Infections

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Infections

  1. 1. Urinary tract infectionsUrinary tract infections:Urinary tract is the system that makes urine and carries it out of your body. Itincludes bladder and kidneys and the tubes that connect them. When germs getinto this system, they can cause an infection.Most urinary tract infections are bladder infections. A bladder infection usually isnot serious if it is treated right away. If you do not take care of a bladder infection,it can spread to your kidneys. A kidney infection is serious and can causepermanent damage.Urinary Tract: The urinary tract is the network of organs and tubes that process and carry urine out of the body. The kidneys, ureters, bladder, and urethra are part of the urinary tract. Each part of the urinary tract has a specific function. • The kidneys make urine. • The ureters are tubes that carry urine from the kidneys to the bladder. • The bladder stores urine. • The urethra is a tube that carries urine from the bladder to the outside of the body.The kidneys and ureters are the upper urinary tract. The bladder and urethra arethe lower urinary tract.The kidneys and bladder work together to make urine and remove it from yourbody. The kidneys filter waste products and water from the blood to form urine.The urine moves from the kidneys through tubes called ureters to the bladder,which stores the urine until it is full. From the bladder, urine leaves the body
  2. 2. through another thin tube, the urethra. After the bladder starts to empty, itnormally empties all of the urine.Causes of UTIs:Usually, germs get into your system through your urethra, the tube that carriesurine from your bladder to the outside of your body. The germs that usuallycause these infections live in your large intestine and are found in your stool. Ifthese germs get inside your urethra, they can travel up into your bladder andkidneys and cause an infection.Women tend to get more bladder infections than men. This is probably becausewomen have shorter urethras, so it is easier for the germs to move up to theirbladders. Having sex can make it easier for germs to get into your urethra.You may be more likely to get an infection if you do not drink enough fluids, youhave diabetes, or you are pregnant. The chance that you will get a bladderinfection is higher if you have any problem that blocks the flow of urine from yourbladder. Examples include having kidney stones or an enlarged prostate gland.For reasons that are not well understood, some women get bladder infectionsagain and again.Symptoms of UTIs:You may have an infection if you have any of these symptoms: • You feel pain or burning when you urinate. • You feel like you have to urinate often, but not much urine comes out when you do. • Your belly feels tender or heavy. • Your urine is cloudy or smells bad. • You have pain on one side of your back under your ribs. This is where your kidneys are. • You have fever and chills. • You have nausea and vomiting.Call your doctor right away if you think you have an infection and: • You have a fever, nausea and vomiting, or pain in one side of your back under your ribs. • You have diabetes, kidney problems, or a weak immune system. • You are older than 65. • You are pregnant.
  3. 3. Respiratory Tract InfectionsFollow the links below to find information on respiratory tract infections such asbronchitis, diphtheria, influenza (flu), colds, croup, pneumonia, sinusitis,Legionnaires ‘ disease, severe acute respiratory syndrome (SARS), tuberculosisand whooping cough. 1. Bronchitis 2. Common Cold 3. Croup 4. Diphtheria 5. Influenza 6. Legionnaires Disease 7. Pleurisy 8. Pneumonia 9. Severe Acute Respiratory Syndrome (SARS) 10. Sinusitis 11. Tuberculosis 12. Whooping Cough 13. Systematic Reviews of Treatments for Respiratory Tract Infections
  4. 4. 1. Bronchitis:Bronchitis means that the tubes that carry air to the lungs (the bronchial tubes)are inflamed and irritated. When this happens, the tubes swell and producemucus. This makes you cough.There are two types of bronchitis:
  5. 5. • Acute bronchitis usually comes on quickly and gets better after 2 to 3 weeks. Most healthy people who get acute bronchitis get better without any problems. See a picture of acute bronchitis. • Chronic bronchitis keeps coming back and can last a long time, especially in people who smoke. Chronic bronchitis means you have a cough with mucus most days of the month for 3 months of the year for at least 2 years in a row.This topic focuses on acute bronchitis. Both children and adults can get acutebronchitis.Causes acute bronchitis:Acute bronchitis is usually caused by a virus. Often a person gets acutebronchitis after having an upper respiratory tract infection such as a cold or theflu. In rare cases, acute bronchitis is caused by bacteria.Acute bronchitis also can be caused by breathing in things that irritate thebronchial tubes, such as smoke. It also can happen if a person inhales food orvomit into the lungs.Symptoms of bronchitis:The most common symptom of acute bronchitis is a cough that is dry andhacking at first. After a few days, the cough may bring up mucus. You may havea low fever and feel tired.Acute bronchitis symptoms usually start 3 or 4 days after an upper respiratorytract infection. Most people get better in 2 to 3 weeks. But some people continueto have a cough for more than 4 weeks.Pneumonia can have symptoms like acute bronchitis. Because pneumonia canbe serious, it is important to know the differences between the two illnesses.Symptoms of pneumonia can include a high fever, shaking chills, and shortnessof breath.2. Common Cold:The common cold usually causes a runny nose, nasal congestion, and sneezing.You may also have a sore throat, cough, headache, or other symptoms.
