A Simple Guide to Osteomyelitis

A Simple Guide to Osteomyelitis
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What is Osteomyelitis?
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Osteomyelitis is an infection of the bone substance by pyogenic bacteria and fungus.


What causes Osteomyelitis?
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The most causes of Osteomyelitis is

1.Staphylococcus aureus bacteria(80%).

Other bacteria involved are:

2.Streptococci Group A & B

3.Enterobacter species including E.Coli

4.Haemophilus influenzae

5.Pneumococci

6.Serratia marcescens

Systemic mycotic (fungal) infections may also cause osteomyelitis.

1.Blastomyces dermatitidis

2.Coccidioides immitis.

In children,
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1.the long bones are usually affected in children.

2.Spread of bacteria occurs from the bloodstream from a skin boil, dental abscess, direct injury to the bone.

3.Acute osteomyelitis almost invariably occurs in children.

In adults
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1.injury to the bone is the most common cause.

The bone injury is exposed to local infection in the skin or environment.

Staphylococcus aureus is the most common bacteria in osteomyelitis resulting from bone injury and infection.

Other bacteria such as Pseudomonas aeruginosa, E. coli, and Serratia marcescens, are also common.

2.The vertebrae and the pelvis are the bones most commonly affected in adults.

For osteomyelitis of the vertebral bodies,
50% are due to Staphylococcus aureus,
and the remaining 50%f are due to tuberculosis usually from the lungs.

3.Bone infection in adults are usually due to their lower resistance from

debilitation,
intravenous drug abuse,
infectious root-canal teeth,
other disease or drugs (e.g. immunosuppressive therapy).


What are the symptoms of Osteomyelitis?
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Symptoms:
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1.pain and swelling of the bone

2.fever

3.toxemia

Signs:
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1.Hot tender bones

2.Throbbing pain of bones

3.Abscess and swelling


How do you made the diagnosis of Osteomyelitis?
-------------------------------------------------

Diagnosis of osteomyelitis is often based on:

1.radiologic results showing a translucent center with a ring of sclerosis(hardened bones)

2.Blood and bone cultures are normally required to identify the specific pathogen


What are the complications of Osteomyelitis?
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The complications of Osteomyelitis are:

1.fractures of the bone

2.amyloidosis

3.endocarditis

4.septicemia


What is the treatment of Osteomyelitis?
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1.antibiotic therapy - usually as prolonged treatment lasting a matter of weeks or months.

2.Hyperbaric oxygen therapy has helped in the treatment of refractory osteomyelitis.

3.Immobilization of the bone affected(bed rest, plaster casts,splints)

4.Osteomyelitis may also need surgical debridement to remove pus and damaged bone tissues.

5.Severe cases may lead to the loss of a limb.


What is the prognosis of Osteomyelitis?
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Prognosis depends on the rapidity of onset of treatment.

The faster the treatment the faster thee cure.

Otherwise the condition may become a chronic illness requiring multiple surgical procedures.

A Simple Guide to Cervicitis

A Simple Guide to Cervicitis
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What is Cervicitis?
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Cervicitis is non-specific infection of the cervix.

It is most common on the posterior cervix but may be anterior or concentric.


Who is affected by Cervicitis?
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1.Congeital cervical erosions or cervicitis can occur in virgins.

2.sexually active females

3.dilatation in labor or during abortion

What are the types of Cervicitis?
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1.Simple:

Erosion surface is smooth

2.Papillary:

Erosion surface is rough

3.Follicular:

Erosion surface is cystic

What are the Causes of Cervicitis?
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Bacterial infections:
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1.Gonorrhea

2.Chlamydia

3.staphylococcus aureus

4.Streptococcus

5.Mycobacterium tuberculosis.

6.E.coli

Viral infections:
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1.Genital herpes

2.Human Papilloma Virus

Other causes:
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1.Cervical cap

2.Device to support the uterus (pessary)

3.Diaphragm

4.allergy to spermicides

5.Exposure to a chemical

What are the complications of Cervicitis?
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1.Pelvic inflammatory disease

2.Urethritis and cystitis

3.rarely malignant changes in cervix

4.inguinal lymphadenitis

5.Cervical cancer

What are the Symptoms and signs of Cervicitis?
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1.Mucopurulent vaginal discharge (Gray, white, or yellow color) with odor

2.Blood in the vaginal discharge
a.After intercourse
b.After menopause
c.Between periods

3.Urinary infection symptoms - frequency and pain

3.hematuria (blood in the urine)

4.Pelvic pain

5.Backache

6.Painful sexual intercourse

7.Pain in the vagina

8.Pressure or heaviness in the pelvis

Signs:

1.reddened area of cervix

2.erosion of cervical wall

3.Vaginal surface of cervix may be affected

4.pus discharge from the cervix

5.Swelling (inflammation) of the walls of the vagina

How is diagnosis of Cervicitis made?
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1.Vaginal examination with Pap's smear of cervical cells

2.Cervical swab for culture and sensitivity to antibiotics

3.Blood tests( white cell count , blood culture, chlamydia, gonorrhea)

4.Biopsy of cervical erosions.

