Hunter's Tropical Medicine and Emerging Infectious Diseases

Front Matter
Copyright Page
Preface
Acknowledgments
List of Contributors
PART 1 Clinical Practice in the Tropics
SECTION A Organ-Based Chapters
1 Tropical Lung Diseases
Key Features
Introduction
Pneumonia
Investigations and Management
Tuberculosis
Parasitic and Other Pulmonary Infections in the Tropics
Eosinophilic Pneumonias
Non-Communicable Lung Diseases
Pleural Effusion
Non-Tuberculous Granulomatous Lung Disease
Occupational and Dust Lung Diseases
References
2 Cardiovascular Diseases
Key Features
Common Syndromes of Cardiovascular Disease in the Tropics
Heart Failure
Stroke
Vascular Disorders
An Approach to the Patient With Cardiovascular Disease
Diagnosis and Differential Diagnosis
Heart Failure
Stroke
Vascular Disorders
Management and Outcomes
Pediatric Consideration: Congenital Heart Disease
Clinical Presentation
References
3 Gastrointestinal Diseases
Key Features
Presentations
Diarrhea
Etiology and Distribution
Transmission and Epidemiology
Pathogenesis
Clinical Manifestations
Antibiotic-Associated Colitis
Chronic Diarrhea
Complications
Diagnosis
Treatment and Prognosis
Treatment of Dehydration.
Antimicrobial Agents.
Additional Therapy.
Prevention and Control
Traveler’s Diarrhea
Abdominal Pain
Abdominal Distension and Intestinal Obstruction
Gastrointestinal Bleeding
Anatomic Differentials
Mouth
Dental Caries
Oral Cancer
Candidiasis
Herpes Simplex Virus Infection
Cancrum Oris (Noma)
Esophagus
Esophagitis
Caustic Esophageal Injury
Esophageal Varices
Megaesophagus
Esophageal Cancer
Stomach
Gastritis
Peptic Ulcer Disease
Gastric Neoplasms
Small Bowel
Tropical Sprue
Celiac Disease
Protein-Losing Enteropathy.
Immunoproliferative Small Intestinal Disease
Enteritis Necroticans (Pigbel)
Intussusception
Colon
Appendicitis
Intestinal Tuberculosis
Inflammatory Bowel Diseases
Megacolon
Stenosing Lesions of the Colon and Rectum
Rectum and Anus
Proctitis
Rectal Prolapse
Anal Lesions
Anal Cancer
Gastrointestinal Diseases in Patients With HIV/AIDS
References
4 Hepatobiliary Diseases
Key Features
Introduction
Approach to Liver Disease
Hepatitis and Jaundice
Acute Hepatitis
Chronic Liver Disease
Jaundice and Biliary Obstruction
Vascular Liver Disease (see Table 4.2)
Focal Liver Lesions
HIV and the Liver
References
5 Hematologic Diseases
Key Features
Red Cell Disorders
Epidemiology
Anemia Reference Ranges
Clinical Features
Diagnosis
Management of Different Types of Anemia
Anemia Caused by Reduced Red Cell Production
Iron Deficiency.
Folate Deficiency.
Vitamin B12 Deficiency.
Anemia Caused by Excessive Loss of Red Cells
Anemia Caused by Reduced Bone Marrow Activity
Anemia of Inflammation
Anemia and HIV
Anemia and Parvovirus B19
Anemia Caused by Excessive Red Cell Destruction (Hemolytic Anemias)
Important Tropical Infections Associated With Anemia
Malaria
Visceral Leishmaniasis
Thalassemias
β-Thalassemia
β-Thalassemia Major.
Diagnosis.
Management and Outcome.
β-Thalassemia Intermedia.
β-Thalassemia Trait.
α-Thalassemia
Silent Carrier (-α/αα).
α-Thalassemia Trait (-α/-α or –/αα).
Hemoglobin H Disease (–/-α).
Hemoglobin Bart’s Hydrops Fetalis.
Sickle Cell Hemoglobinopathies
Sickle Cell Disease
Diagnosis.
Management and Outcome.
Sickle Cell Trait
Hemoglobin Sickle Cell Disease.
Hemoglobin S β-Thalassemia.
Enzymopathies
Glucose-6-Phosphate Dehydrogenase Deficiency
Diagnosis.
Red Cell Membrane Defects
White Cell Disorders
Leukemia
Acute Leukemias
Diagnosis.
Chronic Myeloid Leukemia
Diagnosis.
Chronic Lymphocytic Leukemia
Investigations.
Lymphomas
Disorders of Hemostasis
Acquired Bleeding Disorders
Vitamin K Deficiency
Dietary and Absorption Deficiency.
Hemorrhagic Disease of the Newborn.
Disseminated Intravascular Coagulation
Immune Thrombocytopenic Purpura
Congenital Bleeding Disorders
Thrombophilia
References
6 Genitourinary Diseases
Key Features
Communicable Diseases Affecting the Genitourinary Tract
Bacterial Cystitis and Pyelonephritis
Schistosomiasis
Filariasis
Tuberculosis
Hydatid Disease
Neisseria gonorrhoeae and Urethral Stricture Disease
HIV/AIDS
Non-Communicable Genitourinary Diseases
Congenital Abnormalities
Genetic Diseases
Metabolic Diseases
Trauma
Diseases of Aging
References
7 Sexually Transmitted Infections
Key Features
Epidemiology of STIs
STIs in Low- and Middle-Income Countries
STI Transmission Dynamics
Interactions Between HIV and Other STIs
Clinical Management of STIs
History Taking and Examination
Counseling
Key STI Syndromes
The Syndromic Approach
Urethral Discharge (Figs. 7.1 and 7.2)
Scrotal Swelling (Epididymo-Orchitis) (Fig. 7.3)
Genital Ulcer (Fig. 7.4)
Inguinal Bubo (Fig. 7.5)
Vaginal Discharge (Figs. 7.6, 7.7 and 7.8)
Lower Abdominal Pain (Pelvic Inflammatory Disease) (Fig. 7.9)
Anorectal Syndrome (Fig. 7.10)
Ophthalmia Neonatorum (Fig. 7.11)
Control of STIs
Partner Notification
Screening
Male Circumcision
Vaccination
Ocular Prophylaxis
References
8 Tropical Dermatology
Key Features
Vesicles/Bullae
Vascular Papules and Nodules (Angiomatous Lesions)
Petechiae and Purpura
Ulcers/Verrucous Plaques
Subcutaneous Mycoses
Deep Mycoses
Painless Papules
Painful Papules/Urticaria
Pruritus and Papules
Pruritus Without Primary Skin Lesions
Hypopigmentation
Morbilliform Exanthems
Papulosquamous and Eczematoid Lesions
Erythroderma
Icthyosis
Serpiginous Lesions
Edema
Cachexia: Nutritional Deficiencies
References
9 Ophthalmologic Diseases
Key Features
Introduction
Differential Diagnosis of the Painful, Red Eye: Key Syndromes
Conjunctivitis
Keratitis and Corneal Ulceration
Corneal Necrosis
Corneal Trauma
Uveitis
Endophthalmitis
Acute Angle-Closure Glaucoma
Chronic Diseases
Refractive Error
Cataract
Glaucoma
Age-Related Macular Degeneration
Diabetic Retinopathy
Proptosis
References
10 Neurologic Diseases
Key Features
Meningism and Meningitis
Key Syndromes and Clinical Approach
Approaches to Investigation, Diagnosis, and Management
Encephalopathy and Encephalitis
Key Syndromes and Clinical Approach
The Patient in Coma
Approaches to Investigation, Diagnosis, and Management of Encephalopathy
Neurophysiologic Investigations
Management of Patients With Encephalopathy and Encephalitis
Epilepsy
Dementia and Cognitive Impairment
Hemiparesis
Peripheral Nerve and Muscle Syndromes
Key Syndromes and Clinical Approach
Peripheral Neuropathic Syndromes
Myopathic Syndromes
Myasthenic Syndromes
Approaches to Investigation, Diagnosis, and Management
References
11 Psychiatric Diseases
Key Features
Getting Organized
Culture and Mental Health
Assessment
Basic Principles
History
Mental State Examination
Informant History and Previous Case Notes
Physical Examination
Investigations
Assessment and Differential Diagnosis of Common Syndromes (Box 11.1)
The Acutely Disturbed Patient
Delirium
Acute Psychosis
Mood Disorder
Other
The Patient Who Is Sad, Worried, or Has Medically Unexplained Somatic Complaints
Differential Diagnosis
The Patient Who Is Misusing Alcohol or Other Substances
Management of Patients With Psychiatric Illness
Basic Principles
The Acutely Disturbed Patient
Acute Psychosis
Drug-Induced Psychosis
Epilepsy-Associated Psychosis
Catatonia
Acute Manic Episode
Bipolar Affective Disorder
Depressive Psychosis
Depression, Anxiety, and Somatization
Substance Dependence
References
Further Reading
12 Ear, Nose, and Throat Disorders
Key Features
Global Burden of ENT Diseases
Deafness and Hearing Impairment
Other Causes of Deafness
Auditory Rehabilitation
Cleft Lip and Palate
Nose and Throat Infections
Acute and Chronic Rhinosinusitis
Granulomatous Involvement of the Head and Neck
Salivary Gland Infections
Deep Fascial Space Infections
Cysticercosis
Ulcers
Cancrum Oris
Leishmaniasis
Myiasis
Halzoun
Head and Neck Neoplasms
Benign Neoplasms
Malignant Neoplasms
Investigations
Diagnosis and Differential Diagnosis
Management and Outcomes
References
13 Diseases of the Musculoskeletal System
Key Features
Introduction
Trauma and Injury
Intentional Injuries
Orthopedic Infections
Osteomyelitis
Septic Arthritis
Soft Tissue Infections
Tuberculosis
Leprosy
Poliomyelitis
Pediatric Conditions
Congenital Talipes Equinovarus
Cerebral Palsy
Age-Related Conditions
References
SECTION B Skills-Based Chapters
14 General Surgery in the Tropics
Key Features
Introduction
Practical Aspects of Surgery in Low-Resource Settings
Water and Electricity
Equipment and Supplies
Sterilization
Anesthesia
Laboratory
Imaging and Endoscopy
Histopathology
Transfusion Service
An Overview of Surgical Practice in the Tropics
General Surgery
Trauma
Skin and Soft Tissue Infections
Neoplasms
Abdominal Pathology
Peritonitis
Intestinal Obstruction
Hepatobiliary Disease
Laparoscopy
Obstetrics and Gynecology
Orthopedics
Urology
Ear–Nose–Throat and Dental Surgery
Burns and Plastic Surgery
Neurosurgery
Pediatric Surgery
Cardiothoracic Surgery
Ophthalmology
Topics of Interest to Surgeons and Non-Surgeons
Ascaris lumbricoides
Tetanus
Typhoid (see Chapter 74, Typhoid and Paratyphoid (Enteric) Fever)
Tuberculosis
Schistosomiasis
Hydatid Cyst
American Trypanosomiasis (see Chapter 103)
Filarial Elephantiasis
Conclusion
References
15 Oral Health and Disease in the Tropics
Key Features
Introduction
Background Information
Examining the Oral-Maxillofacial Complex
Dental Caries
Description
Etiology
Symptoms/Signs and Differential Diagnosis of Toothache
Clinical Diagnosis and Treatment
Prevention of Dental Caries: Individual Programs
Oral Mucosal Lesions (Including Oral Cancer), Other Tumors, and Noma
Description
General Etiology
Oral Maxillofacial Trauma
Description
Etiology
Symptoms/Signs and Differential Diagnosis of Oral Maxillofacial Trauma and Emergency Actions (Table 15.4)
References
16 Maternal and Newborn Health
Key Features
Global Targets and Indicators for Maternal and Newborn Health
Maternal Mortality
Causes of Maternal Mortality—Why Do Women Die?
