Malaria Life Cycle

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Malaria: Symptoms, Treatments and Causes

What is Malaria?
Synonyms: paludismo

Malaria is an acute febrile infectious disease transmitted by the female bite of the Anopheles mosquito, infected by Plasmodium.



Causes
Streaming

Transmission occurs after the female bite of the Anopheles mosquito, infected by protozoa of the genus Plasmodium. In Brazil, three species are associated with malaria in humans: P. vivax, P. falciparum and P. malariae.

The protozoan is transmitted to man by blood, usually through the bite of the female Anopheles mosquito, infected by Plasmodium or, more rarely, by another type of medium that puts the blood of an infected person in contact with that of a healthy person, such as Sharing of syringes (drug users), blood transfusion or even from mother to fetus in pregnancy.

 symptoms
Symptoms of Malaria
The most common symptoms are: chills, high fever (at first continuous and then every three days), headaches and muscle, tachycardia, enlargement of the spleen and sometimes delusions. In the case of P. falciparum infection, there is also a 10-fold chance of developing what is called cerebral malaria, responsible for about 80% of the lethal cases of the disease. In addition to the current symptoms, there is slight stiffness in the nape of the neck, sensory disturbances, disorientation, drowsiness or excitement, convulsions, vomiting and headaches, and the patient may experience coma.


Malaria: High fever and muscle pain are the main symptoms
 Treatment and care
Malaria Treatment
The decision on how to treat the patient with malaria should be in accordance with the Manual of Malaria Therapy, edited by the Ministry of Health, and be guided by the following aspects:

Species of plasmodium depending on the species of plasmodium the patient will receive a type of treatment
Disease severity - the need for injectable drugs to act faster on the parasites, aiming to reduce lethality.
Malaria Medications
The most commonly used drugs to treat malaria are:

Clordox
Doxycycline
Only a doctor can tell you which drug is most appropriate for your case, as well as the correct dosage and duration of treatment. Always follow your doctor's advice and NEVER self-medicate. Do not stop using this medication without first consulting a doctor and if you take it more than once or in much larger quantities than prescribed, follow the instructions in the package insert.


Prevention
Individual prevention measures: use of mosquito nets impregnated or not with insecticides, clothes that protect legs and arms, screens on doors and windows, use of repellents.

Collective prevention measures: drainage, small sanitation works to eliminate vector breeding sites, landfill, cleaning of the banks of breeding sites, modification of water flow, control of aquatic vegetation, improvement of housing and working conditions, rational use of land .

Sexually Transmitted Disease by Lucinete Messina

The Venereal Disease Research Laboratory (VDRL) is a test to detect patients who have had syphilis, a sexually transmitted disease.

When the test is negative (non-reactive), it usually indicates that the patient never had contact with the syphilis bacterium, Treponema pallidum, or that, having already had the patient come in contact with the bacteria, the organism or treatment was sufficient To delete it.

However, the patient may have syphilis and the negative test is called the prozone effect, which occurs when there is a high number of antibodies produced by the organism during the latent or secondary stage of the disease.


When VDRL is positive (reagent), usually the result is shown in titers (1/2, 1/8, 1/64, 1/128, etc.), which reflects the amount of treponemal antigens present in the patient's blood The greater the denominator, the greater the amount of circulating antigens).

Sometimes the VDRL is positive, but the patient did not have contact with the treponema, it is the so-called false positive result, which can occur in some conditions, such as: infectious mononucleosis, systemic lupus erythematosus, hepatitis A, leprosy, malaria and occasionally, Until the pregnancy.

Since VDRL is not a very specific test for the diagnosis of syphilis, it is advisable to analyze it together with the history and clinical examination and the collection of specific treponemal test, such as FTA-ABS or TPHA, which may be positive or negative. Once the patient has had contact with the treponema, the test will remain positive for the rest of the life, regardless of the treatment.

VDRL collection, associated with a specific treponemal test, is part of the prenatal exams because congenital syphilis can cause several damages to the baby.

If you have a positive VDRL, you should seek an infectious or dermatologist or gynecologist for a better evaluation.

