When Tuberculosis Infection Comes Back

Even if you successfully beat tuberculosis, you can get tuberculosis infection again. In fact, TB reinfection is becoming more common.

 Tuberculosis is a potentially life-threatening, airborne bacterial infection that can be found worldwide. The treatment regimen is a lengthy one, but if you stick with it and take medications the way you should, you can beat the disease. Even with treatment, however, tuberculosis reinfection is becoming a problem.

The Lengthy Tuberculosis Treatment Regimen

It's very common for people with tuberculosis to relapse during treatment. Treatment for tuberculosis symptoms can last anywhere from six months to a year, and sometimes more for drug-resistant tuberculosis. There are multiple pills that need to be taken every single day – at the same time each day, without fail – or the treatment might not work.

You may start to feel better and think that your tuberculosis has been successfully treated, only to find out that it's back – stronger and more difficult to treat. Or you may have done everything right and the disease is gone, only to find that you are infected with tuberculosis again.

How Tuberculosis Reinfection Happens

There is much debate over whether recurrent tuberculosis is caused by a relapse — getting sick again with the same strain of tuberculosis even after treatment — or tuberculosis reinfection with a new strain of the bacteria.

In the United States and Canada, it seems that most recurrent tuberculosis cases are a relapse of the original infection, perhaps because of insufficient treatment, and not because of tuberculosis reinfection with a new strain of bacteria.

The situation is different in other parts of the world. In a study done in Cape Town, South Africa, where tuberculosis is very common, 18 percent of the 612 study participants had tuberculosis reinfection. Fourteen percent of those patients had been successfully treated for their illness and were infected again with a different strain of TB.

Many people may have what's called latent tuberculosis infection, meaning that they have no tuberculosis symptoms, but the bacteria are still in their body. Once the bacteria become active and cause tuberculosis symptoms, the infection becomes active TB.

Who Gets Reinfected?

Based on the Cape Town study results, researchers did not find any risk factors that made people who had been reinfected with tuberculosis more likely to get sick again.

People who have had tuberculosis before and get it again are at a much higher risk of developing tuberculosis disease than someone who has never had the illness. More research needs to be done, but scientists suspect that some people may be more susceptible to tuberculosis than others for reasons that are not yet known.

Another study conducted on HIV-positive people infected with tuberculosis suggests that HIV makes them more susceptible to tuberculosis reinfection than non-HIV positive patients are.

Tuberculosis Reinfection Treatment

Treating recurrent tuberculosis that is caused by relapse — treatment that wasn't successful or was incomplete — is difficult. Often the bacteria have become resistant to treatment and a different combination of drugs, taken over a longer period of time, is often the recommended course of treatment.

One study showed that a main cause of drug-resistant tuberculosis, the kind that's most difficult to treat, is reinfection. Even when tuberculosis reinfection occurs from a different strain of bacteria, the recurrent type is often drug-resistant, meaning that some kind of a mutation of the original strain of bacteria doesn't respond to drugs.

If the recurrent case responds to the drugs, then it can be successfully treated. Again, the regimen must be followed to the letter.

Preventing Tuberculosis Reinfection

You can't always prevent tuberculosis, be it a primary or recurrent infection. But you can take steps to reduce your risk.

For those with HIV, one way of trying to prevent tuberculosis reinfection is to use the antibiotic isoniazid (INH). Once treatment for tuberculosis is completed, a course of preventive antibiotics might be an option to reduce the risk of tuberculosis reinfection in HIV-positive people.

The best way to prevent tuberculosis from striking again is to always take medications exactly as recommended by your doctor. And as obvious as it sounds, limiting exposure to people who may be contaminated with tuberculosis also reduces the risk of reinfection. 

Human Immunodeficiency Virus (HIV) Infection - What Increases Your Risk

Most people get HIV by having unprotected sex with someone who has HIV. Another common way of getting the virus is by sharing needles with someone who is infected with HIV when injecting drugs.

You have an increased risk of becoming infected with HIV through sexual contact if you:

    Have unprotected sex (do not use condoms).
    Have multiple sex partners.
    Are a man who has sex with other men.
    Have high-risk partner(s) (partner has multiple sex partners, is a man who has sex with other men, or injects drugs).
    Have or have recently had a sexually transmitted infection, such as syphilis or active herpes.

