What is a respiratory infection ?

This system is much more vulnerable to infections than other body parts

RESPIRATORY TRACT INFECTIONS

Respiratory infections are divided into upper respiratory tract infections and lower, separated by Carina. In health, the lower respiratory tract is normally sterile because of an extremely effective defense system. Upper respiratory tract infections are particularly common in the paranasal sinuses and childhood.The Middle ear structures are consistent and may be involved minor viral infections of lower respiratory nasopharynx.The is often compromised by smoking, pollution air, aspiration of airway secretions and chronic lung diseases, including chronic bronchitis and chronic obstructive pulmonary disease. Respiratory infections is defined clinical, radiological, sometimes, as in cases of pneumonia, and appropriate microbiological sampling.

The respiratory system is much more vulnerable to infection than other body parts. This is because it is easier for bacteria or viruses from entering the channel when someone breathes in. respiratory tract infections are more common during the winter. This is probably due to the winter people are more likely to stay in close contact with each other. Children tend to get more respiratory infections such as colds than adults. Because they have not yet developed immunity to many viruses that cause colds.

Respiratory infections are a common cause of the disease. Respiratory infection is most common cold. The respiratory system is a general term used to describe all parts of the body that are involved in helping a person to breathe. health professionals generally make a distinction between:

UPPER RESPIRATORY TRACT INFECTIONS
LOWER RESPIRATORY TRACT INFECTIONS

PATHOPHYSIOLOGY

The transmission of microorganisms responsible for the URI is produced aerosol droplets or direct contact with the hand in hand with infected secretions, including transport as a result of the nostrils or eyes. 7Thus, transmission occurs most often in crowded conditions. Direct invasion of respiratory epithelium results in symptoms compatible with the area (s) in question. sinusitis and acute bronchitis is often preceded by a cold. sinus allergies, anatomical abnormalities like a deviated septum, sinus ostium blockage caused by swelling of the mucosal immune disorders such as hypogammaglobulinemia and infection with human immunodeficiency virus, the abuse of cocaine and predispose to the development of acute sinusitis.

The majority of influenza epidemics, 20 century were caused by viruses, but few have been caused by influenza B. Most of the epidemics is believed to spread from students to their families. Annual influenza epidemics due to the supply of influenza virus mutants that most people have no immunity (antigenic drift). Pandemics, on the other hand, occur when a completely new influenza virus is transmitted to humans from other species, pigs and birds most common (antigenic shift). Persons aged 65 years and the underlying disease are at higher risk than healthy people to death and hospitalization due to worsening of their underlying disease as a result of influence....... read more

Bacterial infection of the central nervous system can cause abscesses

INFECTIONS OF THE NERVOUS SYSTEM 

 

The central nervous system or central nervous system includes the brain, spinal cord and membranes. In certain circumstances, bacteria can penetrate the central nervous system areas. If this occurs, abscesses or empyemas may be established. In general, the CNS is well defended against infection. The spine and brain are sheathed in hard, protective membrane. The outer membrane, the dura, and the next layer, the arachnoid, totally covering the brain and spinal cord. However, these defenses are not absolute. In rare cases, bacteria have access to areas of central nervous system.

 

There are four main causes of infections of the central nervous system (CNS): bacteria, viruses, fungi and protozoa.

 

Bacterial infection of the central nervous system can cause abscesses and empyema (accumulation of pus). Abscesses have fixed boundaries, but no definable shape and size empyema. CNS infections are classified according to where they occur. For example, a spinal epidural abscess is located above the dura mater, and subdural empyema occurs between the dura and arachnoid injury. As the pus and other material of an infection accumulate, pressure is exerted on the brain or spinal cord. This pressure can damage the nervous system tissue, perhaps permanently. Without treatment, CNS infection is fatal.

The brain is highly protected, and is essential for the maintenance of life. Yet the central nervous system infections are occurring. They range from a latent is rapidly fatal. This guide describes some of the features of CNS infection and laboratory diagnosis. The membranes surrounding the brain infections called meningitis. When the content of the brain that is infected with meningitis. brain abscesses are defined, localized lesions within the brain. "Slow" brain infections also occur, and these are usually fatal. Rapid diagnosis of CNS infections is important because many of the central nervous system infections are life threatening.

 

Viruses that infect the central nervous system (brain and spinal cord) include herpesviruses, arboviruses, coxsackieviruses, echoviruses and enteroviruses. Some of these infections primarily affect the meninges (the tissues covering the brain and spinal cord) and the result of meningitis. Others affect primarily the brain and cause encephalitis. Infections that affect both the meninges and brain after a meningo-encephalitis. Meningitis is most common in children than is encephalitis.

The virus affects the central nervous system in two ways. They can directly infect and destroy cells of the central nervous system during acute illness. After recovery from an infection of the central nervous system or elsewhere in the body's immune response to infection sometimes causes secondary damage to cells that surrounds nerve. These secondary damage (postinfectious encephalomyelitis or acute disseminated encephalomyelitis) results in children having more symptoms weeks after recovery from acute illness.