What is the treatment of Cervicitis?
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1. Antibiotics is given according to the sensitivity of bacteria in the culture.

2.Pelvic pain and backache may be treated with paracetamol

3.Local application of sulphonamide, tetracycline or other antibiotic cream to affected cervical area

4.Electro-Cauterisation of the affected cervical area

5.Cryosurgery of cervical erosions

6.Cone biopsy if necessary of affected cervix area.

7.Hormonal therapy (especially in postmenopausal women)

8.Laser therapy of cervical erosions

What is the prognosis of Cervicitis?
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Prognosis with appropriate treatment and antibiotics is generally good.

Recurrence is common.

Cervicitis may last for months to years.

Cervicitis may lead to pain with intercourse (dyspareunia).

What are Preventive measures for Cervicitis?
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Avoid sexual intercourse with multiple partners.

Use condoms during sexual intercourse.

Vaccination against human papilloma virus

Avoid chemical irritants such as douches and deodorant tampons.

Avoid using spermicidal contraceptives

Make sure that any foreign objects that inserted into the vagina is clean or sterile

A Simple Guide to Stomatitis

A Simple Guide to Stomatitis
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What is Stomatitis?
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Stomatitis means inflammation of the mouth

What are the Causes of Stomatitis?
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There are many many disorders which can cause Stomatitis:

1.Bacteria, viruses, fungus

2.avitaminosis

3.leukemia,agranulocytosis

4.Dental problems,poor fitting denture, poor dental hygience

5.smoking

6.medicines: phenytoin, iodides, barbiturates

7.stress

What are the Symptoms of Stomatitis?
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Stomatitis usually appear on the inner surface of the cheeks and lips, tongue, soft palate, and the base of the gums.

It may begin with a tingling or burning sensation, followed by a red hyperemia of the inside of the lining of the cheek, gums or tongues.

The inflamed surfaces may develop into ulcers

Occasionally, a severe occurrence may be accompanied by fever,lymphadenopathy and lethargy.

Most mouth inflammation is not infectious except bacterial,fungal and viral infections.

Oral mucosal smears may be necessary to determine those with bacterial or fungal infections.

What is the Treatment of Stomatitis?
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The exact treatment will depend on the cause of the Stomatitis.
Sometimes all that is required is to remove the cause of the Stomatitis such as an ill fitting denture.

The following measures may help to reduce pain from Stomatitis:
Proper oral hygience:
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1.keep your mouth clean at all times,

2.avoid foods that are spicy, acidic, salty or particularly hot or cold, which can make the symptoms worse,

3.eat a healthy diet that includes fresh fruit and vegetables,

4.gargle with warm salt water,

5.use a diluted chlorhexidine mouthwash once a day to help reduce the length of time the stomatitis last.

6.sprays and rinses are also available for pain relief.

Medical treatment:
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The main treatment of the Stomatitis is application of topical corticosteroids (Kenalog in orabase or Oracorte E), or other soothing preparations.

Where bacteria are present the appropriate antibiotic will treat the Stomatitis.

Antifungal agents are used to treat fungal infection.

Vitamin B replacements are important in cases due to deficiency of the vitamins.

Underlying condition:
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Treatment of systemic condition causing the Stomatitis such as leukemia,

What are the Prevention measures in Stomatitis?
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Good oral hygiene may help in the prevention of some types of stomatitis or complications from stomatitis.

This includes brushing the teeth at least twice per day, flossing at least daily, and going for regular dental checkup and cleaning.

Try to avoid getting run down by making sure you eat a balanced diet, take regular exercise and learn to manage stress.

What is the prognosis of the Stomatitis?
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The outlook for most stomatitis is good.

Those with underlying condition such as leukemia will improve with treatment of the illness.

A Simple Guide to Balanitis

A Simple Guide to Balanitis
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What is Balanitis?
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Balanitis is an infection of the glans and prepuce of the penis.

