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Definition

Nocardiosis is a serious infection caused by a fungus-like bacterium


that begins in the lungs and can spread to the brain.
Description
Nocardiosis is found throughout the world among people of all ages,
although it is most common in older people and males. While people
with poor immunity are vulnerable to this infection, it sometimes
strikes individuals with no history of other diseases. Nocardiosis is
rare in AIDS patients. It is not transmitted by person-to-person
contact.
Causes and symptoms
Nocardiosis is caused by a bacterium of the Nocardia species
usually N. asteroides, an organism that is normally found in the soil.
The incubation period is not known, but is probably several weeks.
The bacteria can enter the human body when a person inhales
contaminated dust. Less often, people can pick up the bacteria in
contaminated puncture wounds or cuts.
Symptoms
The infection causes a cough similar to pneumonia or tuberculosis,
producing thick, sometimes bloody, sputum. Other symptoms
include chills, night sweats, chest pain, weakness, loss of appetite
and weight loss. Nocardiosis does not, however, respond to shortterm antibiotics.
Complications
In about one-third of patients, the infection spreads from the blood
into the brain, causing brain abscesses. This complication can

trigger a range of symptoms including severe headache, confusion,


disorientation, dizziness, nausea and seizures, and problems in
walking. If a brain abscess ruptures, it can lead to meningitis.
About a third of patients with nocardiosis also have abscesses in the
skin or directly underneath the skin. They may also have lesions in
other organs, such as the kidneys, liver, or bones.
Diagnosis
Nocardia is not easily identified from cultures of sputum or
discharge. A doctor can diagnose the condition using special
staining techniques and taking a thorough medical history. Lung
biopsies or x rays also may be required. Up to 40% of the time,
however, a diagnosis can't be made until an autopsy is done.
Treatment
Treatment of nocardiosis includes bed rest and high doses of
medication for a period of 12 to 18 months, including sulfonamide
drugs or a combination of trimethoprim-sulfamethoxazole (Bactrim,
Septra). If the patient doesn't respond to these drugs, antibiotics
such as ampicillin (Amcill, Principen) or erythromycin (E-Mycin, Eryc)
may be tried.
The abscesses may need to be drained and dead tissue cut away.
Other symptoms are treated as necessary.
Prognosis
Nocardiosis is a serious disease with a high mortality rate. If it has
been diagnosed early and caught before spreading to the brain, the
prognosis is better. Even with appropriate treatment, however, the
death rate is still 50%. Once the infection reaches the brain, the
death rate is above 80%. This outcome is most commonly seen in
patients with a weakened immune system

Trachoma: A chronic inflammatory disease of the eye and the


leading cause of blindness. Trachoma is due to infection with the
bacterium Chlamydia trachomatis. Transmission occurs mainly
among children and from children to women caring for them. Key
risk factors include inadequate supplies of water and low
socioeconomic status. Trachoma affects millions of people
worldwide, primarily in rural communities of the developing world
and in the arid areas of tropical and subtropical zones. Australia is
the only developed country where trachoma is still a significant
health problem. The disease goes by a number of names, such as
sandy blight.
\Pneumocystis carinii pneumonia is a pneumonia chiefly
affecting immunocompromised individuals that is caused by
a microorganism (Pneumocystis carinii syn. P. jiroveci),
attacks especially the interstitial and alveolar tissues of the
lungs, and is characterized especially by a nonproductive
cough, shortness of breath, and fever abbreviation PC
Signs and symptoms of PCP include fever, non-productive
cough (because sputum is too viscous to become
productive), shortness of breath (especially on exertion),
weight loss, and night sweats.

Erythema (from the Greek erythros, meaning red) is redness


of the skin or mucous membranes, caused by hyperemia of
superficial capillaries.[1] It occurs with any skin injury,
infection, or inflammation. Examples of erythema not
associated with pathology include nervous blushes
Megaloplastic

an abnormally large, immature, and dysfunctional red blood cell found in the blood of
persons with pernicious anemia or certain other disorders.
Megaloblastic anemia (or megaloblastic anaemia) is an anemia (of macrocytic
classification) that results from inhibition of DNA synthesis during red blood cell
production.[1] When DNA synthesis is impaired, the cell cycle cannot progress from
the G2 growth stage to the mitosis (M) stage. This leads to continuing cell growth
without division, which presents as macrocytosis. Megaloblastic anemia has a rather
slow onset, especially when compared to that of other anemias. The defect in red cell
DNA synthesis is most often due to hypovitaminosis, specifically a deficiency of
vitamin B12 and/or folic acid. Vitamin B12 deficiency alone will not cause the
syndrome in the presence of sufficient folate, as the mechanism is loss of B 12
dependent folate recycling, followed by folate-deficiency loss of nucleic acid
synthesis (specifically thymine), leading to defects in DNA synthesis. Folic acid
supplementation in the absence of vitamin B 12 prevents this type of anemia (although
other vitamin B12-specific pathologies may be present). Loss of micronutrients may
also be a cause. Copper deficiency resulting from an excess of zinc from unusually
high oral consumption of zinc-containing denture-fixation creams has been found to
be a cause.[2]
Megaloblastic anemia not due to hypovitaminosis may be caused by antimetabolites
that poison DNA production directly, such as some chemotherapeutic or antimicrobial
.agents (for example azathioprine or trimethoprim)
The pathological state of megaloblastosis is characterized by many large immature
and dysfunctional red blood cells (megaloblasts) in the bone marrow[3] and also by
hypersegmented neutrophils (those exhibiting five or more nuclear lobes
("segments"), with up to four lobes being normal). These hypersegmented neutrophils
are found in the "peripheral blood" (i.e., a diagnostic smear of a blood-sample taken
from the circulation
DNA gyrase, also known as topoisomerase II or simply as gyrase, is an enzyme that
relieves strain while double-stranded DNA is being unwound by helicase.[1][2] This
causes negative supercoiling of the DNA. The gyrase supercoils (or relaxes positive
supercoils) into DNA by looping the template so as to form a crossing, then cutting
one of the double helices and passing the other through it before releasing the break,

changing the linking number by two in each enzymatic step. This process occurs in
prokaryotes (in particular, in bacteria), whose single circular DNA is cut by DNA
gyrase and the two ends are then twisted around each other to form supercoils. Gyrase
has been found in the apicoplast of the malarial parasite Plasmodium falciparum, a
unicellular eukaryote.[3][4] Bacterial DNA gyrase is the target of many antibiotics,
.including nalidixic acid, novobiocin, and ciprofloxacin
Stevens-Johnson syndrome is a rare, serious disorder of your skin and mucous
membranes. It's usually a reaction to a medication or an infection. Often, StevensJohnson syndrome begins with flu-like symptoms, followed by a painful red or
purplish rash that spreads and blisters. Then the top layer of the affected skin dies and
.sheds
Stevens-Johnson syndrome is a medical emergency that usually requires
hospitalization. Treatment focuses on eliminating the underlying cause, controlling
.symptoms and minimizing complications
Recovery after Stevens-Johnson syndrome can take weeks to months, depending on
the severity of your condition. If it was caused by a medication, you'll need to
permanently avoid that drug and others closely related to it

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