 

Meningitis is usually caused by viruses. Viral meningitis is a self-limiting disease. Bacterial meningitis is much less common, but is a potentially fatal condition. Other organizations may be a rare cause meningitis, for example, spirochetes and fungi. Symptoms include fever, severe headache, neck stiffness and photophobia. Due to the severity of the condition, so it may be caused by a number of staff, fast and accurate diagnosis of the cause is essential for prompt initiation of appropriate treatment.

 

Fungal infections of the central nervous system (CNS) are increasingly diagnosed both in immunocompromised and immunocompetent persons. Sinocranial aspergillosis more frequently described from temperate countries, most often in otherwise immunocompetent individuals. The clinical syndromes as fungal infections of the central nervous system can present are protean and may involve most neuroaxis. Certain clinical syndromes are specific to certain fungal infections. The nose shape is the most common syndrome with zygomycosis and skull-base syndromes frequently in clinical syndromes in patients with aspergillosis sino-cranial. Sub-acute and chronic meningitis in patients infected with HIV are more likely to be due to cryptococcal infection. Early recognition of clinical syndromes in an appropriate clinical context, it is the first step towards full recovery in some of these infections. 

 

 

CONGENITAL INFECTIONS OF CENTRAL NERVOUS SYSTEM 

 

Although vaccines, new antimicrobial agents and improvement in hygiene practices, congenital infections remain a major cause of mortality and neurological morbidity in children long term worldwide. important players are Toxoplasma gondii, cytomegalovirus, Treponema pallidum, herpes simplex virus types 1 and 2, and rubella. In addition, several other agents, such as varicella-zoster, parvovirus B19, and Borrelia burgdorferi, which potentially can infect the fetus and result in the fetus. This paper provides an overview of these infectious disorders, and outlines current strategies for the treatment of acute and long-term treatment.

               

Infectious diseases

INFECTION AND INFECTIOUS DISEASE 

INFECTIOUS AGENTS 

The world is full of microorganism ,the vast majority of which are harmless to man and many of which are essential to life .Some of these organism live on or within human hosts: most of these form part of our normal flora and are benign passenger or symbiotes.A minority ,however ,ar pathogenic ,causing illness or even death to their host .It is thses viruses ,bacteria , protozoa ,and worms which are responsible for the infectious disease.

Infection remains the main cause of morbidity and mortality in man ,particularly in underdeveloped areas where it is associated with poverty and overcrowding .In the developed world increasing prosperity ,universal immunization and antibiotics have reduced the prevalence of infectious disease .However ,antibiotic -resistant strains of bacteria as well as viruses and ' new ' diseases such as human immunodeficiency virus ( HIV ) infection and variant Creutzfeldt-jakob disease ( vCJD) have emerged .Increased global mobility has aided the spread of infectious disease and allowed previously localized pathogens to establish themselves world-wide .Deteriorating social conditions in the inner city areas of our major conurbations have facilitated the resurgence of tuberculosis and other infection.Changes in farming and food-processing methods have controlled to an increase in the incidence of food and water-borne disease.

In the developing world successes such as the eradication of smallpox have been balance or outweighed by the new plagues.Infectious cause nearly 25% of all human deaths .Two billion people -one third of the world's population-are infected with tuberculosis ,250-300 million people catch malaria every year ,and 200 million are  infected with schistosomiasis .Infections are often multiple and there is synergy both between different infections ,and between infection and other factors such as malnutrition.Many of the infectious diseases affecting developing countries are preventable or treatable ,but continue to thrive owing to lack of money and political will.

INFECTIOUS AGENTS

The causative agents of infectious diseases can be divided into four groups.

Prions  are the most recently-recognized and the simplest infectious agents ,consisting of a single protein molecule.They contain no nucleic acid and therefore no genetic information : their ability to propagate within a host relies on inducing the conversion of endogenous protein into prion protein.

viruses  contain both protein and nucleic acid and so carry the genetic information for their own reproduction.However ,they lack the apparatus to replicate autonomously ,relying instead on "hijacking " the cellular machinary of the host .They are smalll ( usually less than 200 nanametres in diameter ) and each virus possesses only one species of nucleic acid ( either RNA or DNA ).

Bacteria  are usually though not always ,larger than viruses .Unlike the latter they have both DNA and RNA , with the genome encoded by DNA ,They are enclosed by a cell membrane ,and even bacteria which have adopted an intracellular existence remain enclosed within their own cell wall. Bacteria are capable of fully autonomous reproduction ,and the majority are not  dependent on host cells.

Eukaryotes are the most sophisticated infectious organism ,displaying sub-cellular compartmentalization .Different cellular functions are restricted to specific organelles ,e.g photosynthesis takes place in the choloroplast ,DNA transcription in the nucleus and respiration in the mitochondria ,Eukaryotic pathogens include unicellular protozoa ,fungi ( which can be unicellular or filamentous ) ,and multicellular parasite worms.

