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1
Calder, Peter. Acute osteomyelitis. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.011004.
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♦ Bacteraemia resulting in bone deposition of bacteria♦ Local bony tenderness, fever, and malaise may not be present initially♦ WCC may be normal, ESR and CRP normally raised♦ Plain radiographs normally take 10–12 days to occur♦ Staphylococcus aureus remains the commonest organism♦ Immediate antibiotics with surgical drainage of abscess formation.
2
Peterson, Susan, and Staci Reintjes. Otitis Externa, Otitis Media, and Mastoiditis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0011.
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Otitis Externa is an infection of external auditory canal. Infection typically occurs via penetration of the epithelial barrier. Patients typically present with inflammation of the auricle, external auditory canal, or outer tympanic membrane. First-line therapy includes topical acidic agents and antibiotic drops. Oral antibiotics should be considered for recurrent infections, those resistant to topical therapy, severe disease, extension beyond the external auditory canal, diabetics, or immunocompromised patients. Otitis Media is an infection of the middle ear. Patients typically present with otalgia, otorrhea, fever, irritability, anorexia, and hearing loss. Mastoiditis is an infection of the mastoid bone. Patients present with pain, swelling, and erythema over the mastoid bone. Fever, irritability, otalgia, and hearing loss are also often present. Infection can be serious and may lead to sepsis, sigmoid sinus thrombosis, and intracranial abscess if not treated appropriately. More common complications include chronic infection, resistant bacteria, and mild hearing loss.
3
Young, Raymond. Infection in the Patient with Sickle Cell Anemia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0060.
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This chapter provides a brief overview of the clinical manifestations of and management strategies for infectious complications in the immunocompromised sickle cell disease patient. The chapter discusses infections in various organ systems, including the respiratory tract, central nervous system, bone, hematopoietic cell lineage, and blood-borne infections. Differentiating infections from noninfectious processes that often have similar presentations in the sickle cell patient may at times be difficult, and clinicians managing sickle cell patients should be keenly aware of this fact. This chapter discusses the common bacterial pathogens associated with infection and a notable viral agent known to profoundly worsen anemia in the sickle cell host, parvovirus B19. Additionally, fundamental antimicrobial regimens and primary and secondary prophylactic strategies are included in this concise summary prepared for clinicians involved in the acute care management of the sickle cell patient.
4
Pearson, Andrew. Tularaemia. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198570028.003.0031.
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Tularaemia is a plague-like bacterial disease of animals (particularly rodents, hares, and rabbits) and man caused by five subspecies of Francisella. Two subspecies predominate: F. tularensis tularensis in North America and F. tularensis holarctica throughout the northern hemisphere. F. tularensis occurs in persistent natural foci causing localized epidemics and sporadic cases in man.Francisella tularensis subspecies tularensis was described originally as causing a more virulent form of tularaemia than was seen in Europe. More recently recognized are subpopulations of Francisella tularensis subspecies tularensis which have markedly different virulence for man. These have been designated A1a, A1b and A2. Infections resulting from type A1b have been shown to have an attributable mortality of 24% as compared to 4% for tularaemia caused by A1a types.F. tularensis is one of the most potent bacterial pathogens affecting humans with an infective dose from 1 to 10 organisms. The incubation period is usually 3–5 days (range from 1–21 days). Onset of disease is abrupt, with fever, chills, fatigue, general body aches, and headache. When the bacteria are acquired through skin or mucous membranes, tender regional node enlargement may become conspicuous. When bacteria are inhaled, the infection will result in deep lymph node enlargement.The clinical epidemiology of human infection is complex since it relates to one of four modes of transmission of the agent harboured in multiple hosts from diverse ecosystems. Clinical presentation of the human disease is indicative of both the mode of transmission and often the source of infection in a specific ecosystem. Tularaemia presenting as ulceroglandular disease results from either vector-borne infection from mosquito or tick bites or occurs as a result of animal contact from bites, hunting or from skinning hares or muskrats. Oropharyhgeal and typhoidal infections predominate in waterborne outbreaks of F. tularensis holarctica. Pulmonary or influenza disease results from airborne transmission associated with either farmers moving rodent contaminated hay or laboratory acquired infection. An intentional aerosol release of F. tularensis tularensis would be expected to result in clinical manifestations similar to those recognized in natural respiratory tularaemia. Both vector-borne and airborne transmission of F. tularensis may both be associated with florid skin manifestations as a presenting symptom of tularaemia. Pulmonary or typhoidal forms of the tularaemia may occur as a complication of localized infection.
