Definition
Tonsillitis is inflammation (swelling) of the tonsils.
Causes
When bacteria and viruses enter your body through your nose or mouth, your tonsils act as a filter — engulfing the offending organisms in white blood cells. This may cause a low-grade infection in your tonsils, which stimulates your immune system to form antibodies against future infections. But sometimes the tonsils are overwhelmed by a bacterial or viral infection. The result is tonsillitis.
Various viruses and bacteria can cause tonsillitis, including the virus that causes mononucleosis (the Epstein-Barr virus) and the bacterium that causes strep throat (Streptococcus pyogenes).
Symptoms
Tonsillitis is characterized by red, swollen tonsils. You may also notice white patches on the tonsils. Other signs and symptoms of tonsillitis include:
§ Difficult or painful swallowing
§ Headache
§ Fever and chills
§ Enlarged, tender glands (lymph nodes) in the jaw and neck
§ Ear pain
§ Fever, chills
§ Sore throat - lasts longer than 48 hours and may be severe
§ Voice changes, loss of voice
Diagnosis
The health care provider will check your tonsils and the back of your throat for signs of infection, such as redness , have white spots on them and pus. The lymph nodes of the jaw and neck may be enlarged and tender to the touch.
A culture of the tonsils may show bacterial infection. A culture for the streptococcus bacteria (strep) may be taken because it is the most common and most dangerous form of tonsillitis.
Treatment
# Tonsillitis is typically treated with self-care or antibiotics. Although surgery is no longer the standard treatment for tonsillitis, it may be recommended in some cases.
# Self-careIf tonsillitis is caused by a viral infection, you'll need to let the virus run its course. #Drink warm, soothing liquids — such as soup, broth and tea — and gargle with warm salt water. Acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) can help reduce fever and decrease pain. Because of the risk of Reye's syndrome — a potentially life-threatening illness — don't give aspirin to children younger than age 12.
# AntibioticsIf tonsillitis is caused by a bacterial infection, your doctor will prescribe antibiotics. Oral antibiotics typically need to be taken for at least 10 days. Stopping medication early may cause the infection to come back — which can lead to potentially serious complications.
# Surgical removal of the tonsils (tonsillectomy) is rarely needed for adults. During childhood, surgery may be recommended if:
§ child has seven or more episodes of tonsillitis in one year
§ child has five or more episodes of tonsillitis a year for two years
§ Swollen tonsils interfere with your child's breathing or swallowing
§ An abscess develops in the tonsils
Prognosis
Tonsillitis symptoms usually lessen in 2 or 3 days after treatment starts. The infection usually is cured by then, but may require more than one course of antibiotics. Complications of untreated strep tonsillitis may be severe. A tonsillectomy may be recommended if tonsillitis is severe, comes back, or does not respond to antibiotics.
Complications
# Pharyngitis - bacterial
# Pharyngitis - viral
# Dehydration from difficulty swallowing fluids
# Peritonsillar abscess or abscess in other parts of the throat
# Rheumatic fever and subsequent cardiovascular disorders
# Kidney failure
# Post-streptococcal glomerulonephritis
# Sometimes the swelling can be so severe that the roof of the mouth and tongue meet, blocking airflow and making swallowing extremely difficult. Rarely, the abscess may spread into the bloodstream or into the neck or chest.
# Some strains of streptococcal bacteria that cause tonsillitis can also cause kidney inflammation (nephritis) a serious condition that can affect the heart, joints, nervous system and skin.
Sabtu, 24 November 2007
CRF ( Chronic Renal Failure )
Definition
Chronic renal failure is a gradual and progressive loss of the ability of the kidneys to excrete wastes, concentrate urine, and conserve electrolytes.
Causes and risk factors
The most common causes of chronic renal failure are diseases or illnesses that damage the kidneys little by little for many years. These include high blood pressure, diabetes mellitus, polycystic kidney disease, obstructions of the urinary tract, glomerulonephritis, certain cancers, analgesic nephropathy, kidney stones and infection, autoimmune disorders such as systemic lupus erythematosus, and diseases of the heart or lungs. Using painkilling medications for a long period time may also damage the kidneys and cause chronic renal failure.
