Exotic Infections Research Articles

The Tetracyclines

The tetracyclines, among the first of the antibiotics to become available 50 years ago, remain widely used. Tetracyclines have bacteriostatic activity against a wide variety of pathogens that are responsible for many common and some exotic infections. They are particularly valuable in the treatment of atypical pneumonia syndromes, chlamydial genital infections, rickettsial infection (Rocky Mountain spotted fever, typhus, Q fever), Lyme disease, and ehrlichiosis. On the basis of pharmacokinetic considerations, doxycycline is the preferred agent among the tetracycline congeners. Minocycline may have a limited role in the treatment of methicillin-resistant staphylococcal disease in situations in which an oral antimicrobial agent may be appropriate. The tetracyclines are generally contraindicated during pregnancy and childhood because of their association with dental staining and interference with bone growth. Photosensitivity may occur with some tetracyclines, and several drug and food interactions may limit gastrointestinal absorption.

Tropical viral infections

This section should be of particular interest to the travel medicine physician as it reports many new manifestations of exotic viral infections, both in terms of new clinical expression or extension to new geographical territory. Included are descriptions of improved diagnostic methodologies for arboviral diseases, a discussion of safety issues involving a licensed travel medicine vaccine and a randomized placebo-controlled trial of a drug widely prescribed to reduce vascular permeability in dengue hemorrhagic fever.

Book Review: Exotic Viral Infections

Book Review: Exotic Viral Infections

Book Review: Exotic Viral Infections

Book Review: Exotic Viral Infections

Surgical Infections

In the past 25 years a full discussion of surgical infections has grown from sturdy sections of various surgical texts into a hefty volume of its own. The new information has derived largely from two sources: the explosion of knowledge about the structure and function of the infecting agents and about how they infect or can be prevented from doing damage; and the increasing prevalence of exotic infections, as surgical practice has extended into the realm of impaired immunity, as seen in cancer therapy, transplantation, shock, and HIV infection. Of course, traditional surgical infections remain, as always, the practitioner's chief adversary, and despite new understanding of invaders, more accurate diagnosis and more effective drugs, clinical skills in surgical intervention and in wound healing are still critical to gaining therapeutic success. "lifestyles of the infecting invaders" <i>Surgical Infections</i>, edited by Donald E. Fry, covers all corners of this sprawling field in

Adverse effects of chemotherapeutic agents used in tropical medicine.

Traditionally, many of the chemotherapeutic agents used in tropical medicine have possessed limited efficacy and serious adverse effects. This scenario has been revolutionised by the introduction into clinical parasitology of the benzimidazole compounds, praziquantel (and other schistosomicidal agents) and ivermectin for helminthiases, and the 5-nitroimidazoles for protozoan infections. An effective armamentarium against Plasmodium spp. infections, especially P. falciparum, is receding as widespread multiple drug resistance becomes commonplace. Although management of several more exotic parasitic infections, including trypanosomiasis, leishmaniasis and onchocerciasis remains unsatisfactory, several newer and relatively non-toxic preparations (including eflornithine and ivermectin) are now available, and offer optimism. However, there remains a very long way to go before a single preparation is available to combat all major protozoan and/or helminthic infections; such an agent would also need to be 100% effective when given as a single dose, safe not only in the healthy adult but also during pregnancy and lactation, stable at high ambient temperature and relatively low in cost.

