CANDIDA ALBICANS - virtually all of us play host to it!!!

Facts :
        - Its a yeast infection and predominantly focuses on GI tract invasion
        - People having H-pylori infection also has candida overgrowth (60%-70%)
        - By age of 6 months, about 90% of the babies are positive for candida test
        - And by adulthood virtually we all have become the host of it
        - Our GI bacteria act in part to keep Candida growth in check in our body ecology

Features :
      Medium used :
                - Lownstein-Jensen medium

                - Two tubes of Sabouraud’s dextrose agar, SDA, one incubated at 37°C and the other at 20°C

     Upon culture :
                - After incubating for 48 hours typical creamy pasty colonies appeared on the blood agar and     both tubes of SDA.

                - it was then isolated and identified by the germ tube test

Disease caused by it is called Candidiasis, also called thrush or moniliasis, is a yeast infection

 Clinical pictures : for clinical pictures of candidiasis click on the below highlighted names
               1.    ORAL CANDIDIASIS
               2.   CANDIDIAL ESOPHAGITIS
               3.   YEAST VAGINITIS
               4.   CANDIDA GRANULOMA
               5.   CUTANEOUS CANDIDIASIS 

 

Symptoms : 

            1. Infection of skin : well defined patch of red, itchy skin, often leaking fluid

            2. Vaginal yeast infection : slow leakage of a thick, white, cheese-like substance, itching or burning sensation during urination and intercourse

            3. Infection of fingernail : painful, red, swollen area around the fingernail. In worse cases, the fingernail may separate, revealing a discoloured white or yellow nail bed.

            4. Oral thrush : curd like white patches in mouth, palate, tongue and around the lips

Investigations :

          - Proper diet history

          - History of medication and antibiotics which may weaken the immune system

          - History of diabetes, cancer, HIV, or other chronic disease

          - Microscopic examination after being scraped off the affected area

Treatment :

                 Candidiasis is not normally a dangerous disease except in rare cases when it enters the blood and spreads to vital organs of people with weakened immune systems

                Anti-fungal cream or powder

Precaution :

           - wipe from front to back after going to the toilet - the rectal area is full of yeast

           - take baths not showers - sitting in the bath can clear yeast from the vaginal area

           - dry yourself thoroughly afterwards, especially the pubic hair - use a hair dryer on low setting if you have to

          - don't use soap around the vagina - soap kills the bacteria you want to keep, and has no effect on yeast

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DRACUNCULUS MEDINENSIS - silent killer which remains in body silent upto 1 year !!!!!!

Facts :
          - Also known as guinea worm disease (GWD)
          - These are among the longest nematodes infecting humans.
          - Dracunculus medinensis is one of four filarial nematodes that cause subcutaneous filariasis in humans. The other three filarial nematodes are Loa loa (the African eye worm), Mansonella streptocerca, and Onchocerca volvulus (river blindness)
          - The longest adult female recorded was 800 millimetres (31 in), while the adult male was only 40 mm (1.6 in)
          - Guinea worm has been found in calcified Egyptian mummies
          - An Old Testament description of "fiery serpents" may have been referring to Guinea Worm: "And the Lord sent fiery serpents among the people, and they bit the people; and much people of Israel died."

          - Humans become infected by drinking unfiltered water containing copepods

The disease caused is  Dracunculiasis
 Symptoms include :
           - Pruritus
           - Nausea
           - Vomiting
           - Diarrhea or
           - Asthmatic attacks

 Treatment :
           - There is NO vaccine or medicine to treat or prevent Guinea worm disease
           - Once a Guinea worm begins emerging, the first step is to do a controlled submersion of the affected area in a bucket of water. This causes the worm to discharge many of its larva, making it less infectious
           - To extract the worm, a person must wrap the live worm around a piece of gauze or a stick. The process can be long, taking anywhere from hours to months.
           - Gently massaging the area around the blister can help loosen the worm up a bit.
           - Use of metronidazole or thiabendazole may make extraction easier, but also may lead to migration to other parts of the body

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ROUND WORM - infects 1 in every 4 persons in world!!!!!!