Hemorrhage
Pre-eclampsia and Eclampsia
Sepsis
Complications of Obstructed Labor
Abortion
Perinatal Mortality
Maternal and Neonatal Morbidity
Strategies to Reduce Maternal and Perinatal Mortality and Morbidity
Skilled Birth Attendance
Emergency Obstetric Care
Antenatal and Postnatal Care
Quality of Care
References
17 Pediatrics in a Resource-Constrained Setting
Key Features
Preventive Schemes
Expanded Programme for Immunization
HIV/AIDS
Sustainable Development Goals
Newborns
Pneumonia
Malaria
Gastroenteritis
Fluids in Sepsis
References
SECTION C Service-Based Chapters
18 Diagnostic Imaging in the Tropics
Key Features
Introduction
Equipment and Service Development
Personnel
The Imaging of Tropical Infectious Diseases
Plain Radiographs
Ultrasound
Advanced Imaging Techniques
References
19 Blood Transfusion in Resource-Limited Settings
Key Features
Introduction
Blood Supply and Safety
The Global Blood Supply
Blood Supply in Africa
Blood Safety
Infectious Risk of Blood Transfusions
Other Risks of Transfusion
Blood Donor Selection
Progress in Improving Blood Supply and Safety in Sub-Saharan Africa
Clinical Use of Blood Transfusion
Who Needs Blood?
Transfusion Guidelines
Misuse of Blood Transfusions
Outcomes After Blood Transfusions
Alternatives to Transfusion
Reducing Transfusions by Preventing Anemia
References
20 Infection Prevention and Control in the Tropics
Key Features
Introduction
Basics of Infection Control
Infection Control Practices to Decrease the Risk of Infection Transmission
Standard Infection Control Practices
Transmission-Based Precautions for Prevention of Infection
Surveillance for Health Care–Associated Infections
Burden of Health Care–Associated Infections in Developing Countries
Risk Factors for Health Care–Associated Infections in Developing Countries
Special Problems of the Tropics
Crossover of Community Infections into Hospitals
Viral Hemorrhagic Fevers
Viral Respiratory Infections
Vaccine-Preventable Diseases
Emerging Infections
Tuberculosis
Antimicrobial Resistance
Sepsis and HAIs in Neonates
Hospital Design in the Tropics
Device-Associated Infections
Surgical Site Infections
Unsafe Injections and Needle Stick Injuries
Strengthening Health Systems in the Tropics
References
21 Microbiology
Key Features
Introduction
The Need for Laboratory Services
What Are the Problems for Laboratory Services?
What Can Be Done to Improve Laboratory Services?
The Importance of Biosafety
What Tests Should Be Available?
Conclusion
References
SECTION D Topic-Based Chapters
22 Approach to the Patient With Diarrhea
Key Features
Key Syndromes
Acute Watery Diarrhea
Invasive Diarrhea
Multiple Pathogens
Persistent Diarrhea
Clinical Evaluation
Assessment of Dehydration
Assessment of Nutritional Status
Evaluation for Concomitant Illness
Laboratory Investigations
Investigations in Acute Watery Diarrhea
Investigations in Invasive Diarrhea
Investigations in Persistent Diarrhea
Management and Outcomes
Rehydration
Replacement Phase
Maintenance Phase
Antibiotics
Antibiotics and the Risk of Hemolytic Uremic Syndrome
Nutrition
Malnourished Children
Apparently Well-Nourished Children
Micro-nutrient Supplementation
Other Therapies
Prevention
References
23 Cancer in the Tropics
Key Features
Introduction
Infection and Malignancy
Bacterial Infections
Viral Infections
Parasitic Infections
Tobacco
Obesity
Management
References
24 Heat-Associated Illness
Key Features
Definition
Epidemiology
Pathophysiology
Assessment and Investigations
Diagnosis
Management and Outcomes
References
25 Traditional Medicine
Key Features
Definition
General Principles
Why Is It Important for Physicians in the Tropics to Know About Traditional Medicine?
Traditional Medicine Is Widely Used
Traditional Medicine Is Often the First Treatment Used
Traditional Medicine May Interact With Modern Treatment
Traditional Medicine May Be a Valuable Option
Effectiveness
Can the Effectiveness of Traditional Medicine Be Evaluated?
Some Examples of Effective Traditional Treatments
Malaria: From Local Practice to Global Solution
Case Study.
Wounds
Ophthalmic Conditions: A Range of Practices, from Harmful to Sight-Saving
Safety of Traditional Medicine
Regulatory Development
Counterfeit or “Fake” Medicines
Traditional and Modern Health Systems: the Need for Cooperation
Examples
In a Refugee Population
In a Health District
Development of New Drugs and Treatments: Intellectual Property Rights
Clinical Scenarios
A Traditional Bone-Setter in Mali
Last Hope After an Open Fracture
Tackling Water-Borne Disease the Traditional Way
Conclusion
Acknowledgments
References
26 Environmental Health Hazards in the Tropics
Key Features
Introduction
Exposure Concepts
Major Environmental and Occupational Hazards
Ambient Air Pollution
Indoor Air Pollution
Water and Sanitation
Lead Poisoning
Pesticides
Mold/Food Impurities
Heat
Recognition of Environmental and Occupational Hazards
Control and Reduction of Environmental Hazards
Global Efforts
References
27 Neglected Tropical Diseases
Key Points
Introduction
Mass Drug Administration
Lymphatic Filariasis
Onchocerciasis
Soil-Transmitted Helminth Diseases: Ascariasis, Trichuriasis, Hookworm
Schistosomiasis
Trachoma and the Neglected Skin Infections: Yaws and Scabies
Integrated MDA for Control and Elimination
Intensified Disease Management: Case Detection and Treatment and Vector Control
Conclusion
References
28 Health Systems and Health Care Delivery
Key Features
Introduction
Leadership and Governance
Health Care Financing
Health Workforce
Medical Products and Technologies
Health Information and Research
Health Care Service Delivery
Facilities
Knowledge Management
Linking Community and Facility-Based Care
Quality
Equity
References
29 The Health Care Response to Disasters, Complex Emergencies, and Population Displacement
Key Features
The Health Effects of Complex Emergencies
Health Response and International Standards: the Sphere Project
Prioritization of Health Services
Prevention of Communicable Diseases: Vaccine-Preventable Diseases
Diarrhea Prevention and Management Programs
Provide Elementary Sanitation and Clean Water
Provide Adequate Shelter, Clothes, and Blankets (Non-Food Items)
Ensure Food Supplies Are Adequate and Reach Intended Recipients
Establish Appropriate Diagnostic and Management Services
Organize Human Resources and Utilize Local Assets
Coordinate Activities of Local Authorities and Relief Agencies
Role of Emerging Technologies
Summary
References
PART 2 Viral Diseases
30 Introduction and General Principles
Introduction
Epidemiologic Considerations
Clinical Syndromes and Pathogenesis
Diagnostic Challenges
Opportunities for Treatment
Disease Control
References
31 Human Immunodeficiency Virus Infection
Key Features
Introduction
Molecular Epidemiology
Modes of Transmission
Geographic Epidemiology
Sub-Saharan Africa
Asia and the Pacific
Latin America
Natural History, Pathogenesis, and Pathology
Manifestations and Management of HIV Infection and Complications of HIV
Acute HIV Infection
Staging of HIV Disease
Opportunistic Infections and Malignancies
Select Major Opportunistic Infections and Co-Infections
Fungal Infections—Focus on Cryptococcal Meningitis and Pneumocystis Pneumonia
Cryptococcal Meningitis
Pneumocystis Pneumonia
Bacterial Infections
Sexually Transmitted Infections
Viral Hepatitis
Schistosomiasis
The Approach to Common Clinical Presentations
Fever
Dermatologic Disease
Ophthalmologic Disease
Pulmonary Disease
Esophageal Disease
Gastroenteritis/Diarrheal Disease
Focal Central Nervous System Lesions
HIV-Associated Neurocognitive Disorder
Immune Reconstitution Inflammatory Syndrome
HIV-Associated Malignancies
Kaposi’s Sarcoma
Non-Hodgkin’s Lymphoma
Cervical Cancer
Patient Evaluation, Diagnosis, and Differential Diagnosis
HIV Testing
HIV Diagnosis
Post-Test HIV Counseling
Initial Evaluation of the Newly Diagnosed Patient
Initial Evaluation of Newly Diagnosed Women of Reproductive Age
AntiRetroviral Therapy
Introduction
Goals of ART
When to Start
Initiating Therapy for Women of Reproductive Age
What to Start
Special Considerations for Women Previously Given Antiretroviral Drugs as Prevention of Mother-to-Child Transmission of HIV
Special Considerations for Pregnant Women
Special Considerations in Patients With Chronic Hepatitis B Virus Infection and Chronic Hepatitis C Virus Infection
Adherence to Therapy
Monitoring Effectiveness
Monitoring for Tolerability
Metabolic Complications During Treatment
When to Change ART
How to Change (Switch) ART
ART for Children
Prevention of Opportunistic Infections
Special Considerations for Antimicrobial Prophylaxis in Resource-Limited Settings
Trimethoprim–Sulfamethoxazole/Cotrimoxazole
Fluconazole and Itraconazole
Non-Tuberculosis Anti-Mycobacterials (Mycobacterium avium Complex)
Chronic Primary Care Considerations
Non-Communicable Diseases
Vaccinations
Nutrition
Primary HIV Prevention
Prevention of Gender-Based Violence
Prevention With Positives
Palliative Care
31.1 HIV, Tuberculosis, Malaria, and Streptococcus pneumoniae
Key Features
HIV and Tuberculosis
The Effect of HIV on Tuberculosis
The Effect of Tuberculosis on HIV Disease
Management Points
HIV and Malaria
The Effect of HIV on Malaria
The Effect of Malaria on HIV
Management Points
HIV And Streptococcus pneumoniae
Interactions
Management Points
References
Further Reading
References
32 Viral Infections With Cutaneous Lesions
32.1 Measles
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Prevention and Treatment
References
32.2 Poxviruses
Key Features
Introduction
Epidemiology
Natural History and Pathogenesis
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Prevention and Treatment
References
32.3 Nonpolio Enterovirus Mucocutaneous Infections
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Prevention and Treatment
References
32.4 Kaposi’s Sarcoma–Associated Herpesvirus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Prevention and Treatment
References
33 Viral Respiratory Infections
Key Features
Introduction
Etiology
Orthomyxoviridae: Influenza Viruses
Paramyxoviridae: Respiratory Syncytial Virus, Parainfluenza Virus 1–4, Human Metapneumovirus
Coronaviruses
Picornaviruses: Enteroviruses and Parechoviruses
Adenoviruses
Epidemiology
Clinical Syndromes and Pathogenesis
Common Cold
Pharyngitis
Acute Laryngotracheobronchitis (Croup)
Tracheitis and Tracheobronchitis
Bronchiolitis
Viral Pneumonia
Diagnosis
Prevention and Treatment
References
34 Viral Gastroenteritis
Key Features
Introduction
34.1 Rotavirus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment and Prevention
References
34.2 Norovirus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Disclaimer
References
34.3 Enteric Adenoviruses
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Prevention and Treatment
References
34.4 Astroviruses
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
34.5 Sapovirus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
35 Viral Hepatitis
Introduction
Natural History, Pathogenesis, and Pathology
Clinical Features
Acute Hepatitis
Chronic Hepatitis
Complications
Fulminating Hepatitis
Cirrhosis
Patient Evaluation
Treatment and Prevention
35.1 Hepatitis A
Key Features
Introduction
Epidemiology
Age and Pattern of Infection
Routes of Transmission
Clinical Features
Diagnosis
Treatment
Prevention and Control
Sanitation
Immunization
References
35.2 Hepatitis B
Key Features
Introduction
Epidemiology
Geographic Distribution
Modes of Transmission
Clinical Features
Acute Infections
Chronic Infections and Complications
Chronic Hepatitis and Cirrhosis
Hepatocellular Carcinoma
Co-infections With HIV
Diagnosis
Detection of HBV Antigens and Antibodies
Detection of HBV-DNA
Treatment
Prevention and Control
HBV Vaccination
References
35.3 Hepatitis D
Key Features
Introduction
Epidemiology
Clinical Features and Natural History
Diagnosis
Prevention
References
35.4 Hepatitis C
Key Features
Introduction
Epidemiology
Distribution
Transmission
Pathogenesis and Pathology
Clinical Features
Acute Infection
Chronic Infection
Cirrhosis
Hepatocellular Carcinoma
Extrahepatic Complications
Essential Mixed Cryoglobulinemia
Non-Hodgkin’s Lymphoma
Diagnosis
Treatment
Justification for Treatment
Therapeutic Goals
Therapeutic Regimens
Treatment of Acute Hepatitis C
Prevention and Control
References
35.5 Hepatitis E
Key Features
Introduction
Epidemiology
Clinical Features
Diagnosis
Treatment
Prevention and Control
References
35.6 Non-A–E Hepatitis
References
References