5
Steiner, Lisa A. Osteomyelitis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0049.
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Osteomyelitis is an infectious process that affects any part of the bone, including the periosteum, the cortex, or the marrow. It most often occurs in the lower extremities and can be an acute, subacute, or chronic process. Osteomyelitis is often characterized as a consequence of a contiguous spread or hematogenous spread of bacterial infection or as a consequence of vascular insufficiency. Chronic osteomyelitis can be associated with significant bone necrosis, sometimes requiring months to years of treatment with antibiotics or even surgical debridement. Consultation with the orthopedic service (or spine service for vertebral osteomyelitis) should be considered. Vascular service consultation should also occur if there is a concern for osteomyelitis in the foot of a patient with diabetes mellitus. These patients often require admission to the hospital for follow-up.
6
Richard, Coombs, and Fitzgerald Robert H. 1942-, eds. Infection in the orthopaedic patient. London: Butterworths, 1989.
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7
Wilson, John W., and Lynn L. Estes. Tick-Borne Infections. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199797783.003.0155.
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Numerous species of ticks have been associated with transmission of infectious diseases to humans. Recognizing the type of tick and its geographic distribution can aid identification of select bacterial, viral, and protozoan infection risk assessment.• Consists of the hard ticks that transmit nearly all tick-borne human diseases; 2–30 mm...
8
Raghavan, Sri. Infection in the Cancer Patient. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0054.
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Cancer patients have increased susceptibility to a variety of both common and atypical infections due to the steady increase in outpatient chemotherapy regimens, these patients are presenting more often to the emergency department when acutely ill. Already immunocompromised, patients’ chemotherapy regimens lead to neutropenia, deficits in cellular and humoral immunity, and disruption of mucosal barriers that predisposing them to severe disease presentations with high morbidity and mortality rates. There are different subsets of oncologic patients predisposed to specific infections. One of the most common presentations of oncologic chemotherapy patients is neutropenic fever caused by bacterial infection; neutropenic patients are also highly susceptible to fungal infections. Patients with hematologic malignancies, particularly those undergoing chemotherapy or bone marrow transplant, can present with inflammation of the cecum with high risk for bacterial translocation and possible perforation. Patients who have indwelling catheters or mediports are at risk for catheter-associated bloodstream infections.
9
1923-, Eberle H., ed. Gentamicin-PMMA-chains in bone and soft-tissue infections. Basel: Karger, 1988.
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10
Gilsdorf, Janet R. Continual Raving. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190677312.001.0001.
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This book explores the lives and work of scientists who unraveled the mysteries of meningitis and describes the steps (and sometimes missteps) they used to accomplish their splendid achievements. Although symptoms of meningitis were recorded as early as the time of Hippocrates, its origin remained obscure. Then, in 1892, one of the bacteria that cause meningitis in children, Haemophilus influenzae, was discovered when Richard Pfeiffer saw it in material coughed up by a patient with influenza. Pfeiffer mistakenly thought the bacteria caused influenza, and it has carried that unfortunate, erroneous name since that time. Discovery, however, marched forward, and Quincke discovered how to obtain spinal fluid by inserting a needle between two bones in the patient’s back. Pittman discovered the sugar overcoat that protects H. influenzae from being eaten by white blood cells. Flexner managed epidemics of meningitis with serum from a horse. Griffith unknowingly stumbled on DNA, the master of all life. Weech gave the first antibiotic used in America to a little girl with meningitis. Alexander learned why antibiotics sometimes fail in such patients. Smith won the Nobel Prize for showing how DNA invades bacteria, the right conclusion for the wrong reasons. And four scientists, in two teams, vied to be the first to create the best vaccine to prevent meningitis in infants.
