Infectious Disease Pathologies

Question 1

Cellulitis and Erysipelas

Answer 1

Cellulitis is a bacterial skin infection creating inflammation of dermal and subcutaneous layers

Erysipelas is a more superficial bacterial skin infection of the dermis and upper subcutaneous layer, producing a well-defined edge

Aetiology:
* Bacterial: Staphylococcus aureus, infections can enter skin through minor trauma, eczema, IV drug abuse, traumas
* Can originate from streptococci bacteria in subjects nasal passages (common in erysipelas – facial involvement)

Signs and symptoms:
* Very red, inflamed skin
* Fever
* Malaise

Diagnosis/investigations:
* Microbe analysis – can be difficult to detect
* Usually diagnosed from clinical presentation

Allopathic treatment:
* Anti-biotics

Alternative treatment:
* Herbs (immune and antimicrobial) topical and internal
* Acupuncture, Homeopathy
* Nutrition to support immunity and antimicrobial activity

Other notes:
* Both often co-exist, so it can be difficult to make a distinction between the two

Question 2

Impetigo

Answer 2

A very contagious bacterial infection

Aetiology:
* Common in infants / young adults (poor hygiene / breaks in skin)
* Bacterial: Staphylococcus aureus or haemolytic streptococci
* Very contagious; spread by direct or indirect contact; e.g. towels

Signs and symptoms:
* Pustules with round ozzing patches and golden-yellow crusts that grow larger daily
* Mostly affects exposed areas (hands and face) or in skin folds (particularly armpits)

Allopathic treatment:
* Antibiotics (e.g. flucoxacillin or erythromycin)

Alternative treatment:
Immune and anti-microbial;
* Herbs, Nutrition
* Homeopathy, Acupuncture

Question 3

Oral Candidiasis

Answer 3

A superficial fungal yeast infection of mucous tissues

Aetiology:
* Mostly Candida albicans (less than 60% have Candida in their flora where it is commensal).
* Often presents after broad spectrum antibiotics or in immune compromised patients (normally skin / mucous membranes provide physical barrier with support of CD4 cells)

Main signs and symptoms:
* White plaques
* Can cause dysphagia and reduced appetite

Allopathic treatment:
* Antifungals (e.g. clotrimazole – topical or oral). (can significantly impact liver function and damage local skin or mucous membranes)

Alternative treatment:
* Anti-candida protocol: Remove carbohydrates that feed yeast, apple cider vinigar, coconut oil, manuka honey, turmeric, garlic, oregano, probiotics and prebiotics, grapefruit seed extract.
* Support immune system; e.g. vit C, beta glucans
* Herbs (immune and antifungal) internally
* Homeopathy, Acupuncture

Complications:
* Can become systemic in severely immune-compromised patients (deposited on organs) = systemic candidiasis

Question 4

Genital Candidiasis

Answer 4

A very common fungal infection (mycosis) of the genitals

Aetiology:
* Not sex related
* Immune compromise, anti-biotic treatment, diabetes mellitus, pregnancy, immune system disorders

Main signs and symptoms:
* Vaginal / genital itch, discomfort or irritation
* Think, clumpy discharge (cottage cheese)

Diagnosis/investigations:
* Physical examination, Fungal culture and analysis

Allopathic treatment:
* Antifungals (e.g. clotrimazole – topical or oral). (can significantly impact liver function and damage local skin or mucous membranes)

Alternative treatment:
* Anti-candida protocol: Remove carbohydrates that feed yeast, apple cider vinigar, coconut oil, manuka honey, turmeric, garlic, oregano, probiotics and prebiotics, grapefruit seed extract.
* Support immune system; e.g. vit C, beta glucans
* Herbs (immune and antifungal) internally
* Homeopathy

Question 5

Lyme Disease

Answer 5

Caused by a bacterium called ‘borrelia’ which is often transmitted by tick bites

Aetiology:
* Different bacterial strains cause different clinical manifestations (hence differences between Europe and USA)

