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Sathaporn Kunnathum
21 January 2010
The patient does not care about your science;
what he wants to know is, can you cure him?
~Martin H.
Fischer
Dengue Infection
transmitted by the bite of an Aedes mosquito
infected with any one of the four dengue
viruses.
Clinical disease course
Dengue fever is usually a self-limiting
disease
DHF/DSS occurs mostly in endemic areas
Source: Malaria in Children, Department of tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University.
4 months up to 4 - <10 ½ ½ ¼ -
12 months
13 months up to 5 10 - <19 1 1 ½ ¼
years
6 - 7 years 19 - < 24 1½ 1½ 1 ½
8 - 11 years 24 - <35 2½ 2½ 1 ¾
12 - 14 years 35 - < 50 3 3 2 1½
15 + 50 or more 4 4 2 2
P. vivax malaria
Young infant less than 5kg or below 4
months should be treated with
Chloroquine alone for three days
consecutive (Table 4b).
Table 4b. Dosage and administration of
Chloroquine for malaria vivax in young infant
skin,mucosa
Initial stage leptospiremia toxic symptoms
(1~3days) three symptoms:
fever,myalgia,fatigue;
three signs:
conjunctival suffussion;
muscle tenderness;
enlargement of lymphonodes;
PATHOGENESIS
severe toxic symptoms
lesion of organs:
influenza form
pneumorrhagic form
middle stage icterohemorrhagic form
(3~10d)
meningoencephalitis
renal failure form.
PATHOGENESIS
immunopathological reaction
after fever;
sequelae of eyes;
reactive
meningitis;
cerebro arteritis
obliterans.
convalescent stage
PATHOLOGY
1. basic pathological change is
infective,toxic injured of systemic
capillaries;
2. severe:lung,liver,kidneys,brain.
exudation,hemorrhage,
edema or necrosis.
Investigation
CBC
BUN/Cr , Elyte
LFT
CPK
UA
CXR
Serology
LP
Treatment
1. Supportive treatment
2. medication
- Pen G 1.6 mu iv q 6 hr
- Doxycycline (100) 1x2 o pc
- Ceftriaxone 2 g iv OD
for 7 days
Melioidosis
Cause : Burkholderia pseudomallei
Organism
Burkholderia pseudomallei
Aerobic, gram-negative
motile bacillus
Found in water and moist soil
Opportunistic pathogen
Produces exotoxins
Can survive in phagocytic cells
Latent infections common