Symptoms
Because chronic renal failure progresses gradually, symptoms may be so mild
# At first, symptoms include frequent urination, especially at night. The urine is dilute, which means it has a high water content, making it appear pale to clear in color.
# Nausea, fatigue, confusion, joint pain, reduced urination, blood in the urine, seizures, headaches, itching, pain in the kidney area, and a yellowish-brown appearance to the skin.
# Chronic renal failure can lead to coma and death.
# Unintentional weight loss
Additional symptoms that may be associated with this disease:
# Excessive thirst
# Abnormally dark or light skin
# Paleness
# Nail abnormalities
# Breath odor
# High blood pressure
# Loss of appetite
# Agitation
Diagnosis
To diagnose chronic renal failure:
# physical examination, checking specifically for any enlargement or tenderness in the kidney area.
# blood and urine tests to check levels of waste products, sodium, and potassium in bloodstream and urine. Levels of waste products called creatinine and urea will be high in patients with renal failure.
# Check bladder and may need to insert a tube, called a catheter, into the bladder to remove urine.
# With abdominal ultrasound, abdominal computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans, which produce a picture of the kidneys and surrounding structures. Renal or abdominal x-ray.
# Arterial blood gas and blood chemistry analysis may show metabolic acidosis
Treatment
# Treatment for chronic renal failure depends upon the cause, focuses on controlling the symptoms, minimizing complications, and slowing the progression of the disease.
# Don’t forget to Control of blood pressure .Blood transfusions or medications such as iron and erythropoietin supplements may be needed to control anemia.
# Fluid intake may be restricted, often to an amount equal to the volume of urine produced.
# Dietary protein restriction may slow the build-up of wastes in the bloodstream and control associated symptoms such as nausea and vomiting. Salt, potassium, phosphorus, and other electrolytes may be restricted.
# Dialysis or kidney transplant may be required eventually.
Prognosis
There is no cure for chronic renal failure. Untreated, it usually progresses to end-stage renal disease. Lifelong treatment may control the symptoms of chronic renal failure.
Complications
# End-stage renal disease
# Pericarditis
# Cardiac tamponade
# Congestive heart failure
# Hypertension
# Loss of blood from the gastrointestinal tract
# Ulcers
# Hemorrhage
# Anemia
# Decreased functioning of white blood cells
# Decreased immune response
# Increased incidence of infection
# Peripheral neuropathy
# Joint disorders
# Changes in glucose metabolism
# Electrolyte abnormalities including hyperkalemia
Chronic renal failure is a gradual and progressive loss of the ability of the kidneys to excrete wastes, concentrate urine, and conserve electrolytes.
Causes and risk factors
The most common causes of chronic renal failure are diseases or illnesses that damage the kidneys little by little for many years. These include high blood pressure, diabetes mellitus, polycystic kidney disease, obstructions of the urinary tract, glomerulonephritis, certain cancers, analgesic nephropathy, kidney stones and infection, autoimmune disorders such as systemic lupus erythematosus, and diseases of the heart or lungs. Using painkilling medications for a long period time may also damage the kidneys and cause chronic renal failure.
Symptoms
Because chronic renal failure progresses gradually, symptoms may be so mild
# At first, symptoms include frequent urination, especially at night. The urine is dilute, which means it has a high water content, making it appear pale to clear in color.
# Nausea, fatigue, confusion, joint pain, reduced urination, blood in the urine, seizures, headaches, itching, pain in the kidney area, and a yellowish-brown appearance to the skin.
# Chronic renal failure can lead to coma and death.
# Unintentional weight loss
Additional symptoms that may be associated with this disease:
# Excessive thirst
# Abnormally dark or light skin
# Paleness
# Nail abnormalities
# Breath odor
# High blood pressure
# Loss of appetite
# Agitation
Diagnosis
To diagnose chronic renal failure:
# physical examination, checking specifically for any enlargement or tenderness in the kidney area.
# blood and urine tests to check levels of waste products, sodium, and potassium in bloodstream and urine. Levels of waste products called creatinine and urea will be high in patients with renal failure.
