Chapter 23: General Medical Conditions and Additional Health Concerns

General Medical Conditions and Additional Health Concerns1

2General informationLike everyone athletes can become ill.It is important to recognize these conditions early and refer them for the appropriate medical attention.The majority of these illnesses and conditions will require referral to a physician for care.3General information VirusesSmall organism that can live only in a cell.Upon entering cell it may immediately trigger a disease or remain dormant.Can damage host cell by blocking normal function and using metabolism for own reproduction.Virus ultimately destroys cell.They can not be treated by antibiotics.

4General information BacteriaBacteria are single celled micro-organisms.Disease development:Bacterial pathogen enters host.Growth of bacteria & production of toxic substances occurs.Host attempts to fight infection.They can be treated by antibiotics.

5Skin infections HerpesCause of conditionHerpes simplex: viral infection that tends to occur in the same location (mucus membranes).Type I (cold sore) Type II (genitals)Herpes zoster (Shingles)Appears in specific pattern on body (innervated by specific nerve root).Re-appearance of chicken pox virus.6

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Cold soresShingles8Signs of conditionEarly indication = tingling or hypersensitivity in an infected area 24 hours prior to appearance of lesions.Local swelling followed by outbreak of vesicles.Heal in generally 10-14 days.CareIf an athlete has an outbreak, they should be disqualified from competition due to contagious nature of condition.Utilize universal precautions when dealing with herpes virus.Use of antiviral drugs can reduce recurrence and shorten course of outbreak.9Skin infections Verruca Virus & WartsVaried forms exist:Verruca plana (flat wart)Verruca plantaris (plantar wart)Condyloma acuminatum (venereal wart)Different types of human papilloma virus have been identified.Uses epidermal layer of skin to reproduce and grow.Wart enters through lesion in skin.10

Flat wartsPlantar warts11Signs of conditionSmall, round, elevated lesion with rough dry surfaces.Painful if pressure is applied.May be subject to secondary bacterial infection.CareIf vulnerable, they should be protected until treated by a physician.Use of electrocautery, topical salicylic acid, or liquid nitrogen are common means of managing this condition.12Skin infections BacterialImpetigo ContagiosaCaused by streptococci.Spread through close contact.Furuncle (Boils)Infection of hair follicle that results in pustule formation.Generally the result of a staph infection.Become large and painful.Folliculitis Inflammation of hair follicle around face/neck or in the groin.13

Impetigo Contagiosa

Furuncle (boil)

Folliculitis14Symptoms of conditionMild itching and soreness followed by eruption of small vesicles and pustules that rupture and crust.Exhibits signs of inflammation.CareCleansing and topical antibacterial agents.Systemic antibiotics.Pus filled lesions should be drained.Minimize the chances of the infection to spread to others.15Methicillin-Resistant Staphylococcus Aureus (MRSA)CauseStrain of bacteria that is resistant to methicillin and other antibiotics.Often times occurs in patients in hospitals that are already ill, or have open wounds/bed sores/burns.Can also infect individuals outside of the hospital.SymptomsBroad range of symptoms.Typically redness, tenderness and swelling.May carry MRSA without having symptoms.CareMay require much heavier dose of antibiotics.Some infections can only be treated with intravenous antibiotics (requires several weeks of treatment).16

17Skin infections FungalCause of condition: Ringworm fungi (tinea)Cause of most skin, nail and hair fungal infections.Tinea of the groin (tinea cruris)Signs and symptomsMild to moderate itching and found bilaterally.Brownish or reddish lesion resembling outline of butterfly in groin.18

19CareTreat until cured.Will respond to many of the non-prescription medications.Medications that mask symptoms should be avoided.Failure to respond to normal management may suggest a non-fungal problem (such as bacteria) and should be referred to a physician.May require additional topical medications and oral prescriptions.20Athletes Foot (tinea pedis)Cause of conditionMost common form of superficial fungal infection.Webs of toes may become infected by a combination of yeast and dermatophytes.Signs of conditionExtreme itching on soles of feet, between & on top of toes.Appears as dry scaling patch or inflammatory scaling red papules forming larger plaques.May develop secondary infection from itching and bacteria.CareTopical antifungal agents and good foot hygiene.21

22Respiratory conditions The common coldCause of conditionAttributed to filterable virus that produces infection in upper respiratory tract in susceptible individual.Susceptible individualPhysical debilitation from overwork or lack of sleep.Chronic inflammation from local infection.Inflammation of nasal mucosa from allergy or from breathing in foreign substance.Sensitivity to stress.