Main signs and symptoms:
* A circular pink or red rash at the site of the tick attachment that radiates from the bite, usually over 5cm diameter
* Flu like symptoms. Can lead to Neurological disease, cardiovascular disease and arthgritis especially if untreated

Allopathic treatment:
* Antibiotics

Alternative treatment:
Immune and anti-microbial;
* Herbs, Acupuncture, Nutrition, Homeopathy

Question 6

Diptheria

Answer 6

A high contagious upper respiratory tract infection affecting primarily the nose and throat

Aetiology:
* Bacterial; Corynebacterium diphtheriae (gram-positive), transmitted by droplets

Main signs and symptoms:
* Sore throat and fever
* Grey membrane (necrosis) grows accorss the tonsils / pharynx or nose (impairs breathing).
* Enlarged cervical lymph nodes

Diagnosis/investigations:
* Throat culture

Allopathic treatment:
* Medical emergency: Anti-toxins and antibiotics may be required; respirator
* DTP vaccine introduced in 1941 (diphtheria / tetanus / whopping cough / polio)

Alternative treatment:
* Herbs and nutrition (immune and antimicrobial)
* Homeopathy
* Acupuncture

Complications:
* Exotoxins cause endothelial necrosis by inhibiting protein synthesis. Can cause myocarditis and paralyse diaphragm. The membrane can block the airways

Question 7

Scarlet Fever

Answer 7

An infectious disease resulting from exotoxons released by streptococci pyogenes bacteria

Pathophysiology:
* Bacteria seceret haemolytic enzymes and exotoxins (damage capillaries which both cause red rash)

Aetiology:
* Bacterial; Streptococcus pyogenes (haemolytic streptococcus)
* Transmission: Droplet transmission

Main signs and symptoms:
* Sore throat
* Fever
* Scarlet rash (blanches under pressure)
* Haemorrhagic spots on palate
* First two days ; white tongue with red papillae. After this, more raw / red.

Allopathic treatment:
* Antibiotics (penicillin)

Alternative treatment:
* Herbs (immune and antimicrobial)
* Acupuncture
* Nutrition- support immunity /antimicrobial activity
* Homeopathy

Other notes:
* Usually occurs in children (90% <10 yoa)
* Much less common and less serious than it once was. Full recovery is usual
* Incubation time = 3-4 days

Question 8

Cold sores

Answer 8

Caused by the herpes Simplex Virus (Type I)

Pathophysiology:
* The virus remains dormant in the trigeminal nerve

Question 9

Cold sores

Answer 9

Caused by the herpes Simplex Virus (Type I)

Pathophysiology:
* The virus remains dormant in the trigeminal nerveAetiology:
* Transmission; direct contact or indirect – saliva (viruses can be present in saliva for weeks after symptoms)

Main signs and symptoms:
* Commonly asymptomatic
* Begins as tingling on lip as virus travels down nerve
* Painful fluid lesions around mouth that scab then heal
* Reoccurrence can be triggered by infection, stress, sun, etc.

Allopathic treatment:
* Acyclovir (inhibits viral replication if early treatment)

Alternative treatment:
* Herbs (immune and antiviral) topically and internally
* Acupuncture
* Nutrition to support immunity and antimicrobial activity (apple cider vinegar), nano silver
* Homeopathy (e.g. Nat mur)

Complications:
* Spreading to eyes

Question 10

Chicken Pox

Answer 10

Highly infectious viral disease, mostly in children (90%)

Aetiology:
* Varicella zoster virus (part of the herpes viral family)
* Transmission; Droplets into the upper respiratory tract mucosa and direct contact

Main signs and symptoms:
* Duration approx two weeks: Prodromal fever and malaise
* Vesicular eruptions on the skin appear over three – five days mostly on head / neck / trunk. Itchy
* Infective two days before rash until all lesions at ‘crusting’

Allopathic treatment:
* None or Acyclovir

Alternative treatment:
* Herbs (immune and antiviral)
* Acupuncture
* Nutrition – support immunity and antimicrobial activity
* Homeopathy
* Oats in bath, bicarb soda, ACV, raw honey, lavender

