"INTERNATIONAL" Infectious diseases....

In clinical practice and frequently on board exams, it is important to consider infectious diseases
that occur in certain "international", geographic regions, as these subtle hints will help with diagnosis
and in correctly answering the question. Examples:



1.     Patient from Egypt/Northern Africa develops hematuria. What organism is the likely cause?


2.     Patient from Mexico (Central/South America) develops a seizure.
        What is the likely cause?


3.    Patient from Scandinavia, develops B12 deficiency.
       Likely etiology?


4.    Patient returning from a vacation in the Caribbean, develops sudden headache,
       retroorbital pain, myalgias, arthralgias and high fever.
       What is the causative factor?



5.    Patient returning from a wild boar hunting trip develops gradual onset of
       myalgias, ,periorbital edema, persistent fever,malaise and photophobia.
       What organism is responsible?


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Answers:

 1.  The diagnosis is SCHISTOSOMIASIS, specifically, S. Haematobium, that is prevalent
      in the fresh waters of African continent, Middle East and India.
      It is a Trematode (Fluke), a flat worms that infect mainly the GU tract, causing bladder
      ulceration, hematuria, that can frequently result in anemia and squamous  cell carcinoma
      of the bladder. Infertility is a frequent consequence.


2.   Diagnosis is NEUROCYSTICERCOSIS. It is a pork tapeworm, Taenia Solium.
      It can only occur from consuming undercooked pork. When the agent invades the
      CNS, the first symptoms is usually a seizure as usually it is asymptomatic.
      However, can have vague headaches, focal neurologic deficits and hydrocephalus.


3.   Diagnosis is DIPHYLLOBOTHRIASIS. The organism is a freshwater fish tapeworm.
      It is prevalent in Northern, cooler climates, worldwide, and especially common in
      Finland, Norway, Sweden.   Consumption of raw fish causes, the D. Latum to invade
      the small intestine, especially the terminal ileum, causing B12 deficiency, from
      continued feeding.



4.    Diagnosis: Acute DENGUE FEVER.  It is a disease transmitted by mosquitos, especially
       common in tropical regions. Caribbean, Puerto Rico, etc.  Caused by a flavivirus.



5.    Diagnosis:  Acute TRICHINOSIS.    This is another infectious disease, common in
       countries that consume pork, wild boar or even bear meat. The classic nematode is
       T. Spiralis. 



Will soon continue.