11
Sun, Lisa, and Michael V. Johnston. Rickettsial Diseases. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0157.
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Tick-borne rickettsioses are emerging as more important health problems throughout the world. The spotted fever group including Rickettsia rickettsia can cause encephalopathy, meningitis and brain damage by selectively targeting capillary endothelial cells in the brain, and stimulating inflammation, capillary leakage, hemorrhage, and intravascular coagulation. Rickettsia are are arthropod-borne gram-negative coccobacilli bacteria and are obligate intracellular organisms that do not survive in artificial medium. In North and South America, the most common rickettsial disorder is rocky mountain spotted fever (RMSF) transmitted by the dog tick Dermacentor variabilis or the wood tick Dermacentor andersoni. A characteristic “starry sky” pattern can be seen on MRI imaging of the brain in some patients with RMSF encephalopathy and is thought to reflect the organisms targeting of brain endothelial cells in capillaries the white matter. Early treatment with doxycycline is curative and reverses signs of encephalopathy if given within a few day of onset, but delayed treatment can be associated with permanent neurological disability. The typhus group of rickettsia bacteria include R. prowazekii, which causes epidemic typhus and R. typhi, which causes murine typhus (endemic) typhus in tropical and subtropical parts of the world. Flying squirrels and humans carry R prowazekii and rats are carry R. typhi. Q fever caused by the rickettsia organism Coxiella burnetti is transmitted from farm animals including sheep and is seen throughout the world including the United States.
12
Sean, Hughes, and Fitzgerald Robert H. 1942-, eds. Musculoskeletal infections. Chicago: Year Book Medical Publishers, 1986.
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13
Vialle, Luiz, AOSpine International (Firm) Staff, Shanmuganathan Rajasekaran, Rishi M. Kanna, and Giuseppe Barbagallo. Spinal Infections. Thieme Medical Publishers, Incorporated, 2018.
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14
Mavingui, Patrick, Claire Valiente Mor, and Pablo Tortosa. Exploiting symbiotic interactions for vector/disease control. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780198789833.003.0011.
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Arthropods transmit a variety of diseases to humans and animals, including arboviruses, bacteria and parasites. No efficient treatments or control methods are available for many vector-borne diseases, especially for emerging diseases. Therefore, the development of alternative strategies aiming at controlling disease transmission is encouraged worldwide. Although transmission phenomenon is a result of complex interactions involving several actors evolving in a changing environment, the biotic relationship between pathogens and their vectors represents a key step in successful disease transmission. Recent studies highlighted a strong impact of microbiomes on the life-history traits of arthropod hosts. This chapter emphasizes those biotic interactions having an impact on adaptive traits influencing disease transmission. Evidence in behavioral alterations of vector populations/individuals with relevance to vector-pathogen transmission mitigation is reviewed. Opportunities to take advantage of such biotic processes in the control of vector-borne diseases in different epidemiological, entomological and environmental settings are explored.
15
Angelakis, Emmanouil, and Didier Raoult. Scrub typhus. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198570028.003.0013.
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Bacteria of the genus Rickettsia are obligate intracellular rods that retained basic fuchsin when stained by the method of Gimenez. This genus has long been used as a generic term of small intracellular bacteria. However, taxonomic progress made over the last years has deeply modified the definition of “rickettsia”. As a result, in 1995 the position of R. tsutsugamushi has reclassified from the genus Rickettsia into a separate new genus, Orientia (Tamura et al. 1995).Scrub typhus, also known as ‘tsutsugamushi fever’, occurs only in Asia and is a chigger-borne zoonosis. The disease is acute, febrile, potentially fatal and has been known for centuries in China where it was probably described as early as in the fourth century BC (Parola and Raoult 2006). These last years this infection has been re-emerging because of descriptions of strains of O. tsutsugamushi with reduced susceptibility to antibiotics and of the surprising interactions between scrub typhus and the human immunodeficiency virus (HIV). It is estimated that more than a million cases of scrub typhus are transmitted annually in Asia and more than a billion people are at risk (Rosenberg 1997).