36 Viral Febrile Illnesses and Emerging Pathogens
Key Features
Introduction
Epidemiology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment and Control
36.1 Dengue and Dengue Hemorrhagic Fever
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention
References
36.2 Chikungunya Fever
Key Features
Introduction
Epidemiology
Pathogenesis
Clinical Features
Diagnosis
Treatment
References
36.3 Zika
Key Features
Introduction
Epidemiology
Transmission
Pathogenesis and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment and Prevention
References
36.4 O’nyong Nyong Fever
Key Features
Introduction
Epidemiology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment and Control
References
36.5 Ross River Virus Disease
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Prevention and Treatment
References
36.6 Oropouche Virus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment and Prevention
References
36.7 Mayaro Virus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment and Prevention
References
36.8 Pathogenic Phleboviruses: Severe Fever With Thrombocytopenia Syndrome, Heartland Virus Disease, and Sandfly Fever
Key Features
Introduction
Severe Fever With Thrombocytopenia Syndrome
Heartland Virus Disease
Sandfly Fever
References
36.9 Sindbis Fever
Key Features
Introduction
Epidemiology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
References
37 Viral Hemorrhagic Fevers
Introduction
References
37.1 Yellow Fever
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment and Prevention
References
37.2 Lassa Fever
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
37.3 South American Hemorrhagic Fevers
Key Features
Introduction
Epidemiology
Argentine Hemorrhagic Fever
Bolivian Hemorrhagic Fever
Venezuelan Hemorrhagic Fever
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Laboratory Diagnosis
Treatment
Supportive Treatment
Anti-Viral Therapy
Preventive Medicine
References
37.4 Ebola and Marburg Virus Infections
Key Features
Introduction
Epidemiology
Maintenance in Nature and Transmission to Humans
Human-to-Human Transmission
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Diagnosis
Differential Diagnosis
Treatment
Supportive Care
Anti-Viral Therapy
Discharge and Monitoring
Prognosis
Sequelae
Virus Persistence and Recrudescence
Prevention
Infection Prevention and Control
Contact Tracing
Vaccines
Post-Exposure Prophylaxis
Reservoir Control
Acknowledgment
References
37.5 Crimean-Congo Hemorrhagic Fever
Key Features
Introduction
Epidemiology
Ecology and Transmission
Disease Presentation
Pathogenesis
Laboratory Diagnosis
Differential Diagnosis
Treatment
Prevention
Post-Exposure Prophylaxis
Vaccines
Disclaimer
References
37.6 Diseases Caused by Hantaviruses
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Hantavirus Cardiopulmonary Syndrome
Hemorrhagic Fever With Renal Syndrome
Diagnosis
Treatment
Prevention
References
37.7 Rift Valley Fever
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential DiagnosIs
Treatment and Prevention
Disclaimer
References
38 Viral CNS Infections
38.1 Rabies and Related Viruses
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Clinical Manifestations
Furious Rabies
Paralytic Rabies
Complications of Prolonged Survival
Infections by Rabies-Related Viruses
Patient Evaluation, Diagnosis, and Differential Diagnosis
Diagnosis
Prognosis
Treatment and Prevention
Pre-Exposure Prophylaxis
Post-Exposure Prophylaxis
Local Measures
Post-Exposure Vaccine
Efficacy of Post-Exposure Prophylaxis
Complications of Rabies Vaccines
Control of Animal Rabies
References
38.2 Enterovirus Infections That Cause Central Nervous System Disease (Including Poliomyelitis)
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Aseptic Meningitis
Poliomyelitis
Enterovirus A71 Infection of the Central Nervous System
Hand-Foot-and-Mouth Disease
Herpangina
Patient Evaluation, Diagnosis, and Differential Diagnosis
Laboratory Diagnosis of Enterovirus Infections
Treatment and Prevention
References
38.3 Venezuelan, Eastern, and Western Equine Encephalitis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
38.4 Japanese Encephalitis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Investigations
Diagnosing Japanese Encephalitis
Treatment
Prevention of Japanese Encephalitis
References
38.5 West Nile Virus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
38.6 St. Louis Encephalitis and Rocio Viruses
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment and Prevention
References
38.7 Other Arboviral Encephalitides
Key Features
Introduction
Epidemiology
Bunyaviridae
Flaviviridae
Reoviridae
Patient Evaluation and Diagnosis
Treatment and Prevention
References
38.8 Human T-Lymphotropic Virus (HTLV) Type I and II Infection
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Adult T-Cell Leukemia Pathogenesis
HAM/TSP Pathogenesis
Clinical Features
Adult T-Cell Leukemia/Lymphoma
Symptoms
Diagnosis
Treatment
HTLV-I–Associated Myelopathy/Tropical Spastic Paraparesis
General
Symptoms
Diagnosis
Monitoring and Treatment
General Infections
Other Neurologic Manifestations
Infective Dermatitis and Scabies
Tuberculosis and Other Mycobacterial Disease
Strongyloides stercoralis Infection
Rheumatologic and Pulmonary Conditions
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
38.9 Prion Disease
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Sporadic CJD
Variant CJD
Other Forms of Prion Disease
Treatment
References
PART 3 Bacterial Infections
SECTION A Infections of the Eye and Throat
39 Trachoma and Inclusion Conjunctivitis
Key Features
Trachoma
Introduction
Epidemiology
Clinical Features and Natural History
Pathogenesis
Chlamydia Biology
Histopathology
Protective Immune Responses
Immunopathology
Transmission and Risk Factors
Trachoma Assessment
Clinical Examination
Laboratory Tests
Differential Diagnosis
Trachoma Control
Surgery for Trichiasis
Antibiotics for C. trachomatis Infection
Facial Cleanliness and Environmental Improvements to Interrupt C. trachomatis Transmission
Conclusion
Inclusion Conjunctivitis
Epidemiology
Clinical Features and Transmission
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention and Control
References
40 Group A Streptococcus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
41 Diphtheria
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention
References
SECTION B Respiratory Tract Infections
42 Bacterial Pneumonia
Key Features
Introduction
Epidemiology
The Bacterial Etiology of Pneumonia
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Clinical Examination Findings
Supportive Clinical Findings
Laboratory Investigations
Chest Roentgenograms (Chest X-Rays)
Miscellaneous Clinical Findings
Differential Diagnosis
Treatment
Good Clinical Practice
Prevention and Control
References
43 Tuberculosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Pulmonary Tuberculosis
Tuberculous Adenitis
Pleural Tuberculosis
Tuberculosis of the Central Nervous System
Osteoarticular Tuberculosis
Other Manifestations
Patient Evaluation, Diagnosis, and Differential Diagnosis
Genotypic Testing for TB and Drug-Resistant TB
Sputum Smear Microscopy
Tuberculosis Culture
Radiography
Analysis of Other Bodily Fluids and Tissue Samples
Drug Susceptibility Tests
Tests for Tuberculosis Infection
Empiric Treatment of Tuberculosis
Monitoring Treatment Response
Treatment
Treatment of Patients With Drug-Susceptible Tuberculosis
Re-Treatment Regimens and the Treatment of Individuals With Drug-Resistant Tuberculosis
Adjunctive Treatments
Adherence
Treatment of Tuberculosis Infection (“Preventive Therapy”)
TB and Children
Epidemiology
Diagnosis
Prevention
Treatment
Future Prospects
Reference
44 Pertussis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Manifestations
Patient Evaluation
Clinical Diagnosis
Laboratory Diagnosis
Serology
Treatment
Immunization Strategies
References
SECTION C Gastrointestinal Tract Infections
45 Helicobacter pylori Infection
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Pathogenesis
Clinical Features
Gastritis
Peptic Ulcer Disease
Gastric Cancer
Mucosa-Associated Lymphoid Tissue Lymphoma
Ménétrier’s Disease
Gastroesophageal Reflux Disease
H. pylori Infection in Children
Patient Evaluation, Diagnosis, and Differential Diagnosis
Noninvasive Tests
Urea Breath Tests
Serology
Fecal Antigen Testing
Urine Antigen Testing
Invasive Tests
Culture
Histology
Rapid Urease Test
Treatment
Indications
Antimicrobials
Prevention
References
46 Escherichia coli Diarrhea
Key Features
Introduction
Epidemiology, Clinical Manifestations, and Pathogenesis
Enteropathogenic E. coli
Shiga Toxin–Producing E. coli
Enteroaggregative E. coli
Enterotoxigenic E. coli
Enteroinvasive E. coli
Diffusely Adherent E. coli
Adherent Invasive E. coli
Diagnosis
Treatment
Prevention
References
47 Cholera and Other Vibrios
Key Features
Vibrio Cholerae
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Correction of Fluid Loss
Antibiotics
Prevention and Vaccines
Other Vibrios
Vibrio parahaemolyticus
Vibrio vulnificus
References
48 Shigellosis
Key Features
Introduction
History and Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Antimicrobial Therapy
Supportive Therapy and Treatment of Complications
Prevention
References
49 Nontyphoid Salmonella Disease
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Diarrheal Disease
Invasive Disease
Microbiology
Clinical Features
Diarrheal NTS Disease
iNTS Disease
Recurrent iNTS Disease
Focal and Suppurative NTS Disease
Patient Evaluation, Diagnosis, and Differential Diagnosis
Diarrheal Disease
Invasive Disease
Treatment
Diarrheal Disease
Invasive Disease
Prevention of Recurrence
Vaccination
References
50 Campylobacter Infections
Key Features
Introduction
Epidemiology
Breastfeeding and Infection
Clinical Features
Post-Infectious Inflammatory Complications
Guillain–Barré Syndrome
Irritable Bowel Syndrome
Reactive Arthritis
Laboratory Diagnosis and Typing
Treatment
Prevention and Control
Acknowledgment
References
51 Miscellaneous Bacterial Enteritides
51.1 Yersinia enterocolitica
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Gastroenteritis
Septicemia
Post-Infectious Sequelae
Miscellaneous Infections
Diagnosis
Treatment
Prevention and Control
References
51.2 Clostridium Infections
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
51.3 Aeromonas
Key Features
Introduction
Microbiology
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention and Control
References
SECTION D Sexually Transmitted Diseases
52 Chlamydial Infections
Key Features
Classification
Biology
Pathogenesis and Immunity
Epidemiology
Clinical Manifestations
Clinical Manifestations in Men
Urethritis
Epididymitis
Proctitis
Clinical Manifestations in Women
Cervicitis
Urethritis
Pelvic Inflammatory Disease
Pregnancy Outcome
Other Conditions of the Female Genital Tract
Clinical Manifestations Occurring in Both Sexes
Adult Paratrachoma (Inclusion Conjunctivitis) and Otitis Media
Reactive Arthritis
Neonatal Infections
Diagnosis
Treatment of Chlamydia Trachomatis Infection
Control
References
53 Lymphogranuloma Venereum
Key Features
Introduction
Epidemiology
Geographic Distribution
Transmission
Etiology and Pathology
Clinical Features
Primary Lymphogranuloma Venereum
Secondary Lymphogranuloma Venereum
Inguinal Syndrome
Anorectal Syndrome
Tertiary Lymphogranuloma Venereum
Diagnosis
Microscopic Diagnosis
Molecular Diagnosis
Antibody Detection Tests
Treatment
Antibiotic Treatment
Surgical Treatment
Prevention
References
54 Gonorrhea
Key Features
Introduction
Etiology
Antigens and Immunity
Antibiotic-Resistant Strains
Clinical Manifestations
Urethritis
Endocervical Infection
Gonococcal PID
Gonococcal Proctitis
Gonococcal Pharyngitis
Ocular Infections
DGI
Laboratory Diagnosis
The Gram Stain
Culture
Non-Culture Tests
Treatment
Uncomplicated Gonococcal Infections
Epididymo-Orchitis
PID and Other Genital Complications
Disseminated Gonococcal Infection
Gonococcal Eye Infections
Prevention and Control
References
55 Chancroid
Key Features
Definition
Etiology
Pathogenesis
Epidemiology
Reservoir
Interaction With HIV
Clinical Features
Laboratory Diagnosis
Treatment
Prevention
References
56 Donovanosis (Granuloma Inguinale)
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis (Table 56.1)
Treatment (Table 56.2)
References
57 Syphilis and the Endemic Treponematoses
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features (Adults)
Primary Syphilis
Secondary Syphilis
Tertiary Syphilis
Gummata (“Benign” Tertiary Syphilis).
