Communicable Diseases Local

Communicable diseases

Different systems – CNS – Circulatory – – – – –

Integumentary Respiratory GI GU Others

Central nervous system

classification Bacterial tetanus meningitis Viral poliomyelitis rabies Creutzfeldt-Jackson Disease

Tetanus

tetanus AKA : C.A. : M.O.T. : I.P. :

“lockjaw” clostridium tetani open wounds 7-14 days

Signs and symptoms Six P’s - pain at the site - painful swallowing - perspiration - position alteration - “plastic” smile - painful movt. of the jaw and neck

opisthotonus position

risus sardonicus

stiffness of the jaw and neck

Diagnostic exam - clinical observation - history of wound

management - Tetanus immune globulin antibody - antibiotic

Nursing responsibility • Safety and prevent injury • Provide adequate nutrition • Prevent spasm as much as possible

Prevention - Immunization

- Wound care

Meningitis

meningitis

- Infection/inflammation of the

covering of the brain and spinal cord C.A. : H. influenza bacilli CMV (if with AIDS) cryptococcus (with AIDS)

MENINGOCOCCEMIA/MENINGO COCCAL INFECTION/SPOTTED FEVER - most fatal, involves the vascular system

C.A. : neisseria meningitis M.O.T. : direct contact/droplet I.P. : 2- 10 days

Signs and symptoms

- flu-like symptoms (SIC)

-Severe HA/Joint Pain -Increased temp. -Chills

Signs and symptoms -

Photophobia Restlessness Increased ICP Nausea and vomiting Seizure Increased ICP Photophobia,diplopia Ecchymosis

Petechiae

Nuchal rigidity

Kernig’s sign

Brudzinski’s sign

Signs and symptoms

Diagnostic procedure • Lumbar puncture • C & S of CSF • Counter immuno electrophoresis • Culture of blood, urine, throat

management -

Antibiotic (ampicillin) Corticosteroid Anticonvulsant Osmotic diuretic

Nursing responsibility • • • •

Assess neurologic function Maintain fluid balance Adequate nutrition Provision of comfort

prevention • Immunization • Covering of mouth and nose • Proper disposal of secretion

VIRAL Poliomyelitis, rabies, creutzfeldtjackson disease

poliomyelitis

poliomyelitis • AKA infantile paralysis/heine-medin disease/acute flaccid paralysis • C.A. : poliovirus (entero virus) • M.O.T. : direct contact

types • Unapparent/sub clinical • Abortive • Major a. non- paralytic b. paralytic

Non paralytic • • • • •

Painful head Irritability Lethargy Arm, neck and leg pain Yielding muscle spasm

paralytic • affectation of the medulla

Diagnostic procedure • Throat culture • Stool exam • Convalescent serum antibody titer

Nursing responsibility - assess for the exacerbation of paralysis -

Assess for neurologic damage VS Nutrition Emotional support

prevention - immunization

Rabies

Rabies AKA : hydrophobia, lyssa, La Rage C.A. : rhabdo virus M.O.T. : contact with saliva of a rabid animal/ droplet I.P. : 10 days to years

Signs and symptoms • Prodromal stage

-local pain and burning sensation, pruritus at the bite site - flu-like symptom (SIC) - nervousness - photophobia - sensitivity to noise - pupillary dilatation and altered LOC

Excitement stage

Excitement stage

Signs and symptoms Excitement stage - intermittent hyperactivity - aerophobia - hydrophobia

Hydrophobia

• CNS dysfunction

Signs and symptoms Paralytic stage - rapid and progressive deterioration - coma - death

Diagnostic procedure • Rapid fluorescent focus inhibitor test • Brain biopsy

management • Post exposure prophylaxis • vaccination

Creutzfeldt-jacob disease

CJD

• Slow progressive disease commonly affecting 40 years old and above • C.A. : infective protein pathogen • M.O.T. : corneal transplant, human growth hormone, beef with mud cow dis.

