Cardiovascular, Lymphatic and Systematic Diseases

What is bacteremia?

Bacteremia refers to a bacterial invasion into blood circulation.

Bacteremia can occur when you brush your teeth, pick a scab, or squeeze a zit.

Bacteremia may also result from any type of dental or surgical procedure.

Bacteremia may or may not cause any symptoms, depending on whether the organism was able to replicate themselves in the blood stream.

For most people, the immune system should "notice" the organisms immediately and respond with specialized white blood cells to search out and destroy them.

Of course, it is possible for bacteremia to progress to septicemia, especially if an individual has a weakened immune system.

What is septicemia?

Septicemia, sometimes called sepsis, also refers to the presence of bacteria in the blood, but this is an infection that that moves rapidly and is life-threatening.

Simply put, septicemia is bacteremia with replicating bacteria to cause an infection.

Septicemia is characterized by a combination of different processes going on in the body, which are toxemia, bacteremia, and septic inflammatory response syndrome (SIRS)

Septicemia can result from a kidney infection, pneumonia, meningitis, endocarditis, osteomyelitis and other illnesses.

Symptoms Septicemia can begin with spiking fevers, chills,

rapid breathing, and rapid heart rate. The person looks very ill.

The symptoms rapidly progress to shock with fever or decreased body temperature (hypothermia), falling blood pressure, confusion or other changes in mental status, and blood clotting problems that lead to a specific type of red spots on the skin (petechiae and ecchymosis).

There may be decreased or no urine output.

Physical signs

Low blood pressure

Low body temperature or fever

Signs of associated disease (such as meningitis, epiglottitis, pneumonia, or cellulitis)

Treatment Septicemia is a serious condition that requires a

hospital stay. You may be admitted to an intensive care unit (ICU).

Fluids and medicines are given by an IV to maintain the blood pressure.

Oxygen will be given. Antibiotics are used to treat the infection.

Plasma or other blood products may be given to correct any clotting abnormalitie

Diagnosis Blood culture

Blood gases

Clotting studies

PT

PTT

Fibrinogen levels

CSF culture

Culture of any suspect skin lesion

Platelet count

Urine culture

Puerpural feverAlso known as childbed feverCaused by group A, beta hemolytic

streptococci (S. pyogenes)Sample – blood collection

Symptoms:Fever-fluAbdominal painFoul-smelling vaginal dischargeAbnormal vaginal bleeding

Misdiagnose – placental remnants / bacterial infection in vaginal

Background

Acquired thru direct contact with Bacillus anthracis spores from infected domestic animals

The animal that plant-eating such as cattle, sheep and goat

Few yrs ago, used as biological weapons

The bacteria is Gram +ve, large, facultative anaerobic and endospore-forming rod

Endospore form only under aerobic condition, so only when the blood spill of the body/tissues

Diagnosis from blood smears

Treated by penicillin and tetracycline

Types of anthrax

Cutaneous anthrax

Respiratory anthrax

Intestinal anthrax

Lyme Diseases

Also known as BorreliosisLyme disease is caused by the

bacterium Borrelia burgdorferi (B. burgdorferi). Certain ticks carry these bacteria. The ticks pick up the bacteria when they bite mice or deer that are infected with Lyme disease. You can get the disease if you are bitten by an infected tick.

Stages

Stage 1 is called primary Lyme disease.

Stage 2 is called secondary Lyme disease and early disseminated Lyme disease.

Stage 3 is called tertiary Lyme disease and chronic persistant Lyme disease

Symptoms

ChillsFever HeadacheLethargyMuscle pain

Later stage

Body-wide itching

Joint inflammation

Stiff neck

Unusual or strange behavior

Lyme diseasehere may be a "bulls eye" rash, a flat or slightly raised red spot at the site of the tick bite. Often there is a clear area in the center. It can be larger than 1 - 3 inches wide.

Diagnosis

A blood test can be done to check for antibodies to the bacteria that cause Lyme disease. The most commonly used is the ELISA for Lyme disease test. A western blot test is done to confirm ELISA results.

A physical exam may show joint, heart, or brain problems in people with advanced Lyme disease

Rikettsial systematic diseases

Short notes submit after Raya

Dengue fever

Caused by arbovirus

Also called as breakbone fever

Severe bone and joint pain

Followed by loss appetite, nausea, high fever, headache, weakness and rashes

Main vector - Aedes aegypti (Asia) and Aedes albopictus (US)

Diagnosis thru serological test

No vaccine available

Protozoan disease (malaria)*

Leishmaniasis

Is protozoan infection (Leishmania donovani) by sandflies

Attack only blood cell and will be phagocyte by macrophage

So protozoan continue replication in macrophage and release during rupture

Also known as black poison

Irregular fever, spleen enlargement

Caused fatal after 6mnths - 2-3 yrs

Toxoplasmosis

Caused by toxoplasma gondii

Infected thru contact wt animal feces

Cat that usually feed with undercooked raw meat (raw beef)

That can go thru the placenta and attack the fetus of infected mother

Babesiosis

Transmitted by ticksDiagnosis thru blood

smearTreatment using

chloroquine

Malaria

caused by a parasite (Plasmodium species) that is transmitted from one human to another by the bite of infected Anopheles mosquitoes. In humans, the parasites (called sporozoites) travel to the liver, where they mature and release another form, the merozoites. These enter the bloodstream and infect the red blood cells.

Infection period

The parasites multiply inside the red blood cells, which then rupture within 48 to 72 hours, infecting more red blood cells.

Cont. The majority of symptoms are caused by

the massive release of merozoites into the bloodstream, the anemia resulting from the destruction of the red blood cells, and the problems caused by large amounts of free hemoglobin released into circulation after red blood cells rupture.

Falciparum malaria, one of four different types of malaria, affects a greater proportion of the red blood cells than the other types and is much more serious. It can be fatal within a few hours of the first symptoms

Symptoms Anemia

Chills

Coma

Convulsion

Fever

Headache

Jaundice

Muscle pain

Nausea

Stools, bloody

Sweating

Vomiting

Transmission

Malaria can also be transmitted from a mother to her unborn baby (congenitally) and by blood transfusions.

Malaria can be carried by mosquitoes in temperate climates, but the parasite disappears over the winter.

Diagnosis and treatmentDuring a physical examination, the doctor may

identify an enlarged liver or an enlarged spleen. Malaria blood smears taken at 6 to 12 hour intervals confirm the diagnosis

Chloroquine is a frequently used anti-malarial medication, but quinidine or quinine plus doxycycline, tetracycline, or clindamycin; or atovaquone plus proguanil (Malarone); ormefloquine or artesunate; or the combination of pyrimethamine and sulfadoxine, are given for chloroquine-resistant infections.

The choice of medication depends in part on where you were when you were infected.