16
Champigneulle, Benoit, and Frédéric Pène. Pathophysiology and management of neutropenia in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0274.
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Neutropenia is defined by an absolute neutrophil count <500 per mm3. Chemotherapy-induced myelosuppression represents the main mechanism accounting for neutropenia, although various bone marrow disorders might also result in impaired granulopoiesis. Neutropenia, especially when profound and prolonged, is a major risk factor for severe bacterial and fungal infections. Early initiation of empirical broad-spectrum antibiotic therapy represents the cornerstone of the treatment of febrile neutropenia. A number of infected neutropenic patients may exhibit organ failures, such as acute respiratory failures and/or severe sepsis requiring intensive care unit (ICU) admission. This chapter discusses the particularities in the management of neutropenic patients in the ICU, including outcome and criteria for ICU admission, management of antimicrobials with respect to the current epidemiological trends, and other measures specific to this subgroup of patients.
17
Stewart, Alex G., Sam Ghebrehewet, and Peter MacPherson. New and emerging infectious diseases. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198745471.003.0026.
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This chapter describes the increasing global problem of new and emerging infections, many zoonotic, ranging from the recently described Middle East respiratory syndrome (MERS) to bacteria now resistant to all locally available antimicrobial agents. The environmental, human, technological, and microbial factors contributing to disease emergence are assessed. Changes in environment and land use result in the spread of vector-borne diseases into new areas, and global travel and trade may introduce pathogens to non-immune populations. The breakdown of health services following political change or during conflict can result in the resurgence of previously controlled communicable diseases. The importance of collaboration between human and veterinary health services is emphasized, and the UK ‘DATER’ strategy (Detection, Assessment, Treatment, Escalation, Recovery) for dealing with pandemic influenza is applied to new and emerging infections. Finally, the role of internet-based, syndromic surveillance to create early awareness of new infections is considered.
18
Roberts, Charlotte A. Leprosy. University Press of Florida, 2020. http://dx.doi.org/10.5744/florida/9781683401841.001.0001.
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Leprosy is an infection and neglected tropical disease that is steeped in myths, and, although it is described in history books, it can remain a challenge to manage today. Written in an accessible manner for professionals and the public alike, this book takes a global view of leprosy past and present. As a backdrop, it starts with exploring what we actually know about leprosy from medicine, how it is spread to humans, and its effects on the body. It then moves to consider its diagnosis and treatment in people, past and present. The focus switches next to the ways in which leprosy is diagnosed in skeletons (paleopathology), from just looking at the bones to analyzing the DNA of the bacteria preserved in the bones. By doing so, information on skeletons with evidence of leprosy across the globe is synthesized with the aim of considering the current state of global knowledge regarding the origin, evolution, and history of leprosy. In particular, the book explores how all the people diagnosed with leprosy in their skeletons in the past were buried, and the myth that everybody was ostracized and segregated into leprosy hospitals, due to stigma, is dismissed. It concludes with thoughts on a future for leprosy, the need to continue to dispel its myths and to seriously reconsider the use of the word “leper” when discussing leprosy today and in the past.
19
Lipman, Jeffrey, and Robert J. Boots. Diagnosis, assessment, and management of tetanus, rabies, and botulism. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0245.
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Tetanus, rabies and botulism are all infections characterized by the production of a neurotoxin, and generally do not give rise to a systemic inflammatory response. Typically tetanus result from the infection of wounds by the ubiquitious soil-borne bacteria Clostridium tetanii, botulism is most commonly due to toxin produced in food contaminated with Clostridium botulinum. Rabies usually results from an animal bite infected with the rabies virus of the Lyssavirus group. Neurological involvement by all three infections is characterized by paralysis and autonomic instability with tetanus also being associated with muscular rigidity. Importantly, the autonomic dysfunction of tetanus can be severe and may necessitate prolonged treatment in an intensive care unit (ICU). Active immunization can prevent or minimize the symptoms of tetanus and rabies, while passive immunization may slow symptom progression in botulism. Intensive care support is often required to manage respiratory failure and autonomic dysfunction. Rabies is typically fatal in the absence of prior immunization.
