Infectious Disease Pathologies Flashcards
Cellulitis and Erysipelas
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
Impetigo
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
Oral Candidiasis
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
Genital Candidiasis
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
Lyme Disease
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
Diptheria
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
Scarlet Fever
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
Cold sores
Caused by the herpes Simplex Virus (Type I)
Pathophysiology:
* The virus remains dormant in the trigeminal nerve
Cold sores
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
Chicken Pox
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
Shingles
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
Whooping Cough
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)
Tuberculosis
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
Measles
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
Mumps]
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
Rubella
(German measles)
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
Viral Hepatitis
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)
Poliomyelitis (Polio)
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
Dysentery
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
Human Immunodeficiency Virus
(HIV)
and
Acquired Immune Deficiency Syndrome
(AIDS)
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
Malaria
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
Chlamydia
(Sexually Transmitted Infections)
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
Gonorrhoea
(Sexually Transmitted Infections)
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
Genital Herpes
(Sexually Transmitted Infections)
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
Genital Warts
(Sexually Transmitted Infections))
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 )
Syphilis
(Sexually Transmitted Infections)
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