Complications:
* Infection because of scratching
* Encephalitis
* Viral Pneumonia

Other notes:
* Incubation time: two - three weeks

Question 11

Shingles

Answer 11

Infection by the varicella zoster virus following chicken pox infection

Aetiology:
* Varicella zoster virus – travels down infected nerve causing neuritis (nerve inflammation) in immune-compromised
* Commonly affects thoracic nerves or trigeminal nerve (head / face)

Signs and symptoms:
* For 1-2 days before the rash – burning, itching, tingling
* Then ‘eruptive phase’ – producing skin lesions similar to chicken pox, causing severe dermatomal pain, altered sensation and vesicular rash only in the affected dermatome

Allopathic treatment:
* Acyclovir

Alternative treatment:
* Addressing patients immune system is paramount;
* Herbs (immune and antiviral)
* Acupuncture
* Nutrition – support immunity and antimicrobial
* Homeopathy

Question 12

Whooping Cough

Answer 12

A bacterial infection with characteristic coughing attacks where there is a desperate attempt to breath in, creating ‘whooping’

Aetiology:
* Bordetella pertussis (bacterial)

Signs and symptoms:
* Initial 1-2 weeks cold-like symptoms
* Then a cough which does not respond to usual cough medicine. The cough gets worse and presents with attacks (for 3-6 weeks)

Complications:
* Pneumonia, rib fracture, death (esp. if <6 months)

Question 13

Tuberculosis

Answer 13

A systemic infection usually caused by pyroenic bateria – Mycobacterium tuberculosis

Pathophysiology:
* A chronic granulomatous disease
* When first encountered macrophages in the lungs engulf the bacteria and carry them to the hilar lymph nodes. Some organisms can spread to distant areas.
* In 80% of cases the granulomas formed will be eliminated by the immune system. If not, the bacteria can become active immediately, later, or may remain dormant
* Priamrily affects the lungs (75%) because highly aerobic
* Also affects CNS, lymph, circulation, genitourinary, bones, joints, skin

Aetiology:
* Transmission; Droplet, inspiration of dust, dry excretions, contaminated milk
* Immunity of the patient plays an important role

Signs and symptoms:
* Pulmonary TB; fever, chronic cough, purulent / bloody sputum, nught sweats, severe malaise, weight loss, anorexia

Diagnosis/investigations:
* Blood tests; High ESR, leukocytosis
X-rays and other imaging

Allopathic treatment:
* Antibiotics for 6 months
* BCG vaccine

Alternative treatment:
* Herbs (immune and antiviral)
* Nutrition – support immunity and antimicrobial activity
* Homeopathy

Question 14

Measles

Answer 14

Acute and very infectious viral disease, mainly in children

Aetiology:
* Measles virus

• Incubation time: 11 days
• Transmission: Droplet infection

Main signs and symptoms:
1. For 3-5 days; non-specific cold symptoms (cough, runny nose and red eyes, fever).
* ‘Koplik spots’; small grey spots on oral mucosa opposite molar teeth
2. Eruptive phase; Measles-like rash that initially begins on face / forehead. Rash fades within one week (contagious four days before and after rash)

Allopathic treatment:
* No specific treatment, only symptomatic

Alternative treatment:
* Herbs and nutrition (immune and antiviral)
* Acupuncture
* Homeopathy
* Vitamin A

Complications:
* Middle ear infection, pneumonia, encephalitis

Other notes:
* Small outbreaks of the disease

Question 15

Mumps]

Answer 15

Acute viral infection associated with the mumps virus causing swelling of the parotid / salivary gland

Main signs and symptoms:
* Feeling generally unwell, fever, head and joint pains, swollen parotid glands, first one then both sides
* Pain at jaw angle

Allopathic treatment:
* Self-limiting.
* MMR vaccine

Alternative treatment:
* Herbs (immune and antiviral)
* Nutrition – support immunity and antimicrobial activity
* Homeopathy

Complications:
* After puberty about 30% of males get testicular inflammation. However, these rarely lead to sterility

Question 16

Rubella
(German measles)

