Notes in Melioidosis/Chiggers/Myiasis

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Published	01/06/2024	Burkholderia pseudomallei is a gram-{{c1::negative}} {{c1::bacillus}}. That has a {{c1::safety pin}} staining pattern. It grows selectively on {{…
Published	01/06/2024	Melioidosis is associated with annual {{c1::rains}}. The main endemic region is {{c1::SE Asia}}. It is found in {{c1::soil, surface water, mud, r…
Published	01/06/2024	Transmission of melioidosis{{c1::Inoculation or contamination of wounds}} (rice farmers){{c1::Mucosal exposure}}{{c1::Inhalation}} (hel…
Published	01/06/2024	In the immunocompetent, melioidosis can remain {{c1::latent}} for years. It peaks at age {{c1::40-60}}.
Published	01/06/2024	Clinical features of melioidosisSpectrum of disease: {{c1::asymptomatic (majority) -> mild/flu-like -> septicemia}}Similar to {{c1::TB…
Published	01/06/2024	Localized melioidosis affects the {{c1::lung}} most commonly causing a {{c1::subacute cavitating lesion}} in the {{c1::upper …
Published	01/06/2024	{{c1::Septicemic}} melioidosis is characterized by an acute onset of high fevers and rigors, altered mental status, jaundice, diarrhea, anemia, w…
Published	01/06/2024	Differential diagnosis of melioidosis{{c1::Pneumonia}}{{c1::Empyema}}{{c1::TB}}{{c1::Lung neoplasm}}{{c1::Paragonomis (lung fluke)}}
Published	01/06/2024	Diagnosis of melioidosisHistory: endemic region, underlying illness (DM){{c1::Microscopy}} of pus, sputum, urine{{c1::Giemsa}} or {{c1::gram…
Published	01/06/2024	Initial treatment of melioidosisProlonged course (2-4 weeks IV){{c1::Ceftazidime}} if relatively uncomplicated{{c1::Carbapenem}} (imipenem, …
Published	01/06/2024	Prolonged treatment of melioidosis{{c1::Oral eradication therapy}} = 20 week course of oral antibiotics + IV meds initially{{c1::TMP/SMX, doxycyc…
Published	01/06/2024	{{c1::Chiggers}} is caused by infestation with larval form of Trombiculid mites. It is found in grasslands, forests, lakes, streams.
Published	01/06/2024	Risk factors for {{c1::Chiggers}} include farming, fishing, trekking, camping, military.
Published	01/06/2024	Clinical presentation of Chiggers{{c1::Itchy}} after few hours{{c1::Papules, vesicles, urticaria, bullous eruptions}}Resolve in {{c1::1-2}} …
Published	01/06/2024	Treatment of Chiggers = {{c1::symptomatic relief (topical steroids, antipruritics)}}
Published	01/06/2024	{{c1::Doxycycline}} is given as prophylaxis for high-risk groups (military) to prevent Chiggers.
Published	01/06/2024	{{c1::Myiasis}} is an infestation of animals and humans by larval flies (Botfly/Tumbu fly).
Published	01/06/2024	{{c1::Cutaneous}} myiasis is the penetration of larva into {{c1::healthy}} skin causing an erythematous furuncle-like nodule. There are {{c1…
Published	01/06/2024	Wound myiasis is a fly larvae infestation in {{c1::open wounds}}. Risk factors include {{c1::existing wound, lack of wound hygiene, poor SES, lac…
Published	01/06/2024	Treatment of myiasisUsually {{c1::self-limiting but treatment recommended}}Induce {{c1::local hypoxia (paraffin oil)}} at lesion to force em…
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