Signs and symptoms • • • • • • • •

Memory changes Nervousness Startle reflex Sleep disturbance Rapid deterioration Confusion Dementia (+) babinski reflex

Babinski

Diagnostic procedure • Neurologic exam • CT scan

management • NO SPECIFIC TREATMENT • Comfort measure

prevention • Avoid mode of transmission

Circulatory system Bacterial (lyme’s dis.), viral (colorado tick fever), riccketsiae (rocky mountain spotted fever)

Lyme’s disease C.A. :borrelia burgdoferi (spirochete) M.O.T. : bite of tick or feces of tick I.P. : 3-32 days

Signs and symptoms first stage - flu like symptoms with regional lymphadenopathy - bull’s eye rash – classic skin lesion - erythema chromicum migrans (ECM)

- bull’s eye rash – classic skin lesion

- erythema chromicum migrans (ECM)

Signs and symptoms • Second stage Neurologic affectation - HA - stiff neck - memory loss Cardiovascular affectation - heart block - palpitation

Signs and symptoms Third stage musculoskeletal affectation - bone pains - cartilage affectation - arthritis - joint swelling and pain - limited movement

Diagnostic procedure • Observation • ELISA • Blood tests

management - Antibiotic

Nursing responsibility • Rest • Passive exercise • Strengthening exercise

prevention • Avoid tick infested places • Use of protective clothing

Colorado tick fever

Colorado tick fever C.A. : M.O.T. : I.P. :

arbo virus wood tick 3-6 days

Signs and symptoms • • • • • • • •

Abrupt onset of fever and chills Arching of the back Photophobia HA with eye movement N&V Conjunctival infection Alt.LOC Maculo papular petechial rashes

Diagnostic procedure • Blood tests • Smear stain

Management • Removal of tick’s head

Nursing responsibility • Bleeding precaution • Comfort measures

Rocky mountain spotted fever

RMSF C.A. : M.O.T.: I.P. :

ricketsia ricketsii wood/dog tick 2-12 days

Signs and symptoms • • • • • • • • •

Flu-like symptom Excruciating pain Anorexia Rashes Petechiae Erythomatous macule Bronchial cough Rapid RR thrombocytopenia

Diagnostic procedure • Immunofluorescent assay • Cutaneous biopsy of rash • Blood test

Management - careful removal of tick’s head - Antibiotic treatment - Provision of comfort

Integumentary system

classification Viral measles, german measles, erythema infectiosum, roseola infantum, chicken pox Bacterial scarlet, impetigo Fungal ringworm, pediculosis, scabies, scarlet disease

measles

measles AKA : rubeola morbilli, hard measles, little red disease C.A. : rubeola virus (paramyxovirus) M.O.T. : airborne I.P. : 8-14 days

Signs and symptoms Prodromal stage - high grade fever (3-4days) - anorexia - voice hoarseness - 3 C’s (coryza, conjunctivitis, cough) - white spot in buccal mucosa

Koplik spot

Signs and symptoms Eruptive stage - fever peaks - rash appears

Signs and symptoms Post eruptive stage fine desquamation

Diagnostic procedure • Clinical observation • Blood tests

Management • • • •

Symptomatic treatment Antibiotic Keep warm and dry Hygienic measure

Prevention • immunization

German measles

German measles AKA : C.A. M.O.T. : I.P. :

third disease, Roteln, Rubella toga viridae (psedoparamyxovirus) droplet 14-21 days (18 days)

Signs and symptoms • Pre eruptive - low grade fever - HA - malaise - sore throat - coryza - colds - fine red, petechial spots on soft palate

Signs and symptoms • Eruptive - maculo-papular pinkish rash, - enlargement of lymphnodes

German measles DX : MNGT :

clinical observation symptomatic

Erythema infectiosum

Erythema infectiosum AKA : C.A. : M.O.T. : I.P. :

5th disease, slapped cheek disease human parovirus direct, droplet 4-10 days

Signs and symptoms -

Low grade fever Mild colds Intensify red rash Body malaise Pale ring around the mouth

Diagnostic procedure

- Clinical exam - Light and electron microscopy

Roseola infantum

Roseola infantum AKA : C.A. : I.P. :