  6. 6. Causes, incidence, and risk factors:It is called the “common cold” for good reason. There are over one billion colds inthe United States each year. You and your children will probably have morecolds than any other type of illness.Colds are the most common reason that children miss school and parents misswork. Parents often get colds from their children.Children can get many colds every year. They usually get them from otherchildren. A cold can spread quickly through schools or daycares.Colds can occur at any time of the year, but they are most common in the winteror rainy seasons.A cold virus spreads through tiny, air droplets that are released when the sickperson sneezes, coughs, or blows their nose.You can catch a cold if: • A person with a cold sneezes, coughs, or blows their nose near you • You touch your nose, eyes, or mouth after you have touched something contamined by the virus, such as a toy or doorknob.People are most contagious for the first 2 to 3 days of a cold. A cold is usuallynot contagious after the first week.Symptoms:Cold symptoms usually start about 2 or 3 days after you came in contact with thevirus, although it could take up to a week. Symptoms mostly affect the nose.
  7. 7. The most common cold symptoms are: • Nasal congestion • Runny nose • Scratchy throat • SneezingAdults and older children with colds generally have a low fever or no fever.Young children often run a fever around 100-102°F.Depending on which virus caused your cold, you may also have: • Cough • Decreased appetite • Headache • Muscle aches • Postnasal drip • Sore throat3. Croup:Croup is breathing difficulty accompanied by a "barking" cough. Croup, which isswelling around the vocal cords, is common in infants and children and can havea variety of causes.
  8. 8. Croup Causes:Croup is most commonly caused by a viral respiratory infection that is easilypassed among children. Common viral causes include parainfluenza, influenza,adenovirus, respiratory syncytial virus (RSV), and rhinovirus. Prior to the vaccineera, diphtheria caused most cases of croup and was referred to as membranouscroup, but today, fortunately, this is exceedingly rare.Croup Symptoms:The infection starts with a cold, cough, and low-grade temperature. Symptoms graduallydevelop over two days. The typical barking cough is usually present by day three and ismore likely to be worse at night. The presence of stridor (wheezing on inspiration),hoarseness, difficulty swallowing, and respiratory distress are common but may or maynot be severe.4. Diphtheria:Diphtheria is an infectious disease caused by the bacterium Corynebacteriumdiphtheriae. This disease primarily affects the mucous membranes of therespiratory tract (respiratory diphtheria), although it may also affect the skin(cutaneous diphtheria) and lining tissues in the ear, eye, and the genital areas.