Other higher classes ,notably the insects and the arachnids ,also contain species which can parasitize man and cause disease .

       

Infection

INFECTION AND INFECTIOUS DISEASE

ORGANISM INTERACTION AND SOURCES OF INFECTION

HOST / ORGANISM INTERACTIONS

Each of us is colonized with huge numbers of micro-organism ( bacteria plus viruses ,fungi , protozoa , and worms ) with which we coexist .The relationship with some of these organism is symbolic ,in which both partners benefit ,while others are commensals , living on the host without causing harm .Infection and illness may be due to these normally harmless commensals and symbiotes evading the body's defences and  penetrating into abnormal sites.Alternatively ,disease may be caused by exposure to exogenous pathogenic organism which are not part of our normal flora.



The symptoms and signs of infection are a result of the interaction between host and pathogen .in some cases ,such as the early stages of influenza ,symptoms are almost entirely due to killing of host cells by the invading organism .Usually ,however ,the harmful effects of infection are due to a combination of direct microbial pathogenicity ,and the body's response to infection .In meningococcal septicemia ,for example ,much of the tissue damage is caused by cytokines released in an attempt to fight the bacteria .In a few instances , such as chronic South American trypanosomiasis ( Chaga's disease ) ,mortality is almost entirely immunological ,with the parasite itself having little effect once the inflammatory process has been triggered .



SOURCES OF INFECTION

The endogenous skin and bowel commensals can cause disease in the host ,either because they have been transferred to an inappropriate site ( e.g bowel coliforms causing urinary tract infection ) ,or because host immunity has been attenuated ( e.g candidiasis in an immune compromised host ) .Many infections are acquired from other people ,who may be symptomatic themselves or be asymptomatic carriers .Some bacteria ,like the meningococcus ,are common transient commensals ,but cause invasive disease in a small minority of those colonized .Infection with other organisms ,such as the hepatitis B virus ,can be followed in some cases by an asymptomatic but potentially infectious carrier state.



Zoonoses are infections that can be trasmitted from wild or domestic animals to man .Infections can be acquired in a number of ways : direct contact with the animal ,ingestion of meat or animal products , contact with animal urine or faeces ,aerosol inhalation ,via an arthropod vector ,or by inoculation of saliva in a bite person to person .



Most microorganisms do not have a vertebrate or arthropod host but are free-living in the environment . The vast majority of these environmental organisms are non-pathogenic ,but a few can cause human disease.Person to person transmission of these infections is rare .Some parasites may have a stage of their life cycle which is environmental ( for example the free-living larval stage of Strongyloides stercoralis and the hookworms ) even though the adult worm requires a vertebrate host.Other pathogens can survive for periods in water or soil and may be transmitted from host to host via this route ,these should not be confused with true environmental organisms.



World -wide mortality from infectious disease such as :

• Acute lower respiratory infections
• HIV/AIDS.
• Diarrheal disease.
• Tuberculosis.
• Malaria.
• Measels.
• Tetanus.
• Whooping cough.
• Meningitis.
• Leishmaniasis.

Infectious endocarditis

INFECTIOUS ENDOCARDITIS 

Infective endocarditis is a form of endocarditis caused by infectious agents. Agents are usually bacteria, but other agencies may also be responsible. Heart valves do not receive the blood supply is engaged. Consequently, immune defense mechanisms (such as white blood cells) can not directly reach the valve through the bloodstream. If an organism (like bacteria) binds to a valve surface and forms of vegetation, the host immune response is blunted. The lack of blood supply to the valve also has implications for treatment, because medicines are also difficult to reach the infected valve. Normally, blood flows smoothly through these valves. If damaged - rheumatic fever, for example - the risk of bacterial adhesion is higher.

Infective endocarditis (IE) is an infection of the endocardial surface of the heart. The impact of this infection include severe valvular regurgitation intracardiac, which can lead to intractable congestive heart failure and myocardial abscesses. IE also produces a wide variety of systemic signs and symptoms through several mechanisms, including both sterile and infected emboli and various immunological phenomena.

There are several ways to classify endocarditis. The simplest classification is based on the causes of this disease , whether infected or not the infection, depending on whether the organism causes inflammation. Regardless, the diagnosis of endocarditis on the basis of clinical features, investigations such as cardiac ultrasound, as well as all blood cultures demonstrated the presence of micro-organisms that cause endocarditis.