Infectious disease and the internationally adopted child

The breakup of the former Soviet Union and other Communist bloc nations and Koreas shift from a developing to an industrialized country has changed international adoption of orphans by US citizens. Nevertheless the reasons for availability of children for adoption are the same: poverty abandonment abuse or neglect and political upheaval. Newly adopting families are very concerned about the potential for exotic infections. Proof of prearrival medical care (i.e. medical history and immunization records) is at best limited. No international standards for medical evaluation before adoption exist. No specific tests of a child younger than 16 years old other than physical examination are required when applying for a US orphan visa. Except in cases of excludable conditions (several sexually transmitted diseases e.g. HIV) the adopting parents or pediatrician providing subsequent care rarely have access to the results of the visa examination. Each incoming orphan should undergo a thorough re-evaluation upon arrival. Examining physicians should follow a simple standardized protocol which will identify most serious or chronic diseases of the internationally adopted child. They should conduct a urinalysis and a complete blood count and screen for syphilis tuberculosis intestinal parasites HIV and hepatitis B. Screening for delta virus should be done for any child with chronic hepatitis B infection. Some specialists have recommended routine screening for other infections including cytomegalovirus salmonellosis hepatitis A hepatitis C and malaria but the author (a pediatrician) thinks such screenings should be limited to the symptomatic child.

Tropical Pediatrics

Tropical pediatrics often is more a study of the consequences of poverty than of exotic infections. Pediatricians involved with the care of children in or from the tropics must deal with poverty, place an appropriate emphasis on preventive medicine, and seek to bridge their own cultural and linguistic barriers. Malaria, diarrheal disease, and malnutrition account for a large part of pediatric morbidity and mortality in tropical countries. P falciparum can cause severe malarial disease. Treatment must be initiated promptly; resistance to antimalarial drugs is possible. Hygienic and nutritional prevention of diarrhea must be coupled with widespread use of oral rehydration therapy for acute cases of diarrhea. Identification and early treatment of mildly malnourished children can prevent some of the mortality of overt marasmus and kwashiorkor.

Tropical pediatrics.

Tropical pediatrics often is more a study of the consequences of poverty than of exotic infections. Pediatricians involved with the care of children in or from the tropics must deal with poverty, place an appropriate emphasis on preventive medicine, and seek to bridge their own cultural and linguistic barriers. Malaria, diarrheal disease, and malnutrition account for a large part of pediatric morbidity and mortality in tropical countries. P falciparum can cause severe malarial disease. Treatment must be initiated promptly; resistance to antimalarial drugs is possible. Hygienic and nutritional prevention of diarrhea must be coupled with widespread use of oral rehydration therapy for acute cases of diarrhea. Identification and early treatment of mildly malnourished children can prevent some of the mortality of overt marasmus and kwashiorkor.

I. ESSAY: Developing AIDS Community Service Consortia

The early years of the acquired immunodeficiency syndrome (AIDS) epidemic in the United States were marked by rapidly increasing numbers of young people dying from a bewildering array of exotic infections, often following lengthy and costly hospitalizations.1 A lack of knowledge about modes of transmission, combined with extreme prejudice against the populations at highest risk, engendered an aura of hysteria that impeded understanding and access to care. By 1986, 21,570 cases of AIDS had been reported to the Centers for Disease Control (CDC); over half of these people had died. Urban hospitals were reeling under the human immunodeficiency virus (HIV) epidemic and the medical consequences of drug abuse and violence. The lifetime cost of AIDS was estimated to be $145,000 per person, almost all of which was associated with hospital use. Medicaid programs were facing unanticipated costs. A strategy was needed to reduce reliance on hospitals by developing outpatient treatment and community support services. The Robert Wood Johnson Foundation (RWJF) initiated the AIDS Health Services Program in 1986 to develop integrated networks of human services agencies (consortia) and to coordinate the provision of services using case management. The program emphasized community-based care, inspired by the “San Francisco model,” which is based on the premises that patients prefer community care to hospitalization and that this approach is also less costly. This essay summarizes the program evaluation, with particular focus on the approach to organizing and delivering case management services.