  9. 9. Causes of diphtheria:Diphtheria is caused by toxin-producing strains of the gram-positive bacillusCorynebacterium diphtheriae. There are four biotypes of the bacterium (gravis,mitis, intermedius, and belfanti), and each differs in the severity of disease itproduces. Nontoxigenic strains are usually responsible for less severe cutaneousdiphtheria.The signs and symptoms of respiratory diphtheria are caused by the bacteriumsability to cause a localized inflammatory reaction of the cells lining the upperrespiratory tract. In certain cases, the disease can become more severe andwidespread, and it can involve other organs of the body as well.Symptoms:Symptoms usually occur 2 to 5 days after you have come in contact with thebacteria. • Bluish coloration of the skin • Bloody, watery drainage from nose • Breathing problems o Difficulty breathing o Rapid breathing o Stridor • Chills • Croup-like (barking) cough • Drooling (suggests airway blockage is about to occur) • Fever
  10. 10. • Hoarseness • Painful swallowing • Skin lesions (usually seen in tropical areas) • Sore throat (may range from mild to severe)5. Influenza:Influenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, commonly called the flu, is not the same as the stomach "flu" viruses that cause diarrhea and vomiting.Influenza and its complications can be deadly. People at higher risk ofdeveloping flu complications include: • Young children • Older adults • Pregnant women • People with weakened immune systems • People who have chronic illnessesYour best defense against influenza is to receive an annual vaccination.Causes:Flu viruses travel through the air in droplets when someone with the infectioncoughs, sneezes or talks. You can inhale the droplets directly, or you can pick up
  11. 11. the germs from an object — such as a telephone or computer keyboard — andthen transfer them to your eyes, nose or mouth.Influenza viruses are constantly changing, with new strains appearing regularly. Ifyouve had influenza in the past, your body has already made antibodies to fightthat particular strain of the virus. If future influenza viruses are similar to what youhad before, either by having the disease or by vaccination, those antibodies mayprevent infection or lessen its severity.But antibodies against flu viruses youve encountered in the past cant protectyou from new influenza subtypes that are very different immunologically fromwhat you had before. Four such different (novel) virus subtypes have appeared inhumans since the global epidemic (pandemic) of 1918, which killed tens ofmillions of people.Symptoms:Initially, the flu may seem like a common cold with a runny nose, sneezing andsore throat. But colds usually develop slowly, whereas the flu tends to come onsuddenly. And although a cold can be a nuisance, you usually feel much worsewith the flu.Common signs and symptoms of the flu include: • Fever over 100 F (38 C) • Aching muscles, especially in your back, arms and legs • Chills and sweats • Headache • Dry cough • Fatigue and weakness • Nasal congestion6. Legionnaires disease:Legionnaires disease is a severe form of pneumonia — lung inflammationusually caused by infection. Legionnaires disease is caused by a bacteriumknown as legionella.You cant catch Legionnaires disease from person-to-person contact. Instead,most people get Legionnaires disease from inhaling the bacteria. Older adults,smokers and people with weakened immune systems are particularly susceptibleto Legionnaires disease.Legionella bacterium also causes Pontiac fever, a milder illness resembling theflu. Separately or together, the two illnesses are sometimes called legionellosis.Pontiac fever usually clears on its own. But untreated Legionnaires disease can
  12. 12. be fatal. Although prompt treatment with antibiotics usually cures Legionnairesdisease, some people continue to experience problems after treatment.Symptoms:Legionnaires disease usually develops two to 14 days after exposure tolegionella bacteria. It frequently begins with the following signs and symptoms: • Headache • Muscle pain • Chills • Fever that may be 104 F (40 C) or higherBy the second or third day, youll develop other signs and symptoms that mayinclude: • Cough, which may bring up mucus and sometimes blood • Shortness of breath • Chest pain • Fatigue • Loss of appetite • Gastrointestinal symptoms, such as nausea, vomiting and diarrhea • Confusion or other mental changesAlthough Legionnaires disease primarily affects the lungs, it occasionally cancause infections in wounds and in other parts of the body, including the heart.A mild form of Legionnaires disease — known as Pontiac fever — may producesymptoms including fever, chills, headache and muscle aches. Pontiac feverdoesnt infect your lungs, and symptoms usually clear within two to five days.
  13. 13. Causes:The bacterium Legionella pneumophila is responsible for most cases ofLegionnaires disease. Outdoors, Legionella bacteria survive in soil and water,but rarely cause infections. Indoors, though, Legionella bacteria can multiply in allkinds of water systems — hot tubs, air conditioners and mist sprayers in grocerystore produce departments.Although its possible to contract Legionnaires disease from home plumbingsystems, most outbreaks have occurred in large buildings, perhaps becausecomplex systems allow the bacteria to grow and spread more easily.How the infection spreadsMost people become infected when they inhale microscopic water dropletscontaining legionella bacteria. This might be the spray from a shower, faucet orwhirlpool, or water dispersed through the ventilation system in a large building.Outbreaks have been linked to a range of sources, including: • Hot tubs and whirlpools on cruise ships • Cooling towers in air conditioning systems • Decorative fountains • Swimming pools • Physical therapy equipment • Water systems in hotels, hospitals and nursing homesScientists arent certain how much exposure to the bacteria is needed to causedisease, but some people have developed infections after inhaling contaminateddroplets for just a few minutes. And unlike many bacteria, which spread within asmall radius, legionella bacteria may be capable of traveling as far as four milesthrough the air.Although legionella bacteria primarily spread through aerosolized water droplets,the infection can be transmitted in other ways, including: • Aspiration. This occurs when liquids accidentally enter your lungs, usually because you cough or choke while drinking. If you aspirate water containing legionella bacteria, you may develop Legionnaires disease. • Soil. A few people have contracted Legionnaires disease after working in the garden or using contaminated potting soil. Its also possible that the disease may spread when earth containing the bacteria is stirred up at large construction sites.