Cardiovascular Syphilis.
Neurosyphilis
Clinical Features (Children and Neonates)
History and Examination
Patient Evaluation, Diagnosis, and Differential Diagnosis
Differential Diagnosis
Treatment
The Endemic Treponematoses
Introduction
Epidemiology
Clinical Features
Yaws
Endemic Syphilis
Pinta
Diagnosis
Treatment
References
SECTION E Infections Causing Neurologic Manifestations
58 Acute Bacterial Meningitis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Patient Evaluation
Diagnosis
Pathogen Detection
Brain Imaging
Treatment
Antibiotics
Adjuvant Therapies
Fluid Management
Vaccination
Risk of Severe Sequelae and Death From Bacterial Meningitis
References
59 Tetanus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
60 Botulism
Key Features
Introduction
Natural History, Pathogenesis, and Pathology
Epidemiology
Food-Borne Botulism
Wound Botulism
Infant Botulism
Adult Intestinal Toxemia Botulism
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Pediatric Considerations
Clinical Features
Treatment
Acknowledgments
References
SECTION F Infections of Skin and Soft Tissues
61 Bacterial Skin and Soft Tissue Infections in the Tropics
Key Features
Impetigo
Ecthyma
Folliculitis, Furuncles, and Carbuncles
Cellulitis
Gas Gangrene
Necrotizing Fasciitis
Tropical (Phagedenic) Ulcer
Tropical Pyomyositis
References
62 Leprosy
Key Features
The Causative Organism and Host Response
Diagnosis of Leprosy
Laboratory Tests
Classification of Leprosy
Clinical Features
Treatment
Alternative Antimicrobial Agents
Reactions
Management of Type 1 Reactions
Management of Erythema Nodosum Leprosum Reactions
Management of Nerve Function Impairment
Ongoing Management and Prevention of Complications
Chemoprophylaxis and Immunotherapy
Leprosy and HIV
Conclusion
References
63 Buruli Ulcer
Key Features
Introduction
Epidemiology and Transmission
Clinical Presentation
Diagnosis
Management
Complications
Prevention
References
64 Mycobacterium marinum Infection
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Diagnosis
Treatment
References
65 Anthrax
Key Features
Introduction
Epidemiology
Incidence of Human Anthrax
Zoonotic Anthrax
Geographic Occurrence
Human Anthrax
Industrially Acquired Anthrax
Agricultural Anthrax
Natural History, Pathogenesis, and Pathology
Bacillus anthracis Virulence Factors
Cutaneous Anthrax
Inhalational Anthrax
Gastrointestinal Anthrax
Septicemic Anthrax
Clinical Features
Cutaneous Anthrax
Inhalational Anthrax
Gastrointestinal Anthrax
Central Nervous System Anthrax
Patient Evaluation, Diagnosis, and Differential Diagnosis
Differential Diagnosis
Direct Smear and Culture Diagnosis
Serologic Diagnosis
Treatment
Cutaneous Anthrax
Other Anthrax Syndromes
Anti-Toxin
Supportive Therapy
Isolation of Patients
Post-Exposure Prophylaxis
References
SECTION G Febrile Systemic Syndromes With or Without Lymphadenopathy
66 Epidemic Louse-Borne Typhus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
67 Murine Typhus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Pediatric Considerations
Treatment
Treatment Considerations in Children
Prevention
References
68 Scrub Typhus
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
69 Tick-Borne Spotted Fever Rickettsioses
Key Features
Introduction
Etiology
Epidemiology
Spotted Fever Group Rickettsioses With Inoculation Eschar
Mediterranean Spotted Fever
Astrakhan Fever
Indian Tick Typhus
Israeli Spotted Fever
Siberian Tick Typhus
Lymphangitis-Associated Rickettsiosis
African Tick-Bite Fever
Scalp Eschar and Neck Lymphadenopathy
Far-Eastern Tick-Borne Rickettsiosis
Japanese or Oriental Spotted Fever
Queensland Tick Typhus
Flinders Islands Spotted Fever
Pacific Coast Tick Fever
Spotted Fever Group Rickettsioses With Few or No Inoculation Eschar
Rocky Mountain Spotted Fever
Diagnosis
Standard Laboratory Features
Diagnostic Tools
Treatment
Prevention and Control
References
70 Rickettsialpox
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention and Control
References
71 Q Fever
Key Features
Introduction
Epidemiology
Reservoir
Transmission to Humans
Temporal and Geographic Distribution
Natural History, Pathogenesis, and Pathology
Clinical Features
Acute Infection
Persistent Infection
Endocarditis
Q Fever in Pregnancy
Children
Patient Evaluation, Diagnosis, and Differential Diagnosis
Laboratory Findings
Polymerase Chain Reaction
Culture
Serology
Immunohistochemistry
Differential Diagnosis
Treatment
Medical Therapy
Acute Q Fever in Patients With Underlying Valvular Disease
Pregnancy
Q Fever Endocarditis
Children
Prevention
References
72 Trench Fever
Key Features
Introduction
Natural History, Pathogenesis, and Pathology
Epidemiology
Clinical Features
Trench Fever
Chronic Infection and Complications Caused by B. quintana
Patient Evaluation and Diagnosis
Tropical Areas
Prevention
Treatment
References
73 Bartonellosis
Key Features
Introduction
Epidemiology
Microbiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Other Bartonella Infections
References
74 Typhoid and Paratyphoid (Enteric) Fever
Key Features
Introduction
Epidemiology
Incidence and Distribution of Enteric Fever
Typhoid Fever
Paratyphoid Fever
Transmission and Patterns of Infection
Source of Infection
Mode of Transmission
Antimicrobial Resistance
Severity
Age and Immunity
Sporadic Disease and Travelers
Natural History, Pathogenesis, and Pathology
Invasion and Latency
Disseminated Infection
Pathologic Findings
Relapse and Chronic Carriage
Clinical Features
Mild Illness
Severe Illness and Complications
Gastrointestinal Complications
Neurologic Complications
Other Complications
Patient Evaluation, Diagnosis, and Differential Diagnosis
Clinical Evaluation
Differential Diagnosis
Microbiologic Diagnosis
Serologic and Molecular Diagnosis
Treatment and Prevention of Enteric Fever
Antibiotics for Enteric Fever
Chloramphenicol, Ampicillin, and Trimethoprim–Sulfamethoxazole
Fluoroquinolones and Nalidixic Acid–Resistant S. Typhi and S. Paratyphi A
Third-Generation Cephalosporins
Azithromycin
Supportive and Adjunctive Therapy
Management of Intestinal Complications
Treatment of Relapse
Treatment of Chronic Carriers
Prevention
References
75 Brucellosis
Key Features
Introduction
Epidemiology
Pathogenesis
Clinical Manifestations
Diagnosis
Treatment
Prevention
References
76 Melioidosis and Glanders
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
77 Plague
Key Features
Introduction
Epidemiology
Plague Cycles
Animal Infection
Human Plague (Fig. 77.2)
Geographic Distribution of Human Plague
Natural History, Pathogenesis, and Pathology
Yersinia pestis
Pathogenesis
Clinical Features of Plague
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention and Control
References
78 Tularemia
Key Features
Introduction
F. Tularensis
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
79 Leptospirosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Anicteric Leptospirosis
Symptoms and Signs
Laboratory Findings
Icteric Leptospirosis (Weil’s Disease)
Laboratory Features of Weil’s Disease
Patient Evaluation, Diagnosis, and Differential Diagnosis
Patient Evaluation
Diagnosis
Differential Diagnosis
Anicteric Leptospirosis
Weil’s Disease
Severe Pulmonary Hemorrhage Syndrome
Childhood Leptospirosis
Treatment
Prevention
References
80 Relapsing Fever and Borrelioses
Key Features
Introduction
Epidemiology
Reservoirs and Transmission of Relapsing Fever Borreliae (Fig. 80.1)
Geographic Distribution (Fig. 80.2)
Natural History, Pathogenesis, and Pathology
Relapsing Fever Borreliae
Pathogenesis
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention and Control
References
PART 4 The Mycoses
81 General Principles
Key Features
Distribution and Medical Importance
Morphology
Diagnosis
Disease Classification
Superficial Mycoses (See Chapter 82)
Subcutaneous Mycoses or Mycoses of Implantation (See Chapter 83)
Systemic Mycoses (See Chapters 84 and 85)
References
82 Superficial Mycoses
Key Features
Dermatophyte Infection: Ringworm, Tinea
Introduction
Epidemiology
Natural History, Pathology, and Pathogenesis
Clinical Manifestations
Foot Infections
Tinea Imbricata
Tinea Cruris (Ringworm of the Groin)
Tinea Corporis (Ringworm of the Body)
Tinea Capitis (Ringworm of the Scalp)
Onychomycosis
Dermatophytosis of Other Sites
Diagnosis
Culture and Molecular Diagnosis
Treatment
Topical Therapy
Topical Antifungals
Systemic Therapy
Superficial Candidiasis
Definition
Epidemiology
Natural History and Pathogenesis
Clinical Manifestations
Oral Candidiasis (Thrush)
Vaginal Candidiasis
Paronychia and Candida Onychomycosis
Candida Intertrigo
Diagnosis
Treatment
Pityriasis (Tinea) Versicolor
Introduction
Epidemiology
Pathology and Pathogenesis
Clinical Manifestations
Diagnosis
Treatment
Other Superficial Mycoses
Black Piedra
White Piedra
Tinea Nigra
References
83 Subcutaneous Mycoses
Key Features
Introduction
Mycetoma (Maduromycosis, Madura Foot)
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Diagnosis and Differential Diagnosis
Diagnosis
Direct Examination
Culture or Molecular Detection
Imaging
Differential Diagnosis
Treatment
Eumycetoma
Actinomycetoma
Sporotrichosis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Cutaneous Sporotrichosis
Pulmonary Sporotrichosis
Disseminated Sporotrichosis
Diagnosis and Differential Diagnosis
Treatment
Chromoblastomycosis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Manifestations
Diagnosis and Differential Diagnosis
Treatment
Rhinosporidiosis
Introduction
Diagnosis and Differential Diagnosis
Treatment
Subcutaneous Mucormycosis Caused by Basidiobolus
Introduction
Pathogenesis and Pathology
Clinical Manifestations
Diagnosis and Differential Diagnosis
Treatment
Subcutaneous Mucormycosis Caused by Conidiobolus
Introduction
Epidemiology
Clinical Manifestations
Diagnosis and Differential Diagnosis
Treatment
Other Subcutaneous Mycoses
Phaeohyphomycosis
Introduction and Epidemiology
Clinical Manifestations and Treatment
Lobomycosis
References
84 Protothecosis
Key Features
Introduction
Epidemiology, Natural History, and Pathogenesis
Clinical Features and Histopathology
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Disclaimer