PATHOPHYSIOLOGY 

Though uncertain, it is believed that the heart valve  of infective endocarditis and other surfaces  of heart when exposed to bacteria or fungi microemboli moves into the bloodstream. Dextran-producing bacteria for example Streptococcus mutans, a virulence factor in promoting compliance with the endovascular surfaces. Coagulase-negative staphylococci to produce biofilm is a prosthetic surface, which also contribute to a commitment. beta-hemolytic streptococci and enteric gram-negative bacteria is recognized factors such as respect, and seems less likely to cause blood poisoning. Endocardial surface is already damaged heart valve disease, endocarditis, surgery, or pacemaker wires create a favorable environment for the formation of thrombi. Over time, microorganisms multiply in whirlwinds, which is a classic vegetation. Micro-organisms to be put into circulation, usually continuously, which often leads to interesting results.

CAUSES 

The infection of the heart valve relatively resist by normal structure. Bacteria and fungi are not easy to attach to the endocardial surface, and constant good blood supply can prevent it from depositing in the structures of the endocardium. Thus, two factors generally required for  infective endocarditis: predisposing alteration of the endocardium and microorganisms in the bloodstream (bacteremia).  In a rare cases , bacteremia or mass of microorganisms specifically virulent cause of endocarditis on normal valves of the heart.

Endocarditis commonly involves the cardiac valves. The main predisposing factors are congenital heart defects, rheumatic valve disease, bicuspid or calcific aortic, mitral valve prolapse and hypertrophic cardiomyopathy. artificial valves are at particular risk. Sometimes, the sites of mural thrombus, ventricular septal defects and patent ductus arteriosus will be infected. The actual nidus of infection is usually a sterile fibrin-platelet vegetation ,it can formed when tissue factor release by damaged endothelial cells.

The microorganisms that infect the some layer of heart ( endocardium ) can originate from distant infected sites (example, skin abscesses, inflammation or infection of the gums, urinary tract infection) or visible portals of entry like in a central venous catheter or an injection site . Almost all the foreign material implanted (eg, ventricular peritoneal implants) runs the risk of bacterial colonization, thereby becoming a source of infection and therefore endocarditis.  Infective Endocarditis can also be asymptomatic bacteremia, as  occurs during invasive dental procedures, medical or surgical procedures. Even brushing your teeth, chewing, can cause septicemia (usually due to Streptococcus viridans) in gingivitis patients........ read more

Endocarditis treatment

It rapidly damages cardiac sites seeds extra-cardiac sites hematogenously and can progress to death within weeks ,incidence increases in elderly 

The incidence of infective endocarditis in the general population is estimated  approximately at 2 and 6 cases of 100 000 person-years, but significantly higher in patients with underlying valvular heart disease and the abuse of intravenous drugs. In addition, invasive procedures are performed also technically strong health care system can cause infections of the bloodstream and cause blood poisoning. Although historically rheumatic  valvulitis has often been regarded as a predisposing factor in endocarditis, times have changed. mitral valve prolapse, bicuspid aortic disease and aortic valvular heart disease are now the most frequent causes. Furthermore, the prosthetic valve heart defects in about one third of all cases of endocarditis, and affects 1% to 3% of patients after cardiac valvular surgery.

SIGN AND SYMPTOMS

In many cases the infection develops very slowly. Sometimes called subacute bacterial endocarditisor SBE. Symptoms can develop gradually, over weeks or months and may be vague. You tend to feel generally unwell and may have general aches and pains, fatigue, and may be out of food. The fever (high temperature) develops at some point in most cases. In these early symptoms may be caused by many other conditions, the cause of the symptoms can not be diagnosed for a while. Murmurs tend to develop heart. These are sounds that can be heard by a doctor listens to your heart with a stethoscope. murmurs are caused by an abnormal flow of blood through faulty valves or damaged. If you already have a murmur heart of an existing valve problem, the murmur may change or become more intense. A new murmur or change is often what alerts a physician to suspect infective endocarditis.

In some cases, the symptoms pretty quickly and it can be very bad for several days. Speed at which the disease develops depends in part on which bacteria or fungi that cause infection. Some bacteria are more virulent than others.



DIAGNOSIS

Infective endocarditis diagnosis based on symptoms, results of medical examinations and results of diagnostic tests:

Blood cultures show bacteria or microorganisms commonly found in endocarditis. blood cultures, blood tests can be time consuming for the laboratory to isolate specific bacteria causing the infection. Must be taken before antibiotics are started, if you have blood poisoning.

Echocardiogram (heart ultrasound) may show growths, abscesses (holes), the new regurgitation (leakage) or stenosis (narrowing), or an artificial heart valve that has begun to move away from the heart tissue. Occasionally, doctors insert an ultrasound probe in your esophagus or esophageal (TEE) to obtain a very detailed look at heart.

