#trypanosomiasis

[wikipediapictures]

African trypanosomiasis

“Trypanosoma forms in blood smear from patient with African trypanosomiasis.” - via Wikimedia Commons

[er-cryptid]

Patreon

[symbiosisonlinepublishing]

Some of the most common neurological disorders include:

Stroke: A stroke is a sudden loss of brain function caused by a blood clot or bleeding in the brain.

Multiple sclerosis: Multiple sclerosis is a chronic disease that affects the central nervous system. It is characterized by inflammation and damage to the myelin sheath, which is a protective layer that surrounds nerve fibers.

Visit: https://symbiosisonlinepublishing.com/neurology/

[postcard-from-the-past]

Child suffering from trypanosomiasis

French vintage postcard

[transorzekochi]

ICD-10 code B56.9 for African trypanosomiasis, unspecified is a medical classification as listed by WHO under the range - Certain infectious and parasitic diseases .

For more details:

🌐 www.transorze.com

☎️ 9495833319

[transorzesolutionstvm]

ICD-10 code B56.9 for African trypanosomiasis, unspecified is a medical classification as listed by WHO under the range - Certain infectious and parasitic diseases .

For more details:

🌐 www.transorze.com

☎️ 9495833319

[drugcarts]

An infectious disease caused by a parasite found in the faeces of the triatomine bug.

[jobskenyaplace]

VARIOUS TENDER NOTICE KENTTEC SEPTEMBER 2024 

KENYA TSETSE AND TRYPANOSOMIASIS ERADICATION COUNCIL TENDER SEPTEMBER 2024  TENDER NOTICE The Kenya Tsetse and Trypanosomiasis Eradication Council (KENTTEC) was established via legal Notice No. 77 of 27th July 2012 under the State Corporations Act Cap 446. It is mandated to be the Government agency on strategies, resource mobilization, linkages and coordination of tsetse and Trypanosomiasis…

[ikrutt]

Do you have any cultural/historical influences you draw on when worldbuilding?

This is a great question, and I'm afraid I can't point towards anything too specific. There are two main reasons for this:

The worldbuilding for Kalandakar exist mainly so I can do humorous drawings that reflect my own experiences with, for example, academia. Albeit in a roundabout and cartoony manner.

I wish for the concepts to be broad strokes and not inspired too closely by any one historical epoch or event. Mostly because I don't trust myself to write historical analogues with the nuance and sensetivity this deserves.

The backdrop of the Jar-Lorego storyline deals with topics such as classism, social inequality, colonialism and the clash of cultures at different levels of technological advancement. I haven't touched too closely upon this, but one of my goals is to write the meeting between stand-ins for indeginous cultures and colonial powers that doesn't result in assimilation or genocide.

My main goal, however, is still to develop these characters and their world, and just... see what happens.

Fadesi science and technology in the region is approximately at the level of Medieval Islam. I.e. Ma-Vireva would have access to steel, hydraulics and indoor plumbing, paper and bookbinding, sophisticated mathematics, navigation and astronomy, as well as a fledgling medical field with herbal drugs and rudimentary surgery. As of yet, there is no germ theory, steam power, electricity or firearms.

To kick of the storyline (Adreas being dumped in the desert), I have drawn inspiration from African trypanosomiasis throughout history. As well as the "white spot" phenomenon on 19th century maps.

See, unbeknownst to Adreas, there is a mysterious disease preventing the Fadesi from advancing into the Jar-Lorego, one which doesn't seem to affect the other two sophonts. After several research missions fail horribly (i.e. everyone dies), they send a Tenel and a Moskuan as a last ditch effort and/or for shits and giggles.

Regardless of the outcome, the university considers this a a win-win; either they'll be rid of the thorn in their side that is Adreas, or they'll have more information on the vast and unexplored desert. That is until Adreas starts putting together the pieces of the greater circumstances, and realize he can utilize this against the Fadesi to benefit Tenel and Moskuan society.