# Check bladder and may need to insert a tube, called a catheter, into the bladder to remove urine.
# With abdominal ultrasound, abdominal computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans, which produce a picture of the kidneys and surrounding structures. Renal or abdominal x-ray.
# Arterial blood gas and blood chemistry analysis may show metabolic acidosis
Treatment
# Treatment for chronic renal failure depends upon the cause, focuses on controlling the symptoms, minimizing complications, and slowing the progression of the disease.
# Don’t forget to Control of blood pressure .Blood transfusions or medications such as iron and erythropoietin supplements may be needed to control anemia.
# Fluid intake may be restricted, often to an amount equal to the volume of urine produced.
# Dietary protein restriction may slow the build-up of wastes in the bloodstream and control associated symptoms such as nausea and vomiting. Salt, potassium, phosphorus, and other electrolytes may be restricted.
# Dialysis or kidney transplant may be required eventually.
Prognosis
There is no cure for chronic renal failure. Untreated, it usually progresses to end-stage renal disease. Lifelong treatment may control the symptoms of chronic renal failure.
Complications
# End-stage renal disease
# Pericarditis
# Cardiac tamponade
# Congestive heart failure
# Hypertension
# Loss of blood from the gastrointestinal tract
# Ulcers
# Hemorrhage
# Anemia
# Decreased functioning of white blood cells
# Decreased immune response
# Increased incidence of infection
# Peripheral neuropathy
# Joint disorders
# Changes in glucose metabolism
# Electrolyte abnormalities including hyperkalemia
more about....pneuMOnia
Definition
Pneumonia is an inflammation of the lung and respiratory system, usually caused by an infection. Three common causes are bacteria, viruses and fungi. The air sacs in the lungs fill with pus and other liquid. Oxygen has trouble reaching your blood. If there is too little oxygen in your blood, your body cells can't work properly. Because of this and spreading infection through the body pneumonia can cause death.
Signs and symptoms
The main symptoms of pneumonia are:
# Cough with greenish or yellow mucus; bloody sputum happens on occasion
# Fever with shaking chills
# Sharp or stabbing chest pain worsened by deep breathing or coughing
# Rapid, shallow breathing
# Shortness of breath
Additional symptoms include:
# Headache
# Excessive sweating and clammy skin
# Loss of appetite
# Excessive fatigue
# Confusion , especially in older people
Causes
Pneumonia is not a single disease. It can have over 30 different causes. There are five main causes of pneumonia:
• Bacteria
• Viruses
• Mycoplasmas
• Other infectious agents, such as fungi -- including pneumocystis
• Various chemicals
Risk factors
You are more at risk of pneumonia if:
# Over 65,
# Smoke,
# A heavy drinker,
# Already have a lung disease, such as asthma or cystic fibrosis,
# Have, or have recently had, an illness that has made your body's natural defences against
infection weaker, such as flu,
# Take medicine for an illness such as AIDS or cancer, which has made it harder for your body
to fight off infection, or
# An intravenous drug user.
# Children under the age of 2 are also at increased risk of pneumonia.
Diagnosis
The following tests may show signs of pneumonia:
# Chest x-ray
# Gram's stain and culture of your sputum to look for the organism causing your symptoms
# CBC to check white blood cell count; if high, this suggests bacterial infection
# Arterial blood gases to check how well you are oxygenating your blood
# CAT scan of the chest
# Pleural fluid culture if there is fluid in the space surrounding the lungs
Complications
The complications of pneumonia:
· Bacteria in the bloodstream ( bacteremia )
· Lung abscess or Emphyema.
· Fluid accumulation and infection around the lungs.
Treatment
The treatment of pneumonia depends on the type of pneumonia you have and the severity of your symptoms.
· Bacterial pneumonia is usually treated with antibiotics, which fight the bacterial infection
· Viral pneumonia can't be treated with antibiotics. The recommended treatment is the
same as for flu - rest and drinking plenty of fluids.
· Aspiration pneumonia is normally treated at first by giving oxygen.
· For all types of pneumonia, painkillers such as paracetamol or ibuprofen can help to ease
the pain and fever caused by the pneumonia. Ibuprofen is not recommended if you have a
history of asthma, kidney, or liver disease.