23Sign of condition Begins w/ scratchy, sore throat, stopped-up nose, watery discharge and sneezing.Some may experience a fever.Various aches and pains.Nasal discharge becomes thick and discolored from inflammation.CareSymptomatic treatment (may last 5-10 days).Non-prescription cold medications.Eat a balanced diet, consume 64 oz. of water.Avoid emotional stress and extreme fatigue.

24Respiratory conditions SinusitisCause of conditionStems from upper respiratory infection caused by a variety of bacteria.Inflammation of nasal sinuses.

Sign of conditionNasal mucous swell and block sinuses.Painful pressure occurring from accumulation of mucus.Skin over sinus may be swollen and painful to the touch.Headache and malaise; purulent nasal discharge.CareIf infection is purulent, antibiotics may be warranted.Nasal vasoconstrictor may be helpful with drainage.

25Respiratory conditions Pharyngitis (sore throat)Cause of conditionResult of postnasal dripMay be virus or streptococcus bacteriaSymptoms of conditionPain w/ swallowing, fever, inflamed and swollen glands, malaise, weakness and fever (occasionally)Throat may appear dark red and swollen with mucous membranes coatedCareThroat cultureTopical gargles and restAntibiotic therapy may be prescribed by a physician26Respiratory conditions TonsillitisCause of conditionAcute inflammation & bacterial infection of tonsil epithelium.Signs & symptomsTonsils appear red, swollen, w/ yellow exudates in pits.Pain w/ swallowing, high fever and chills, headache and neck pain.Sinusitis, otitis media, tonsillar abscesses may also develop.CareCulture to check for streptococcal bacteria and antibiotics for 10 days.Gargling w/ saline water, liquid diet, and antipyretic medication.Frequent bouts of tonsillitis may necessitate removal.27

28Respiratory conditions InfluenzaCause of conditionCaused by a virus & occurs in various forms as an annual epidemic.Symptoms of conditionFever (102-103F), chills, cough, headache, malaise, and inflamed respiratory mucous membrane w/ non-productive cough, watery eyes.General aches and pains, headache becomes worse.Weakness, sweating, fatigue may persist for many days.CareBed rest and supportive care.Steam inhalation, cough medicines, and gargles.Flu prevention avoid contact with someone that has it.29Respiratory conditions AsthmaCause of condition Brought on by exercise w/ exact cause unknownLoss of heat and water (airway reaction), eating certain foods, sinusitis may also triggerSign of conditionAirway narrowing due to spasm and excess mucus productionTight chest, breathlessness, coughing, wheezing, nausea, hypertension, fatigue, headache, and redness of skin30

31CareRegular exercise, appropriate warm-up and cool down, w/ intensity graduated.Inhaled bronchodilators may be useful.Exercise in warm, humid environment.Coaches should be sure to remind athletes to have inhaler with them at all times.

32Gastrointestinal disorders: VomitingCause of conditionResult of some irritation, most often in the stomach.Stimulates vomiting center of the brain, causing a series of forceful diaphragm and abdominal contractions to compress stomach.CareAntinausea medications should be administered.Fluids to prevent dehydration (by mouth or intravenously depending on the situation).33Gastrointestinal disorders: DiarrheaCause of conditionAcute or chronic.Caused by a problem in diet, inflammation of the intestinal lining, GI infection, ingestion of certain drugs and psychogenic factors.Signs of conditionAbnormal, loose stool or passage of fluid, unformed stool.Abdominal cramps, nausea, vomiting and frequent elimination of stools .Extreme weakness caused by dehydration.34CareDetermine cause (irritant, infection, or emotional upset).ATC can treat less severe cases by omitting certain foods from athletes diet.Utilizing over the counter medications.Have athlete consume bland food that does not irritate system.The BRAT diet (bananas, rice, apples and toast) has also been recommended.Continue to hydrate.35DiabetesDiabetes- the inability of the body to appropriately metabolize carbohydratesModerate exercise that is sustained can decrease blood glucose, while high-intensity bouts of exercise can increase blood glucose

Type 1- Juvenile- Onset; insulin dependent. Requires an external source of insulin to control blood glucose levels

Type 2- Adult- Onset; Involves the body becoming resistant to the insulin produced by the pancreas

36DiabetesHyperglycemia- exceeding high levels of blood glucoseSymptoms develop slowlyFruity breathExtreme thirstFrequent urinationNausea/ VomitingLoss of consciousnessHypoglycemia- Extremely low levels of blood glucoseSymptoms develops quicklyUnusual behavior (aggression or confusion)Profuse perspirationLoss of motor coordinationExtreme hunger*Immediately give athlete food or beverage containing natural sugar (fruit juice or crackers)37