Tags: Measles

Haemophilus, Bordetella, & Branhamella Species

Before 1990, strains of Haemophilus influenzae type b were found in the upper respiratory tract of 3-5% of children and a small percentage of adults. Colonization rates with type-b strains are even lower now, reflecting routine immunization of infants against H influenzae type b. Non-type-b encapsulated H influenzae are present in the nasopharynx of < 2% of individuals, whereas nonencapsulated (nontypable [see below]) strains colonize the respiratory tract of 40-80% of children and adults.

Haemophilus Influenzae: Clinical Syndromes

H influenzae was first isolated during the 1892 influenza pandemic and was originally believed to be the causative agent of influenza. Although subsequent studies revealed the fallacy of this idea, H influenzae has proved to be a common cause of localized respiratory tract and systemic disease, including meningitis, epiglottitis, pneumonia, pyogenic arthritis, cellulitis, otitis media, and sinusitis, among others (Box 1). Meningitis is the most common and serious form of invasive H influenzae type-b disease. In the mid-1980s, before the introduction of effective vaccines, ~ 10,000-12,000 cases of H influenzae type-b meningitis occurred in the United States each year, and 95% of cases involved children < 5 years old.

Staphylococci

Staphylococcus aureus colonizes the human skin, vagina, nasopharynx, and gastrointestinal tract. Colonization occurs shortly after birth and may be either transient or persistent. Published studies differ widely in estimates of the prevalence of S aureus carriage.

Mumps

Mumps, historically known as epidemic parotitis, was one of the most common early childhood infections before the routine use of mumps vaccination starting in 1968. Reported cases of mumps have dropped 98% when compared with the prevaccine era. It is spread primarily during the late winter and early spring. Before the vaccination era, mumps epidemics occurred in 3- to 4-year cycles.

Order Chloroquine\Hydroxychloroquine (Aralen) No Prescription 250/500mg

Syncope occurred in a hypertensive 48-year-old man who took oral chloroquine sulfate (total 600 mg base) while also taking amlodipine 5 mg/day. Chloroquine and amlodipine both cause vasodilatation, perhaps by release of nitric oxide, and the syncope in this case was probably due to a synergistic mechanism. Malaria itself can also provoke orthostatic reactions, which may be why syncope is not a reported adverse effect of chloroquine.

Common Cold

Inflammation of the nasal passages due to any number of respiratory viruses. Usually not serious; vast majority are self-treated. Incidence/Prevalence in USA: Preschool children 6-10 colds/yr; kindergarten 12/yr; schoolchildren 7/yr; adolescents/adults 2-4/yr. National Ambulatory Survey: 31 episodes/100 persons/year (counting only colds that lead to medical attention or at least one day of restricted activity).

Bronchiectasis

Conditions that may lead to bronchiectasis include severe pneumonia (especially measles, pertussis, adenoviral infections in children), necrotizing infections due to Klebsiella, staphylococci, influenza virus, fungi, mycobacteria, mycoplasma, bronchial obstruction from any cause (foreign body, carcinoma, enlarged mediastinal lymph nodes.