6th disease, exanthum subitum human herpes virus strain B 10-15 days

Signs and symptoms • • • • •

High grade fever Anorexia Irritability Listlessness Maculopapular rash on trunks, arms, neck • Nagayama spot

Diagnostic procedure

- Clinical observation

Chicken pox

Chicken pox AKA : C.A. : M.O.T. : I.P. :

varicella varicella virus airborne, direct or indirect 13-17 days

Signs and symptoms • • • • •

Slight fever Malaise Anorexia Vesico-pustular rash pruritus

management • Comfort measure • Administration of zovirax

Herpes zoster

Herpes zoster AKA : shingles, Zona C.A. : varicella zoster virus M.O.T. :

Signs and symptoms -

Fever Malaise Musculoskeletal pain Pleurisy Painful vesico papular rash

Diagnostic procedure Clinical observation Tzanck smear

herpes

bacterial Scarlet, impetigo, erysipelas

Scarlet fever AKA : scarlatina, 2nd disease C.A. : group A beta hemolytic streptococci M.O.T. : direct/ indirect I.P. : 2-4 days

Signs and symptoms Prodromal stage - abrupt high fever - Nausea &Vomiting - Head Ache - abdominal pain - sore throat - circum oral pallor - exanthum

Signs and symptoms Eruptive stage - edematous and beefy red pharynx and swollen uvula - strawberry tongue - tiny subcutaneous vesicles around the cuticles of the nails - erythema group together at the skin folds

Diagnostic procedure • • • • • •

Pharyngeal culture Throat culture Rapid antigen test CBC Dick’s test Schult’z charlton test

Management • Antibiotic • Proper nutrition

erysipelas

erysipelas

C. A. : Group A betahemolytic streptococci M.O.T. : direct contact

Signs and symptoms

- flu like symptoms - Bright red, large raised spots - Painful, itchy lesions

diagnostic procedure • C&S of secretions • CBC

management

• antibiotic

Impetigo AKA : C.A. :

“mamaso” staphylococcus aureus Group A beta hemolytic streptococci M.O.T. : direct or indirect I.P. : 4-10 days

Signs and symptoms Non bullous - pustular honey colored crust - pruritus - burning sensation - regional lymphadenopathy

Signs and symptoms Bullous - thin vesicle - clear crust - painless

Severe impetigo

Diagnostic procedure • Gram stain of vesicle • Culture and sensitivity

Management • Antibiotic treatment • Comfort measures

Leprosy • Affectation of the skin and peripheral nerves C.A. : mycobacterium leprae/ hansen’s bacillus M.O.T. : prolonged skin contact, droplet infection

Signs and symptoms • Early change in skin color (reddish / whitish) loss of sensation on skin lesion dec./loss sweating & hair growth over lesion thickened or painful nerves muscle weakness/paralysis pain and redness of the eyes nasal obstruction or bleeding ulcer that does not heal

Signs and symptoms • Late sign - loss of eyebrow (madarosis - inability to close eyelids (lagopthalmos - clawing of fingers and toes - contractures - sinking of nose bridge - enlargement of male’s breast (gyne) - chronic ulcer

Late sign

Types • Paucibacillary (tuberculoid/indeterminate) non infectious type 6-9 mos. Of treatment • Multibacillary (lepromatous/ borderline) infectious type 24-30 mos treatment

Management Multi drug therapy (use of two or more drugs, 1 week no longer communicable) Treatment days Paucibacillary 9 mos Day 1 and monthly TX

Daily treatment

Multibacillary 18 mos

Rifampicin6,45 Rifampicin6,45 Dapsone 1 Clofazimine 3 Dapsone 1 Dapsone 1

Clofazimine50/ Dapsone 1 50

Prevention • • • • • •

Avoidance of prolonged skin contact BCG Hygiene NTN Education Support

Fungal Ringworm, pediculosis, scabies,

Ringworm AKA : tinea C.A. : dermatophytes M.O.T. : direct

types • • • • • •

Tinea capitis Tinea corporis Tinea ungium Tinea barbae Tinea pedis Tinea cruris

Diagnostic procedure • C&S • Wood light exam

Management • Antifungal • Comfort measures

Pediculosis

pediculosis AKA : lice M.O.T. : direct contact

types • Corporis • Capitis • pubis

Scabies

Scabies C.A. : M.O.T. : S&SX : DX : MNGT :

sarcoptes scabie direct contact itchiness, threadlike lesion visual exam of burrow antifungal