References
85 Histoplasmosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Pulmonary Histoplasmosis
Chronic Cavitary Pulmonary Histoplasmosis
Disseminated Histoplasmosis
Acute Disseminated Histoplasmosis
Chronic Progressive Disseminated Histoplasmosis
Patient Evaluation, Diagnosis, and Differential Diagnosis
Collection and Transport of Specimens
Direct Examination
Culture
Antigen Detection
Nucleic Acid Probes
Serology and Skin Testing
Differential Diagnosis
Treatment
Prevention
African Histoplasmosis
References
86 Coccidioidomycosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Primary Infection
Pulmonary Infection
Extrapulmonary Disease
Meningitis and Other CNS Disease
Soft Tissue and Osteoarticular Disease
Coccidioidomycosis in Children
Patient Evaluation and Diagnosis
Treatment
References
87 Blastomycosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Lung Lesions
Skin Lesions
Bone Lesions
Systemic Infections
Patient Evaluation, Diagnosis, and Differential Diagnosis
Differential Diagnosis
Treatment
References
88 Paracoccidioidomycosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Non-Progressive Infections
Progressive Forms
Acute Form of Juvenile Type
Chronic Form of Adult Type
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
89 Cryptococcosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Cryptococcus neoformans Infections
CNS Involvement
Lung Disease
Cutaneous Infection
Involvement of Other Sites
Cryptococcus gattii Infections
Patient Evaluation, Diagnosis, and Differential Diagnosis
Patient Evaluation
Diagnosis
Differential Diagnosis
Prevention of Cryptococcal Meningitis
Treatment
Outcome
References
90 Talaromycosis (Penicilliosis)
Key Features
Introduction
Epidemiology
Ecology
Pathogenesis
Clinical Features and Outcomes
Diagnosis
Complications and Co-Infections
Antifungal Treatment and Prevention
References
91 Pneumocystis Pneumonia
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
92 Treatment of Systemic Mycoses
Key Features
Introduction
Amphotericin B
Mechanism of Action
Sensitive Organisms
Pharmacologic Properties
Therapeutic Use
Toxicity
Pregnancy
Flucytosine
Mechanism of Action
Sensitive Organisms
Pharmacokinetics
Dosage and Administration
Toxicity
Therapeutic Indications
Triazoles
Mechanism of Action
Itraconazole
Fluconazole
Voriconazole
Posaconazole
Isavuconazole
Echinocandins
Caspofungin
Micafungin
Anidulafungin
References
PART 5 Protozoal Infections
93 General Principles
Key Features
Parasitism
Definitions
Natural History
Host
Vector
Protozoa
Definitions
Classification
Sarcodina
Mastigophora
Ciliophora
Sporozoa
Physiology
Ectoplasm
Endoplasm
Reproduction
Transmission
Intestinal Protozoa
Blood and Tissue Protozoa
Magnitude of the Health Problem
Malaria
African Trypanosomiasis
American Trypanosomiasis
Leishmaniasis
Conclusion
SECTION A Intestinal and Genital Infections
94 Entamoeba histolytica (Amebiasis)
Key Features
Epidemiology
Transmission
Pathogenesis and Pathology
Clinical Features
Intestinal Amebiasis
Extra-Intestinal Amebiasis
Patient Evaluation, Diagnosis, and Differential Diagnosis
Microscopy
Antigen Detection
PCR
Serology
Endoscopic Procedures
Imaging Procedures
Other
Treatment
Amebic Colitis
Amebic Liver Abscess
Severe Disease
Drainage
Asymptomatic Intestinal Colonization
Prevention
References
95 Giardiasis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention
References
96 Cryptosporidiosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment and Prevention
Prevention
References
97 Cyclosporiasis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
98 Cystoisospora belli (syn. Isospora belli)
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
99 Miscellaneous Intestinal Protozoa
Key Features
Balantidiasis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Diagnosis
Treatment
Dientamoeba Fragilis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Diagnosis
Treatment
Entamoeba Polecki
Introduction
Epidemiology
Clinical Features
Diagnosis
Treatment
Blastocystis Spp.
Introduction
Epidemiology
Clinical Manifestations
Diagnosis
Treatment
Non-Pathogenic Intestinal Protozoa
References
100 Trichomoniasis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
History
Physical Examination
Complications
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
SECTION B Infections of the Blood and Reticuloendothelial System
101 Malaria
Key Features
Introduction
Epidemiology
Transmission
Transfusion Malaria
Acquired Immunity
Innate Immunity
Life Cycle and Pathogenesis
Life Cycle
Pathogenesis
Fever
Anemia
Hypoglycemia
Metabolic Acidosis
Acute Respiratory Distress
Renal Abnormalities
Neurologic Changes and Coma
Clinical Features
Prodromal Symptoms
Periodicity
Uncomplicated Malaria
Laboratory Findings
Complicated Malaria
Cerebral Malaria
Post-Malaria Neurologic Syndrome
Metabolic Acidosis
Severe Anemia
Respiratory Failure
Algid Malaria
Acute Kidney Injury
Malaria in Pregnancy
Diagnostic Evaluation and Differential Diagnosis
Blood Films
Rapid Diagnostic Tests
Interpreting the Results of Malaria Diagnostic Tests
Diagnosing P. ovale
Complicated Malaria
Treatment
Artemisinin-Based Therapies
Uncomplicated Falciparum Malaria
Severe Malaria
Post-Artesunate Delayed Hemolysis
Pregnant Patients
Non-Falciparum Malaria
P. vivax
P. ovale
P. malariae
P. knowlesi
Supportive Care
Fever
Seizures
Anemia
Hypoglycemia
Acidosis
Pulmonary Edema/ARDS
Renal Failure
Adjuvant Therapies
Prevention
Intermittent Preventive Treatment During Pregnancy
Intermittent Preventive Treatment in Infants
Seasonal Malarial Chemoprevention
Vaccines
Pre-Erythrocytic Vaccines
Blood-Stage Vaccines
Transmission-Blocking Vaccines
Non-Falciparum Malaria
Plasmodium vivax
Clinical Presentation
Plasmodium ovale
Plasmodium malariae
Plasmodium knowlesi
References
102 African Trypanosomiasis
Key Features
Introduction
Epidemiology
Vector
Natural History, Pathogenesis, and Pathology
Polyclonal Activation of B Cells
Clinical Features
The Trypanosomal Chancre
Hemolymphatic Stage (HAT Stage I)
Meningoencephalitic Stage (HAT Stage II)
Patient Evaluation, Diagnosis, and Differential Diagnosis
Aspiration of Chancre or Lymph Node
Blood Films
Concentration Methods
Nucleic Acid Amplification Techniques
Serologic Assays
New Developments
Treatment
Management of HAT Stage I
Pentamidine
Suramin
Management of HAT Stage II
Melarsoprol
Eflornithine (DFMO)
Nifurtimox
Combination Treatments in HAT
New Drug Developments
Prevention
Individual Protection
Control in Endemic Areas
References
103 American Trypanosomiasis (Chagas Disease)
Key Features
Introduction
Epidemiology
Vector-Borne Transmission, Vectors, and Non-Human Reservoir Hosts
Non-Vectorial Trypanosoma cruzi Transmission
Geographic Distribution and Disease Burden
Control and Prevention
Natural History and Pathogenesis
Life Cycle
Pathogenesis and Pathology
Clinical Manifestations
Acute Trypanosoma cruzi Infection
Chronic Trypanosoma cruzi Infection
Chagas Cardiomyopathy
Chagas Digestive Disease
Congenital Trypanosoma cruzi infection
Trypanosoma cruzi Infection in the Immunocompromised Host
Acute Trypanosoma cruzi Infection in Organ Transplantation Recipients
Reactivation of Chronic Trypanosoma cruzi Infection in Organ Recipients
Reactivation of Chagas Disease in HIV/AIDS Patients
Diagnosis
Utility of PCR for Diagnosis or Monitoring
Diagnosis of Acute Trypanosoma cruzi Infection
Diagnosis of Congenital Trypanosoma cruzi Infection
Diagnosis of Chronic Trypanosoma cruzi Infection
Patient Evaluation
Management
Specific Anti-Parasitic Drugs
Evidence Base for Anti-Trypanosomal Drug Therapy
Indications for Anti-Trypanosomal Therapy
Treatment of Acute and Early Congenital Infection
Treatment of Chronic Infection
Treatment of Immunocompromised Patients
Documentation of Response After Specific Treatment
Novel Anti-Trypanosomal Drug Candidates
Management of Cardiac Disease
Congestive Heart Failure Treatment
Anti-Arrhythmic Treatment
Cell Therapy
Management of Digestive Disease
References
104 Leishmaniasis
Key Features
104.1 Leishmaniasis: General Principles
Definition
Life Cycle
Taxonomy
Clinical Classification
Transmission and Epidemiology
Immunology
Spectrum of Clinical Disease
Diagnostic Testing
Principles of Treatment
Definition of Cure
Persistence of Viable Parasites
Variability of Treatment Regimens
References
104.2 Visceral Leishmaniasis (Kala-Azar)
Definition
Etiology
Distribution
Transmission and Epidemiology
Reservoir Hosts
Pathogenesis
Clinical Manifestations
Sub-Clinical or Oligosymptomatic Infections
Symptoms of Kala-Azar
Signs of Kala-Azar
Laboratory Abnormalities
Hematologic
Other
Complications
Visceral Leishmaniasis Infection in Immunocompromised Hosts
Post–Kala-Azar Dermal Leishmaniasis
Diagnosis
Clinical Diagnosis
Demonstration of Parasites
Serologic Tests
Differential Diagnosis
Treatment
Non-Specific or Supportive Care
Specific Anti-Leishmanial Therapy
Pentavalent Antimonials (SbV)
Amphotericin B
Paromomycin
Miltefosine
Combination Treatment
Treatment of Relapses
Post–Kala-Azar Dermal Leishmaniasis
HIV Co-Infection
Pregnancy
Prognosis
Prevention and Control
Human Management
Post-Kala-Azar Dermal Leishmaniasis
Reservoir Control
Vector Control
Vaccines
References
104.3 Cutaneous Leishmaniasis of the Old World
Definition
Etiology
Distribution and Epidemiology
Leishmania major
Leishmania tropica
Leishmania aethiopica
Leishmania infantum (syn. L. chagasi)
Pathogenesis
Clinical Manifestations
Leishmaniasis Recidivans
Diffuse Cutaneous Leishmaniasis
Diagnosis
Demonstration of the Organism
Serologic Tests
Differential Diagnosis
Treatment
Old World Cutaneous Leishmaniasis
Local Therapy
Systemic Therapy
Leishmaniasis Recidivans
Diffuse Cutaneous Leishmaniasis
Prevention and Control
Vector Control
Immunization
References
104.4 Cutaneous Leishmaniasis of the New World
Definition
Etiology
Distribution and Epidemiology
Leishmania mexicana
Leishmania amazonensis
Leishmania venezuelensis
Leishmania (Viannia) braziliensis
Leishmania (Viannia) panamensis
Leishmania (Viannia) guyanensis
Leishmania (Viannia) peruviana
Infections Caused by Other Leishmania Species
