Tags: Lung Abscess

Trematodes

Essentials of Diagnosis Blood flukes: demonstration of eggs in feces, urine, or rectal biopsy Liver flukes: demonstration of eggs in feces Intestinal flukes: demonstration of adult worms or eggs in feces Lung flukes: demonstration of eggs in sputum or feces All trematode species that are parasitic for humans are digenetic. Sexual reproduction in the adult fluke is followed by asexual multiplication in the larval stage. Most species of adult trematodes have an oral and ventral sucker. The life cycles of trematodes that are important human pathogens are similar among all five major species. Eggs are excreted in the feces of the host, hatch in fresh water, and require a primary host …

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Other Pseudomonas Species of Medical Importance

P PSEUDOMALLEI MELIOIDOSIS This organism is endemic in Southeast Asia with the highest prevalence in Thailand. The organism is a saprophyte living in the soil. Infection may be subclinical, acute, subacute, or chronic. Pulmonary infection is most common. Histologically, the acute illness is represented by lung abscesses and the subacute form by caseation necrosis. Upper lobe cavities must be distinguished from those caused by tuberculosis. Debilitated patients may develop hematogenous spread of the organism to other organs. Skin lesions from direct inoculation cause suppurative lesions often in association with nodular lymphangitis and regional lymphadenopathy. Diagnosis is made in a patient from an endemic area with a compatible clinical illness who has …

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Enterococci: Clinical Syndromes

URINARY TRACT INFECTION Urinary tract infections, including uncomplicated cystitis, pyelonephritis, prostatitis, and perinephric abscess, are the most common type of clinical infections produced by enterococci (Box 1). Most enterococcal urinary tract infections are nosocomial and are associated with urinary catheterization or instrumentation. BACTEREMIA & ENDOCARDITIS Nosocomial enterococcal bacteremias are commonly polymicrobial. Portals of entry for enterococcal bacteremia include the urinary tract, intra-abdominal or pelvic sources, wounds (especially burns, decubitus ulcers, and diabetic foot infections), intravascular catheters, and the biliary tree. Metastatic infections other than endocarditis are rare in enterococcal bacteremia. Enterococci account for ~5-10% of all cases of infective endocarditis (see site). Most cases are caused by E faecalis, but E …

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Pneumonia

This section focuses on the clinical findings, diagnosis, and treatment of pneumococcal pneumonia. Clinical Findings A. Signs and Symptoms. The so-called classic presentation of pneumococcal pneumonia consists of an abrupt onset of a shaking chill followed shortly after by fever and production of rusty sputum (Box 2). This classic presentation, however, is not the most common. Typically, patients present because of a change in preexisting symptoms. Many have had several days of a viral upper respiratory infection marked by coryza, sore throat, and nonproductive cough, or they have chronic pulmonary disease with its attendant persistent productive cough. In these patients, the development of pneumonia is heralded by the onset of fever …

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Coccidioidomycosis

Description of Medical Condition Pulmonary fungal infection endemic to the Southwest USA. Can become progressive and involve extrapulmonary sites, including bone, CNS, and skin. Known as the “great imitator.” Incubation period is 1 to 4 weeks after exposure. System(s) affected: Pulmonary, Nervous, Musculoskeletal, Skin/Exocrine, Endocrine/Metabolic Genetics: Unknown Incidence/Prevalence in USA: 100,000 cases per year. (0.5% extrapulmonary) Predominant age: All ages Predominant sex: Male = Female Medical Symptoms and Signs of Disease • Note: Over half of cases are subclinical • Anorexia • Arthralgias • Chest pain • Chills • Confusion • Cough, dry or productive • Cyanosis • Dyspnea • Erythema nodosum • Fatigue • Fever • Headache • Malaise • …

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Bronchiectasis

Description of Medical Condition Chronic irreversible, abnormal dilatation of the bronchi, usually accompanied by infection and productive cough System(s) affected: Pulmonary Genetics: Associated with many conditions including some that are congenital or hereditary Incidence/Prevalence in USA: • No reliable figures available • Less common than it once was, probably due to more effective treatment of childhood respiratory infections Predominant age: Begins most often in early childhood, but symptoms may not appear until later in life Predominant sex: Male = Female Medical Symptoms and Signs of Disease • Cough • Sputum — copious and purulent • Hemoptysis • Wheezing • Coarse or moist crackles • Cyanosis • Digital clubbing • Dyspnea • …

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Brain Abscess

Description of Medical Condition Single or multiple abscesses within the brain, usually occurring secondary to a focus of infection outside the central nervous system. May mimic brain tumor but evolves more rapidly (days to a few weeks). It starts as a cerebritis, becomes necrotic, and subsequently becomes encapsulated. System(s) affected: Nervous Genetics: No known genetic pattern Incidence/Prevalence in USA: Infrequent Predominant age: Median age 30-40 Predominant sex: Male > Female (2:1) Medical Symptoms and Signs of Disease • Recent onset of headache becoming severe • Nausea and vomiting • Mental changes progressing to stupor and coma • Afebrile or low-grade fever • Neck stiffness • Seizures • Papilledema • Focal neurological …

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Blastomycosis

Description of Medical Condition An uncommon, systemic, fungal infection with a broad range of manifestations including pulmonary, skin, bone and genitourinary involvement System(s) affected: Skin/Exocrine, Pulmonary, Musculoskeletal, Renal/Urologic, Endocrine/Metabolic Genetics: N/A Incidence/Prevalence in USA: Ranges from 0.4-4 cases per 100,000 population per year. Higher prevalence in states bordering the Mississippi and Ohio Rivers. Sporadic cases occurring in other areas. Predominant age: Adults, but 10-20% of cases occur in children Predominant sex: Male > Female Medical Symptoms and Signs of Disease • Acute infection – Onset may be abrupt or insidious – May be asymptomatic and self-limiting – Incubation period 30-45 days – Fever, chills, myalgias, arthralgias – Cough initially nonproductive, then …

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Amebiasis

Description of Medical Condition Amebiasis is caused by the intestinal protozoan, Entamoeba histolytica. Infection results from ingestion of fecally contaminated food, such as garden vegetables or by direct fecal-oral transmission. Most persons are asymptomatic or have minimal diarrheal symptoms. In a few patients, invasive intestinal or extraintestinal (e.g., liver, and less commonly kidney, bladder, male or female genitalia, skin, lung, brain) infection results. Amebic abscess of the liver may develop during the acute attack or 1 -3 months later; symptoms may be abrupt or insidious. Entamoeba histolytica has been divided into ‘pathogenic” and “nonpathogenic” strains. The pathogenic strains commonly cause invasive infection while the noninvasive strains cause only asymptomatic intestinal infection. …

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Pulmonary Infections

Acute Pneumonias Potential Severity Acute pneumonia is a potentially life-threatening illness requiring rapid diagnosis and treatment. A delay in antibiotic treatment increases the risk of a fatal outcome. General Considerations In Acute Pneumonia Prevalence Annually, 2 to 3 million cases of pneumonia are reported in the United States. Estimates suggest that pneumonia is responsible for more than 10 million physician visits, 500,000 hospitalizations, and 45,000 deaths annually. Overall, 258 people per 100,000 population require hospitalization for pneumonia, and that number rises to 962 per 100,000 among those over the of age 65 years. It is estimated that, annually, 1 in 50 people over 65 years of age and 1 in 20 …

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