People who inject drugs or steroids, especially if they share needles, syringes, cookers, or other equipment used to inject drugs, are at risk of being infected with HIV.

Babies who are born to mothers who are infected with HIV are also at risk of infection. 

What to think about

HIV may be spread more easily in the early stage of infection, and again later, when symptoms of HIV-related illness develop.

The risk of getting HIV from a blood transfusion or organ transplant is extremely low because all donated blood and organs in the United States are screened for HIV.

Infected eczema: Diagnosing, Treating, Prevention of Infection

What does infected eczema look like?
Infected atopic eczema looks red and angry, and is usually ‘weepy’ with a yellowish crust. Yellow pus-filled spots may also be present and small red spots around the body hairs (folliculitis). The skin feels hot, itchy and sore, which leads to more scratching. Scratching damages the outer layers of the skin and creates cracks allowing more bacteria to grow.

Occasionally the glands may swell and there may be an enlargement of lymph nodes in the neck, groin and armpits. Lymph nodes filter out bacteria and stop them from entering the bloodstream. Swollen lymph nodes can be tender to the touch. Infection should always be suspected if the eczema suddenly worsens or does not respond to emollient or topical steroid treatment.

Candida appears red, itchy and sore and there may also be tiny yellow pustules.

Eczema herpeticum produces small blisters, containing clear fluid or yellow pus, which break open and ulcerate the skin. Mild attacks are fairly common but in more serious cases, the virus spreads quickly on first infection. A high temperature and a general feeling of being unwell usually accompany it.

This form of eczema herpeticum is very dangerous and it is essential to contact a doctor immediately and to ask him or her if the symptoms could be eczema herpeticum.

Diagnosing Infection
Dermatologists, dermatology nurses and general practitioners with a special interest in dermatology may be able to tell if eczema is infected just by looking at it. Patients who have already experienced infection are also likely to recognize the signs and symptoms.

However, it is not always clear if eczema is infected, which can make diagnosis difficult. Your doctor may take a swab from the skin to be sent to the microbiology laboratory. This is a quick, painless procedure and can help to confirm what is causing the infection and can also show what antibiotics should be effective as treatment. Skin swabs frequently show the presence of Staph. aureus on the skin, but may also reveal additional bacteria called streptococci.

Treating Infected Eczema
Treatment depends upon the type of infection. Staph. aureus can be treated in several ways. For mild infections emollients and topical steroids, together with a bath oil containing an antiseptic may be sufficient. Sometimes a combination cream or ointment may be prescribed.

Combination creams and ointments contain both a topical steroid to help combat inflammation and an antibiotic to fight the infection. If the eczema is heavily infected, oral antibiotics may be prescribed that help to quickly bring the infection under control, but it is important to continue to use emollients to help restore the skin barrier.

Antiviral drugs such as acyclovir are used to treat eczema herpeticum orally, by injection or in the form of a cream or ointment. If the eczema herpeticum is severe, a few days in the hospital may be needed to get the infection under control.

Candida is usually treated with an antifungal cream that can be prescribed by your doctor or dermatology nurse or bought over the counter from a pharmacist.

Using a medicated shampoo or an anti-yeast shampoo can treat Pityrosporum ovale on the scalp but will depend on the severity of the eczema. These shampoos are available from pharmacies. Several antifungal creams, with or without a mild steroid, are available to treat seborrheic eczema on other parts of the body.

There is no specific medicine to clear molluscum contagiosm. It is up to the body’s own immune system to get rid of the infection and unfortunately this can take months.

Infection and Your Other Treatments
Eczema patients who are using the topical immunomodulators Protopic and Elidel should not continue to use them if their eczema becomes infected. Speak to your doctor if you are using these products and suspect that your eczema may be infected.

Never use wet wrap bandages with infected eczema, as the moist, warm environment created by wet wraps is a perfect breeding ground for bacteria.

If your eczema is infected and you normally use emollient ointments, it may be worth asking your doctor to consider prescribing in addition an emollient cream to use some or all of the time while the infection persists. This is because in some people the ointment – which is occlusive – can also ‘trap in’ the infection.

Whatever emollients you are using, remember that it is easy to spread infection – both on your own skin and your child’s skin – and also to pass it from one person to another.