Diffuse Cutaneous Leishmaniasis
Disseminated Cutaneous Leishmaniasis
Clinical Manifestations
Cutaneous Disease
Mucosal Leishmaniasis
Diagnosis
Demonstration of the Organism
Serologic Tests
Differential Diagnosis
Treatment
New World Cutaneous Leishmaniasis
Pentavalent Antimonial Drugs
Amphotericin B
Pentamidine
Azoles
Miltefosine
Local Agents
Mucosal Leishmaniasis
Diffuse Cutaneous Leishmaniasis
Prognosis
Prevention and Control
Disclaimer
References
105 Babesiosis
Key Features
Introduction
Epidemiology
United States
Europe
Asia
Rest of the World
Natural History, Pathogenesis, and Pathology
Clinical Features
Babesia microti Infection
Other Babesia Infections
Patient Evaluation and Diagnosis
Treatment
Babesia microti Infection
Other Babesia Infections
Prevention
Acknowledgments
References
SECTION C Tissue Infection
106 Toxoplasmosis
Key Features
Introduction
Epidemiology
The Parasite and Its Life Cycle
Transmission
Distribution and Prevalence
Genetic Diversity of Toxoplasma gondii
Pathophysiology
Clinical Manifestations
Acute Postnatal-Acquired Toxoplasmosis in Immunocompetent Patients
Toxoplasmosis in Immunocompromised Hosts
Acute Toxoplasmosis During Pregnancy
Congenital Toxoplasmosis
Ocular Toxoplasmosis
Diagnosis
Laboratory Diagnosis
Direct Detection and Identification of the Parasite
Serologic Testing
Diagnosis of Acute Postnatal-Acquired Toxoplasmosis in Immunocompetent Patients
Diagnosis of Toxoplasmosis in Immunocompromised Hosts
Diagnosis of Congenital Toxoplasmosis
Diagnosis of Ocular Toxoplasmosis
Treatment
Prevention
Conclusion
References
107 Pathogenic and Opportunistic Free-Living Ameba Infections
Key Features
Introduction
History
Life Cycles of Free-Living Ameba and Morphology
Epidemiology
Central Nervous System Infection
Primary Amebic Meningoencephalitis
Clinical Presentation
Diagnostic Evaluation
Pathologic Features
Management
Prevention
Granulomatous Amebic Encephalitis
Clinical Presentation
Diagnostic Evaluation
Pathologic Features
Management
Prevention
Acanthamoeba Infections Outside the Central Nervous System
Acanthamoeba Keratitis
Diagnostic Microbiology
Management
Prevention
Acanthamoeba and Balamuthia Skin Infections
Disclaimer
References
108 Sarcocystosis
Key Features
Transmission and Epidemiology
Pathogenesis
Clinical Manifestations
Enteric Infection
Muscle Infection
Diagnosis
Treatment
Prevention
Public Health Burden
References
109 Microsporidiosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Infections in Immunocompetent Patients
Infections in Patients With Immune Deficiencies
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment (Table 109.2)
Prevention
References
PART 6 Helminthic Infections
110 General Principles
Definitions
Classification
Annelida
Nematoda
Adult Nematodes Residing in the Gut
Adults Nematodes Residing in the Blood, Lymphatic, or Subcutaneous Tissues
Larval Stages Causing Human Pathologic Conditions in Various Tissues
Infections Usually Limited to the Skin and Subcutaneous Tissues
Infections Primarily Involving the Muscles
Infections Causing a Visceral Larva Migrans Syndrome
Platyhelminthes
Trematoda
Cestoda
Anatomy and Physiology
Transmission
Oral Transmission
Transmission by Skin Penetration
Transmission by Bite of a Vector
Magnitude of the Health Problem
Tropics and Subtropics
Temperate Climates
Migrants and Travelers
Chemotherapy
References
SECTION A Intestinal Nematode Infections
111 Nematodes Limited to the Intestinal Tract (Enterobius vermicularis, Trichuris trichiura, Capillaria philippinensis, and Trichostrongylus spp.)
Key Features
Enterobiasis
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Trichuriasis
Epidemiology
Natural History, Pathogenesis, and Pathology
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Intestinal Capillariasis
Epidemiology
Natural History, Pathogenesis, and Pathology
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Trichostrongyliasis
Epidemiology
Natural History, Pathogenesis, and Pathology
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
112 Intestinal Nematodes
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Immune Response
Clinical Features
Pulmonary Migration
Intestinal Infections
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Chemotherapy
Supportive Therapy
Prevention
References
113 Hookworm and Strongyloides Infections
Key Features
Hookworm Infections
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Ground Itch and Cutaneous Larva Migrans
Pulmonary Manifestations
Gastrointestinal Manifestations
Iron-Deficiency Anemia
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Strongyloides Infections
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Acute Infection
Chronic, Persisting Infection
Hyperinfection Syndrome
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
SECTION B Filarial Infections
114 Lymphatic Filariasis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Subclinical Infection
Acute Manifestations
Chronic Manifestations
Genital Manifestations
Lymphedema and Elephantiasis
Chyluria
Tropical Pulmonary Eosinophilia
Lymphatic Filariasis in Expatriates and Travelers
Patient Evaluation, Diagnosis, and Differential Diagnosis
Patient Evaluation
Diagnosis
Differential Diagnosis
Treatment
Prevention and Control
Acknowledgment
References
115 Loiasis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Calabar Swellings
Eye Worm
Other Symptoms
Complications
Central Nervous System
Renal
Endomyocardial Fibrosis
Other Complications
Patient Evaluation, Diagnosis, and Differential Diagnosis
Definitive Diagnosis
Presumptive Diagnosis
Differential Diagnosis
Treatment and Prevention
References
116 Onchocerciasis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Skin Disease
Nodules
Lymph Nodes
Eye Disease
Other Complications
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Control
References
117 Miscellaneous Filariae
Key Features
Mansonella Perstans Infection
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Mansonella Ozzardi Infection
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Streptocerciasis (Mansonella Streptocerca)
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Dirofilariasis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Pulmonary Dirofilariasis
Subcutaneous Dirofilariasis
Clinical Features
Pulmonary Dirofilariasis
Subcutaneous Dirofilariasis
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
SECTION C Other Tissue Nematode Infections
118 Dracunculiasis
Key Features
Introduction
Epidemiology and Eradication
Natural History, Pathogenesis, Pathology, and Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention
References
119 Trichinellosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Intestinal or Enteral Phase
Muscle Invasion or Parenteral Phase
Neurologic Complications
Convalescent Phase
Patient Evaluation, Diagnosis, and Differential Diagnosis
Indirect Diagnosis
Direct Diagnosis
Enteral Phase
Parenteral Phase
Differential Diagnosis
Treatment
References
120 Toxocariasis
Key Features
Natural History, Pathogenesis, and Pathology
Epidemiology
Clinical Features
Laboratory Findings
Diagnosis
Differential Diagnosis
Treatment
Prevention
References
121 Gnathostomiasis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
122 Eosinophilic Meningitis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Differential Diagnosis
Treatment
References
123 Abdominal Angiostrongyliasis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Intestinal Lesions
Extra-Intestinal Lesions
Clinical Features
Extra-Intestinal Findings
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
124 Cutaneous Larva Migrans
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
125 Anisakidosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention
References
SECTION D Trematode Infections
126 Schistosomiasis
Key Features
Introduction
Epidemiology
History
Natural History, Pathogenesis, and Pathology
Immunology
Clinical Features
Cercarial Dermatitis
Acute Schistosomiasis (Katayama’s Fever)
Chronic Pathology and Illness
Urinary Schistosomiasis
Bladder Cancer
Intestinal Schistosomiasis
Hepatosplenic Schistosomiasis
Inflammatory Hepatic Schistosomiasis
Fibrotic or Chronic Hepatic Schistosomiasis
Other Complications and Ectopic Schistosomiasis
Pulmonary Schistosomiasis
Schistosomal Glomerulonephritis
Genital Schistosomiasis
Neuroschistosomiasis
Other Sites
Association of Schistosomiasis and Other Infections
Chronic Salmonella Co-Infections
Co-Infections With Hepatitis B and C
Indirect Pathology and Morbidity
Global Burden of Disease
Diagnosis
Medical History and Examination
Laboratory Findings
Schistosoma Ova Identification by Microscopy
Serology and Antigen Detection
Other Testing
Endoscopy and Cystoscopy
Imaging
Treatment
Chemotherapeutic Agents
Treatment of Acute Schistosomiasis and Complications
Control and Prevention
Other Human Schistosome Infections
References
127 Intestinal Fluke Infections
Key Features
Introduction
Epidemiology
Natural History, Pathology, and Pathogenesis
Clinical Features
Fasciolopsiasis
Echinostomiasis
Heterophyiasis
Gastrodiscoidiasis
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention
References
128 Liver Fluke Infections
Key Features
128.1 Opisthorchiasis and Clonorchiasis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation and Differential Diagnosis
Diagnosis
Treatment
Opisthorchis viverrini
Clonorchis sinensis
Prevention and Control
References
128.2 Fascioliasis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Migratory Phase
Biliary Tract Infection
Ectopic Fascioliasis
Pharyngeal Form
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention and Control
References
128.3 Dicroceliasis and Eurytremiasis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Diagnosis
Treatment
References
129 Paragonimiasis
Key Features
Introduction
Epidemiology
Natural History, Pathology, and Pathogenesis
Pulmonary Lesions
Ectopic Lesions
Clinical Manifestations
Acute Stage
Chronic Stage
Pulmonary Paragonimiasis
Extrapulmonary Paragonimiasis
Cerebral and Spinal Paragonimiasis.
Abdominal Paragonimiasis.
Migratory Subcutaneous Paragonimiasis.