[macgyvermedical]

Magic Bullets: The Antibiotic Story

The year was 1907 and a Dr. Alfred Bertheim was trying to make arsenic less toxic to humans.

Why? Because in addition to killing humans, arsenic also kills trypanosomes- single-celled protozoa that cause the life-threatening infection trypanosomiasis. By creating a version of arsenic that still killed the protozoa, but not the human they infected, Dr. Bertheim could create a drug to treat the disease*.

This was not a fully new idea. About 50 years earlier, a drug called Atoxyl had been created in France. About 40 times less toxic than pure arsenic, it had been shown to not only successfully treat trypanosomiasis, but also the equally devastating syphilis infection.

But 40 times less toxic than pure arsenic is still not great. About 2% of people treated even one time with the drug ended up blind, among a myriad of other side effects. It was a start, but not ideal.

And Dr. Bertheim (under the direction of better-known Dr. Paul Ehrlich) was setting out to change that.

And it just so happened that the sixth compound from the sixth group he tried did so. Known as "compound 606", the new Arsphenamine could treat trypanosomiasis, relapsing fever, and syphilis very effectively- and it didn't leave its takers dead or blind.

Most of the time, at least. See, arsphenamine, also known by the brand name salvarsan, was a pain in the ass to administer. It had to be dissolved in several hundred mililiters of water under a nitrogen atmosphere to prepare it for administration. If it touched air, it would rapidly react, causing toxic byproducts that could cause liver failure, severe skin rashes, and even death.

But both trypanosomiasis and syphilis were definitely going to kill you, so it was worth the risk.

And the seed had been planted, so to say. The idea of a chemical able to kill infection-causing agents without killing the host was a true possibility for the future of medicine.

And by 1912, Neosalvarsan, a drug somewhat less effective -but far easier to administer and with significantly fewer side effects- was on the market. Over the next decade, Neosalvarsan would be responsible for a massive drop in syphilis cases worldwide.

But neither of the drugs could treat deadly infections from staph or strep or the hundreds of other bacterial or viral infections that still had no cure in the 1910's and 1920's.

Then came the first of the heavy-hitters. Bayer was a dye company when it started, and in 1932, three and a half decades after switching mostly to pharmaceuticals, chemists at Bayer were testing the company's dyes for anti-infective properties. They went through thousands of trials, finally finding a dye that could kill streptococcal bacteria without killing a mouse host.

Pre-1930s, streptococcal disease was a major problem. It caused strep throat, cellulitis, scarlet fever, childbed (purpural) fever, some forms of toxic shock syndrome, impetigo, necrotizing fasciitis, rheumatic fever, and many others. The skin infections may have been at least somewhat treatable with a hot compress, but the rest were prone to cause blindness, deafness, loss of limbs, and for many, loss of life.

In 1936, sulfonamide antibiotics changed that. Protosil, the first of the sulfonamides, became available to treat many of the infections listed above. These would be used for wound infections throughout WWII. Unfortunately, they would also cause the untimely death of nearly 100 people via the Elixer Sulfanilamide tragedy.

Sulfanilamide was a similar drug to Prontosil and was safe and effective for treating strep infections. However, when mixed with diethylene glycol (now used as standard car antifreeze) to make it into a liquid suspension, it was deadly. See this letter from a doctor who had prescribed the liquid form of the medication, not knowing it was poison:

[to read more about the Elixer Sulfanilamide Disaster, see here]

Despite the sulfanilamide tragedy, the race was on for more antibiotics. Three years before they went on the market, researchers had found evidence of bacterial resistance to sulfonamides. What would happen when these new bacteria, that didn't die when exposed to the new wonder drug, made up so much of the bacterial population?

In 1942, the Cocoanut Grove fire in Boston caused over 492 deaths and 130 injuries. The injured were among the first to receive a remarkable new drug called penicillin. The fire and the fate of the victims were publicized throughout the world, and penicillin became a household name overnight. But once again, even before it went on the market in 1943, just in time for the end of the Second World War, there was evidence of resistance.