· Make sure that you have plenty to drink to avoid dehydration
Prognosis
With treatment, most patients will improve within two weeks. Elderly or debilitated patients who fail to respond to treatment may die from respiratory failure.
Prevention
# There are vaccines that can help protect against pneumococcal pneumonia - the most common form of pneumonia.
# Wash your hand .
# Don’t smoke cause smoking damage the airways of your lungs making yaour lungs more vulnerable to infection.
Pneumonia is an inflammation of the lung and respiratory system, usually caused by an infection. Three common causes are bacteria, viruses and fungi. The air sacs in the lungs fill with pus and other liquid. Oxygen has trouble reaching your blood. If there is too little oxygen in your blood, your body cells can't work properly. Because of this and spreading infection through the body pneumonia can cause death.
Signs and symptoms
The main symptoms of pneumonia are:
# Cough with greenish or yellow mucus; bloody sputum happens on occasion
# Fever with shaking chills
# Sharp or stabbing chest pain worsened by deep breathing or coughing
# Rapid, shallow breathing
# Shortness of breath
Additional symptoms include:
# Headache
# Excessive sweating and clammy skin
# Loss of appetite
# Excessive fatigue
# Confusion , especially in older people
Causes
Pneumonia is not a single disease. It can have over 30 different causes. There are five main causes of pneumonia:
• Bacteria
• Viruses
• Mycoplasmas
• Other infectious agents, such as fungi -- including pneumocystis
• Various chemicals
Risk factors
You are more at risk of pneumonia if:
# Over 65,
# Smoke,
# A heavy drinker,
# Already have a lung disease, such as asthma or cystic fibrosis,
# Have, or have recently had, an illness that has made your body's natural defences against
infection weaker, such as flu,
# Take medicine for an illness such as AIDS or cancer, which has made it harder for your body
to fight off infection, or
# An intravenous drug user.
# Children under the age of 2 are also at increased risk of pneumonia.
Diagnosis
The following tests may show signs of pneumonia:
# Chest x-ray
# Gram's stain and culture of your sputum to look for the organism causing your symptoms
# CBC to check white blood cell count; if high, this suggests bacterial infection
# Arterial blood gases to check how well you are oxygenating your blood
# CAT scan of the chest
# Pleural fluid culture if there is fluid in the space surrounding the lungs
Complications
The complications of pneumonia:
· Bacteria in the bloodstream ( bacteremia )
· Lung abscess or Emphyema.
· Fluid accumulation and infection around the lungs.
Treatment
The treatment of pneumonia depends on the type of pneumonia you have and the severity of your symptoms.
· Bacterial pneumonia is usually treated with antibiotics, which fight the bacterial infection
· Viral pneumonia can't be treated with antibiotics. The recommended treatment is the
same as for flu - rest and drinking plenty of fluids.
· Aspiration pneumonia is normally treated at first by giving oxygen.
· For all types of pneumonia, painkillers such as paracetamol or ibuprofen can help to ease
the pain and fever caused by the pneumonia. Ibuprofen is not recommended if you have a
history of asthma, kidney, or liver disease.
· Make sure that you have plenty to drink to avoid dehydration
Prognosis
With treatment, most patients will improve within two weeks. Elderly or debilitated patients who fail to respond to treatment may die from respiratory failure.
Prevention
# There are vaccines that can help protect against pneumococcal pneumonia - the most common form of pneumonia.
# Wash your hand .
# Don’t smoke cause smoking damage the airways of your lungs making yaour lungs more vulnerable to infection.
Jumat, 23 November 2007
Cellulitis....skin infection...
Definition
Cellulitis is anacute inflammation of the connective tissue of the skin, caused by infection with staphylococcus, streptococcus or other bacteria (see also Erysipelas).
Causes
Cellulitis usually follows a break in the skin, such as a fissure, cut, burns , laceration, insect bite, puncture wound or sites of intravenous catheter insertion. Cellulitis occurs when one or more types of bacteria enter through a crack or break in your skin. The two most common types of bacteria that cause cellulitis are Group A streptococcus and staphylococcus are the most common of these bacteria, which are part of the normal flora of the skin but cause no actual infection until the skin is broken.