Pump dispensers reduce the risk, as does good hand hygiene before and after putting on emollients. If you do not have a pump dispenser, use a clean spoon to take the emollient out of the pot, rather than using your fingers.

Prevention of Infection in Eczema
Restoring the skin’s barrier to infection, be reducing dryness and cracking will help to reduce the entry points for bacteria. Intensive emollient therapy, with moisturizing creams and ointments, soap substitutes and emollient bath oils are essential. Daily baths and showers can help to prevent infection.

If someone in the family has a cold sore, it is important to refrain from sharing towels and face cloths. Ensure that you change bed linen regularly and wash it in a hot wash.

Even if you take preventative measures it is not always possible to stop eczema becoming infected. However, by treating with the most appropriate medication, the infection can be cleared and the eczema can be kept under control.

Infection and Eczema

We all know that eczema is not infectious – one of the UK National Eczema Society’s messages for very many years. Damaged skin is vulnerable to infection, however, and infected eczema is one of the most common issues raised with the UK National Eczema Society’s helpline. In this article our information team looks at why this might be and what we can do about it.

Broken skin provides an environment where micro-organisms can flourish. As a result, skin infections are not uncommon. Infections may be bacterial, fungal or viral.

Bacterial Infection
Atopic eczema is most often infected by a bacterium called Staphylococcus aureus, which makes the eczema worse and slower to heal. Staph. aureus is found on the skin in less than 10% of healthy individuals.

By contrast, almost everyone who has atopic eczema will have Staph. aureus on their skin somewhere, even thought their skin may not show signs of infection. It is not clear whether the bacteria migrate from the active eczema to areas of skin without eczema or whether people with atopic eczema are simply more susceptible to Staph. aureus colonization than those without eczema.

Colonization is not normally a problem unless the skin is broken. Infection occurs only when the bacteria penetrates the skin’s barrier.

It is likely that people with atopic eczema have an impaired ability to deal with infection. In addition, as we know all too well from practical experience, eczema itches and the natural responses to itch is to scratch. This in turn causes the skin to crack and split and become red and inflamed, warm and moist – a perfect home for bacteria.

This is made worse by the itch-scratch-itch cycle and the vicious cycle that follows. It is also possible that the dry skin of atopic eczema is deficient in certain fatty acids, which may encourage the growth of bacteria.

Viral Infection
The major virus that causes problems in people with eczema is the herpes simplex or cold sore virus. Many people who do not have eczema catch herpes simplex in childhood. It is usually very mild, causing a few mouth or gum ulcers that may not even be noticed.

Our bodies become immune after a first infection by herpes simplex – you tend not to catch it from anyone a second time.  However, your own initial virus can become active again causing small, itchy blisters that quickly form a cold sore. This is how herpes simplex usually affects people who do not have eczema.

Herpes simplex is highly contagious and can appear as genital inflammation or conjunctivitis as well as cold sores. For people with eczema, the herpes simplex virus can be much more serious, probably because they have a lowered resistance to viruses. People with eczema should avoid skin-to-skin contact with anyone who has herpes simplex as this virus can infect eczema, giving rise to a condition called eczema herpeticum, which can cause serious illness.

Many children get molluscum contagiosum, but it may be slightly more common in atopic eczema sufferers. Molluscum contagiosum appears as small, smooth, red or flesh-colored bumps, each with a tiny dimple in the center. They often develop on eczema-prone areas such as skin folds behind the knees.

The condition often becomes red and crusted when the body’s immune system is starting to fight against it. This can look alarming, especially if surrounded by eczema, but is in fact a good sign and means that the molluscum contagiosum will clear up soon.

Fungal Infection
Candida or ‘thrush’ is a yeast or ‘fungal’ infection that may develop on skin with eczema, but can also appear on the skin of people without eczema. Candida likes warm, moist folds of skin such as the groin, under the arms and breasts or around the diaper area in babies.

Pityrosporum ovale is also a fungal infection, from the yeast pityrosporum, and can be found on the skin of people with seborrheic eczema. It likes to live where a lot of sebum (the body’s natural grease) is produced – for example, scalp, chest, ear folds and groin. Pityrosporum ovale may well be responsible for seborrheic eczema developing in many people. 