  14. 14. 7. Pleurisy:Pleurisy is inflammation of the lining of the lungs and chest (the pleura) that leadsto chest pain (usually sharp) when you take a breath or cough.Causes, incidence, and risk factorsPleurisy may develop when you have lung inflammation due to infections such aspneumonia or tuberculosis. This inflammation also causes the sharp chest painof pleurisy.It may also occur with: • Asbestos-related disease • Certain cancers • Chest trauma • Pulmonary embolus • Rheumatoid arthritis • Lupus
  15. 15. SymptomsThe main symptom of pleurisy is pain in the chest. This pain often occurs whenyou take a deep breath in or out, or cough. Some people feel the pain in theshoulder.Deep breathing, coughing, and chest movement makes the pain worse.Pleurisy can cause fluid to collect inside the chest cavity. This can makebreathing difficult and may cause the following symptoms: • Bluish skin color (cyanosis) • Coughing • Shortness of breath • Rapid breathing (tachypnea)8. Pneumonia:Pneumonia is a breathing (respiratory) condition in which there is an infection ofthe lung.Community-acquired pneumonia is pneumonia in people who have not recentlybeen in the hospital or another health care facility (nursing home, rehabilitationfacility).
  16. 16. Causes, incidence, and risk factors:Pneumonia is a common illness that affects millions of people each year in theUnited States. Germs called bacteria, viruses, and fungi may cause pneumonia.Ways you can get pneumonia include: • Bacteria and viruses living in your nose, sinuses, or mouth may spread to your lungs. • You may breathe some of these germs directly into your lungs. • You breathe in (inhale) food, liquids, vomit, or fluids from the mouth into your lungs (aspiration pneumonia)Pneumonia caused by bacteria tends to be the most serious kind. In adults,bacteria are the most common cause of pneumonia. • The most common pneumonia-causing germ in adults is Streptococcus pneumoniae (pneumococcus). • Atypical pneumonia, often called walking pneumonia, is caused by bacteria such as Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae. • Pneumocystis jiroveci pneumonia is sometimes seen in people whose immune system is not working well.Many other bacteria can also cause pneumonia.Viruses are also a common cause of pneumonia, especially in infants and youngchildren.Risk factors (conditions that increase your chances of getting pneumonia)include: • Cerebral palsy • Chronic lung disease (COPD, bronchiectasis, cystic fibrosis) • Cigarette smoking • Difficulty swallowing (due to stroke, dementia, Parkinsons disease, or other neurological conditions) • Immune system problem (See also: Pneumonia in immunocompromised host)
  17. 17. • Impaired consciousness (loss of brain function due to dementia, stroke, or other neurologic conditions) • Living in a nursing facility • Other serious illnesses, such as heart disease, liver cirrhosis, or diabetes mellitus • Recent surgery or trauma • Recent cold, laryngitis, or fluSymptoms:The most common symptoms of pneumonia are: • Cough (with some pneumonias you may cough up greenish or yellow mucus, or even bloody mucus) • Fever, which may be mild or high • Shaking chills • Shortness of breath (may only occur when you climb stairs)Other symptoms include: • Confusion, especially in older people • Excess sweating and clammy skin • Headache • Loss of appetite, low energy, and fatigue • Sharp or stabbing chest pain that gets worse when you breathe deeply or cough9. Severe Acute Respiratory Syndrome (SARS):Severe acute respiratory syndrome (SARS) is a serious form of pneumonia. It iscaused by a virus that was first identified in 2003. Infection with the SARS viruscauses acute respiratory distress (severe breathing difficulty) and sometimesdeath.