Respiratory system

Pneumonia • • • • •

Inflammation of the lung parenchyma C.A. : bacteria, virus, protozoa M.O.T. : direct or indirect I.P. : 24-72 hours Classification • Primary • Secondary

Signs and symptoms • • • • • • • • •

Chills High grade fever Productive cough Purulent sputum Pleuritic chest pain HA Myalgia Crackles Dyspnea

Diagnostic procedure -

general assessment X-ray Blood culture CBC bronchoscopy

pneumonia

Types • • • •

Very severe disease Severe pneumonia Pneumonia No pneumonia

Very severe disease

• Stridor • Convulsion • Abnormally sleepy • Not able to drink and eat

Severe pneumonia • Chest indrawing • Fast breathing

pneumonia • No chest indrawing • Fast breathing

No pneumonia • Cough and colds • No chest indrawing • No fast breathing

management • • • •

Antibiotic Bronchodilator Mucolytic Inhalation therapy

Nursing responsibility • • • • • • •

Positioning Increased Oral Fluid Intake CPT EDBE Suctioning Postural drainage Inhalation TX

Legionaire’s disease

Legionaire’s disease AKA : C.A. : M.O.T. : I.P. :

legonellosis legonella airborne 12-20 days

Signs and symptoms • • • •

Flu-like symptoms General malaise Grayish non purulent sputum Chestpain on coughing

Diagnostic procedure • • • •

CXR CBC ESR Liver enzymes

Management • • • •

Antibiotic Antipyretic Apply chest binder oxygen PRN

Epiglotitis AKA : C.A. :

M.O.T.:

synglotitis Haemophilus influenza B pneumococci GAB streptococci direct/indirect

Signs and symptoms • • • • • • •

High fever Sore throat Dysphagia Inspiratory retraction Nasal flaring Stridor Tripod position

Diagnostic procedure • Throat culture

Management • antibiotic

Diptheria

Diptheria C.A. : corynebacterium diptheria M.O.T. : direct/indirect I.P. : 2-5 days

Signs and symptoms • • • • •

Low grade fever Foul smelling mucopurulent nasal discharge Sore throat Inflammation of cervical lymphnodes Grayish white membrane on soft palate

Diagnosis • • • •

Nose culture Throat culture Schick test Molony test

Management • Diptheria antitoxin • Airborne precaution

Pertusis

Pertusis AKA : C.A. : M.O.T. : I.P. :

whooping cough bordetella pertusis direct/indirect 5-21 days

Signs and symptoms Catarrhal stage - highly contagious - low grade cough - colds, sneezing, lacrimation - listlessness - night cough

Signs and symptoms Paroxysmal stage - spasmodic cough - 5-10 forceful cough and ends with a whoop - expels mucous

Signs and symptoms Convalescent stage - symptoms subsides - no longer communicable

Diagnostic procedure - nasopharyngeal swab - Sputum C & S

Management • • • • • • • •

Antibiotic Pertusis immune globulin Oxygen therapy Antitussive Codeine Rest Aspiration prec! Application of abdominal hernia

Tuberculosis

TB AKA : C.A. : M.O.T.: I.P. :

galloping consumption, phitisis tubercle bacilli airborne ingestion of contaminated milk 4-8 weeks

Signs and symptoms -

fatigue/weakness Low grade fever Chest pain/back pain Productive cough Mucopurulent sputum Occasional hemoptysis

Diagnosis • Tuberculin syringe test • Sputum exam • CXR

Management • • • • •

Rifampicin 450 mg Isoniazid 300 mg Pyrazinamide 500 mg (2 tabs) Ethambutol 400 mg (2 tabs) Streptomycin 1 gm