But fortunately, the fire had been sparked. Over the next 30 years, many dozens of antibiotics would come into clinical use. If you've taken it, it probably came out between 1940 and 1970. Tetracycline, isoniazid, metronidazole, ciprofloxacin, erythromycin, vancomycin, amoxicillin, and dozens more you've never heard of.

And then? Nothing.

Well, not completely nothing, there were a couple that came out in the 1980s and a few in the early 2000s. But nothing like that 30-year golden age.

But now we're running into problems due to drug resistance. About 1.27 million people die annually directly from antibiotic resistant infection, while antibiotic resistance contributes to about 4.95 million more deaths.

The good news is that the drugs that are being made today are directly targeting those antibiotic resistant infections. In fact, as I'm writing this, a new drug (Zosurabalpin) is being tested for a bacteria called Carbapenem-resistant Acinetobacter baumannii, which up until now has had no antibiotic that works against it.

*as you may imagine for the time period, this was not necessarily a benevolent act. See, most of the reason Europeans wanted to treat trypanosomiasis in the first place was because they kept dying of it when they went to colonize Africa. And they wanted something that would give them a leg up on the people who were already there.

[starryvibed]

December update

I passed my first semester! 📝 Went to the movies quite a lot this month. Im always in awe of the beautiful architecture in the south of this city. 🌆 The number of rottweilers 🐕 we get at the hospital with trypanosomiasis 🪱 is getting concerning now. We had this poor dog with right atrial enlargement and in CHF 🫀and A fib with a HR of 240. The owners declined further diagnostics/ interventions and signed up for a euth.

Subjects i have for II Semester:

Ruminant Clinical Medicine Pt. 2

Emergency medicine

Swine Clinical Medicine

Production Diseases

[twistpixel]

No one told you this but Bruce got Human African trypanosomiasis/African sleeping sickness from a tsetse fly bite. Nobody noticed untill it was too late because the main symptom is circadian rhythm disruption and his sleep schedule was already fucked up. And he died. Like six years ago yeah. Everybody just thought it was too awkward to tell you.

[rchivesv]

November 14, 2024

Read namaz

Exercised

Classes

Physiology Action potential - stimulus, definition, graphs, ionic basis, sodium voltage gated channels, hodgkin's cycle, why does the membrane potential not reach +60 mV due to sodium influx

Anatomy - axilla - axillary artery, axillary vein, brachial plexus, lymphatics

Dissection - axilla

Histology lab - connective tissues

Attended my probably first ever Christmas party

Watched 2 episodes of house MD and learnt about Churg-Strauss syndrome (eosinophilia, granulomatus vasculitis and asthma), mixed connective tissue disease, paraneoplastic syndrome (immune system mistakes neurons for tumor cells and attacks them), tularemia (rabbit fever), melarsoprol (arsenic meds for human african trypanosomiasis)

Watched one episode each of cherry magic and from me to you

[flyonthewallmedstudent]

Brucellosis

Case Report

a 45M goat herder in Malaysia develops 3 weeks of fevers, lethargy, night sweats and headache

history revealed he drank unpasteurised milk from said goats, which he also sold to consumers

blood cultures were negative and he tested negative for more common tropical diseases such as malaria, dengue, typhus and lepto

eventually he tested positive for brucella serology, unfortunately about 80 people also developed brucellosis from drinking milk from his farm, and a few lab staff also picked it up from handling their blood samples

consider this differential in PUO

Microbiology

causative organism: Brucella melitensis

gram negative coccobacillus, facultative intracellular

hardy bacteria that can survive prolonged periods in meat/dairy products unless pasteurised/cooked as well as dust & surfaces

picked up in the intestinal submucosa on ingestion and transported by macropahges to lymphoid tissue

it then has the possibility of spreading haematogenously in the liver, spleen, joints etc. causing systemic or localized infection

Transmission

zoonoses (animal associated)

in particular: feral pigs, so hunters are often at increased risk (due to handling the carcasses), but also cattle, sheep, goat and dogs

outbreaks often associated with consumption of unpasteurized milk from infected animals