What Is Abscess Treatment

Often abscess courses without special treatment – it opens by itself and its contents flows out 

Sometimes abscess goes away slowly without burstings as body fights infection and dead tissues go through corresponding changes After abscess goes away, there may be left a hard nodule on its spot.

In order to lessen pain and fasten healing you may prick the abscess and drain it. To drain large amount of abscess it is necessary to consult the doctor to let him examine it to destroy walls and release all white matter.

After draining the large abscess there remains an empty space which should be tamponed. Sometimes there is necessary to insert temporal artificial drainages (usually these are thin plastic tubes).

Abscess is not supplied with blood, therefore antibiotics usually are ineffective. They may be prescribed after abscess drain to prevent relapse.

Antibiotics may be prescribed when abscess is source of infection spread on other organs. Seeding of white matter for antibiotics sensitivity helps the doctor to choose most effective medication.

What Are Abscess Symptoms

Abscess is gathering of white matter due to development of bacterial infection. The bacteria get into healthy tissue and thus infection is developed in particular area. Some cells get damaged and on those spots is accumulated liquid along with infected cells.

To those spots are navigated leucocites (body protectors against infections) which die after they catch bacteria. Gathering of dead leucocites do form white matter that fills damaged area. While white matter accumulates, the healthy tissue moves away.

Gradually around abscess is formed connective tissue and walls around abscess – in this way body prevents further microorganisms spreading. When occurs rupture of abscess, the pathogens may get into the body or under the skin depending on abscess localization.  Abscess may be developed in any organs including lungs, mouth, rectum and muscles. Frequently they occur on the skin, especially on the face.

Abscess symptoms
Symptoms of abscess are detemined by the spot of its location and dysfunction of organ or nerve in abscess area. Symptoms may include pain, painful palpation, local skin temperature increase, intumescence, redding and sometimes increase of body temperature. Abscess that is formed under skin usually looks like intumescence.

Before opening, it becomes white in central part because skin around it gets thin. When abscess is developed deep in the body then for the symptoms appaering it must have significant size. Unobserved deep abscess often is source of infection spreading through the whole body.  

Erythema Infectiosum Symptoms

First signs of the disease do appear in 4 – 14 days after infecting and they are different in different people. In some people there are no evident disease signs.

In children with erythema infectiosum  shows with temperature increase, light weakness, red cheeks as if someone clapped his face. In 1 – 2 days appears rash on hands, legs and body, rarely on palms and feet.

Rash does not itch and consists of red spots sometimes with ragged edges, especially it is heavy on areas of hands which are not covered with clothing because rash aggravates under action of direct sun rays.

The disease lasts from 5 to 10 days. During next several weeks under action of direct sun rays, physical load, warming, body temperature increase, emotional tension, rash may appear periodically. In adults mild pain and arthroncus may appear and disappear in the course of several weeks and months.

Health professional makes diagnosis on the basis of specific rash. Blood tests help to identify virus. The treatment is intended to symptomatic relief. 

Erythema Infectiosum

Erythema infectiosum is an infectious disease that is caused by viruses and followed with appearing of macular red rash and minor ailment. Erythema infectiosum is caused by human parvovirus B19. As a rule, the disease appears in spring and often shows with confined flares among children and teenagers. The virus spreads mainly via breathing of infected person. Infection may be transmitted from mother to fetus during pregnancy which sometimes results in dead birth or severe anaemia and accumulation of excess liquid and edema in fetus. 

Mumps And Male Infertility

Testicles are major male sex gland. This pair organ produces major male sex hormone, testosterone, and male sperm cells.

In case testicles tissue is affected, it leads to development of most severe form of infertility.

Mostly, the gland is exposed to the inflammation called orchitis. The inflammation breaks nutrition of adenoid tissue, thus tissue that was destroyed is unable to provide sex cells and sex hormones anymore.

Male infertility may be a complication of sinusitis, mumps virus and even influenza.

Orchitis causes:

• viral or bacterial infections which may spread through the blood from center of infection found in other organs of the body
• trauma (posttraumatic orchitis)

Orchitis symptoms:

• pains in testicles area
• scrotum increase (most frequently - on one side)
• edema of scrotum tissue
• increase of groin lymph glands on affected side

In assumption of orchitis or after trauma you should necessarily undergo an examination. After all examinations, the diagnosis should also be confirmed with ultrasound examination.