Other signs and symptoms of infective endocarditis included :

Emboli (small clots), bleeding (internal bleeding).
Stroke .
Shortness of breath .
Night sweats.
Loss of appetite or weight loss .
Muscle and joint pain


TREATMENT

When bacteria cause infective endocarditis , identified by blood culture tests ,Doc should start immediately intravenous (IV) antibiotic therapy. Intravenous antibiotics may be administered up to six weeks to control the infection. The symptoms will be monitored during treatment and blood tests to determine the effectiveness of treatment. If damage  of cardiac valves occurs, surgery may be needed to establish the heart valve and improve cardiac function.Treatment of infective endocarditis  starts with prevention. When endocarditis occurs, prompt treatment is necessary to prevent damage to heart valves and for more serious complications, including death...... read more

Lyme disease symptoms

SYSTEMIC / MULTISYSTEM INFECTIONS 

LYME DISEASE

Lyme disease, or other name is Lyme borreliosis, is an emerging clinical infection caused by at  three  type of species of bacteria ,that belong to the genus Borrelia.Borrelia burgdorferi sensu stricto is the major cause of Lyme disease in the U.S. while Borrelia afzelii andBorrelia garinii cause most of the  European cases. 


The disease name is given after the town of Lyme,Connecticut,  in United States of America , where a large number of cases were found in 1975. According to the  Allen Steere Lyme disease was a tick-borne disease in 1978, the main cause of this disease remained a mysterious until 1981, when B. burgdorferi was identified by another person Willy Burgdorfer.



Lyme disease is caused by a bacterial infection transmitted by ticks and the individual's immune response to infection later. It is characterized by arthritis, neurological and cardiac complications, which is a characteristic rash, which extends from the original tick bite. Lyme disease is caused by spirochete Borrelia burgdorferi, which is sent to Ixodes. Spirochete can be transmitted during the blood meal of an infected tick. Studies have shown that the transfer requires at least 24-48 hours of tick attachment. Ticks carrying the voles, moles, sheep and horses, and wide distribution in the U.S., the UK and Europe. They are particularly numerous in wooded areas along or pasture, ie farmers, loggers and bush walkers usually more at risk. Activities are seasonal and peak in spring, summer and early autumn.

Traditionally, the progression of Lyme disease is divided into three phases, but it is somewhat artificial as the progression from the beginning to a later stage is not inevitable, even in the absence of antibiotic treatment. The first, and in most cases the only clinical characteristic of Lyme disease is a rash of classic erythema migrans - an area of redness migrate outwards from the site of a tick bite might have happened anytime from 20-40 days earlier. The second stage of Lyme disease occurs weeks to months after initial infection and the results spread to more distant locations via the bloodstream and lymphatic system. many organs and tissues are potential targets, especially the skin, nervous system, heart and joints. The clinical signs depend on the system and the severity of injuries. Patients may complain of flu-like symptoms with night sweats and muscle aches.

Lyme disease should always be considered if there is a history of exposure to ticks. A negative history of tick bite does not develop the disease. The study was made to work, travel and leisure exposure and pets. Samples can be performed on blood or cerebrospinal fluid. The organism can be cultured in the laboratory for 3-4 weeks. DNA detection is also possible. The prognosis is generally excellent, and only a few deaths have been reported. Even without treatment, a tendency to recurrent episodes of Lyme arthritis to resolve over time. Children seem to have a better chance of complete recovery than adults.

Ebola virus

INSECT AND - ANIMAL BORNE VIRAL INFECTIONS

EBOLA AND MARBURG VIRUS INFECTIONS

Ebola and Marburg viruses are related viruses that cause hemorrhagic fevers - diseases characterized by bleeding (hemorrhage), organ failure, and in many cases, death. Both Ebola and Marburg virus are in Africa, where outbreaks have occurred sporadically for decades. No human case of Ebola haemorrhagic fever have been reported in the United States. Ebola and Marburg live in one or more host animals and humans can contract the virus from infected animals. After the initial transmission, the virus can spread from person to person by contact with bodily fluids or contaminated needles. There is no effective treatment for hemorrhagic fever caused by Ebola and Marburg virus. People diagnosed with Marburg or Ebola virus receive supportive care and treatment of complications.

Virus causes Marburg hemorrhagic fever (MHF), also called the Marburg virus disease, and previously also known as green monkey disease because of its primate origins. Marburg Central and Eastern Europe, and infects humans and nonhuman primates. Marburg virus is the same taxonomic family, Ebola, and both are similar in structure, although it would different antibodies.


HISTORY
This virus has been documented in 1967 when 31 people became sick in the German city of Marburg ,after which it is named  Frankfurt am Main and the then Yugoslav city of Belgrade. The outbreak involved 25 primary infections, with seven dead and six secondary cases, no deaths. The primary infections were in laboratory staff exposed to Marburg virus while working with monkeys or their tissues. The secondary cases involved two doctors, a nurse, a post-mortem worker, and married to a veterinarian. All were in direct contact, usually involving blood, with a primary case. Both doctors became infected through accidental skin pricks when drawing blood from patients.