« Pain or tenderness of the area
« Skin lesion or rash (macule)
« Warmth over the area of redness
«Fever is common
« Other signs of infection:
o Chills, shaking
o Fatigue
o Muscle aches, pains (myalgias)
o General ill feeling (malaise)
o Nausea and vomiting
o Joint stiffness caused by swelling of the tissue over the joint
o Hair loss at the site of infection
DiagnosisSepsis, generalized infection and shock Meningitis (if cellulitis is on the face) Lymphangitis (inflammation of the lymph vessels) Thrombophlebitis may develop, particularly in the lower extremities.
Cellulitis is anacute inflammation of the connective tissue of the skin, caused by infection with staphylococcus, streptococcus or other bacteria (see also Erysipelas).
Causes
Cellulitis usually follows a break in the skin, such as a fissure, cut, burns , laceration, insect bite, puncture wound or sites of intravenous catheter insertion. Cellulitis occurs when one or more types of bacteria enter through a crack or break in your skin. The two most common types of bacteria that cause cellulitis are Group A streptococcus and staphylococcus are the most common of these bacteria, which are part of the normal flora of the skin but cause no actual infection until the skin is broken.
Symptoms
« Localized skin redness or inflammation that increases in size as the
« Pain or tenderness of the area
« Skin lesion or rash (macule)
« Warmth over the area of redness
«Fever is common
« Other signs of infection:
o Chills, shaking
o Fatigue
o Muscle aches, pains (myalgias)
o General ill feeling (malaise)
o Nausea and vomiting
o Joint stiffness caused by swelling of the tissue over the joint
o Hair loss at the site of infection
Diagnosis
- A raised white blood cell count is a frequent finding, along with an increased body temperature
- A blood culture may be performed if generalized infection is suspected.
- Needle aspiration of the advancing edge of cellulitis may be stained with Gram stain and cultured.
- Ultrasonography may be helpful in evaluating suppuration at the site and as an aid in guiding needle aspiration.
Treatment
Cellulitis treatment may require hospitalization if it is severe enough to warrant intravenous antibiotics and close observation. At other times, treatment with oral antibiotics and close outpatient follow-up is enough. Treatment is focused on control of the infection and prevention of complications.Antibiotics are given to control infection, and analgesics may be needed to control pain.
Prognosis
Cure is possible with 7 to 10 days of treatment. Cellulitis may be more severe in people with chronic diseases and people who are susceptible to infection (immunosuppressed).
Complications
Prevention
Good hygiene and good wound care lower the risk of cellulitis. Any wounds should be cleaned and dressed appropriately. Changing bandages daily or when they become wet or dirty will reduce the risk of contracting cellulitis. Finally, maintain good general health and control chronic medical conditions. A body that is healthy can more easily fight bacteria before they multiply and cause infection
, while a body that is run down has less protection against infection.Mmmm...Rheumatic fever????
RHEUMATIC FEVER
Definition
Rheumatic fever is inflammation of the body's organ systems, especially the joints and the heart, resulting from a complication of streptococcal infection of the throat. Rheumatic fever can affect many connective tissues of the body, nervous system and skin. Permanent heart damage from rheumatic fever is called rheumatic heart disease.
Signs and symptoms
Symptoms of rheumatic fever generally appear within five weeks after an untreated strep throat infection. The most common symptoms of rheumatic fever are:
Fever
Joint pain, migratory arthritis -- involving primarily knees, elbows, ankles, and wrists
Joint swelling
Abdominal pain
Skin rash
Skin eruption on the trunk and upper part of arms or legs
Eruptions that are ring-shaped or snake-like in appearance
Skin nodules
Sydenham's chorea ( jerky uncontrollable movements )
Nosebleeds
Shortness of breath
Chest pain
Sore throat
Red and swollen tonsils
Headache
Muscle aches
Causes
The exact cause of rheumatic fever isn't clear. In a few people, it seems that when the body fights a strep throat infection, other parts of the body develop inflammation. For example, the heart valves aren't necessarily infected with the streptococcal bacteria, but they can be injured or inflamed as the body fights strep throat.