Orchitis is treated with antibiotics.

Prevention
major way to prevent men from infertility is to vaccinate them in childhood from mumps
sportsmen (boys and men) should use special devises to protect their groin from all possible traumas

Influenza

Influenza is an acute respiratory disease caused by various types of influenza viruses. The source of the viruses is human, especially at early stage of the disease. The virus releases during talking, coughing or sneezing during 4-7 days of the disease. Infection of healthy people occurs via airborne.

Symptoms
Incubation period lasts 12 – 48 hours. Typical influenza starts acutely, often with chill. Temperature of the body during 24 hours reaches maximum (38-40 degrees C). Clinical manifestations are made of syndrom of common toxicosis (fever, weakness, sweatiness, muscle pains, severe headache, pains in eye-ball, watering, photophobia) and signs of respiratory organs damage (dry cough, congested pipes, gravel voice, stuffiness in nose). During examination is distinguished blood pressure lowering, heart tones muting. Diffuse lesion of upper parts of repiratory organs (rhinitis, pharyngitis, tracheitis, laryngitis) is determined. Peripheral blood is characterized with leukopenia, neutropenia, monocytosis, Blood sedimentation rate is not high. Often influenza may result in such complications as pneumonia, frontal sinusitis, genyantritis, otitis.

Recognition of influenza during epidemic is not complicated and is based on clinical and epidemiological data. In interepidemic time influenza occurs rarely and diagnosis may be made with the help of laboratory methods such as distinguishing influenza agent in mucus of mouth and nose with the help of fluorescent antibodies. For retrospective diagnosis are used serological methods.

Treatment
Patients with uncomplicated influenza are treated at home and are settled into separate room or  are isolated from family by a cover. During fever stage is recommended bed regimen and warmth (plentiful hot drink, warmer to the feet). Polyvitamins are prescribed. Widely are used pathogenetic and symptomatic drugs such as antihistamines (suprastin). To improve drainage function of respiratory organs are used expectorant drugs.

Preventive Measures
To prevent influenza is recommended vaccination. Patients diseased with influenza should eat from their own dishes which should be sterilized with boiling-hot water. People who look after patintes should use mask. 

Viral Hepatitis

Viral hepatitis is a contagious disease, its course is characterized by general intoxication and predominant liver damage. Term “Viral Hepatitis” combines two main nosological entities - viral hepatitis A (infectious hepatitis) and viral hepatitis B (serum hepatitis).

Today is detected a group of viral hepatitis that are not A and not B. Agents are quite resistant in the external area. When the talk is about Viral Hepatitis A, the source of infection are diseased people at the end of their incubation period because at this time hepatitis agent is discharged together with excrements and is transmitted via food, water, objects if hygiene rules are not followed. In Viral Hepatitis B the source of infection are diseased people in acute stage and also carriers of hepatitis B antigen. Main way of infection is via blood when using non-sterile syringes, needles, stomatological, surgical and gynecological instruments. Also is possible to get infected with hepatitis via blood transfusion.

Symptoms and Course
Incubation period of hepatitis A is from 7 to 50 days, and with hepatitis B from 50 to 180 days. The disease courses cyclically and it has next periods: pre-bilious, bilious, post-bilious. Pre-bilious period of hepatitis A in half of patients courses like influenza showing the same symptoms: high temperature, chilly sensation, headache, pain in joints and muscles, sore throat. Hepatitis may also show next symptoms: pain in anticardium, low appetite, nausea, vomit, weakness, giddiness, performance deterioration, problems with sleep. 

Pre-bilious period of hepatitis B is characterized with aching pains in joints, bones and muscles at night, sometimes redness of skin. At the end of pre-bilious period patient's urine becomes darker and fecal masses do discolor. Clinical picture of bilious form of hepatitis A and hepatitis B is similar: icterus of sclera,  mucus membrane, oral pharynx and finally skin. Severity of biliousness increases during the week. Body has normal temperature.

Patient may have weakness, sleepiness, lower appetite, pains in right hypochondrium and sometimes skin itch. Liver is increased, indurated, painful during palpation, and even spleen increase. In blood may be found leukopenia, neutropaenia, monocytosis. Duration of  bilious period of hepatitis A is from 7 to 15 days, and of hepatitis B is about one month.

