行目: | 81行目: | ||
***chiclero = a person who extracts gum from wild or cultivated trees | ***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 | ||
2021年4月16日 (金) 16:02時点における最新版
目次
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
- chiclero's ulcer
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