  18. 18. SARS is a dramatic example of how quickly world travel can spread a disease. Itis also an example of how quickly a connected health system can respond to anew health threat.Causes:SARS is caused by a member of the corona virus family of viruses (the samefamily that can cause the common cold). It is believed the 2003 epidemic startedwhen the virus spread from small mammals in China.When someone with SARS coughs or sneezes, infected droplets spray into theair. You can catch the SARS virus if you breathe in or touch these particles. TheSARS virus may live on hands, tissues, and other surfaces for up to 6 hours inthese droplets and up to 3 hours after the droplets have dried.While the spread of droplets through close contact caused most of the earlySARS cases, SARS might also spread by hands and other objects the dropletshas touched. Airborne transmission is a real possibility in some cases. Live virushas even been found in the stool of people with SARS, where it has been shownto live for up to 4 days. The virus may be able to live for months or years whenthe temperature is below freezing.With other corona viruses, becoming infected and then getting sick again (re-infection) is common. This may also be the case with SARS.Symptoms usually occur about 2 to 10 days after coming in contact with thevirus. There have been some cases where the illness started sooner or later afterfirst contact. People with active symptoms of illness are contagious, but it is notknown for how long a person may be contagious before or after symptomsappears.
  19. 19. Symptoms:The hallmark symptoms are: • Cough • Difficulty breathing • Fever greater than 100.4 degrees F (38.0 degrees C) • Other breathing symptomsThe most common symptoms are: • Chills and shaking • Cough -- usually starts 2-3 days after other symptoms • Fever • Headache • Muscle achesLess common symptoms include: • Cough that produces phlegm (sputum) • Diarrhea • Dizziness • Nausea and vomiting • Runny nose • Sore throatIn some people, the lung symptoms get worse during the second week of illness,even after the fever has stopped.10. Sinusitis:Acute sinusitis; Sinus infection; Sinusitis - acute; Sinusitis - chronic; RhinosinusitisSinusitis refers to inflammation of the sinuses that occurs with a viral, bacterial,or fungal infection.
  20. 20. Causes, incidence, and risk factors:The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones,cheeks, and eyes) that are lined with mucus membranes. Healthy sinusescontain no bacteria or other germs. Usually, mucus is able to drain out and air isable to circulate.When the sinus openings become blocked or too much mucus builds up, bacteriaand other germs can grow more easily.Sinusitis can occur from one of these conditions: • Small hairs (cilia) in the sinuses, which help move mucus out, do not work properly due to some medical conditions. • Colds and allergies may cause too much mucus to be made or block the opening of the sinuses. • A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.Sinusitis can be: • Acute -- symptoms last up to 4 weeks • Sub-acute -- symptoms last 4 - 12 weeks • Chronic -- symptoms last 3 months or longerAcute sinusitis is usually caused by a bacterial infection in the sinuses thoseresults from an upper respiratory tract infection. Chronic sinusitis refers to long-
  21. 21. term swelling and inflammation of the sinuses that may be caused by bacteria ora fungus.The following may increase your risk or your childs risk of developing sinusitis: • Allergic rhinitis or hay fever • Cystic fibrosis • Day care • Diseases that prevent the cilia from working properly, such as Kartagener syndrome and immotile cilia syndrome. • Changes in altitude (flying or scuba diving) • Large adenoids • Smoking • Tooth infections (rare) • Weakened immune system from HIV or chemotherapySymptoms:The classic symptoms of acute sinusitis in adults usually follow a cold that doesnot improve, or one that worsens after 5 - 7 days of symptoms. Symptomsinclude: • Bad breath or loss of smell • Cough, often worse at night • Fatigue and generally not feeling well, • Fever, Headache - pressure-like pain, pain behind the eyes, toothache or facial tenderness • Nasal congestion and discharge • Sore throat and postnasal dripSymptoms of chronic sinusitis are the same as those of acute sinusitis, but tendto be milder and last longer than 12 weeks.Symptoms of sinusitis in children include:
  22. 22. • Cold or respiratory illness that has been improving and then begins to get worse • High fever, along with a darkened nasal discharge, for at least 3 days • Nasal discharge, with or without a cough, that has been present for more than 10 days and is not improving11. Tuberculosis:Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves thelungs, but may spread to other organs.Causes, incidence, and risk factors:Pulmonary tuberculosis (TB) is caused by the bacteria Mycobacteriumtuberculosis (M. tuberculosis). You can get TB by breathing in air droplets from acough or sneeze of an infected person. This is called primary TB.In the United States, most people will recover from primary TB infection withoutfurther evidence of the disease. The infection may stay inactive (dormant) foryears. However, in some people it can reactivate.Most people who develop symptoms of a TB infection first became infected in thepast. However, in some cases, the disease may become active within weeksafter the primary infection.