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention and Control
References
SECTION E Cestode Infections
130 Tapeworm Infections
Key Features
130.1 Taeniasis
Introduction
Epidemiology
Infection
Geography
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Microscopy
Immunologic Tests
Treatment
Prevention and Control
References
130.2 Diphyllobothriasis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
130.3 Hymenolepiasis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
130.4 Dipylidiasis
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
131 Larval Cestode Infections (Cysticercosis)
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Manifestations
Neurocysticercosis
Ophthalmic Cysticercosis
Muscular and Subcutaneous Cysticercosis
Patient Evaluation, Diagnosis, and Differential Diagnosis
History of Taeniasis
Imaging
Serology and Cerebrospinal Fluid Examination
Biopsy
Differential Diagnosis
Treatment
Perilesional Edema Around Calcified Cysticerci
Pediatric Cysticercosis
Asymptomatic Neurocysticercosis
Ophthalmic Cysticercosis
Muscular and Subcutaneous Cysticercosis
Prevention and Control
References
132 Cystic Echinococcosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Liver Cysts
Lung Cysts
Other Sites
Patient Evaluation, Diagnosis, and Differential Diagnosis
Management and Treatment
Benzimidazole Therapy
Percutaneous Treatment of Hepatic Cysts Under Ultrasonographic Guidance
Surgery
“Watch and Wait”
Prevention
References
133 Alveolar Echinococcosis (Alveolar Hydatid Disease)
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Prevention
References
134 Polycystic Echinococcosis (Polycystic Neotropical Echinococcus)
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
135 Sparganosis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Sparganum Proliferum
References
136 Coenuriasis
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
PART 7 Poisonous and Toxic Plants and Animals
137 Animals Hazardous to Humans
Introduction
137.1 Venomous Marine Animals
Key Features
Venomous Fish
Incidence and Epidemiology
Prevention
Venom Composition
Clinical Features
Treatment
CNIDARIANS, Formerly Coelenterates
Epidemiology
Prevention
Clinical Features
Treatment
Echinodermata (Starfish and Sea Urchins) (Fig. 137.1.5)
Treatment
Mollusca (Cone Shells and Octopuses)
Treatment
References
137.2 Leeches
Key Features
Prevention
Clinical Features
Treatment
References
137.3 Fish Capable of Inflicting Serious Trauma
Key Features
Sharks
Management
Prevention
Other Dangerous Fish
Barracudas
Moray Eels (Muraenidae)
Needle Fish (Garfish) (Tylosurus spp.) (Belonidae) (Fig. 137.3.4A and B)
Stingrays (Dasyatidae)
Piranhas (Pirañas) (Characidae) (Fig. 137.3.5A)
Candiru (Vampire, Toothpick, or Penis Fish) (Vandellia cirrhosa) (Trichomycteridae)
Management of Injuries by Other Dangerous Fish
References
137.4 Lizards
Key Features
Introduction
Venom Apparatus
Venom Composition
Heloderma Bites
Symptoms of Envenoming
Investigations
First Aid
Treatment
References
137.5 Snakes
Key Features
Introduction
Distribution of Venomous Snakes
Snake Classification
Colubridae, Dipsadidae, and Natricidae (Back-Fanged Snakes)
Atractaspidinae (Family Lamprophiidae) (Burrowing Asps)
Elapidae
Viperidae
Medically Important Snakes
Incidence and Importance of Snakebite
Epidemiology
Prevention of Snakebite
Venom Apparatus
Venom Composition
Necrotoxins
Neurotoxins
Cardiovascular and Autopharmacologic Toxins
Variation in Venom Composition
Pharmacology
Clinical Effects
General Symptoms and Signs
Local Effects
Bleeding and Clotting Disturbances
Hypotension and Shock
Neurotoxicity
Generalized Rhabdomyolysis
Acute Kidney Injury
Venom Ophthalmia Caused by Spitting Cobras
Laboratory Investigations
Venom Immunodiagnosis
Treatment of Snakebite
First-Aid Treatment
Tourniquets
Pressure-Pad Immobilization and Pressure-Bandage Immobilization
Transport to Medical Care
Treatment by Medically Trained Personnel in a Hospital or Dispensary
Antivenom Treatment
Indications
Contraindications
Administration
Response to Antivenom
Adverse Antivenom Reactions
Supportive Treatment
Neurotoxic Envenoming
Circulatory Collapse (Shock)
Local Necrosis
Intracompartmental Syndrome and Fasciotomy
Local Infection at the Site of the Bite
Acute Kidney Injury
Other Drugs
Treatment of Snake Venom Ophthalmia
References
Useful Websites
Reference
138 Injurious Arthropods
Key Features
138.1 Hypersensitization and Anaphylaxis Caused by Stings of Hymenopteran Insects
Epidemiology
Prevention
Clinical Features
Diagnosis of Anaphylaxis and Venom Hypersensitivity
Treatment
Treatment of Anaphylaxis
References
138.2 Bites by Other Insects Resulting in Irritation, Allergy, and Transmission of Infections
Clinical Features
Specific Infections Transmitted by Biting Flies (Diptera) and Bugs (Hemiptera)
Treatment
Prevention
References
138.3 Invasive Larvae of Flies (Myiasis) and Fleas (Tungiasis)
Myiasis
Cutaneous Myiasis
Prevention and Treatment
Wound Myiasis
Control, Prevention, and Treatment
Ophthalmomyiasis (Ocular Myiasis)
Congo Floor Maggots
Prevention and Treatment
Tungiasis
Treatment
Prevention
Differentiating Cutaneous Myiasis From Other Creeping Eruptions
References
138.4 Superficial Infestations by Ectoparasitic Arthropods: Fleas, Lice, Mites, and Ticks
Specific Infections Transmitted by Infesting Arthropods
Fleas (Insecta, Family Pulicidae)
Treatment
Lice (Insecta, Family Pediculidae)
Head Lice (Pediculus capitis)
Treatment
Prevention
Body Lice (Pediculus humanus)
Treatment
Pubic (Crab) Lice (Pthirus pubis, Family Phthiridae)
Treatment
Mites (Arachnida)
Scabies Mites (Acari, Family Sarcoptidae)
Epidemiology
Clinical Features
Complications
Diagnosis
Treatment
Prevention
Trombiculid (Harvest) Mites (Acarani, Leptotrombidium spp., Family Trombiculidae)
Prevention
Bedbugs (Insecta, Cimex spp., Family Cimicidae)
Ticks (Acari)
Prevention of Tick-Transmitted Infections
References
138.5 Envenoming by Arthropods (Phylum Arthropoda)
Ticks (Class Arachnida, Subclass Acari)
Taxonomy and Epidemiology
Clinical Features
Treatment
Spiders (Class Arachnida, Order Araneae)
Epidemiology
Clinical Features
First-Aid Treatment
Specific Treatment
Supportive Treatment
Tarantula Spiders (Mygalomorphae, Family Theraphosidae)
Treatment
Prevention
Scorpions (Class Arachnida, Order Scorpiones, Families Buthidae, Hemiscorpiidae)
Epidemiology
Prevention
Clinical Features
Treatment
Wind Scorpions, Camel Spiders, or Sun Spiders (Arachnida, Order Solifugae)
Insects (Class Insecta)
Beetles (Order Coleoptera)
True Bugs (Order Hemiptera)
Wasps, Bees, and Ants (Order Hymenoptera) (See Also Chapter 138.1)
Epidemiology
Clinical Features
Treatment
Moths (Order Lepidoptera)
Centipedes and Millipedes (Subphylum Myriapoda)
Centipedes (Class Chilopoda)
Millipedes (Class Diplopida)
References
Useful Website
139 Poisonous Plants and Aquatic Animals
139.1 Seafood Poisoning: Fish and Shellfish Poisoning
Key Features
Introduction
Prevention of Seafood Poisoning
Ciguatera Fish Poisoning
Tetrodotoxin Poisoning
Histamine Fish Poisoning (Scombroid Fish Poisoning or Pseudoallergic Fish Poisoning)
Seafood Poisoning With Generalized Rhabdomyolysis
Poisoning by Ingesting Carp Gallbladder
Shellfish Poisoning
Diarrheal (Diarrhetic) Shellfish Poisoning and Azaspiracid Shellfish Poisoning
Neurotoxic Shellfish Poisoning
Paralytic Shellfish Poisoning
Amnesic Shellfish Poisoning
Pfiesteria-Associated Possible Estuary- Associated Syndrome
Laboratory Diagnosis of Seafood Poisoning
Differential Diagnosis
Treatment of Seafood Poisoning
References
139.2 Plant Poisoning
Key Features
Introduction
Specific Plant Poisonings (Box 139.2.1)
Gastrointestinal Irritants
Skin Lesions
Neurotoxic Plants
Belladonna Alkaloids
Hallucinogenic Plants
Plants Causing Convulsions
Plants With Nicotinic Effects
Cardiotoxic Plants
Aconitine
Miscellaneous Cardiotoxic Plants
Cytotoxic Plants
Colchicine
Toxalbumins
Cyanogenic Glycosides
Hepatotoxic Plants
Nephrotoxic Plants
References
139.3 Plant Cardiac Glycoside Poisoning
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
References
139.4 Fungal Poisoning: Mycotoxicosis and Mushroom Poisoning
Key Features
Claviceps (Ergot) Poisoning
Aspergillus (Aflatoxin) Poisoning
Mushroom Poisoning (Mycetism, Mycetismus)
Epidemiology
Diagnosis
Mushroom Toxins
Cytotoxic Mushroom Poisoning
Primary Hepatotoxicity (Amatoxin Poisoning)
Mechanisms of Toxicity
Symptoms
Management
Primary Nephrotoxicity
Early Nephrotoxicity (Aminohexadienoic Acid Poisoning)
Late Nephrotoxicity (Orellanine Poisoning)
Neurotoxic Mushroom Poisonings
Hallucinogenic (“Magic Mushroom”) Psilocybin Poisoning
Autonomic-Toxicity Mushrooms (Muscarinic Poisoning)
CNS Neuroexcitatory Mushrooms (Isoxazole Poisoning)
Myotoxic Mushroom Poisoning
Early Myotoxicity (Cycloprop-2-Ene Carboxylic Acid Poisoning)
Late Myotoxicity (Saponaceolide B and M Poisoning)
Metabolic Toxicity Mushroom Poisoning
GABA-Blocking Mushroom Poisoning (Gyromitrin Poisoning)
Disulfiram-Like Mushroom Poisoning (Coprine Poisoning)
Antabuse Syndrome
Gastrointestinal Irritant Mushroom Poisoning
Chlorophyllum (Lepiota) molybdites (False or Green-Spored Parasol) and Macrilepiota (Lepiota) morganii (Morgan’s Mushroom) Poisoning
Other Toxic Events Caused by Fungi
Shiitake Mushroom Dermatitis (Lentinan Poisoning)
Paxillus Syndrome
References
140 Bats
Key Features
Introduction
Bat Biology
Bat-Transmitted Infections (Table 140.1)
Rabies and Rabies-Related Lyssaviruses
Species 1: (Classic) Rabies
Species 2: Lagos Bat Virus
Species 4: Duvenhage Virus
Species 5 and 6: European Bat Lyssavirus
Species 7: Australian Bat Lyssavirus
Other Rabies-Related Viruses
Vampire Bat Rabies (Latin America)
Vampire Bat Biology
Rabies Epizootics
Prevention and Control of Vampire Bat Rabies
Non-Vampire Bat Rabies
Filoviruses: Marburg Virus and Ebola Virus
Paramyxoviruses (Nipah, Hendra, Menangle)
Hendra Virus
Nipah Virus
Other Viruses
Bacterial Infections
Histoplasmosis
Other Fungi
Protozoa
Prevention of Bat-Transmitted Infections
References
141 Pentastomiasis
Key Features
Introduction
Human Infection With Linguatula Species
Clinical Features
Visceral and Ocular Pentastomiasis
Nasopharyngeal Pentastomiasis
Human Infection With Armillifer Species
Clinical Features
Visceral and Ocular Pentastomiasis
Human Infection With Rare Pentastome Species
Diagnosis
Treatment
Prevention
References
PART 8 Nutritional Problems and Deficiency Diseases
142 General Principles
143 Protein-Energy Malnutrition in Children
Key Features
Introduction
Epidemiology and Consequences
Causes of Protein-Energy Malnutrition
Clinical Features
Management of Mild or Moderate Malnutrition
Phases of Management of Severe Acute Malnutrition
Step 1: Treat/Prevent Hypoglycemia
Step 2: Treat/Prevent Hypothermia
Step 3: Treat/Prevent Dehydration
Step 4: Correct Electrolyte Imbalance
Step 5: Treat Infection
Step 6: Correct Micronutrient Deficiencies
Step 7: Start Cautious Feeding
Criteria for Increasing Volume/Decreasing Frequency of F-75 Feeds
Step 8: Achieve Catch-Up Growth
Step 9: Provide Sensory Stimulation and Emotional Support
Step 10: Prepare for Follow-Up After Recovery
Treatment of Complications
Community-Based Management of SAM
Dose of Ready-to-Use-Therapeutic Food
Reference
Further Reading
144 Vitamin Deficiencies
Key Features
Introduction and Significance
Vitamin A
Clinical Manifestations, Diagnosis, and Prevention of Vitamin A Deficiency
Xerophthalmia
Diagnosis of Vitamin A Deficiency
Prevention of Vitamin A Deficiency
Clinically Important B Vitamin Deficiencies
Beriberi and Thiamine (Vitamin B1)
Ariboflavinosis and Riboflavin (Vitamin B2)
Pellagra and Niacin (Vitamin B3)
Folate (Vitamin B9)
Vitamin B12 (Cobalamin)
Scurvy and Vitamin C (Ascorbic Acid)
Rickets, Osteomalacia, and Vitamin D
Diagnosis of Vitamin D Deficiency
Treatment of Vitamin D Deficiency
Prevention of Vitamin D Deficiency
References
145 Mineral Deficiencies
Key Features
Introduction
Iron
Global Burden of Iron Deficiency
Overview of Iron Biology