Diagnosis
Bases the diagnosis of rheumatic fever mainly on the characteristic combination of symptoms. Diagnosing rheumatic fever requires not only the presence of key signs and symptoms but also evidence of a recent strep infection. Blood tests showing high levels of antibodies to streptococci may be helpful, but low levels of these antibodies are present in many children who do not have rheumatic fever. Abnormal heart rhythms caused by heart inflammation can be seen on an electrocardiogram (ECG—a recording of the heart's electrical activity). An echocardiogram (an image of structures in the heart produced by ultrasound waves) may be used to diagnose abnormalities of the heart valves.
Complications
Some common complications of rheumatic fever are:
« Damage to heart valves
« Endocarditis
« Heart failure
« Arrhythmia
« Pericarditis
« Permanent heart damage due to rheumatic fever is known as rheumatic heart disease
Prevention and Treatment
The best way to prevent rheumatic fever is with prompt and complete antibiotic treatment of any streptococcal throat infection. In addition, children who have had rheumatic fever should be given penicillin by mouth every day or by monthly injections into the muscle to help prevent another streptococcal infection. How long this preventive treatment should be continued is unclear. It depends on the severity of the disease and is usually continued at least until adulthood.
Treatment of rheumatic fever has three goals: eliminating any residual streptococcal infection; reducing inflammation, particularly in the joints and heart, and thus relieving symptoms; and limiting physical activity that might aggravate the inflamed structures.
Definition
Rheumatic fever is inflammation of the body's organ systems, especially the joints and the heart, resulting from a complication of streptococcal infection of the throat. Rheumatic fever can affect many connective tissues of the body, nervous system and skin. Permanent heart damage from rheumatic fever is called rheumatic heart disease.
Signs and symptoms
Symptoms of rheumatic fever generally appear within five weeks after an untreated strep throat infection. The most common symptoms of rheumatic fever are:
Fever
Joint pain, migratory arthritis -- involving primarily knees, elbows, ankles, and wrists
Joint swelling
Abdominal pain
Skin rash
Skin eruption on the trunk and upper part of arms or legs
Eruptions that are ring-shaped or snake-like in appearance
Skin nodules
Sydenham's chorea ( jerky uncontrollable movements )
Nosebleeds
Shortness of breath
Chest pain
Sore throat
Red and swollen tonsils
Headache
Muscle aches
Causes
The exact cause of rheumatic fever isn't clear. In a few people, it seems that when the body fights a strep throat infection, other parts of the body develop inflammation. For example, the heart valves aren't necessarily infected with the streptococcal bacteria, but they can be injured or inflamed as the body fights strep throat.
Diagnosis
Bases the diagnosis of rheumatic fever mainly on the characteristic combination of symptoms. Diagnosing rheumatic fever requires not only the presence of key signs and symptoms but also evidence of a recent strep infection. Blood tests showing high levels of antibodies to streptococci may be helpful, but low levels of these antibodies are present in many children who do not have rheumatic fever. Abnormal heart rhythms caused by heart inflammation can be seen on an electrocardiogram (ECG—a recording of the heart's electrical activity). An echocardiogram (an image of structures in the heart produced by ultrasound waves) may be used to diagnose abnormalities of the heart valves.
Complications
Some common complications of rheumatic fever are:
« Damage to heart valves
« Endocarditis
« Heart failure
« Arrhythmia
« Pericarditis
« Permanent heart damage due to rheumatic fever is known as rheumatic heart disease
Prevention and Treatment
The best way to prevent rheumatic fever is with prompt and complete antibiotic treatment of any streptococcal throat infection. In addition, children who have had rheumatic fever should be given penicillin by mouth every day or by monthly injections into the muscle to help prevent another streptococcal infection. How long this preventive treatment should be continued is unclear. It depends on the severity of the disease and is usually continued at least until adulthood.
Treatment of rheumatic fever has three goals: eliminating any residual streptococcal infection; reducing inflammation, particularly in the joints and heart, and thus relieving symptoms; and limiting physical activity that might aggravate the inflamed structures.
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