Viral Colds, influenza, RSV, hantavirus pulmonary syndrome

Colds AKA : C.A. : M.O.T. : I.P. : S&SX : eyes

coryza, rhinitis subgroup of myxovirus direct/indirect 1-4 days pharyngitis, chills, HA, watery

Influenza AKA : C.A. : M.O.T. : I.P. :

flu, la grippe myxovirus influenza direct/ indirect 24-72 hours

S&SX : body malaise, HA, chills, myalgia, conjuctivitis MNGT : amantadine

Respiratory syncitial virus C.A. : M.O.T. : I.P. : S & SX :

subgroup of myxo virus direct/indirect 4-5 days

inflamed mucous membrane coughing, wheezing, malaise, dyspnea DX : C&S of secretion, serum antibody titer, ELISA

Hantavirus pulmonary syndrome C. A. : hantavirus M.O.T. : inhalation, ingestion and contact with infected rodents S & SX : fever, myalgia, HA, N&V, cough, hypoxia, dec. BP, inc. RR & CR DX : CXR, blood exam MNGT : ribavirin

Fungal Coccidioiodomycosis, blastomycosis, histoplasmosis

coccidioiodomycosis AKA : C.A. : M.O.T. : I.P. :

San Joaquin Valley fever coccidiodes inhalation of spore in soil 1-4 weeks

Signs and symptoms • • • • • •

Flu like symptoms Sore throat Malaise Itchy macular rash Dry cough Chest pain

Severe case

Diagnostic procedure • • • •

Coccidiodine skin test CBC ESR CSF analysis

Management • Antifungal

Blastomycosis

Blastomycosis AKA : Gilchrist’s disease C.A. : blastomyces dermatitidis M.O.T. : inhalation I.P. : weeks- months S & SX : mimics URTI, night sweats, chest pain DX : C&S MNGT : antifungal

Histoplasmosis

Histoplasmosis AKA : Ohio Valley Disease/cultural Mississippi disease/amphotericin mountain disease/Darling’s disease C.A. : H. capsulatum H. Duboisi M.O.T. : inhalation of spores from infected source I.P. : 5-18 days

Signs and symptoms • Flu like symptoms • TB like symptoms if chronic

Diagnostic procedure • Tissue biopsy • Sputum culture

Management • Antifungal • glucocorticoids

Gastrointestinal system

Bacterial • • • • • •

Gastroenteritis Shigelosis Cholera Staphylococcal food poisoning Traveller’s diarrhea Botulism

Gastroenteritis C. A. :

bacterial- salmonella virus- norvale virus protozoa – amoeba helminths – enterobius toxin – plants, toad stool drug RX - antibiotic

Gastroenteritis M.O.T. : fecal-oral 5 F’s feces food fomites flies fingers

Signs and symptoms • • • • •

Anorexia N&V Abdominal pain and cramping Borborygmi Diarrhea

Diagnostic procedure • Stool exam • GM stain • Blood culture

Management • • • • •

Antibiotic Oral rehydration IVF replacement F & E balance Nutrition

salmonellosis AKA : C.A. : M.O.T. : foods I.P. :

salmonella food poisoning salmonella specie ingestion of protein rich infected 6-8 hours

Staphylococcal food poisoning C.A. : staphylococcus M.O.T. : CHON & CHO rich infected foods I.P. : 2- 6 hours

Botulism C.A : clostridium botulinum M.O.T. : ingestion of improperly preserved food, contaminated honey, wound infection I.P. : 12-36 hours

Signs and symptoms -

Vertigo dry mouth sore throat weakness, constipation CNS affectation

Diagnostic procedure • Lab analysis

Management • Botulism antitoxin • NGT gastric lavage • enema

shigellosis AKA : dysentery bacillary, bloody flux C. A. : shigella dysenteriae M.O.T. : fecal oral I.P. : 1-4 days S & SX : abrupt diarrhea,abdominal cramping, painful straining, mucoid stool with blood