  23. 23. The following people are at higher risk for active TB: • Elderly • Infants • People with weakened immune systems, for example due to AIDS, chemotherapy, diabetes, or certain medicationsYour risk of contracting TB increases if you: • Are in frequent contact with people who have TB • Have poor nutrition • Live in crowded or unsanitary living conditionsThe following factors may increase the rate of TB infection in a population: • Increase in HIV infections • Increase in number of homeless people (poor environment and nutrition) • The appearance of drug-resistant strains of TBIn the United States, there are approximately 10 cases of TB per 100,000 people.However, rates vary dramatically by area of residence and socioeconomic status.Symptoms:The primary stage of TB usually doesnt cause symptoms. When symptoms ofpulmonary TB occur, they may include: • Cough (usually cough up mucus) • Coughing up blood • Excessive sweating, especially at night • Fatigue • Fever • Unintentional weight lossOther symptoms that may occur with this disease: • Breathing difficulty • Chest pain
  24. 24. • Wheezing12. Whooping Cough (Pertussis):Pertussis is a highly contagious bacterial disease that causes uncontrollable,violent coughing. The coughing can make it hard to breathe. A deep "whooping"sound is often heard when the patient tries to take a breath.Causes, incidence, and risk factorsPertussis, or whooping cough, is an upper respiratory infection caused by theBordetella pertussis or Bordetella parapertussis bacteria. It is a serious diseasethat can cause permanent disability in infants, and even death.When an infected person sneezes or coughs, tiny droplets containing thebacteria move through the air, and the disease is easily spread from person toperson.The infection usually lasts 6 weeks.Whooping cough can affect people of any age. Before vaccines were widelyavailable, the disease was most common in infants and young children. Now thatmost children are immunized before entering school, the higher percentage ofcases is seen among adolescents and adults.SymptomsInitial symptoms, similar to the common cold, usually develop about a week afterexposure to the bacteria.Severe episodes of coughing start about 10 to 12 days later. In children, thecoughing often ends with a "whoop" noise. The sound is produced when thepatient tries to take a breath. The whoop noise is rare in patients under 6 monthsof age and in adults.Coughing spells may lead to vomiting or a short loss of consciousness. Pertussisshould always be considered when vomiting occurs with coughing. In infants,choking spells are common.
  25. 25. Other pertussis symptoms include: • Runny nose • Slight fever (102 °F or lower) • Diarrhea Typhoid fever Enteric feverTyphoid fever is an infection that causes diarrhea and a rash - most commonlydue to a type of bacteria called Salmonella typhi (S. typhi).Causes, incidence, and risk factors:The bacteria that cause typhoid fever S. typhi spread through contaminated food,drink, or water. If you eat or drink something that is contaminated, the bacteriaenter your body. They travel into your intestines, and then into your bloodstream,where they can get to your lymph nodes, gallbladder, liver, spleen, and otherparts of your body.A few people can become carriers of S. typhi and continue to release thebacteria in their stools for years, spreading the disease.Typhoid fever is common in developing countries, but fewer than 400 cases arereported in the U.S. each year. Most cases in the U.S. are brought in from othercountries where typhoid fever is common.Symptoms:Early symptoms include fever, general ill-feeling and abdominal pain. A high(typically over 103 degrees Fahrenheit) fever and severe diarrhea occur as thedisease gets worse.Some people with typhoid fever develop a rash called "rose spots," which aresmall red spots on the abdomen and chest.Other symptoms that occur include: • Abdominal tenderness • Agitation • Bloody stools • Chills
  26. 26. • Confusion • Difficulty paying attention (attention deficit) • Delirium • Fluctuating mood • Hallucinations • Nosebleeds • Severe fatigue • Slow, sluggish, lethargic feeling • WeaknessDiarrheaDiarrhea is loose, watery, and frequent stools. Diarrhea is considered long-term(chronic) when you have had loose or frequent stools for more than 4 weeks.ConsiderationsDiarrhea in infants and children (especially under age 3) can cause dangerousdehydration very quickly.Diarrhea in adults is usually mild and goes away quickly without complications.