Nosocomial Transmission and Infection Control Aspects of Parasitic and Ectoparasitic Diseases: Part I. Introduction/Enteric Parasites

Interest in parasitic diseases has been stimulated by the entry of large numbers of Southeast Asian refugees into the United States in the last 15 years. The diagnosis of exotic infections such as clonorchiasis, paragonimiasis, and schistosomiasis in these patients has also sometimes provoked unfounded concerns on the part of hospital staff about the nosocomial transmission risks of such diseases. This on occassion has led to unnecessarily stringent isolation precautions and overtreatment with antiparasitic drugs. In reality, tuberculosis and hepatitis B represent much more significant nosocomial infection hazards from this patient population.1 More recently, attention has been focused on parasitic diseases as opportunistic infections in patients with the acquired immunodeficiency syndrome (AIDS). The parasitic infections complicating AIDS have been predominantly All-American protozoa such as Pneumocystis carinii, Toxoplasma gondii, and Cryptosporidium species. Of these, Cryptosporidium in particular, and possibly Pneumocystis may be nosocomially transmitted from AIDS patients. There are already several reports of suspected transmission of Cryptosporidium from patients to healthcare workers.2-4 Thus, it appears timely to review the helminthic, protozoan, and arthropod parasites that either ave been transmitted or that could be acquired within the hospital or institutional environment. Both the potential routes of transmission and the appropriate isolation precautions and other control measures to minimize transmission will be su marized.

Other common types of viral hepatitis and exotic infections

This chapter discusses two distinct sets of viruses which cause hepatitis. The first include common virus infections which cause mild hepatitis rarely in individuals with normal immunity but which may cause severe life-threatening hepatitis in the increasing number of patients with depressed cell mediated immune responses. The second comprise exotic virus infections which are prevalent in particular geographical areas and which frequently involve the liver with high mortality. For each of these viruses the epidemiology, clinical features, diagnosis and treatment are briefly reviewed.

Superficial Phaeohyphomycosis of the Scrotum in a Patient With the Acquired Immunodeficiency Syndrome

To the Editor.— Patients with the acquired immunodeficiency syndrome (AIDS) often have exotic opportunistic infections or unusual presentations of common infections. Report of a Case.— A 28-year-old male homosexual with AIDS, manifested by Kaposi's sarcoma and cytomegalovirus retinitis, presented to Dermatology Clinic with tiny brown spots on the scrotum over the last three weeks. He had been undergoing chemotherapy for Kaposi's sarcoma and had a white blood cell count of 6 × 109/L (600/mm3). Examination revealed flat, rough 1- to 3-mm papules with variegated pigmentation on the scrotum (Fig 1). Some resembled small follicular seborrheic keratoses. However, examination of one lesion with potassium hydroxide showed a mass of mycelia. Two separate lesions removed with a sterile scalpel were directly inoculated onto fungal culture slants and were evaluated by different mycology laboratories. The initial slants yielded a dull black-brown mycelia, which, on subculture, yielded two organisms: a fluffy

Fulminant Community-Acquired Infectious Diseases: Diagnostic Problems

The processes presented here do not represent an all-inclusive list of fulminant infectious diseases. Some of the more common acute, overwhelming infections of the central nervous system and lungs are covered elsewhere in this issue. We have selected less common, potentially catastrophic syndromes that might be recognized earlier if certain historical clues, physical findings, or laboratory abnormalities are appreciated. Specific and effective therapy is available for most of the diseases we have chosen. Meningitis due to Naegleria fowleri, a free-living ameba that may invade the central nervous system through the cribriform plate in persons swimming in brackish water, and hemorrhagic mediastinitis due to inhalation of Bacillus anthracis, which is acquired in occupational exposure to goat's hair, wool, or an animal with anthrax, are other examples but are lacking in proven effective therapy. Although most physicians quickly consider exotic and overwhelming infections in the severely compromised patient, fewer recognize this risk in the diabetic, cirrhotic, or healthy person with a unique occupational or travel history. During the present epidemic of AIDS, previous exposure to the HTLV-3 virus must be considered in all severely ill patients. The proper use of new diagnostic tests may permit the physician to intercede effectively if these life-threatening diseases are suspected.

Chemotherapy for 'exotic' RNA viruses.