What are the causes of Balanitis?
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It can occur because of:

1. Sexually transmitted bacterial diseases such as gonorrhea, chlamydia, candidiasis.

2. Viral diseases like genital herpes

3. Parasitic infection such as trichomoniasis

4. drug allergy and eruptions

5. Contact dermatitis,psoriasis,lichen planus,seborrheic dermatitis

6. collagen disease (Reiter's syndrome)

7. phimosis

What are the symptoms of Balanitis?
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1. Itchiness of the glans and prepuce with scratch marks

2. Pain and burning sensation on passing urine

3. Subpreputial(below prepuce) discharge 2-3 days after intercourse in venereal disease

4. Oedema of prepuce

5. Ulceration of the glans

6. Blisters or rashes in genital herpes

7. enlarged inguinal lymph nodes

How do you diagnose Balanitis?
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Physical examination.

Blood tests for venereal disease and glucose

Urine for sugar and leucocytes

What is the treatment of Balanitis?
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1. Antibiotic

2. Hygience

3. Treat underlying cause. (eg Diabetes)

4. circumcision

What is the prognosis of Balanitis?
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Prognosis is good.

Sometimes the disease may recur due to underlying causes.

Circumcision will cure any balanitis due to phimosis

A Simple guide to Diphtheria

A Simple guide to Diphtheria
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What is Diphtheria?
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Diphtheria is an acute, infectious childhood disease of the respiratory tract caused by the bacillus Corynebacterium diphtheriae, a Gram positive, non-sporulating aerobic micro-organism.

How is Diphtheria transmitted?
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Diphtheria is transmitted by droplets from the throat of infected patients or clothes soiled by discharges from the patients.
It is highly infectious.
Incubation period is 2-4 days.

The organism multiplies in the upper respiratory tract, secreting toxins which produce necrosis and fibrinous exudate.
This fibrinous exudate can form a leathery membrane which extends through the throat, tonsils, nasopharynx, larynx and trachea.
Through the blood, the toxin can spreadto the heart, nervous system and kidneys. Infections may also be localised in wounds in the skin,conjunctiva and rarely the vagina.
The infections occur in persons of all ages.

What are the Signs and Symptoms of Diphtheria?
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The incubation peroid is usually 2-4 days after contact with an infected patient.

Symptoms start off with:
1. sudden onset of malaise

2. mild fever

3. sore throat

4. Thick white or grayish tonsillar exudate

5. Membrane may spread to nasopharynx

5. cervical lymphadenopathy

6. difficult breathing

7. respiratory stridor,

8. hoarseness of voice

9. brassy cough

10.dilirium and coma

What are the complications of Diphtheria?
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The worst affected are children below the 1 year old.

Some serious complications are:
1.myocarditis

2.cranial nerve paralysis, especially the soft palate and oculomotor nerves

3.peripheral neuritis

4.laryngeal obstruction

5.death can occur if there is obstruction to breathing.

Serious complications are less with older children or adults.

Adults rarely get Diphtheria because their immunity from vaccination usually last 10 years after the last dose.
When adults get Diphtheria, there is only slight inflammation with little or no exudates.

What are the investigations necessary to diagnose Diphtheria?
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Pharyngeal and nasal swabs for culture in Loeffler medium
Methylene blue stain of membrane

What is the Treatment of Diphtheria?
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Isolation in hospital is necessary.

1.Antibiotics (erythromycin or Penicillin) are used in the treatment of Diphtheria.

2.Antitoxin can be given by intramuscular or intravenous injection

3.Intravenous fluids given for dehydration

4.Tracheostomy if breathing obstruction is bad

5.Oxygen therapy in cases of breathing difficulty

6.Cardiac failure should be treated


Besides antibiotics, the following will help:
Steam inhalation
cough mixtures
avoid smokes, dust, dry air,sudden temperature change

What is the Prevention for Diphtheria?
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Vaccination against Diphtheria is the best prevention .
Since vaccination began, the worldwide incidence of Diphtheria has declined.

Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.

There is also a booster vaccination at 18 months.

What is the prognosis in Diphtheria?
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Death occurs in 10% of cases.

Mortality is highest in children under 10 and adults over 50.

One attack usually confers immunity.

A Simple Guide to Stye & Chalazion

A Simple Guide to Stye & Chalazion
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What is a Stye?
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A Stye is an infected gland at the edge of the eyelid.

How does a Stye develop?
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A stye develops when a gland supplying wax to eyelash at the edge of the eyelid becomes blocked and infected.
A stye can grow on the inside or outside of the eyelid.
Styes are not harmful to vision.
They can occur at any age.

