TROPICAL DESEAESE

Tropical disease 14

4. Leishmaniasis (Oriental Sore)

The causitive organism is L. tropica or Braziliensia in the west.

The organism is transmitted by a sandfly. The intermediate host

are dogs and rodents.

The disease occurs in dessert areas of India, Pakistan and the

middle east. With the eradication of sandflies with use of DDT

the incidene has been markedly reduced

4.1 CLINICAL

The disease occurs on exposed areas of the face or arms, a small

Indurated pappule if untreated breaks down resulting as a

persistant ulcer.

The lesion does respond to pentavalent

antimony therapy.

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TROPICAL DISEASE 13

HYDATID DESEASE


3.5 TREATMENT
- Thio bendazole can be used for treatment (50mg/kg/day),
albendazole better absorbed so a lower dose is effective 4 tabs
of 200 mg. daily for 28 days.
- Surgical excision of cyst wall (laminated and germinal) layers is
the standard treatment, the cyst is treated at the time of
operation with hypertonic fluid to kill all scolices.(Fig.8.7)
- Medical therapy with mebendazole is only considered in those
where surgical treatment is contraindicated.

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TROPICAL DESEASE 12

3.2 PREVENTION
1. Use of safe water, ponds may be contaminated
2. All domestic dogs be de-wormed

3.3 CLINICAL FEATURES
- The cysts in the liver and other organs (lungs muscles or bones)
can remain silent for long periods.
- Large cysts in the liver can cause a dull pain because of their
size.
- Infection and rupture can cause pain, bring on symptoms related
to these complcations.

3.4 DIAGNOSIS
* An X-ray may show a calcified cyst
* An intradermal skin test (Casoni's) to hydatid fluid is
positive in 70% of cases
* An indirect haemagglutination test is more dependable
* Ultrasound scan may demonstrate this cyst and its contents
in greater detail
· An ELISA test is helpful for mass screening of the population


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TROPICAL DESEASES 11

3. HYDATID DISEASE

The disease is caused by the ingestion of ova of Eccinococcus
granuloses (tape worm) by man.
- The tape worm lives in the intestine of dogs (definitive host),
man; sheep and cattle are the intermediate hosts (Fig.9.6)
- The ova on ingestion develops into embryos that penetrate the
intestinal mucosa and enter the portal circulation, 80% of all
cysts are formed in the liver in man.
- The cysts are slow in growth, and consist of an inner germinal
layer within which are the brood capsule, and the scolices, which
are the heads of future worms.
- When the organs of a dead sheep or cattle containing hydatid
cysts are fed on by the canine species, the worm develops in the
intestine of the animal and once again they shed ova in the
feaces and if ingested through contact with dogs or contaminated
vegetable or water by the intermediate hosts, the life cycle of
the parasite is completed.

- The tape worm lives in the intestine of dogs (definitive host),
man; sheep and cattle are the intermediate hosts (Fig.9.6)
- The ova on ingestion develops into embryos that penetrate the
intestinal mucosa and enter the portal circulation, 80% of all
cysts are formed in the liver in man.
- The cysts are slow in growth, and consist of an inner germinal
layer within which are the brood capsule, and the scolices, which
are the heads of future worms.
- When the organs of a dead sheep or cattle containing hydatid
cysts are fed on by the canine species, the worm develops in the
intestine of the animal and once again they shed ova in the
feaces and if ingested through contact with dogs or contaminated
vegetable or water by the intermediate hosts, the life cycle of
the parasite is completed.
Any questions be sent to drmmkapur@gmail.com
All earlier posts are stored in archives for your access ad review.
Visitors that follow the site may post contributions to the site.
To introduce consumer/provider convergence visit http://bit.ly/cPTh6f
www.otmanage.blogspot.com
Click on image to see detail.