「South America」の版間の差分

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***chiclero = a person who extracts gum from wild or cultivated trees
 
***chiclero = a person who extracts gum from wild or cultivated trees
  
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==Paracoccidiodomycosis==
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===pathogen===
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*''Paracoccidioides brasiliensis''
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*soil-transmitted fungus
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*dimorphic fungus
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**mould <28℃
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**yeast >37℃
 +
 
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===epidemiology===
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*confined to Latin America, esp. Brazil 80%
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*male vs female 14:1
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**most patients from tobacco/coffee crops
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**female hormone inhibit the transformation to yeast
 +
 
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===disease===
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*pneumonia
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**cough, sputum, hemoptysis, fever, weight loss
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*mimic pulmonary tuberculosis not only in history but also in imaging
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*skin and mucous membrane lesion
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**ulcer, painful
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**teeth loss
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*bone erosion
 +
 
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===diagnosis===
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*KOH microscopy of oral mucosa, skin lesion, sputum
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**Mickey Mouse or ship pilot wheel appearance of yeast form
 +
*histopathology
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**epithelioid granulomas
 +
**microabscess
 +
 
 +
===treatment===
 +
*co-trimoxazole
 +
*itraconazole
 +
 
 +
==Histoplasmosis==

2021年4月16日 (金) 15:22時点における版

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