TRANSMISSION
Disease spreads to body fluids such as blood, faeces, saliva and vomit. The first symptoms are often vague, and usually include fever, headache and muscle aches after the incubation period is 3-9 days. After five days, maculopapular rash is often present in the body. At a later stage of Marburg infection is acute and may have jaundice, pancreatitis, weight loss, delirium and neuropsychiatric symptoms, bleeding, hypovolemic shock and multi-organ failure, liver failure most common. offshore accounts to evade physical gaps are widespread popular references to the disease, but in fact rare. Now, of course, varies, but symptoms usually last from one to three weeks, to repair disease or kill the infected host. The mortality rate is 23% more than 90%....... read more

PRECAUTIONARY MEASURES FOR TREATING PATIENT'S OF EBOLA AND MARBURG INFECTION 

Ebola virus and marburg virus disease spread from person to person by contact

INSECT AND - ANIMAL BORNE VIRAL INFECTIONS 

EBOLA AND MARBURG VIRUS INFECTIONS 

CAUSES 

Marburg and Ebola virus has risen to tropical rainforests in Africa, in mid-20th century. Live virus animal host or reservoir's .People were probably infected when they invaded their habitats, and found a virus for the first time. Researchers Have identified a type of African fruit bat as a source of virus. Even if infected with Ebola and Marburg in contact with monkeys, chimpanzees and other nonhuman primates, these animals are not subject to natural virus. Instead, they are a ring of infection.

Once a person has been infected with Ebola or Marburg virus, the virus can spread to others through contact with bodily fluids that his person or through the use of contaminated needles or syringes. Investigators do not believe that humans produce enough Ebola or Marburg virus in droplets to cause infection through casual contact.

SIGN AND SYMPTOMS 

After the incubation period of 5-10 days, fever, muscle aches and headaches often occur abdominal symptoms (nausea, vomiting, pain, diarrhea), and upper respiratory symptoms (cough, chest pain, pharyngitis). Photophobia, conjunctival injection, jaundice and lymphadenopathy occur. Delirium, stupor and coma may occur, suggesting the involvement of the CNS. hemorrhagic symptoms begin within the first days and include petechiae, bruising, bleeding and Frank puncture sites and mucous membranes. Maculopapular rash, mainly in wood, from about 5 days.

During the second week of symptoms, or fever clearance occurs and patients begin to recover, or multiple organ failure patients develop fatal. The recovery is long and may be complicated by recurrent hepatitis, uveitis, transverse myelitis, and orchitis. Mortality ranges from 25-90% (higher Ebola).

DIAGNOSIS 

Ebola and Marburg hemorrhagic fever is difficult to diagnose because many of the early signs and symptoms resemble other infectious diseases such as typhoid and malaria. But if doctors suspect that you have been exposed to Ebola or Marburg virus, using laboratory tests to identify the virus in a few days. Most people with Ebola or Marburg haemorrhagic fever have high concentrations of virus in their blood. Blood tests known as enzyme-linked immunosorbent assay (ELISA) and reverse transcriptase chain reaction (PCR) can detect specific genes or viruses or antibodies against them.

TREATMENT 

No antiviral drug has proven effective in the treatment of infection with Ebola or Marburg virus. Consequently, treatment consists of medical support. This includes the provision of fluids to maintain adequate blood pressure to replace blood loss and treat all infections that develop. Some people receive transfusions of plasma to restore blood proteins to enhance coagulation. Public health officials urge hospitals to keep people with Ebola or Marburg haemorrhagic fever isolated from others in negative pressure rooms, which maintain the flow of air rather than enclosed spaces. Health workers should follow strict precautions for infection control.

COMPLICATIONS 

Both Ebola and Marburg hemorrhagic fever lead to death for a large percentage of people who suffer. As the disease progresses, it can cause multiple organ failure, severe bleeding, jaundice, delirium, convulsions, coma and shock. Death often occurs within 10 days after the onset of signs and symptoms. One reason why viruses are so deadly is that they interfere with the immune system's ability to defend itself. But scientists do not understand why some people recover from Ebola and Marburg and others not. For those who survive, recovery is slow. It can take months to regain weight and strength, and the virus remains in the body for several weeks. People may experience hair loss, sensory changes, hepatitis, weakness, fatigue, headache,  inflammation of eye , inflammation of the testicles........ read more

Bone infection

BONE AND JOINT INFECTIONS 

 

Osteomyelitis is the name given to infections of the bone. This may be acute or chronic in nature. More than 90% of acute osteomyelitis caused by Staphylococcus aureus, Streptococcus pyogenes, and Haemophilus influenzae but also cause an acute infection of Haemophilus inflenzae bone is rare due to the widespread use of Hib vaccine.

 

Bone has been infected by the bacteria move into the bloodstream, where seeds of infection. Acute osteomyelitis usually affects the long bones points higher, because blood flow is slow in these areas. This allows the possibility of bacteria in motion to resolve the infection and establish at these sites. Although rare, osteomyelitis more often in children and adolescents who are growing rapidly. Sometimes, acute osteomyelitis can cause the spread of infection to adjacent tissues. In such cases, the infection is likely to be polymicrobial.