Cholera AKA : Violent dysentery, El Tor C.A. : Vibrio cholera/Comma M.O.T. : ingestion I.P. : few hours- 5 days usually 3 days S & SX: vomiting, abdominal cramping, severely frequent defecation

Traveller’s diarrhea C. A. : E. coli M.O.T. : ingestion I.P. : 24-72 hours S & SX : abrupt diarrhea, abdominal cramping, N & V

Hepatitis

Hepatitis C.A. A (infectious Hepa A RNA hepa/catarrhal containing jaundice) virus

M.O.T. Fecal-oral

I.P. 2-6 weeks

B (serum hepa/viral) C (post tranfusion)

HBV DNA containing HCV

Sexual / parenteral Sexual / parenteral

8-24 weeks

D (dormant type of hepa B E (enteric virus) G

HDV delta virus HEV

Sexual / parenteral Fecal - oral

3-13 weeks

HGV

Sexual / parenteral

unknown

5-12 weeks

3-6 weeks

Signs and symptoms Pre icteric stage - malaise, fatigue, fever, HA, N & V - anorexia - RUQ pain - diarrhea - anemia

Signs and symptoms Icteric stage - jaundice - pruritus - tea colored urine - light colored stool

Signs and symptoms Post icteric/ convalescent stage - increase energy - GI symptoms subsides

Diagnostic procedure Serum antigen antibody HBSag HBEag anti HBS Liver enzyme tests Bilirubin test Prothrombin test

Management -

Symptomatic treatment Diet Rest medicate

prevention Immunization Proper handwashing Proper food handling

Protozoan Giardiasis/ amoebiasis/ cryptosporidiosis

Giardiasis AKA : C.A. : M.O.T. : I.P. :

lambliasis giardia lamblia fecal oral 1-3 weeks

Signs and symptoms • • • • • • • •

Abdominal cramps Nausea Anorexia Diarrhea Stool changes Vomiting Weight loss Distention/flatulence / belching

Diagnostic procedure • Stool exam • Duodenal aspiration biopsy

Management • • • • •

Increase OFI F & E balance Nutrition Medicate

Amoebiasis AKA : C.A. : M.O.T. : I.P. :

amoebic dysentery entomoeba hystolitica fecal –oral 2-4 weeks

Signs and symptoms • Stool changes • Diarrhea • Foul smelling stool

Diagnostic procedure • Stool exam • Indirect hemo agglutination test

Management • • • •

Increased OFI Nutrition Rest Medicate

Cryptosporidiosis C. A. : M.O.T. : I.P. : S & SX : DX : biopsy MNGT :

cryptosporidium fecal –oral 2-10 days sudden watery stool specific stool exam, small bowel medicate

Schistosomiasis AKA : C.A. :

bilhariasis or snail fever Schistosoma japonicum (bld fluke) S. Mansoni S. haematobium

Signs and symptoms • • • • • • • •

Diarrhea bloody stool Enlargement of abdomen Spleenomegaly Weakness Anemia Inflamed liver p222

Severe case

Management • Praziquantel (biltricide) • Oxamniquine (S.mansoni) • Metrifonate (S. haematobium)

Genito-urinary system Bacterial/ fungal/ viral

Bacterial • • • • •

Chlamydial Gonorrhea Syphillis Chancroid Bacterial vaginitis

Chlamydia C.A. : chlamydia trachomates M.O.T. : sexual contact, delivery I.P. : 7- 14 days S & SX : women - clear vaginal discharge, burning sensation, itchiness, PID men – clear penile discharge, dysuria, epididymitis DX : vaginal culture, Gram stain,ELISA MNGT : medicate (doxycycline, azithromycin, erythromcin) education behavior modification

Gonorrhea AKA : C.A. : M.O.T. : I.P. :

clap, strain, jack, morning drop neisseria gonorrhea sexual contact, delivery 2-10 days

Signs and symptoms • Women -low abdominal pain, dysuria, urinary frequency,itchy, red edematous meatus, purulent discharge - Men - Sx of urethritis, dysuria, purulent discharge