Causes of Iron Deficiency
Assessment of Iron Status
Persons Affected and Consequences of Iron Deficiency
Control of Iron Deficiency
Conclusion
Zinc
Global Burden of Zinc Deficiency
Overview of Zinc Biology
Causes of Zinc Deficiency
Assessment of Zinc Status
Persons Affected and Consequences of Zinc Deficiency
Control of Zinc Deficiency
Conclusion
Iodine
Global Burden of Iodine Deficiency
Overview of Iodine Biology
Causes of Iodine Deficiency
Assessment of Iodine Status
Persons Affected and Consequences of Iodine Deficiency
Control of Iodine Deficiency
Conclusion
Selenium
Calcium and Magnesium
Fluorine
Lead
Summary
References
PART 9 Vector Transmission of Diseases and Zoonoses
SECTION A Medical Entomology
146 Arthropods of Public Health Importance
Key Features
Definitions
Background
Mosquitoes
Biting Flies
Phlebotomine Sand Flies
Black Flies
Tsetse Flies
House Flies and Other “Filth Flies”
Human Lice
Human Body Lice
Human Head Lice
Human Pubic Lice
Human Fleas
Human Bed Bugs
Kissing Bugs
Ticks
Ixodid (Hard) Ticks
Argasid (Soft) Ticks
Mites
Biting Mites
Human Scabies Mites
References
SECTION B Diseases Associated With Vectors (Arthropods in Disease Transmission)
147 Human Diseases Associated With Vectors (Arthropods in Disease Transmission)
Key Features
History
Disease Transmission
Mechanical Transmission
Biologic (or Horizontal) Transmission
Propagative
Cyclopropagative
Cyclodevelopmental
Transovarial or Vertical
Extrinsic Incubation Period
Entomologic Inoculation Rate
Barriers to Pathogen Development
Factors Influencing Transmission
Importance
References
SECTION C Vector Control
148 Arthropod Vector Control
Key Features
Introduction
Ecology of Vector-Borne Diseases
Personal and Household Vector Control
Community-Level Vector Control
Conclusion
References
PART 10 The Sick Returning Traveler
149 General Principles
Key Features
References
150 Fever in the Returned Traveler
Key Features
Introduction
Epidemiology
Individual Factors
Pathogen Factors
Clinical Features
Undifferentiated Fever
Malaria
Enteric Fever (Salmonella Typhi, S. Paratyphi)
Rickettsiae
Arbovirus
Acute Schistosomiasis (Katayama Fever)
Leptospirosis
Amebic Liver Abscess
Brucellosis
Q Fever (Coxiella burnetii )
HIV and Other STIs
Respiratory Tract Infections
Upper Respiratory Tract Infections
Lower Respiratory Tract Infections
Gastrointestinal Infections
Diarrhea
Abdominal Pain
Jaundice
Neurologic Infections
Meningitis
Encephalitis
Patient Evaluation, Diagnosis, and Differential Diagnosis
Treatment
Malaria
Amebic Liver Abscess
Enteric Fever
Leptospirosis
Rickettsiae
Acute Schistosomiasis
Bacterial Sepsis
References
151 Malaria in the Returned Traveler
Key Features
Introduction
Epidemiology
Clinical Features
Uncomplicated Malaria
Severe or Complicated Malaria
Patient Evaluation and Differential Diagnosis
Treatment
Uncomplicated Disease
Non-Falciparum Malaria
Falciparum Malaria
Severe Disease
Chemotherapy
Supportive Therapy
Adjunctive Treatment
Monitoring and Prognosis
References
152 Screening of the Asymptomatic Long-Term Traveler
Key Features
Introduction
How Does a Clinician Evaluate an Asymptomatic Long-Term Traveler on Return?
History
Examination
General Screening Tests
Targeted Disease Evaluation
Eosinophilia
Schistosomiasis
Sexual Health and HIV Screening
Trypanosomiasis
Tuberculosis
Rabies Post-Exposure Prophylaxis
Malaria
Psychological Health
Conclusions
References
153 Persistent Abdominal Symptoms in the Returned Traveler
Key Features
Introduction
Pathoetiologic Classification
Assessment
Investigations
Management
References
154 Skin Lesions in Returning Travelers
Key Features
Introduction
Approach to a Traveler With a Skin Lesion
Localized Skin Diseases
Skin and Soft Tissue Infection
Creeping Dermatitis
Cutaneous Ulcer
Fixed Localized Papules and Nodules
Fixed and Localized Pruritic Eruption
Arthropod-Related Dermatitis
Contact Dermatitis
Dermatophytosis
Other Localized Dermatologic Syndromes
Disseminated Skin Diseases
Febrile Exanthem
Urticaria
Disseminated Pruritus With or Without Rash
Prevention
References
155 Eosinophilia in Migrants and Returned Travelers
Key Features
Introduction
General Principles
History and Physical Examination
Laboratory Investigations
Direct Microscopy
Serology
Management
Follow-Up Issues
Clinical Syndromes
Asymptomatic Eosinophilia
Fever and/or Respiratory Symptoms
Katayama Syndrome
Loeffler’s Syndrome
Gastrointestinal/Genitourinary Symptoms
Strongyloidiasis
Soil-Transmitted Helminths (Geohelminths)
Schistosomiasis/Bilharzia: Schistosoma mansoni, S. japonicum, and S. haematobium
Hydatid
Liver Flukes
Neurologic Symptoms
Dermatologic Presentations
Filariasis: Onchocerciasis, Lymphatic Filariasis, and Loa loa
References
156 Immigrant Medicine
Key Features
Introduction
Pre-Departure and Post-Arrival Health Assessment
Infectious Diseases of Immigrants
Febrile Illnesses
Pulmonary
Gastrointestinal
Neurologic and Ophthalmologic
Cardiac
Genitourinary
Dermatologic
Non-Infectious Diseases of Immigrants
Conclusion
References
157 International Adoption
Key Features
Introduction
Overall Approach and Initial Evaluation
Tuberculosis
Hepatitis A
Hepatitis B
Hepatitis C
Syphilis
HIV
Intestinal Pathogens
Malaria
Eosinophilia
Skin Disease
Immunizations
Conclusion
References
158 Medical Tourism
Key Features
Introduction
Services Available via Medical Tourism
Statistics on Medical Tourism
Locations for Medical Tourism Services
Infection-Related Risks
Quality Control, Safety, and Risk
The Returning Medical Tourist
General Concerns
Conclusions
References
159 Transplant Patients and Tropical Diseases
Key Features
Introduction
Transplant Tourism
Degrees of Immunosuppression
Disease Distribution in Returning Travelers
Malaria in Stem Cell and Solid Organ Transplant Recipients
Leishmaniasis in Stem Cell and Solid Organ Transplant Recipients
Strongyloidiasis in Stem Cell and Solid Organ Transplant Recipients
Toxoplasmosis in Stem Cell and Solid Organ Transplant Recipients
Chagas Disease (American Trypanosomiasis) in Stem Cell and Solid Organ Transplant Recipients
References
160 Delusional Infestation (Delusional Parasitosis)
Key Features
Introduction
Epidemiology
Natural History, Pathogenesis, and Pathology
Classification of Delusional Infestation
Primary Delusional Infestation
Secondary Delusional Infestation: Associated With Underlying Psychiatric Disease
Secondary Delusional Infestation: Associated With Underlying Medical Conditions
Morgellons
Clinical Features
Patient Evaluation, Diagnosis, and Differential Diagnosis
Psychiatric Assessment
Treatment
First-Generation Anti-Psychotic Agents
Second-Generation Anti-Psychotic Agents
Outcome and Prognosis
References
PART 11 Laboratory Diagnosis of Parasitic Diseases
161 General Principles
161.1 Preparation of Samples for Morphologic Diagnosis of Parasites in Stool and Urine Specimens
Introduction
Physical Characteristics of the Specimen
Techniques of Stool Examination
Direct Wet Film
Modified D’Antoni Iodine Solution
Permanent Staining of Fixed Specimens
Concentration Methods
Examination of Urine and Vaginal Secretions
Special Detection Methods
Agar Plate Culture for Strongyloides Larvae
Cellophane Tape for Enterobius and Taenia Eggs
Methods for Estimation of Worm Burden
Kato–Katz Thick-Smear Technique
Special Methods for Intestinal Helminths
Platyhelminths
Nematodes
References
161.2 Examination of Blood, Other Body Fluids, Tissues, and Sputum
Examination of Fresh Blood
The Thin Film
Thick Blood Films
Estimating Numbers of Malaria Parasites in Blood
Blood Concentration Procedures
Rapid Diagnostic Tests for Malaria
Examination of Cerebrospinal Fluid
Tissue Impressions
Biopsy and Aspiration
Duodenal Sampling and Biopsy
Examination of Sputum
Culture Methods
Animal Inoculation
References
PART 12 Drugs Used in Tropical Medicine
162 Albendazole
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
Adverse Events and Serious Adverse Events
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60 Years)
Resistance
Storage
Further Reading
163 Artemisinin
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
Adverse Events and Serious Adverse Events
Key Drug IntERactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pedatrics
Elderly (Age >60)
Resistance
Storage
Availability in the United States
Comments on Use
Further Reading
164 Benznidazole
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
Adverse Events and Serious Adverse Events
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60)
Resistance
Storage
Availability in the United States
Further Reading
165 Dapsone
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
How to Give the Drug
Adverse Events and Serious Adverse Events
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60)
Resistance
Storage
Availability in the United States
Comments on Use
Further Reading
166 Diethylcarbamazine (DEC)
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
How to Give the Drug
Adverse Events and Serious Adverse Events
Due to the Drug Itself
Due to the Effect on the Parasite
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60)
Resistance
Storage
Availability in the United States
Comments on Use
References
167 Eflornithine
Description
Available Product
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
Adverse Events and Serious Adverse Events:
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60)
Resistance
Storage
Availability in the United States
Further Reading
168 Ivermectin
Description
Available Product
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
How to Give the Drug
Adverse Events and Serious Adverse Events
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60)
Resistance
Storage
Availability in the United States
References
169 Mebendazole
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
Adverse Events and Serious Adverse Events
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60 Years)
Resistance
Storage
Further Reading
170 Miltefosine
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Hepatic Failure
Dose
Route of Administration
How to Give the Drug
Adverse Events and Serious Adverse Events
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy (boxed warning)
Lactation
Pediatrics
Elderly (Age >60)
Resistance
Storage
Availability in the United States
Comments on Use
Further Reading
171 Nifurtimox
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adustments in Liver Failure
Dose
Route of Administration
Adverse Events and Serious Adverse Events
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60)
Resistance
Storage
Availability in the United States
Comments on Use
Further Reading
172 Nitazoxanide
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
Adverse Events and Serious Adverse Events
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60 Years)
Resistance
Storage
Further Reading
173 Pentamidine
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Injectable
Inhaled
Route of Administration
How to Give the Drug
Adverse Events and Serious Adverse Events
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60 Years)
Resistance
Storage
Availability in the United States
Comments on Use
Further Reading
174 Pentavalent Antimony
Description
Available Products
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
How to Give the Drug
Adverse Events and Serious Adverse Events
Key Drug Interactions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (Age >60 Years)
Resistance
Storage
Product Insert
Availability in the United States
Comments on Use
References
175 Praziquantel
Description
Available Product
Indications
Mode of Action
Pharmacokinetics
Dose Adjustments in Renal Failure
Dose Adjustments in Liver Failure
Dose
Route of Administration
Adverse Events and Serious Adverse Events
Key Drug IntEractions
Contraindications
Use in Special Populations
Pregnancy
Lactation
Pediatrics
Elderly (age >60)
Resistance
Storage
Availability in the United States
Further Reading
Index
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z