20
B, Gustilo Ramon, Gruninger Robert P, and Tsukayama Dean T, eds. Orthopaedic infection: Diagnosis and treatment. Philadelphia: Saunders, 1989.
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21
Gustilo, Ramon B., Robert P. Gruninger, and Dean T. Tsukayama. Orthopaedic Infection: Diagnosis and Treatment. W.B. Saunders Company, 1989.
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22
Kriemler, Susi, Thomas Radtke, and Helge Hebestreit. Exercise, physical activity, and cystic fibrosis. Edited by Neil Armstrong and Willem van Mechelen. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198757672.003.0027.
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Cystic fibrosis (CF) is a genetic disease resulting in an impaired mucociliary clearance, chronic bacterial airway infection, and inflammation. The progressive destruction of the lungs is the main cause of morbidity and premature death. Diverse other organ systems such as heart, muscles, bones, gastro-intestinal tract, and sweat glands are often also affected and interfere with exercise capacity. Hence, exercise capacity is reduced as the disease progresses mainly due to reduced functioning of the muscles, heart, and/or lungs. Although there is still growing evidence of positive effects of exercise training in CF on exercise capacity, decline of pulmonary function, and health-related quality of life, the observed effects are encouraging and exercise should be implemented in all patient care. More research is needed to understand pathophysiological mechanisms of exercise limitations and to find optimal exercise modalities to slow down disease progression, predict long-term adherence, and improve health-related quality of life.
23
Burdmann, Emmanuel A., and Vivekanad Jha. Rickettsiosis. Edited by Vivekanand Jha. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199592548.003.0193.
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Rickettsiae are obligate intracellular bacteria transmitted by arthropods to a vertebrate host. Clinically relevant rickettsioses have a similar clinical pattern, manifesting as an acute febrile disease accompanied by headache, articular and muscle pain, and malaise.Epidemic typhus is a worldwide distributed disease caused by the Rickettsia prowazekii, with a human louse as a vector. Data on epidemic typhus-related renal injury is extremely scarce.Murine typhus is caused by the Rickettsia typhi and has a rodent flea as the vector. It is one of the most frequent rickettsioses, and is usually a self-limited febrile illness. Proteinuria, haematuria, elevations in serum creatinine (SCr) and/or blood urea nitrogen (BUN) and AKI have been reported. The real frequency of renal involvement in murine typhus is unknown. Renal abnormalities recover after the infectious disease resolution.Scrub typhus, caused by the Orientia tsutsugamushi, has the Leptotrombidium mite larva as vector. It is endemic in the Tsutsugamushi triangle delimited by Japan, Australia, India, and Siberia. It can manifest either as a self-limiting disease or as a severe, life-threatening multiorgan illness. Early administration of adequate antibiotics is essential to prevent adverse outcomes. Proteinuria, haematuria, and acute kidney injury (AKI) are frequent.Tick-borne rickettsioses are caused by bacteria from the spotted fever group and have ticks as vectors. Rocky Mountain spotted fever (RMSF) is caused by Rickettsia rickettsii. It is the most severe of the spotted fever rickettsial diseases, causing significant morbidity and lethality. RMSF occurs in North, Central, and South America. Renal impairment is frequent in severe forms of RMSF. Mediterranean spotted fever is caused by Rickettsia conorii, and is endemic in the Mediterranean area. It is usually a benign disease, but may have a severe course, clinically similar to RMSF. Haematuria, proteinuria, increased serum creatinine, and AKI may occur. Japanese spotted fever is caused by Rickettsia japonica. Lethal cases are reported yearly and AKI has occurred in the context of multiple organ failure.
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Oakley, Jeremy E., and Helen E. Clough. Sensitivity analysis in microbial risk assessment: Vero-cytotoxigenic E. coli O157 in farm-pasteurized milk. Edited by Anthony O'Hagan and Mike West. Oxford University Press, 2018. http://dx.doi.org/10.1093/oxfordhb/9780198703174.013.4.