What are the Symptoms and Signs of Stye?
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A stye starts with pain, redness, tenderness and swelling in the area of the oil gland of the eyelid. Then a small pimple appears. Sometimes just the immediate area is swollen.
At other times the entire eyelid swells.
There may be frequent tearing in the affected eye, a feeling like something is in the eye or increased light sensitivity.

What Causes Styes?
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Most Styes are caused by staphylococcal bacteria.
This bacterium is often found in the nose, and it's easily transferred to the eye by rubbing first your nose, then your eye.
Styes are not normally harmful to vision
They generally heal within a few days.

What is the Treatment for Stye?
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Most styes heal within a few days on their own.
You can apply hot compresses for 10 to 15 minutes, three or four times a day over the course of several days. This will relieve the pain and bring the stye to a head, much like a pimple. The stye ruptures and drains, then heals.

If you have frequent styes, your eye doctor may prescribe a course of antibiotic and ask you to apply an antibiotic eye ointment to kill the bacteria causing the stye.

In most cases, the Styes formed inside the eyelid either disappear completely or rupture on their own. In some cases, the styes become bigger and can be more serious.
These styes may need to be surgically incised and drained by your eye care practitioner.

What is a Chalazion?
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Chalazion is an another type of Eyelid swelling usually inner to the edge of the eyelid.
Often mistaken for a stye, a chalazion is an enlarged, blocked oil gland (tarsal gland)in the inner lining of the eyelid and not at the edge of the eyelid as in the case of a stye.

A chalazion may look like a stye for the first few days, then turns into a hard painless lump in the inner eyelid later on.
Most chalazion develops further from the eyelid edge than stye.

The same treatment is used for the healing of a chalazion.
However in this case, the swelling may linger for one to several months.
If the chalazion remains after several months, your eye doctor may surgically incise and drain it to facilitate healing.

A Simple Guide to Sinusitis

A Simple Guide to Sinusitis
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What is sinusitis?
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Sinusitis is a condition in which the lining of your sinuses becomes inflamed.

The sinuses are the air chambers in the bone behind your cheeks, eyebrows and jaw.
They produce mucus, a fluid that cleans bacteria and other particles out of the air you breathe. Tiny hairs called cilia sweep mucus out of your sinuses so it can drain out through your nose.
The paranasal sinuses are in direct communication with the nose.
The sinuses are normally sterile.

If the sinus openings may become blocked, the mucus becomes congested in the sinuses, resulting in stagnation of secretion and finally bacterial growth.

What causes sinusitis?
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Anything that causes swelling in your sinuses or keeps the cilia from moving mucus can cause sinusitis.
This can occur because of changes in temperature or air pressure,
Using decongestant nasal sprays too much,
Smoking, and
Swimming or diving.
Some people have growths called polyps that block their sinus passages.
When sinusitis is caused by a bacterial or viral infection, you get a sinus infection.

Sinus infections sometimes occur after you've had a cold.
The cold virus attacks the lining of your sinuses, causing them to swell and become narrow.
Your body responds to the virus by producing more mucus, but it gets blocked in your swollen sinuses.
This built-up mucus makes a good place for bacteria to grow.
The bacteria can cause a sinus infection.

Acute sinusitis is usually bacterial in origin.
Haemophilus influenzae and Streptococcus pneumoniae are the organisms most commonly found in adults.
In children, similar organisms are seen, with the addition of Moraxella catarrhalis.
In older children and young adults, Staphylococcus aureus is an occasional finding.
In systemically impaired hosts, Candida, Aspergillus, and Phycomycetes may be the cause.

Risk factors include the following: diabetes mellitus, cancer, hepatic disease, renal failure, burns, extreme malnutrition, and immunosuppressive diseases.

What are the signs of acute sinusitis?
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Presentation of sinusitis is often nonspecific.

Patients may present with a persistent cold.
A cold that starts to get better and then gets worse may be a sign of acute sinusitis.

Pain or pressure in some areas of the face (forehead, cheeks or between the eyes) is often a sign of blocked sinus drainage and can be a sign of acute sinusitis.

Pain in your forehead that starts when you lean forward can also be a sign.

Other symptoms may include a stuffy nose.

Some patients complain of dental pain or alteration in smell.

Fever is seen in fewer than 2% of individuals with sinusitis.

Facial tenderness to palpation is present.

Complete opacification of sinus on transillumination is present.

An X-ray of the paranasal sinuses usually confirms the presence of sinusitis as opacity in the sinuses.

How is acute sinusitis treated?
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Your doctor may prescribe an antibiotic.
You may take an antibiotic for 10 to 14 days, but you will usually start feeling better a couple of days after you start taking it. It is important to take this medicine exactly as your doctor tells you and to continue taking it until it is gone, even after you're feeling better.

