Category Archives: Infectious Diseases Tropical Medicine and Sexually Transmitted Diseases

Further Reading

.Adler M (1990) The ABC of Sexually Transmitted Diseases, 2nd edn. London: BMA Publications. Adler M (1993) The ABC of AIDS, 3rd edn. London: BMA Publications. Arnold E (1990) Modern vaccines. London: Lancet Publications. Bannister B (1983) Infectious Diseases. London: Bailliere Tindall. raude AI (1985) Infectious Diseases and Medical Microbiology, 2nd edn. Philadelphia: WB Saunders. Collier L & Oxford J (199

Diagnosis

Detection of IgG antibody to envelope components (gp120 and its subunits) is the most commonly used marker of infection with HIV. The routine tests are based on ELISA techniques which may be confirmed with Western blot assays. Up to 3 months may elapse from initial infection to antibody production (the window period). These antibodies have no protective function. As with all IgG antibodies they cross the pla

Microsporidiosis

This is a frequent cause of diarrhoea. Spores can be detected with great accuracy in the stools using a trichrome or a fluorescent stain that attaches to the chitin of the spore surface. Albendazole is effective in eradicating the organism. FUNGI Cryptococcus In the context of HIV with AIDS the commonest presentation is with meningitis, although it can cause pulmonary and disseminated infection. Clinical feat

Persistent generalized lymphadenopathy (PGL) (eDe Group III)

A subgroup of patients with asymptomatic HIV infection have PGL, defined as lymphadenopathy (>1 ern) at two or more extra-inguinal sites for more than 3 months in the absence of causes other than HIV infection. The nodes are usually symmetrical, firm, mobile and non-tender. There may be associated splenomegaly. The architecture of the nodes shows hyperplasia of the follicles and proliferation of the capil

HIV and AIDS

Introduction HIV was identified as the causative organism of AlDS in 1983. Current WHO estimates are of 13 million adults infected worldwide, of whom 2.5 million have died. By the year 2000 WH 0 estimates that there will be up to 80 million infections worldwide. In the UK, women currently account for 15% of known HIV infections and 6% of AIDS cases reported. Epidemiology Despite the fact that HIV can be isolat

CLINICAL FEATURES

Vaginal discharge and odour are the commonest complaints although a proportion of women are asymptomatic. A homogeneous, greyish white, adherent discharge is present in the vagina, the pH of which is raised (greater than 5). Associated complications are ill-defined but may include chorioamnionitis and an increased incidence of premature labour in pregnant women. Whether BV disposes non-pregnant women to upp

Warts

Anogenital warts are amongst the commonest sexually acquired infections with ever growing numbers of people seeking treatment. The causative agent is human papillomavirus (HPV) especially types 6 and 11. HPV is acquired by direct sexual contact with a person with either clinical or subclinical infection. Neonates may acquire HPV from an infected birth canal which may result either in anogenital warts or in l

Lymphogranuloma venereum (lGV)

Chlamydia trachomatis types 1, 2 and 3 is responsible for this sexually transmitted infection. It is endemic in the tropics, with the highest incidences in Africa, India and South East Asia. CLINICAL FEATURES The primary lesion is a painless ulcerating papule on the genitalia and only occurs in one-quarter of the patients. A few days after this heals, regional lymphadenopathy develops. The lymph nodes are pai

DIAGNOSIS

TP is not amenable to in vitro culture-the most sensitive and specific method is identification by dark-ground microscopy. Organisms may be found in variable numbers from primary chancres and the mucous patches of secondary lesions. Individuals with either primary or secondary disease are highly infectious. Serological tests used in diagnosis are either treponemal specific or non-specific. Three main tests a

CLINICAL SYNDROMES

Gonorrhoea The incidence of gonorrhoea (GC) in developing countries has fallen dramatically since the early 1970s but in Asia and Africa it still remains high. In 1990 WHO estimated 35 million cases worldwide, second to Chlamydia trachomatis amongst STDs. The causative organism, Neisseria gonorrhoeae (gonococcus), is a Gram-negative intracellular diplococcus which infects epithelium particularly of the uroge