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This article discusses the use of Bayesian methods for performing uncertainty analysis in complex computer models, focusing on a mechanistic model that has been applied in a risk assessment of contamination of farm-pasteurized milk with the bacterium Vero-cytotoxigenic E. coli (VTEC) O157. The VTEC model has uncertain input parameters, which makes outputs from the model used to inform the risk assessment also uncertain. The question that arises is how to reduce output uncertainty in the most efficient manner possible. The article first provides an overview of microbial risk assessment before analysing the frequency and consequences of food-borne outbreaks associated with VTEC O157. It then introduces the risk assessment model, along with model input distributions. Finally, it presents the results of a variance-based sensitivity analysis that was conducted to identify the most important uncertain model inputs.
25
McLauchlin, J. Listeriosis. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198570028.003.0014.
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Listeriosis occurs in a variety of animals including humans, and most often affects the pregnant uterus, the central nervous system (CNS) or the bloodstream. During pregnancy, infection spreads to the foetus, which will either be born severely ill or die in-utero. In non-pregnant animals, listeriosis usually presents as meningitis, encephalitis. In humans, infection most often occurs in the immunocompromised and elderly, and to a lesser extent the pregnant woman, the unborn, or the newly delivered infant. Infection can be treated successfully with antibiotics, however 20–40% of human cases are fatal..In domestic animals (especially in sheep and goats) listeriosis usually presents as encephalitis, abortion, or septicaemia, and is a cause of considerable economic loss.The genus Listeria comprises six species of Gram-positive bacteria. Almost all cases of listeriosis are due to Listeria monocytogenes although up to 10% of cases in sheep are due to Listeria ivanovii.Listeriae are ubiquitous in the environment worldwide, especially in sites with decaying organic vegetable material. Many animals carry the organism in the faeces without serious infection. The consumption of contaminated food or feed is the principal route of transmission for both humans and animals, however other means of transmission occur.Human listeriosis is rare (<1 to > 10 cases per million people in North America and Western Europe), but because of the high mortality rate, it is amongst the most important causes of death from food-borne infections in industrialized countries. In the UK, human listeriosis is the biggest single cause of death from a preventable food-borne disease. Listeriosis in domestic animals is a cause of considerable economic loss. Control measures should be directed towards both to exclude Listeria from food or feed as well as inhibiting its multiplication and survival. Silage which is spoiled or mouldy should not be used, and care should be taken to maintain anaerobic conditions for as long as possible.Dietary advice is available for disease prevention, particularly targeted at ‘at risk’ individuals to modify their diet to avoid eating specific foods such as soft cheese and pâté.
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O’Connell, Sue. Lyme borreliosis. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198570028.003.0009.
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Lyme borreliosis is the most common vector-borne bacterial infection in the temperate northern hemisphere. In the United States of America over 35,000 confirmed or probable cases were reported by state health departments to the Centers for Disease Control and Prevention (CDC) in 2008. It is likely that well over 100,000 cases occur in Europe each year. Lyme borreliosis is caused by several genospecies of Borrelia burgdorferi sensu lato, which are transmitted by ticks of the Ixodes ricinus complex. The infection occurs most commonly in forested, woodland and heathland habitats that support the lifecycles of Ixodes ticks and the small mammals and birds that are reservoir-competent hosts for B burgorferi. The most common presenting feature of Lyme borreliosis is erythema migrans, a slowly spreading rash. The spirochaetes can disseminate through the bloodstream and lymphatics to other organs and tissues and cause later manifestations, most commonly affecting the nervous and musculoskeletal systems. The infection responds to appropriate antibiotic treatment at any stage of disease, with excellent outcomes in most cases, but patients with severe tissue damage from previously untreated late stage disease may recover incompletely. A small proportion of patients can have persistent non-specific symptoms following treatment, without evidence of continuing active infection. This has been termed “post-Lyme syndrome” and appears to be similar to other post-infection syndromes. Prevention relies mainly on personal protection measures against tick bites.