Answer 16

A rare, usually harmless viral infection, that often passes unnoticed, caused by the Rubella virus

Aetiology:
* Rubella virus

Main signs and symptoms:
* Sore throat, fever, headache. Petechiae on hard palate
* Pink rash with small macules that starts on face and behind ears

Allopathic treatment:
* Self-limiting

Alternative treatment:
* Herbs (immune and antiviral)
* Acupuncture
* Nutrition to support immunity and antimicrobial activity
* Homeopathy

Complications:
* Abnormal foetal development (birth defects) and can cause miscarriage and foetal death

Question 17

Viral Hepatitis

Answer 17

An acute viral infection of the liver

Aetiology:
* Hepatitis virus (types; A, B, C, D and E)

• Transmission;
• A and E – faecal-oral
• B, C, D – blood and other bodily functions

Main signs and symptoms:
1. Pre-icteric stage; Malaise and diarrhoea
2. Icteric stage: Jaundice, pale stools, dark urine (hepatic stasis), pruritic skin, enlarged liver, impaired blood clotting
N/B; Icteric = presence of jaundice

Diagnosis/investigations:
* Blood test (liver function test)

Allopathic treatment:
* Limited: Antiviral therapy
* Hep B vaccine in ‘vulnerable’ groups

Alternative treatment:
* Herbs (immune, antiviral and liver-supporting)
* Nutrition to support immunity and antimicrobial activity

Complications:
* Chronic liver disease; Cirrhosis, liver cancer (85% of hepatitis C becomes chronic)

Question 18

Poliomyelitis (Polio)

Answer 18

Acute viral infectious disease

Pathophysiology: * Targets anterior horn cells of CNS (motor) and has no cure

Aetiology:
* Transmission: Faecal-oral transmission
* Poliovirus (PV)

Main signs and symptoms:
* 90% of polio infections are asymptomatic
* Initially: Fever, fatigue, headache, vomiting, neck stiffness
* In 1% of cases, the virus enters the CNS and causes paralysis
* 5-10% die from respiratory failure

Question 19

Dysentery

Answer 19

An infection of the intestines that causes diarrhoea containing blood and / or mucus

Aetiology:
* Bacterial (Shigella)
* Amoebic (protozoan)
* Via faecal-oral contamination

Main signs and symptoms:
* Diarrhoea (watery stools) with mucus and blood
* Cramping and possible nausea / vomiting

Diagnosis/investigations:
* Stool microscopy

Allopathic treatment:
* Anti-parasitic / anti-bacterial
* Rehydration: Fluid and mineral replacement

Alternative treatment:
* Herbs (antimicrobial and immune)
* Oregano oil
* Probiotics
* Colon hydrotherapy (removes amoebic cysts)

Complications:
* Dehydration can be severe

Question 20

Human Immunodeficiency Virus
(HIV)
and
Acquired Immune Deficiency Syndrome
(AIDS)

Answer 20

HIV: An STI which attacks the immune system. A retrovirus 0 a double strand RNA virus
AIDs: Describes the later stages of HIV when the immune system is severely impaired & life threatening, opportunistic infections occur

Pathophysiology:
* HIV binds to CD4 receptors, which are found on:
- T-helper cells
- Macrophages
* The viral envelope and cell membrane fuse and viral RNA enters the cell. It is converted by an enzyme called ‘reverse transcriptase’ into viral DNA.
* Using ‘intergrase’ it integrates into the host cell DNA
* The viral DNA forces the host cell to produce viral RNA and proteins
* Assembles in cytoplasm and buds off
* As the viral load goes up, T-cell count goes down

Aetiology:
* HIV = Directly transmissible
* AIDS = Non transmissible (develops from HIV)
* Tramsmission: Primarily through blood and semen (low risk with saliva and vaginal secretions).
* primarily via unprotected anal sex
* Recent increase in heterosexual transmission \
* 6-7% from IV drug use
* Risk of transmission during pregnancy / birth, potentially through breastfeeding