Complication • Sterility • Gonococcal septicemia

Diagnostic procedure • Vaginal/penile culture • Cervical exam • Pap smear

Management • Medicate oral - cephalosporin, ciprofloxacin, ofloxacin IV/IM – ceftriaxone (rocephin)

Syphillis AKA : Rox, Lues, Bad blood disease C.A. : Treponema pallidum M.O.T.: sexual/blood transfusion/vertical transmission I.P. : 10-90 days averagely 21 days

Signs and symptoms Primary stage - chancre - regional lymphadenopathy

Signs and symptoms Second stage - infectious, skin rashes, flu like symptoms - condylomata lata/condylomata - generalized lymphdenopathy

Second stage

Signs and symptoms Third stage/ late stage - assymptomatic - not communicable - CV changes - CNS changes - gummatous lesion

Diagnostic procedure • • • •

History taking VDRL FTA ABC Rapid plasma reagent

Management • Antibiotic (peniccilin G benzathine, doxycycline, tetracycline)

Complication Effects on pregnancy saw like teeth anterior bowing of tibia inflammation of fingers

Chancroid C.A. : M.O.T. : I.P. : S & SX :

Haemophilis Ducruyi sexual contact 3-7 days irregular painful papule inguinal tenderness dysuria DX : Gm stain, blood culture, lesion biopsy MNGT : azithromycin, erythromycin,IM ceftriazone

chancroid

Bacterial vaginitis C.A. : Gardnella vaginalis M.O.T. : sexual contact I.P. : 5-7 days S & SX : itchiness, thin white discharge, gas bubbles, fishlike odor DX : culture MNGT : metronidazole

Fungal Candidiasis

Candidiasis AKA : candidosis/ moniliasis C.A. : candida albicans M.O.T. : sexual contact, delivery I.P. : 2-5 days S & Sx : pruritus, dyspareunia, white gray raised patches,cottage cheese yellow odorless, contain curds DX : culture, GM MNGT : ketoconazole, fluoconazole

Oral candidiasis

Protozoan Trichomoniasis

Trichomoniasis C.A. : trichomonas vaginalis M.O.T. : sexual contact, contaminated douche, delivery I.P. : 4-20 days

Signs and symptoms - itching, dyspareunia, dysuria, urinary frequency - Post coital spotting, menorrhagia, dysmenorrhea - Greenish yellow discharge, malodorous frothy

Diagnostic procedure • Direct microscopic exam • Urine culture • Cervical exam

Management • Metronidazole • Sitz bath to relive symptoms

Viral Genital warts/ genital herpes/AIDS

Genital warts AKA : codylomata accuminata, venereal warts C.A. : human papilloma virus M.O.T.: sexual contact I.P.: 4 wks-9 mos. S & Sx : painless warts DX : dark filled microscopy MNGT : podofilox 0.5%, cryosurgery, electo cautery, laser

Genital warts (men)

Genital warts (women)

warts

Genital herpes C.A. : genital herpes simplex type 2 M.O.T. : sexual contact, delivery I.P. : 3-7 days S & SX : fluid filled, painless, inguinal lymph node, fever, body malaise, dysuria DX : physical exam, TZANCK TEST MNGT : acyclovir

Genital herpes

HIV/ AIDS C.A. : human immuno virus/ retrovirus M.O.T. : sexual contact, blood transfusion, exposure to infected blood, pregnancy, sharing of infected needles

Signs and symptoms Major - fever - chronic diarrhea - 10% weight loss Minor - persistent cough -generalized lymphadenopathy - pruritus - oral pharyngeal candidiasis - recurrent herpes zoster - progressive disseminated herpes simplex

Diagnostic procedure • ELISA • Western blot • CD4 cell count

Management • 2. 3. 4.

4 cocktail drug (21 tabs a day) AZT – terminate viral replication Viramune – blocks DNA activity of virus Protease inhibitor – inhibits maturation of virus 5. Fusion inhibitor –n does not allow fusion of virus to human cell

Other communicable diseases

Filariasis C. A. :

wuchereria bancrofti brugia malayi brugia timori M.O.T. : insect bites (aedes poecillus I.P. : 8-16 mos.