Most threatening complication is growth of hepatic impairment showing with disturbance of memory, strengthening of weakness,  giddiness, excitement, vomit, yellowness of skin, lowering of liver size, fever and other symptoms. Often  hepatic impairment results in hepatic encephalopathy. In case of favorable course, after biliousness comes period of recovery with quick disappearance of clinical and biochemical manifestations of hepatitis.

Recognition
Is based on clinical and epidemiological data. Diagnosis of hepatitis A is made by taking into account staying into focus of infection 15 days before disease, short pre-bilious period showing symptoms of influenza, rapid development of  biliousness, short  bilious period. Diagnosis of viral hepatitis B is made if patient had operational intervention about two months before examination. Laboratory analysis help to confirm diagnosis.

Treatment
There is no etiotropic therapy. Main treatment is regimen and nutrition. Diet should be caloric, where should be excluded roast food, smoked food, pork, lamb, chocolate spices, alcohol. It is recommended abundant drinking up 2-3 liters daily and also vitamin complex.
In hard cases is made intensive fluid therapy (5% glycose solution intravenously).  In case of development of hepatic failure doctors prescribe corticosteroids.

Preventive Measures
In order not to get infected with viral hepatitis A, you should:
1. monitor food and water
2. follow rules of hygiene
In order not to get infected with viral hepatitis B, you should:
1. careful monitoring of donors
2. quality sterilization of needles and other medical instruments

Rubella

Rubella is a virus disease with specific small spotted rash called exanthem, generalized  lymphadenopathy, moderately frank fever and affect of fetus of women being pregnant. The disease is caused by the agent called togavirus and has a RNA genome. It is nonpersistent in external environment, dies rapidly when heated up to 56° C, when drying, under the action of ultraviolet rays, either, formalin and other abluents. The focus of infection is man diseased with rubella, especially being in subclinical form that passes without rash.

In interepidemic period selected cases are observed. The maximum number of cases are registered in April – June. The disease represents a particular risk for pregnant because of fetal infection. Rubella virus releases into external environment one week before the rash appears on skin and during the week when rash has appeared. Infection is transmitted via airborne.

Symptoms and course
Incubation period lasts 11-24 days. General condition suffers weakly that is why the first noticeable symptom is rash resembling with measly or scarlatina rash. Ill men suffer from little weakness, lack of energy, headache, pain in muscles and in joints. Temperature of the body often is subfebrile, although it in some cases  riches 38-39°C and keeps 1-3 days. When physical examination low-grade symptoms of catarrh, little redding of pharynx and conjunctivitis are observed.

From the very first days of disease appears generalized lymphadenopathy (in other words, the affection of lymphatic system). The most expressed are increasing and painfulness of back-necked and occipital lymph glands. Exanthem appears on 1-3 day from the beginning of disease, first on the neck and after several hours spreads on the whole body and it can be itching. Also there is some inspissation of rash of extensor surface of limbs, back and buns.

Elements of the rash represent little spots with diameter of 2-4 mm, usually they do not merge, are kept for 3-5 days and disappear without living pigmentation on skin. In 25-30% of cases rubella progresses without rash and is characterized by moderate fever and lymphadenopathy. The disease can course without symptoms, having the only manifestation of viremia and increasing of titre in blood of specific antibodies.

Complications
Arthritis, Acute Encephalitis.

Recognition
Clinical and laboratory data help to carry out the recognition of the disease. Nowadays virologic methods are not used widely. From serological tests are used the neutralization test and hemagglutination-inhibition test  injected together with paired sera taken 10-14 days apart.

Treatment
There is prescribed comfort care when uncomplicated rubella. When arthritis doctors usually prescribe 0.25g of  chingamin (chloroquine) 2-3 times per day during 5-7 days. Also are advised diphenylhydramine (0.05g two times a day), butadiene (0.15g 3-4 times a day), nosotropic treatment. When encephalitis, are advised corticosteroid remedies.
The general prognosis for rubella is favorable, excepting when encephalitis which has mortality of 50%.

Preventive Measures
Are very important for women in child-bearing age. Some specialists recommend to vaccinate girls of 13-25 years. People diseased with rubella should be isolated up to five days since appearing of rash.