Main signs and symptoms:
HIV:
* Fatigue
* Anaemia
* Anorexia, diarrhoea, cachexia (weight loss, muscle wasting)
* Neurological disease with no other cause
* Peripheral neuropathy
* Neutropenia and thrombocytopenia
* Demintia (HIV dementia)
* Cognitive / motor dysfunction
AIDS:
Opportunistic infections:
* Recurrent pneumonia
* Active TB
* Candida (esp. oral, vaginal)
* Lymphoma
* Cervical cancer
* Kaposi’s sarcoma (cancer of blood vessels)
* Herpes zoster (shingles)
* Herpes simplex
* Cytomegalovirus

HIV progression:
1. Initial stages:
* 1-6 weeks after infection
* 50% symptomatic
* Flu / glandular fever-like sore throat, fever, malaise, muscle / joint pain, rash, swollen lymph nodes
* Negative antibody (IgG) tests, but viral RNA and p24 core protein high
2. Late stage:
* Huge reduction CD4 count and rise in viral load
* Severely impaired immune function
* Opportunistic infections can cause disease
* AIDS diagnosis based on T-helper count (<14%) and presence of opportunistic infections

Opportunistic infections become more serious as the CD4 count lowers:
* CD4 < 500: Herpes infections, candidasis, Kaposi’s sarcoma
* CD4 < 200: Toxoplasmosis (parasite), pneumonia
* CD4 < 50: Severe mycobacterium infection, HIV dementia

Diagnosis/investigations:
* Blood test for antibodies – there is a delay in the appearance of HIV antibodies (2 weeks – 6 months) – during this time window, tests are inaccurate
* Babies will have antibodies from mother

Allopathic treatment:
* Prognosis: increased with highly active anti-retroviral therapy (HAART)
* Use of anti-retrovirals increases life expectancy, but causes a variety of adverse effects due to high toxicity from the drugs. Most patients will have a combination of two-three drugs
* Currently no cure – focus on slowing progression and prevention

Alternative treatment:
Immune support

Complications:
* HIV destroys CD4 cells leading to immune compromise

Other notes:
HIV:
. HIV dies quickly outside the body
Avoids the immune system:
* As with all viruses: HIV can mutate, uses few structures of its own, and does not have its own metabolism. HIV also destroys CD4 cells leading to immune compromise
AIDS:
. ‘AIDS’ used less often now - late stage / advanced HIV is used more often

Question 21

Malaria

Answer 21

A tropical infectious disease spread by anopheles mosquitoes that are infected by plasmodium species

Pathophysiology:
* Transmission (Three stages in malaria life cycle: Mosquito / human liver/ erythrocyte stage):
1. Infected female anopheles mosquito bites human
2. Plasmodium parasites (‘sporozoites’) taken up by the liver where they proliferate and mature – some varaities may lie dormaont for up to a year
3. Spread to erythrocytes and proliferate further. Symptoms begin (i.e. fever)
4. Infected cells burst and spread infection
5. Protozoan gametes are formed and are taken up by mosquito during a blood meal

Aetiology:
* Plasmodium species (protozoa)
* Five types / species of the plasmodium parasite can infect humans
* Spread by vector / host mosquito
* Incubation; up to 9 months

Main signs and symptoms:
* Cyclical fever attacks depending on type of malaria – first chills, then fever for several hours followed by extreme sweating and then shibering.
* Headache, fever, malaise, arthralgia, nausea, vomiting, diarrhoea, anaemia (haemolysis), haemoglobinuria, convulsions
* Signs; Splenomegaly, hepatomegaly, jaundice (due to excessive haemolysis)

Allopathic treatment:
* Quinine / chlroquine (tetracycline, anti-inflammatories, antipyretics, analgesics)
* Preventative drugs (Resistance in becoming common)

Alternative treatment:
* Prevention of mosquito bites – using essential oil based products (i.e. Citronella), Vitamin B1, Homeopathy

Complications:
* Death (can be misdiagnosed as flu)
* Relapses

Other notes
* 5 million affected each year

Question 22

Chlamydia
(Sexually Transmitted Infections)

Answer 22

A very common sexually-transmitted infection, most commonly affecting under 25s.