Signs and symptoms • • • • • •

Assymptomatic at first Inflammation of lymph nodes Inflammation of blood vessel Swelling of scrotum Swelling of upper and lower extremities Enlargement and thickening of the skin

filariasis

Diagnostic procedure • • • •

History taking Observation Nocturnal blood exam Immunochromatographic test

Management • Diethylcarbamazine or hetrazan • surgery

Malaria C.A. : genus plasmodium types : Plasmodium falciparum P. vivax P. ovale P. malariae M.O.T. : insect bite

Signs and symptoms • • • • • • •

Recurrent chills Fever Profuse sweating Anemia Malaise Hepatomegaly spleenomegaly

Management • Medicate (blood schizonticides)

Dengue hemorrhagic fever AKA : H fever C.A. : dengue virus types 1,2,3,4 and chikungunya virus (aedes aegypti) M.O.T. : mosquito bite I.P. : uncertain (6days-1week)

Stages First 4 days / invasive stage high fever abdominal pain HA hot flushes vomiting conjunctival infection epistaxis

Stages 4th-7th days/ toxic or hemorrhagic stage lowering of temperature abdominal pain bleeding unstable bp tourniquet test no longer reliable death may occur

Stages 7th-10th days/ convalescent or recovery stage - generalized flushing - regained appetite - stable BP

Classification • Severe, frank type - flushing, sudden high fever, severe hemorrhage followed by sudden drop of temp.,shock - Moderate - with high fever but less hemorrhage - mild - slight fever with or without petechial hemorrhage

Diagnostic procedure • • • •

Tourniquet test Supportive Symptomatic Rapid replacement of body fluids

Mumps • Swelling of one or both parotid glands C. A. : filterable virus M.O.T. : contact with infected secretion of the mouth and nose I.P. : 12-26 days

Signs and symptoms • Painful swelling in front of ear jaws and • • • •

neck Fever Malaise Anorexia Swollen testicle

Management • • • •

Prophylaxis Active treatment Soft or clear liquids Nasal and oral care

Paragonimiasis C.A. : paragonimus westermani, P. siamenses M.O.T. : ingestion of improperly handled food S & SX : chronic cough, blood streaked sputum, chest or back pain, PTB like symptoms DX : sputum exam, immunology, cerebral paragonimiasis MNGT : praziquantel, bithionol,

Paralytic shellfish poisoning AKA : PSP / red tide poisoning C. A. : dinoflagellates M.O.T. : ingestion of raw or mishandled shellfish I.P. : 30 mins-several hours S & SX : numbness, vomiting, dizziness, HA, tingling sensation, rapid, difficulty in speaking and swallowing, respiratory arrest

Management • No specific treatment • Induced vomiting • Coconut milk in the early stage

leptospirosis AKA : weil’s disease, mud fever, tench fever, flood fever, japanese seven days fever, spiroketal jaundice C.A. : leptospires (leptospirainterrogans) M.O.T. : skin contact esp. open wound I.P. : 7-19 days

Signs and symptoms • Leptospiremic phase - fever - HA - myalgia -N&V - vomiting - cough - chest pain

Signs and symptoms Immune phase with circulating IgM

Diagnostic procedure • • • •

Culture Blood test CSF test Urine testing

Management • Antibiotic - penicillin - tetracycline - ertyhtromycin

Anthrax AKA: malignant pustule, malignant edema, woolsorter disease, ragpicker disease) C.A. : bacillus anthracis M.O.T. : contact with infected animals, flies bites that fed on infected animals I.P. : few hours – 7 days

Signs and symptoms • Cutaneous form -itchiness, papule becomes vesicle then black eschar, painless lesion if left untreated can lead to death - pulmonary form - urti like symptoms, after 3-5 days can become acute can cause death - gastrointestinal form - violent gastroenteritis, vomiting, bloody stools

anthrax

Management • • • •

Education Immunize high risk person Control dust handwashing

Practice clean living!!!!!!!!!!

I WILL PASS MY EXAM!!!!!

GOOD LUCK EVERYBODY!!!!