Abstract : In-vitro screening programmes have identified a number of compounds with broad-spectrum antiviraloactivity against 'Exotic' RNA viruses. Among these, ribavirin has been the most extensively evaluated in man and experimental animals. Passive immunization, with convalescent plasma or immunoglobin preparations, is routinely employed for both prophylaxis and treatment of many viral diseases. For treatment of some of the more exotic viral infections, this approach has had variable success. Interest in combination chemotherapy also has recently increased. Combinations of ribavirin and arabinofuranosyladenine (ara- A) exhibit significant synergy against types types 1 and 2 herpes viruses, while ribavirin in combination with amantadine is more effective against influenza infection is tissue culture as well as mice. The number of natural products which nonspecifically activate macrophages, resulting in enhanced host resistance to viral infections, is growing. The progress made to date in the development of drugs, biological response modifiers including interferons, combination chemotherapy and drug delivery promises that effective treatments will be forthcoming and assures a place for chemotherapy in the treatment of life threatening viral diseases.

Exotic parasitic infections in Australia

Exotic parasitic infections in Australia

In-vivo activity of antivirals against exotic RNA viral infections.

Infection of humans by viruses belonging to the families of Toga-, Bunya-, and Arenaviridae constitutes a major health problem worldwide and certain of the viruses have the potential to cause widespread epidemics. In the search for effective chemotherapy against these viruses several hundred nucleoside and nucleotide analogues have been screened for antiviral activity. Of the compounds tested, ribavirin, has been shown in laboratory animal models to have significant inhibitory effects against Rift Valley Fever virus, the bunyavirus Punta Toro, Hantaan virus and arenaviruses such as Pichinde, Junin, Machupo and Lassa Fever. Clinical studies with ribavirin in persons infected with Lassa Fever virus are in progress. Ribavirin or certain analogues have no detectable in vivo activity against arboviral encephalitic infections caused by Venezuelan or Western Equine Encephalitis or Semliki Forest Viruses. Other compounds including a series of triazolo derivatives, and the thiazole carboxamide nucleoside Tiazofurin appear to have in-vivo activity against certain of these exotic RNA viruses.

Exotic parasitic infections in Australia

Medical Journal of AustraliaVolume 2, Issue 12 p. 592-593 Leading Article Exotic parasitic infections in Australia Douglas E. Moorhouse, Douglas E. Moorhouse Department of Parasitology, University of QueenslandSearch for more papers by this author Douglas E. Moorhouse, Douglas E. Moorhouse Department of Parasitology, University of QueenslandSearch for more papers by this author First published: 01 December 1983 https://doi.org/10.5694/j.1326-5377.1983.tb122687.xCitations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume2, Issue12December 1983Pages 592-593 RelatedInformation

Haemoproteus and Leucocytozoon infections in birds of the Oklahoma City Zoo.

A total of 222 birds, captive or free-flying in the Oklahoma City Zoo, were examined for blood parasites; 31 (14%) harbored Haemoproteus and/or Leucocytozoon. While 21% of the indigenous avifauna were infected, only 8% of the exotic bird species harbored haemoproteids and these parasites were also exotic to North America. There was no evidence to indicate that exotic infections were transmitted to native birds or vice versa.

ISOSPORA BELLI DIARRHEAL INFECTION IN HOMOSEXUAL MEN

Unsporulated Isospora belli oocysts were detected in the stool specimens of three homosexual men. The oocysts were ellipsoidal measuring 23-33 X 12-15 micron. It is acid fast with modified cold kinyoun stain (MCK) and reveals orange fluorescence with the Truant's stain. Sheather's sucrose flotation method is effective in concentrating Isospora oocyst as with other coccidial oocysts. One specimen showed many Charcot-Leyden crystals. All three patients responded to treatment. Isosporiosis is rare in this country and is endemic in the tropics and subtropics. Although one case acquired the infection after returning from an endemic area, the other two cases had no travel history. This raised the suspicion that this, like other parasitic infections (amebiasis, giardiasis, cryptosporidiosis) may be sexually transmitted. Such exotic parasitic infections in homosexual men during the outbreak of the acquired immunodeficiency syndrome adds another unusual infectious agent to the differential diagnosis of diarrheal disease in this high risk group of population.