Roundworms are one of the most common species of intestinal parasites in the world
Also known as Ascaris lumbricoides

Facts :
            - The World Health Organization (WHO) estimates that about 25% of the world's population are infected with roundworm.
            - Female round worm ranges from 16cm to 33 cm and can grow up to the size of pencil
            - WHO estimates that about 25% of the world's population are infected with roundworm.
            - Medical research studies use roundworms to study human diseases which include illnesses like muscular dystrophy and even Alzheimer's disease. This is because of the fact that human beings and roundworms have similar body organization and similar genetic code

 Clinical features :
      - perianal itching
      - abdominal pain
      - diarrhea
      - melena
      - fatigue and weight loss
      - vomiting
      - cough in case of systemic involvement

Diagnosis :
      - stool examination
      - passing of worms in stool
      - radiolophic/ USG imaging
      - endoscopy

Treatment :
Mebendazole, drug of choice
Piperazine, alternative
Albendazole, levamisole, ivermectic other medications
Diethlycarbamazine with filariasis infection

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SABOURAUD DEXTROSE AGAR - fungi growing agent

         Sabouraud agar medium was developed by the French dermatologist Raymond J. A. Sabouraud in the late 1800’s to support the growth of fungi that cause infection of the skin, hair, or nails, collectively referred to as dermatophytes 

Sabouraud dextrose agar is used for growing fungi. It is recommended for skin and nail fungi, as well as other species that are human pathogens

Ingredients : water, dextrose, agar, peptone, antibiotics
Per liter of medium:                    
          Peptone, 10 g                    
          Glucose, 40 g                    
          Agar, 15 g  


External links for reference :
http://philip-mcintosh.suite101.com/sabouraud-dextrose-agar-a189138 

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TCBS CULTURE (microbiology)

Thiosulfate Citrate Bile Sucrose Agar (TCBS) proposed by NAKANISHI (1962), modified by KOBAYASHI et al. (1963).

Use :  isolation and selective cultivation of Vibrio cholera and other enteropahtogenic vibrios

Preparation Suspend 88 g/liter and pour plates. Do not autoclave. pH: 8.6 ± 0.2 at 25°C. The plates are clear and green-blue.

Appearance of colonies                                                                      microorganisms

Flat, 2-3 mm in diameter, yellow	Vibrio cholerae, Vibrio cholerae type El Tor
Small, blue-green centre	Vibrio parahaemolyticus
Large, yellow	Vibrio alginolyticus
Blue	Pseudomonas, Aeromonas and others
Very small, translucent	Enterobacteriaceae and others

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RHIZOPUS SPECIES (microbiology)

Disease caused mucormycosis

Clinical presentation :
       - Rhino-cerebral disease :- unilateral, retro-orbital headache, facial pain, numbness, fever, hyposmia, and nasal stuffiness
       - pulmonary disease :- fever, dyspnea, and cough occasionally hemoptysis
cutaneous disease :- progressive black necrotic lesion
       - GI disease :- abdominal pain, distention, nausea, and vomiting
       - CNS disease :- headache, decreasing consciousness, and focal neurologic symptoms/signs, including cranial nerve deficits
        - Disseminated disease :- involve the kidneys, bones, and heart, with symptoms attributed to these organ systems

Investigations :
      - complete blood cell (CBC)
      - arterial blood gases (ABG)
      - CSF examination
      - CSF and blood culture
      - CT scan and MRI
      - chest X ray
      - biospy

Treatment :
     - prompt institution of liposomal amphoterecin B therapy and surgical resection
     - insulin for diabetic ketoacidosis
     - sodium bicarbonate for acidosis and re-hydration therapy
     - Antifungal treatment consists of lipid formulations of amphotericin B, amphotericin B deoxycholate, or posaconazole. First-line treatment is with an amphotericin derivative.

Prognosis :
      - Mucormycosis carries a mortality rate of 50-85%. The mortality rate associated with rhinocerebral disease is 50-70%. Pulmonary and gastrointestinal (GI) diseases carry an even higher mortality rate, because these forms are typically diagnosed late in the disease course. Disseminated disease carries a mortality rate that approaches 100%

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