Epidemiology

global and notifiable disease in most countries

endemic to Mediterraena, South America and the indian subcontinent

in Australia - largely QLD and NT, but now NSW

Increased risk groups (i.e. what to ask on history and what clues on history to consider for brucellosis)

regular contact with animals (herders, abbatoir workers, vets - there are case reports of lab workers who pick up brucellosis etc)

people who ingest unpasteurized dairy/milk, or the undercooked meat of infected animals

History

first described by another European white man, Dr. George Cleghorn, British Army Surgeon in minorca in 1751 on the island of Malta following the Crimean war

it was named for another British white man, Sir David Bruce who led a commission into a fever outbreak among the army in Malta before they found the organism causing the disease (Sir Themistocles Zammit identified that goats transmit it in milk)

Sir bruce also discovered that trypanosoma brucei (also named for him) was the microbe responsible for animal trypanosomiasis/sleeping sickness. incidentally, he was born in Melbourne Australia

trivia with the Crimean war - was ironically a war fought between Russia and the UK + it's Western Allies and the empire that preceded Turkey (Ottoman)

Today the Crimean war is more well known for producing Florence Nightingale, founder of modern nursing and yay, finally a woman in random medical history that hardly is related to brucellosis.

Clinical features

PUO - cyclical fevers, fatigue, headache, insomnia, myalgias/arthralgias, weight loss, anorexia (fairly non specific, but also systemic)

incubation times can be long, which can be deceptive, reportedly up to 50 yrs from first exposure

otherwise, most cases it ranges from 3 days to several week, on average, expect 2-4

sometimes: hepatosplenomegaly

critical on history to clarify travel/living situation or contacts and consumption of unpasteurised dairy or undercooked meat

localized disease also possible, depending on organs involved

up to 40% will report peripheral arthritis, sacroillitis and spondylititis (kinda sounds like ank spa), at worst can cause osteomyelitis and septic arthritis

endocraditis is a rare but serious complication, with a 5% mortality rate, outside of this it's rarely fatal

if the lungs are affected, cough and SOB can occur but hte CXR will be lcear

GBS has been reported to occur following infection

hepatic abscess and granulmoa in a few

also possible: epididymoorchitis and skin manifestations like erythema nodosum

ocular changes like uveitis, cataracts etc.

it really feels rheum flavoured.

Investigations

hints on basic bloods - neutropaenia and anaemia, thromobcytopaenia in the case of hepatosplenomegaly or ITP

raised ESR and CRP, ALP and LDH

elevated LFTs in hepatomegaly

but diagnosis: blood cultures --> can take weeks as slow growing (due to aerosol transmission, must be handled in a biohazard hood as with the case report)

key really: serology is the most commonly used tool

PCR can also be used, including 16S

tissue also an option depending on organ affected

Management:

atypical cover: azith and doxy

several weeks of treatment usually - i.e. if uncomplicated, doxy for 6 weeks (however relapses are common on monotherapy, up to 40%), often rifampicin 600 mg daily for 6/52 is also added or gentamicin

where doxy can't be used, bactrim is the alternative

Sources

CDC guideilnes

WHO guidelines

ETG - behind a paywall, if your institution covers it, uptodate is gold standard, that said, plenty of free resources that provide a great start

Wikipaedia

Statpearls

Case report (There's actually a lot of background pathophysio, investigations and treatment listed in case reports and many are free)

[howlingday]

Camel!Faunus Ruby

Ruby: Ugh... So hot... So tired...

Ruby: ...

Ren: Why are you staring at me?

Ruby: (Licks lips)

Yang: Ruby! (Holding bottle) Take your medicine!

Fun Fact! In some parts of the middle east, there is a belief that if a camel becomes sick with an illness called surra or hyam, clinically identified as trypanosomiasis, in which they stop eating and stare at the sun. The "cure" for the illness is to force feed the camel a live snake, usually a king cobra. The camel will both recover and "shed healing tears." However, the real best medicine is, surprisingly, real medicine.