Epididymitisis the most common local complication of C. trachomatis infection in young males. Signs and symptoms of epididymitis include: Fever Unilateral scrotal pain Swelling Tenderness Evidence of urethritis on Gram stain Epididymal tenderness or mass on exam Up to 70% of sexually transmitted cases are due to Chlamydia trachomatis. Some sexually transmitted cases are due [...]

  Reiter’s Syndrome Bechet’s Syndrome Oral Ulcers Yes Yes Genital Ulcers Yes Yes Uveitis Iritis Yes Arthritis Yes Axial Yes Rash +/- Yes Male vs Female Males > Females Male = Female Genetics HLA B27 HLA B51 STD associated Chlamydia No Rx Doxycycline/NSAIDS Colchicine: 0.6 mg b.i.d. for mucocutaneous and joint symptoms Who?? Multiple sex [...]

Sporotrichosis is a subacute or chronic infection caused by the soil fungus Sporothrix schenckii.  The characteristic infection involves suppurating subcutaneous nodules that progress proximally along lymphatic channels (lymphocutaneous sporotrichosis). The primary lesion develops at the site of cutaneous inoculation, typically in the distal upper extremities. Patients with these forms are typically afebrile and not systemically [...]

History Scarlet fever generally has a 1- to 4-day incubation period. Emergence of the illness tends to be abrupt, usually heralded by sudden onset of fever associated with sore throat, headache, nausea, vomiting, abdominal pain, myalgias, and malaise. The characteristic rash appears 12-48 hours after onset of fever. In the untreated patient, fever peaks by [...]

Infection Source Clinical Features Alaria americana Undercooked frog legs Disseminated fatal thoracic, gastrointestinal, retroperitoneal, and CNS manifestations; intraocular infections Echinostomiasis (16 species) Freshwater fish, aquatic plants, clams, snails, mollusks, contact with aquatic birds May be asymptomatic; mild abdominal pain, bloating, dyspepsia, diarrhea, eosinophilia Fibricola species Tadpoles Abdominal pain, diarrhea, fever, eosinophilia Fasciolopsis species Water chestnut, [...]

Malignant external otitis is an infection that affects the external auditory canal and temporal bone. The causative organism is usually Pseudomonas aeruginosa, and the disease commonly manifests in elderly patients with diabetes. The infection begins as an external otitis that progresses into an osteomyelitis of the temporal bone. Spread of the disease outside the external [...]

Transmission of molluscum contagiosum has been reported by direct skin contact and has occurred in wrestlers, patients of a surgeon with a hand lesion, and children sharing baths, towels, gymnasium equipment, and benches. Autoinoculation also occurs as evidenced by linear arrays of lesions on infected individuals. Molluscum contagiosum can likely be vertically transmitted, similarly to other [...]

Pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils. The etiology is usually infectious, with most cases being of viral origin. These cases are benign and self-limiting for the most part. Bacterial causes of pharyngitis are also self-limiting, but are concerning because of suppurative and nonsuppurative complications. Other causes include allergy, trauma, [...]

Conjunctivitis is one of the most common nontraumatic eye complaints resulting in presentation to the office. The term describes any inflammatory process that involves the conjunctiva. In classic presentations, patients complain of eyelids sticking together on waking. They may describe itching and burning or a gritty foreign-body sensation. Pus sliding across the eye may distort [...]

Here are the normal parameters : Pressure          = 50-180 mmH2O Color                = clear RBC count       = 0-4 x 10^6/L WBC count      = 0-4 x 10^6/L Glucose            = >60% of the serum level Protein             = < 0.45 g/L Microbiology   = sterile//no growth Subarachnoid haemorrhage : Pressure increased, bloody, RBC count increased, WBC = normal/increased, glucose = normal, protein = increased, [...]

Echoviruses – (30% of all cases) peak during summer and fall among the children and their family members (fecal-oral transmission). Gastroenteritis may be associated as well as maculopapular, vesicular, or petechial skin rash. Coxsackievirus A – (10% of cases) peak in summer and fall, affects children and family members (fecal-oral transmission). Herpangina may be associated [...]

It is due to integrin gene defect and consequent inability to bind to opsonized microorganisms and thus failure of phagocytosis. Patients develop severe bacterial infections, particularly of the mouth and gastrointestinal tract. Patient’s leukocytes cannot adhere to endothelium either, and cannot migrate to the places of infections (this allows for rapid spread of the infection). [...]

Due to defect of phagocytosis (inability of neutrophils to form highly reactive oxygen species required for bacterial killing after phagocytosis). Surviving microorganisms give rise to cell mediated immune response and formation of granulomas. Affected children develop pneumonia, lymphadenitis, sinus infections, and abscesses in the skin, liver and other viscera. Diagnosis is by demonstration of inability [...]

It is a tick-borne disorder from systemic infection by the spirochete Borrelia burgdorferi. Occurs in Europe, Northeastern U.S.A., and Australia Primary infection may manifest by an expanding erythematous annular skin lesion (erythema chronicum migrans), usually on thigh, groin or axilla. Besides neurologic, there are also cardiac involvement (conduction defects, myocarditis, pericarditis, etc.), and symptoms such [...]

TSS is a rare condition (reported incidence in menstruating women is 1:100 000). It is caused by any of several related toxic exoproteins produced by Staph. aureus. TSST-1 is the toxin most frequently implicated and enterotoxin B the second most frequent. For TSS to develop individuals need to be infected or colonized with toxigenic Staph. [...]

Occurs either by direct spread from ruptured lymph node or intraabdominal organs or by hemathogenous seeding Nonspecific abdominal pain, fever, ascites are common signs and should raise suspicion. Coexisting liver disease complicates the diagnosis. Paracentesis reveals exudative fluid with high protein level and leukocytosis (lymphocytosis usually). Yield of direct smear and culture is low. Peritoneal [...]

Accurate diagnosis relies on culture of haemophilus ducreyi. Clinical picture is dominated by painful genital ulcers and marked inguinal adenopathy. Therapy includes – ceftriaxone 250 mg IM as a single dose, – erythromycin 500 mg four times a day X 7 days, and – ciprofloxacin 500 mg twice daily X 3 days. There are also [...]

Caused by Chlamydia psittaci–a bird disease Infection of humans from birds results in pneumonitis with systemic manifestations. Symptoms: – shaking chills and fever (up to 40.5 Celsius), – diffuse and excruciating headache, – dry hacking cough, – epistaxis, – photophobia, and – myalgias, stiffness and spasms of the muscles Diagnosis: – chest x-ray is nonspecific [...]

Infections with Chlamydia P. start to occur in late childhood and peak in young adulthood but continue throughout the life.  Usually males but can occur in either sex. It causes epidemics of pneumonia and other respiratory infections. Transmission is from person to person. Several episodes in the same person are common (first episode is usually [...]

Most common transmission-–breast feeding Endemic in Japan, Caribbean, central Africa, Italy, Israel In Southwestern United States ATL develops in 2-5% of patients. Four types – acute, lymphomatous, chronic and smoldering Poor survival (median – 6 mo for acute and 5 years for smoldering) Associated with myelopathy (tropical spastic paraparesis) This is more common in females. [...]