The bacterium Mycobacterium tuberculosis is the most common cause of chronic osteomyelitis. This condition causes the secondary spread of a lung infection. Unlike osteomyelitis, which affects the growing points of long bones chronic osteomyelitis caused by Mycobacterium tuberculosis is most likely to affect the vertebrae. Other bones, including hip and knee and leg in your hands or feet, may be involved in chronic osteomyelitis. The pressure on the spinal cord due to chronic osteomyelitis may be enough to cause paralysis in the affected region.

 

A bacterial infection of a joint can cause serious and potentially destructive form of arthritis, often called septic arthritis. Common bacterial infections can be caused by a variety of organisms and can occur in natural and artificial joints (eg after total knee arthroplasty). The most frequent common infection caused by N. gonorrhea, sexually transmitted bacteria that cause gonorrhea, this is called a gonococcal joint infection. mixed infection with other types of bacteria called nongonococcal bacterial (septic) arthritis. Infection of an artificial joint is known that infection prosthesis.

 

People who have artificial joints are at risk of developing a common infection. Approximately 0.5 to 1 percent of the population with replacement joints to develop such an infection. Infections may occur during early recovery from hip replacement surgery (within the first two months) or much later. Unfortunately, artificial joint infections are difficult to treat. This is due, in part, the development of structures known as biofilms within the commune. Biofilm develops when bacteria are in accordance with the common artificial solid surface. Biofilm can act as a shield against some bacteria, making it difficult for bacteria to find and destroy the body's natural defenses or antibiotics.

 

Other bacteria that cause chronic osteomyelitis include salmonella and other coliform bacteria, Pseudomonas aeruginosa and the spirochetes Treponema pallidum. This can cause bone lesions in children with congenital syphilis. Also cause sensitization to gum formation of bone in patients suffering from tertiary syphilis. Recent archaeological evidence suggests that bone lesions caused by syphilis is evident in the bones of Europe before the discovery of America. These doubts about the theory that Christopher Columbus brought syphilis during his first return from the New

World.

 

Bone and joint infections occur when a bacterial infection spread from one part of the body for a bone or joint through the bloodstream. The infected bone begins to produce pus, which may cause an abscess or pocket of pus. Over time, the infection can disrupt the blood supply of bone. This can cause the bone to die. One of the most common bone and joint infection called osteomyelitis. Bone and joint infections can cause symptoms such as bone pain, swelling, fever and nausea. Several factors increase a person's risk of bone and joint infections, including trauma, diabetes, dialysis and the use of intravenous drugs. If you experience symptoms similar to those of a bone or joint infection, you should be seen by a specialist in infectious diseases.

 

Gram-positive organisms, particularly staphylococci and streptococci, which are responsible for most infections in bones and joints. The treatment of these infections can be difficult, usually associated with long-term course of antibiotics, often with surgery. The choice of antibiotics depends on the sensitivity profile, patient tolerance and long-term goals, such as the treatment or suppression, but only a few randomized controlled trial in patients compared the efficacy of different antibiotics. Varying degrees of bone penetration and clinical outcome of certain antibiotics, such as beta-lactams, clindamycin and quinolones, has been described, although the method of these studies are not standardized and results are not always be applied directly to patients.

 

The effect of achieving a minimum bactericidal concentration of serum in patients has also been studied, but no longer routinely recommended in clinical practice. Comparative clinical trials are few but have demonstrated the efficacy of oral fluoroquinolones in combination with rifampicin or fusidic acid for selected Gram-positive infections. In the last decade, more and more resistant organisms such as Staphylococcus aureus resistant to methicillin and vancomycin resistant enterococci have been recognized as causes of infection in orthopedics. Individual case reports describe successful treatment with new antibiotics, for example, linezolid and quinupristin / dalfopristin, but results of clinical trials are expected.

Systemic infection

SYSTEMIC / MULTISYSTEM INFECTIONS 

 

SEPTICAEMIA 

 

Sepsis is a serious condition characterized by inflammation in the body. It is caused by bacteria entering the bloodstream, which triggers an immune response, causing inflammation and a closing body systems slow to treat the infection. This disease can be fatal, especially if the patient is allowed to make progress in the shock phase and departure can be alarmingly quickly. If sepsis is suspected, a patient transported to hospital for immediate medical care.

SEPTICAEMIA 

 

The causes of sepsis are varied. Typically, the patient is vulnerable due to age or condition, and bacteria simply enjoy the situation. Surgery latent infections, and burns can all cause blood poisoning, which is a very good reason to keep any infections to ensure they do not spread. A case of sepsis begins with bacteria that produce toxins in the bloodstream, causing blood clotting, the body tries to fight against bacteria.

 

MENINGOCOCCAL SEPTICAEMIA 

 

Meningococcal septicemia (blood poisoning) - This is the most dangerous and deadly of the two diseases. It occurs when bacteria enter the bloodstream and multiply uncontrollably, damaging the walls of blood vessels and cause bleeding under the skin. The disease is called sepsis and meningitis is usually associated with the eruption of purple. Sepsis can cause death within hours, or permanent disabilities such as scars and amputations. See the animation below shows how it travels through the blood system. 

