COMMUNICABLE DISEASES part 2

SKIN AND MUCOUS MEMBRANES

MEASLES (Rubeola)

Causative agent: Paramyxovirus

Mode of transmission: airborne droplets

Incubation period: 7 – 14 days

Period of communicability: 1 – 2 days before and 4 days after the occurrence of rash

Clinical manifestation:

 Koplik spots
 Stimson’s line
 Cough, coryza, conjunctivitis
 Fever
 Photophobia
 Maculopapular rash
 Nasal discharge
 Swollen red eyes
 Drowsiness, anorexia

Diagnostic evaluation:

 Clinical assessment

 Viral culture

Medication:

 MMR, AMV
 Vit. A
 Paracetamol

RUBELLA (German measles)

Causative agent: Rubella Virus (TOGAVIRIDAE)

Mode of transmission: droplet, transplacental

Incubation period: 10 – 27 days

Period of communicability: 5 days before and after rashes appear

Clinical manifestation:

 Forchheimer’s spot
 Low grade fever
 Maculopapular rashes
 Cough
 Red eyes
  Runny nose, nasal congestion
 Itching
 Headache, joint pain, earache

Diagnostic evaluation:

 Rubella Hemaglutination
 ELISA
 TORCH test
 Serum IgM

Medication:

 MMR
 Ibuprofen
 Acetaminophen

MUMPS (Epidemic parotitis, Infectious Parotitis)

Causative agent: Paramyxoviruses

Source of infection: mouth and nose, saliva

Mode of transmission: Direct contact, contact with freshly contaminated secretions from the respiratory
tract of the patient (Fomites)

Incubation period: 12 to 26 days usually 18 days

Clinical manifestations:

 myalgia
 anorexia
 malaise
 headache
 low grade fever
 earache
 parotid gland swelling

LEPROSY (Lepra, Leontiasis,Hansenosis,Hansen’s disease)

Etiologic agent: Mycobacterium leprae

Mode of transmission: Prolonged skin contact, droplet infection

• Children below 12 years old are more susceptible

Clinical manifestation

Cardinal signs
  peripheral nerve enlargement
 loss of sensation
 positive smear test

Early manifestations

 Color changes in the skin which does not disappear even with treatment
 Skin ulcers which does not heal with treatment
 Pain and redness of the eyes
 Nasal obstruction and nose bleeding
 Muscle weakness and paralysis
 Loss of sensation on the affected area
 Loss of hair growth
 Anhydrosis- loss of sweating

Late manifestations

 Lagopthalmos
 Madarosis
 Sinking of bridge of the nose
 Leonine face
 Natural amputation-toes,fingers,ear,nose
 Contractures –clawing of fingers and toes
 Chronic skin ulcers
 Gynecomastia

Diagnostic evaluation

 Skin smear test

 Skin lesion biopsy
 Lepromine test

Medications

 Rifampicin
 Dapsone-photosensistivity
 Ofloxacin
 Minocycline
 Clofazimine (lamprene)- discoloration of skin which is reversible, discolors body fluids from pink
to brownish black

VARICELLA

Causative agent: Varicella virus

Mode of transmission: airborne droplets

Incubation period: 10 – 23 days

Period of communicability: 1 day before the eruption of rashes until all vesicles have encrusted

Clinical manifestation:

 Fever
 Body malaise
 Sore throat
 Itching
 Vesicle formation
 Maculo-papular rashes

Diagnostic evaluation:

 Viral culture

 Antigen – detection test

Medications:

 Acyclovir
 Antihistamines
 Paracetamol

DIPTHERIA

Causative agent: Corynebacterium diptheriae, Klebs – Loeffler bacillus

Mode of transmission: airborne droplet, fomites

Incubation period: 2 – 7 days

Period of communicability: 2 – 7 days

Clinical manifestation:

 Nasal drip
 Sore throat
 Fever
 Croup – like cough
 Dyspnea, hoarseness of voice
 Bull neck appearance
 Pseudomembrane gray exudates
Diagnostic evaluation:

 Nose and throat swab

 Schick test
 Moloney test
Medication:

 Vaccine
 Penicillin
 Erythromycin
PERTUSSIS

Causative agent: Bordatella pertussis

Mode of transmission: airborne droplet, fomite

Incubation period: 7 – 10 days, but can extend upto 21 days

Period of communicability: 7 – 14 days

Clinical manifestation

Catarrhal stage

 Sneezing
 Runny nose, lacrimation
 Mild cough
 Fever
Paroxysmal stage

 Whooping cough
 Vomiting
 Dyspnea
Diagnostic evaluation:

 Throat swab culture

 PCR
Medication

 Mucolytics
 Erythromycin
 Penicillin

SCARLET FEVER

Causative agent: Streptococcus pyogenes

Mode of transmission: respiratory droplet, fomites

Incubation period: 1 – 2 days

Period of communicability: 10 – 21 days

Clinical manifestation:

 Fever
 Exudative tonsillitis
 Bright red tongue with white patches
 Rash
 Pastia lines
 Skin desquamation
Diagnostic evaluation:

 Throat swab culture

  Dick test
Medication:

 Penicillin G
 Erythromycin

SMALL POX

Causative agent: Variola virus (V. major, V. minor)