  27. 27. Common CausesThe most common cause of diarrhea is viral gastroenteritis, or the stomach flu.This is a mild viral infection that goes away on its own within a few days.Eating or drinking contaminated food or water can also lead to diarrhea. Suchcommon causes of diarrhea include: • Food poisoning • Travelers diarrheaCertain medications may also cause diarrhea, including: • Certain antibiotics • Chemotherapy • Laxatives containing magnesiumDiarrhea may also be caused by certain medical conditions, including: • Celiac disease • Inflammatory bowel diseases (Crohns disease and ulcerative colitis) • Irritable bowel syndrome (IBS) • Lactose intolerance • Malabsorption syndromesLess common causes of diarrhea include: • Carcinoid syndrome • Nervous systems disorders, including autonomic neuropathy or diabetic neuropathy • Partial removal of the stomach (gastrectomy) • Radiation therapy • Zollinger-Ellison syndrome
  28. 28. RashesRashes involve changes in the color or texture of your skin.
  29. 29. ConsiderationsOften, the cause of a rash can be determined from its visible characteristics andother symptoms.Common CausesA simple rash is called dermatitis, meaning inflammation of the skin. Contactdermatitis is caused by things your skin touches, such as: • Chemicals in elastic, latex, and rubber products • Cosmetics, soaps, and detergents • Dyes and other chemicals in clothing • Poison ivy, oak, or sumacSeborrheic dermatitis is a rash that appears in patches of redness and scalingaround the eyebrows, eyelids, mouth, nose, the trunk, and behind the ears. If ithappens on your scalp, it is called dandruff in adults and cradle cap in infants.Age, stress, fatigue, weather extremes, oily skin, infrequent shampooing, andalcohol-based lotions aggravate this harmless but bothersome condition.Other common causes of a rash include: • Eczema (atopic dermatitis) -- tends to happen in people with allergies or asthma. The rash is generally red, itchy, and scaly.
  30. 30. • Psoriasis -- tends to occur as red, scaly, itchy patches over joints and along the scalp. Fingernails may be affected. • Impetigo -- common in children, this infection is from bacteria that live in the top layers of the skin. Appears as red sores that turn into blisters, ooze, then crust over. • Shingles -- a painful blistered skin condition caused by the same virus as chickenpox. The virus can lie dormant in your body for many years and re- emerge as shingles. • Childhood illnesses such as chicken pox, measles, roseola, rubella, hand- foot-mouth disease, fifth disease, and scarlet fever. • Medications and insect bites or stings.Many medical conditions can cause a rash as well. For example: • Lupus erythematosus • Rheumatoid arthritis, especially the juvenile type • Kawasaki disease
  31. 31. GonorrheaGonorrhea is a common sexually transmitted infection (STI).Causes, incidence, and risk factorsGonorrhea is caused by the bacteria Neisseria gonorrhoeae. Anyone who hasany type of sex can catch gonorrhea. The infection can be spread by contact withthe mouth, vagina, penis, or anus.The bacteria grow in warm, moist areas of the body, including the tube thatcarries urine out of the body (urethra). In women, the bacteria may be found inthe reproductive tract (which includes the fallopian tubes, uterus, and cervix). Thebacteria can even grow in the eyes.Health care providers in every state in the U.S. are required by law to tell theirState Board of Health about anyone diagnosed with gonorrhea. The goal of thislaw is make sure the patient gets proper follow-up care and that their sexualpartners are found and tested.
  32. 32. You are more likely to develop this infection if you: • Have multiple sexual partners • Have a partner with a past history of any sexually transmitted infection • Do not use a condom during sex • Abuse alcohol or illegal substancesSymptomsSymptoms of gonorrhea usually appear 2 - 5 days after infection, however, inmen, symptoms may take up to a month to appear. Some people do not havesymptoms. They may be completely unaware that they have caught the infection,and therefore do not seek treatment. This increases the risk of complications andthe chances of passing the infection on to another person.Symptoms in men include: • Burning and pain while urinating • Increased urinary frequency or urgency • Discharge from the penis (white, yellow, or green in color) • Red or swollen opening of penis (urethra) • Tender or swollen testicles • Sore throat (gonococcal pharyngitis)Symptoms in women can be very mild or nonspecific, and may be mistaken foranother type of infection. They include: • Vaginal discharge • Burning and pain while urinating • Increased urination • Sore throat • Painful sexual intercourse • Severe pain in lower abdomen (if the infection spreads to the fallopian tubes and stomach area) • Fever (if the infection spreads to the fallopian tubes and stomach area)
  33. 33. If the infection spreads to the bloodstream, fever, rash, and arthritis-likesymptoms may occur.

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