MENINGOCOCCAL SEPTICAEMIA 

 

The disease is carried in asmptomatically 50-20% of the population. It is found worldwide in the five major serogroups. Meningococcal group A causes epidemic disease in sub-Saharan Africa and parts of Asia. Groups Y and W also cause an infection outbreak. B and C tend to cause sporadic infections in Europe and North America. The disease occurs only in a small percentage of those colonized. It depends on both host and bacterial factors and are more likely following viral upper respiratory tract. Man is the only known reservoir of disease. Meningococcal disease occurs when bacteria invade the nasal mucosa and into the bloodstream.

 

TULAREMIA 

 

Tularemia, also known as "rabbit fever", is a disease caused by the bacterium Francisella tularensis. Tularemia is typically found in animals, especially rodents, rabbits and hares. Tularemia is a disease usually in rural areas and has been reported in all states of the United States except Hawaii. Typically, people infected by the bites of infected insects (most commonly, ticks and horseflies) by handling infected sick or dead animals, eating or drinking contaminated food or water by respiration bacteria from the air.

Tularemia

 

Its  a common  widespread disease in animals. About 200 human cases of tularemia are reported each year in the United States. In most cases occur in parts of south-central and western states. Almost all cases occur in rural areas, and those resulting from bites of ticks and biting flies or handling infected rodents, rabbits or hares. Cases the result of breathing the bacteria into the air and laboratory accidents. people develop symptoms depends on how they are exposed to tularemia. Possible symptoms include skin sores, swollen lymph nodes, painful, inflamed eyes, sore throat, mouth sores, diarrhea or pneumonia. If bacteria are inhaled, symptoms may include sudden onset of fever, chills, headache, muscle aches, joint pain, dry cough and progressive weakness. People with pneumonia can develop chest pain, difficulty breathing, spitting blood and respiratory failure. Rabbit fever can be fatal if the person has not been treated with appropriate antibiotics.

 

Francisella tularensis is highly contagious. A small number of bacteria (10-50 organisms) can cause disease. If Francisella tularensis were used as a bioweapon, the bacteria were probably made in the air to be inhaled. People who inhale the bacteria can experience severe respiratory diseases like pneumonia and systemic infection serious if not treated.

 

The incubation period (time to be exposed to fall ill) for tularemia is usually 3-5 days, but can vary from 1-14 days. If you think you have been exposed to tularemia bacteria, consult a doctor quickly. Treatment with antibiotics for a period of 10-14 days or more after exposure may be recommended. If you have any antibiotics, it is important to take following the instructions you receive. All medications you take, be taken.

 

 

Bacteremia

Bacteremia can follow surgery ,dental treatment and even tooth brushing .The transient presence of organisms in the blood can occur in healthy people 

SYSTEMIC / MULTISYSTEM INFECTIONS 

Many infections are limited to a body organ or system Especially because the body's metabolic needs that may route of infection, or infections defences.Other o host response may affect multiple systems, or whole body . Under unusual situations host immunity as amended, infections, usually related can become systemic. we are describing infections that typically cause systemic disease in an immunocompetent host.

BACTERAEMIA 

Bacteremia occurs when bacteria enter the bloodstream. This can occur through a wound or infection, or surgery or injection. Bacteremia may cause no symptoms and resolve without treatment or can cause fever and other symptoms of infection. In some cases, the bacteria leads to septicshock, potentially life-threatening condition.

Number of live bacteria on the skin or colonize the moist linings of the urinary tract, lower gastrointestinal tract and other internal surfaces. These bacteria are generally harmless, on how to control the body's natural barriers and the immune system. People in good health with strong immune systems rarely develop bacteremia. However, when bacteria directly from the circulatory system, particularly personwho is sick or aggressive treatment, maynot immune systems can cope with the attack, and symptoms of bacteremia may develop. For this reason, bacteremia is more common in people who have already or treat other medical problems. Furthermore, medical care can add a personal touch of new bacteria, which are invasive than those already residing in the human body, thus increasing the likelihood of bacterial infection.

The bacteria most likely to cause bacteremia include members of Staphylococcus, Streptococcus, Pseudomonas, Haemophilus and Escherichia coli (E. coli) genera. Bacteremia is diagnosed by blood culture for bacteria. The samples may be needed repeatedly tested for several hours. The blood test may also reveal elevated white blood cells. Blood pressure should be closely watched, a decrease of blood pressure may indicate an incipient septic shock. Antibiotics are the cornerstone of treatment and are often initiated before the positive identification of the bacteria are made. Careful observation is necessary to protect against septic shock. Since bacteremia is usually associated with infection from elsewhere in the body, detect and treat this infection is an  important part of treatment.