Mode of transmission: Airborne droplet

Incubation period: 5 – 21 days

Period of communicability: during the full course of disease, until the last scar disappear

Clinical manifestation:

 Fever
 Headache
 Chills
 Convulsions
 Rashes
Diagnostic evaluation:

 Paul test

Medications:

 Acyclovir
 Antihistamines
 Paracetamol

SCABIES

Causative agent: Sarcoptes scabiei

Mode of transmission: direct contact

Incubation period: approx 24 hours after entry

Period of communicability: as long as the mites is present

Clinical manifestation:

 Intense itching
 Papules and vesicles
 Rashes
Diagnostic evaluation

 Ectoparasite preparation test

Medication

 Permethrin cream
  Crotamiton cream
 Sulfur soap
 Calamine lotion

PEDICULOSIS

Causative agent:

 Pediculus humanus capitis

 Pediculus humanus corporis
 Pthirus pubis
Mode of transmission: direct contact, fomites

Clinical manifestation:

 Presence of nits
 Itching
Diagnostic evaluation

 Louse comb

Medication:

 Lindane
 Permethrin

DERMATOPHYTOSIS

 Tinea capitis
 Tinea pedis
 Tinea unguium
 Tinea cruris
 Tinea corporis
 Tinea manuum
 Tinea barbae
 Tinea faciei
Causative agent: Dermatophytes (Trichophyton, Microsporum)

Mode of transmission: Direct contact, fomites

Diagnostic evaluation

 Woods test

Medications:

 Ketoconazole, miconazole, clotrimazole

 Griseofulvin, itraconazole, fluconazole

CANDIDIASIS

Causative agent: Candida albicans

Mode of transmission: direct contact

Incubation period: 2 – 5 days

Period of communicability: as long as the lesions are present in the body

Clinical manifestation

 Severe vulvar pruritis (prominent feature)

 vaginal discharge (scanty, whitish, yellow, thick to form curds, non-offensive)
 sore vulva due to itching
 severe itching
 white patches in the mucous membranes
Diagnostic evaluation:

 Microscopic examination

Medications:

 Nystatine vaginal pessary

 Miconazole
 Clotrmazele creams
 Ketoconazole
 Fluconazole

AUTOIMMUNE DISORDER

SYSTEMIC LUPUS ERYTHEMATOUS

Etiology:

 Genetics
 Environmental factors
 Drugs
Clinical manifestation:

Skin

 Malar rash
 Alopecia
 Skin lesions and ulcers
Musculoskeletal

 Joint pain
 Increased fracture tendencies
Hematologic

 Anemia

Cardiac

 Inflammation of the heart (Pericarditis, Myocarditis, Endocarditis)

 Atherosclerosis
Pulmonary

 Pleural effusion
 Pleuritis
 Shrinking lung syndrome
Renal

 Painless hematuria and proteinuria

 Renal failure
Neuro

 Headache
 Cognitive dysfunction
 Mood disorder
 Seizure
 Convulsions
Systemic

 Fever
 Body malaise
 Fatigue
 Body pain
 Photosensitivity
Diagnostic evaluation

 Antinuclear body testing

 Anti-ENA
 ESR
 Diagnostic criterion
Medication

 Analgesics (NSAIDS, Opioids)

 Steroids
 Intravenous immunoglobulin

SCLERODERMA

Etiology:

 Unknown.
 Cases occurs within families but no specific gene is identified
Clinical manifestation:

 Generalized inflammation
 Calcified nodules on the tips of elbows and fingers
 Headache
 Hypertension
 Dyspnea
 Heartburn
 Constipation or diarrhea
 Vascular spasms
Diagnostic evaluation:

 ANA testing
 Anticentromere antibody
 Antitopoisomerase I antibody
Medications

 Antihypertensive
 Anticoagulants
 Penicillamine
 Methotrexate

SJOGREN’S SYNDROME

Etiology

 Unknown
 Primary rheumatic disorders
Clinical manifestations

 Dry eyes
 Dry mouth
 Vaginal dryness
 Dry skin
 Fatigue
 Myalgia
Diagnostic evaluation

 Schirmer test
 Slit-lamp examination
 ANA, rheumatoid factor
 Ultrasound
 Sialography
Medications

 NSAID’S
 Immunosuppressant
 Artificial tears

LYME DISEASE

Causative agent: Borrelia burgdorferi

Mode of transmission: vector

Incubation period: 7 – 14 days

Clinical manifestation:

 Bull’s eye rash

 Fatigue
 Chills stiff neck
  Back ache
 Swollen glands around the area of bite
 Fever
 Arthritis
 Cough
 Vomiting
 Chest pain
 Irritability
 Paralysis

Diagnostic evaluation

 ELISA

Medications:

 Amoxicillin
 Doxycycline
 Cefuroxime

REITER’S SYNDROME

Etiology:

 Chronic or relapsing infections

Clinical manifestation:

 Dysuria
 Polyarthritis
 Conjunctivitis
 Pericarditis
 Keratoderma blennorrhagica
Diagnostic evaluation:

 MRI
 ESR
 Diagnostic criterion
Medication:

 Antibiotics
 Analgesics
 Immunosuppressant