Aetiology:
* Chlamydia trachomatis
* Incubation; several weeks

Main signs and symptoms:
* Males: 50% asymptomatic, milky-white or yellow discharge from penis, epididymitis, urethritis (dysuria)
* Females: 80% asymptomatic, yellow vaginal discharge

Diagnosis/investigations:
* Urine
* Cervical, urethral swab tests

Allopathic treatment:
* Antibiotics (e.g. erythromycin and tetracycline)

Alternative treatment:
* Herbs and Nutrition (immune & antimicrobial)
* Homeopathy

Complications:
* Pelvic inflammatory disease (PID) and subsequent risk of infertility

Question 23

Gonorrhoea
(Sexually Transmitted Infections)

Answer 23

A very common bacterial STI

Aetiology:
* Neisseria gonorrhoea (bacteria) – infects epithelium of GU tract, rectum, pharynx and conjunctiva
* Transmission: Direct – oral, anal or genital sex, occasional spread from the genital area to rectum
* Mother to baby during birth

Signs and symptoms:
* Males: 90% symptomatic - yellow penile discharge, dysuria
* Females: 50% asymptoatic – yellow vaginal discharge, dysuria, irregular vaginal bleeding, lower abdominal pan, pain during sex

Diagnosis:
* Swab culture of urethra, throat (90% asymptomatic), cervix or rectum
* Urine – less reliable
* Presumptive on-the-spot diagnosis often made

Allopathic treatment:
* Antibiotics
* Abstain from sexual activity until self & all partners are clear

Alternative treatment:
* Herbs and nutrition (immune and antimicrobial)
* Homeopathy

Complications:
* Permanent compilations (particularly In women) if untreated; Pelvic inflammatory disease (PID) and infertility

Question 24

Genital Herpes
(Sexually Transmitted Infections)

Answer 24

A sexually transmitted viral infection causing small blisters in genital region

Aetiology:
* Herpes simplex virus (mostly Type II)

Transmission:
* Sexually transmitted; genital-genital or oro-genital

Main signs and symptoms:
* Always symptomatic. After initial infection the viruses move to sensory nerves, where they remain latent
* Neurological symptoms = Tingling, pins and needles (Early symptoms, esp. when it reactivates)
* Initially painful vesicles, then shallow ulcers

Allopathic treatment:
* Acyclovir

Alternative treatment:
* Herbs and Nutrition (immune & antimicrobial support)
* Homeopathy

Question 25

Genital Warts
(Sexually Transmitted Infections))

Answer 25

STI causing painless growths in genital region

Aetiology:
* Human papillomavirus (HPV)

• incubation: Up to 6 months

Signs and symptoms:
* Soft, fleshy projections / cauliflower like masses / small pointed masses / flat lesions on the vagina, cervix, penis

Allopathic treatment:
* Surgery, laser, cryotherapy.
* Re-occurrence is common

Alternative treatment:
* Herbs (immune and antiviral)
* Nutrition to support immunity and antimicrobial activity
* Homeopathy (Thuja and other remedies )

Question 26

Syphilis
(Sexually Transmitted Infections)

Answer 26

A chronic contagious systemic disease

Aetiology:
* Treponema pallidum (bacterial)
* Transmission: Enters the body through damaged skin or mucus membranes; e.g. sexual contact, pregnancy (crosses placenta)

Signs and symptoms:
Syphilis can be divided into four clinical stages:
1. A hard, painless ulcer on the infection point. Heals completely within 4 weeks of appearance & becomes asymptomatic
2. General, flat, erythematous rash (very contagious)_ potentially covering entire body. Not itchy, lasting several weeks. Latent stage: No symptoms – untreated person may remain infectious for up to 2 years
3. Years later if untreated may lead to:
* Chronic Gummas (granulomas)
* Neurological Syphilis
* Cardiovascular Syphilis

Allopathic treatment:
* Penicillin
* Avoid sex until confirmation the infection is no longer present
* Regular blood tests to ensure NO re-occurrence

Complications:
* Issues with nervous system, cardiovascular system
* Death