If you have sinus pain or pressure, your doctor may prescribe or recommend a decongestant to help your sinuses drain.

Painkillers may be prescribed if there is severe pain.

How to take care of sinusitis?
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1.Get plenty of rest.

2.Lying down can make your sinuses feel more congested, so try lying on the side that lets you breathe the best.

3.Drink plenty of fluids.

4.Apply moist heat by holding a warm, wet towel against your face or breathing in steam through a cloth or towel.

5.Rinse your sinus passages with a saline solution.

How is chronic sinusitis treated?
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In cases where the acute sinus infection does not cleared or become chronic, a sinus washout may be necessary to remove the mucus stucked in the sinuses.

This involves syringing of antiseptic solution through a hole in the septum separating the maxillary sinuses from the nose.
Sometimes syringing of frontal sinuses can be done through a tube inserted into the sinuses.

In severe case of chronic sinusitis, endoscopy surgery may be done to strip the lining of the maxillary sinuses and clean the cavity of the sinuses.

A new therapy is the use of phage therapy where bacterial viruses are used to cause bacterila lysis in the sinuses.

A Simple Guide to Conjunctivitis

A Simple Guide to Conjunctivitis
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What is Conjunctivitis?
---------------

Conjunctivitis is an inflammation of the conjunctiva(the white of the eye and inner lining of eyelids).
It is one of the most common and treatable eye infections in children and adults.

What causes Conjunctivitis?
---------------------------------

Conjunctivitis can be caused by a
virus
bacteria
irritating substances (shampoos, dirt, smoke, and especially pool chlorine)
allergens (substances that cause allergies).

Conjunctivitis caused by bacteria, viruses can spread easily from person to person, but is not a serious health risk if diagnosed promptly.

What are the symptoms of Conjunctivitis?
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1.Redness in the white of the eye or inner eyelid

2.tears overflowing

3.yellow discharge that crusts over the eyelashes, especially after sleep
Other discharge from your eye (green or white) .

4.Pain in the eye

5.Itchy eyes (especially in conjunctivitis caused by allergies)

6.Burning eyes (especially in conjunctivitis caused by chemicals and irritants)

7.Blurred vision

8.sensitivity to light

How is Conjunctivitis spread?
-----------------------------------

Bacterial or viral Conjunctivitis can also be spread through hand contact when rubbing the eyes or touching contact lenses after touching infected skin.

Being around a person who has conjunctivitis and wearing contact lenses may increase your risk of getting conjunctivitis, but the outcome is usually very good with treatment.

How is Conjunctivitis treated?
-----------------------------------

Bacteria:Conjunctivitis caused by bacteria is treated with antibiotics.
The antibiotic can be given as eye drops, ointments, or pills.
Eye drops or ointments may need to be applied to the inside of the eyelid three to four times a day for five to seven days.

Virus: No Medicine can treat conjunctivitis caused by a virus.
This type of conjunctivitis often results from a common cold.
You may, however, help relieve symptoms by applying a cold compress.

Irritating substance:For this type of conjunctivitis, use warm water for five minutes to wash the irritating substance from the eye.

Allergies:Allergy-associated conjunctivitis is treated with antihistamines or when the allergen is determined and removed.

How to relieve symptoms of Conjunctivitis?
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1.Protect your eyes from dirt and other irritating substances.

2.Do not use contact lenses, if you wear them.

3.Place cold compresses on your eyes.

4.Wash your face and eyelids with mild soap or baby shampoo and rinse with water to remove irritating substances.

5.Do not rub your eyes with hands that are not washed.

6. Do not use the same bottle of drops in the other eye if it is not infected.

How to prevent spreading Conjunctivitis?
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1.Do not touch or rub the infected eye(s).

2.Wash your hands often with soap and warm water.

3.Wash any discharge from your eyes twice a day using a fresh cotton ball or paper towel. Afterwards, discard the cotton ball and wash your hands with soap and warm water.

4.Wash your bed linens, pillowcases, and towels in hot water and detergent.

5.Avoid wearing eye makeup.
Don’t share eye makeup with anyone else.

6.Do not wear another person’s contact lens.

7.Wear glasses instead of contact lenses.
Throw away disposable lenses or be sure to clean extended wear lenses and all eyewear cases.

8.Avoid sharing common articles such as unwashed towels, cups, and glasses.

9.Wash your hands after applying the eye drops or ointment to your eye or your child’s eye.

10.Do not use eye drops in a non-infected eye that were used for an infected one.