Syphilis test by Lucinete Messina

The laboratory diagnosis of syphilis is based on microscopy and serological tests.
Microscopy: Identification of the causative agent, Treponema pallidum, can be performed with an adequate collection of material in the recent lesions (primary and secondary phases) by the dark field microscopy technique or by direct immunofluorescence, and it is possible to observe the live and furniture.
Serologies:
Non-treponemic serology: VDRL and RPR.
Treponemal serology: FTA-abs, MHA-Tp or TPHA, ELISA.
In congenital syphilis, in addition to the above examinations, a complete blood count, X-ray of long bones and examination of cerebrospinal fluid or cerebrospinal fluid (CSF) should also be requested for cellularity, proteins and VDRL. The VDRL of the newborn within the case definition should be performed with blood taken from the peripheral vein rather than from the umbilical cord. Treponemal exams may be reactive up to the 18th month of life, due to the passivity of maternal antibodies, and are rarely used for the diagnostic definition in children up to this age.
In congenital syphilis, the involvement of several organs and systems suggests that a differential diagnosis be performed with a blood test to detect the presence of pathogenic organisms and other congenital infections such as rubella, toxoplasmosis, cytomegalovirus, generalized herpes simplex virus infection and malaria . Later lesions may also be confused with measles, chickenpox, scarlet fever, among others. Serologies should be requested for treponemics and non-treponemics.

Quick Test for Syphilis
The rapid test for syphilis is an immunochromatographic, treponemal, single use test for the detection of antibodies specific for Treponema pallidum. It can be done with whole blood, serum or plasma.
Within the proposal to increase access to diagnosis, the rapid test for syphilis is used in special situations and as screening.
The Flowchart for Syphilis Research Using Rapid Treponemal Test of Ordinance No. 3.242, of December 30, 2011, its corrections should be followed. According to the flowchart, obtaining a reagent result in the rapid test for syphilis, there is a need to collect the sample by venipuncture and send it to the laboratory so that the Laboratory Flow Chart for Syphilis Research is performed (Portaria nº 3.242). In specific situations, as an exception, there is a recommendation for treatment only with the result of the rapid reagent test. These situations are set out in the Syphilis Quick Test Manual.
The Department of STDs, AIDS and Viral Hepatitis uses the following Syphilis tests: the Rapid DPP Syphilis Test and the Rapid Check Syphilis Rapid Test.

VDRL: examination makes diagnosis of syphilis by Lucinete Messina

Blood antibody test shows whether person has ever been infected with the bacterium
What is?
VDRL is a blood test to diagnose syphilis. The test identifies antibodies that the body produces to fight the bacterium Treponema pallidum, which causes the disease - so, only those antibodies in the body have those people who have already come into contact with the bacteria.
People who have been infected with syphilis at some point in their lives carry antibodies to the bacteria for life. Therefore, even people who are already cured will present positive results in this examination.
Indications
The VDRL can be requested for people who:
Have syphilis symptoms, such as genital or throat wounds
They are receiving treatment for another type of STD, such as gonorrhea
Are pregnant as part of prenatal testing
Have risky sexual activity
They are infected with the HIV virus
Have one or more partner (s) diagnosed with syphilis.
People who do not have symptoms of syphilis and do not fit into any of the above conditions can also take the exam for screening.
Syphilis: CSF collection shows whether bacteria have reached the nervous system
Contraindications
There are no express contraindications for a complete blood count. However, the doctor or doctor can tell you whether you are fit to take the test or not.
Pregnant can do?
Yes, even VDRL is part of the battery of prenatal tests, as syphilis infection can affect the health of the fetus.
Preparation for the exam
Because it is a common blood test, there is no special preparation for the creatinine dosage. If the blood sample is used only to dose this substance, no special recommendation is necessary. If the sample is used for other tests, the laboratory will probably guide you about the care.
Indeed
In a hospital or laboratory, the VDRL is performed by a health professional as follows:
With the patient seated, a rubber band is tied around his arm to stop the flow of blood. This makes the veins widen, helping the professional to hit one of them
The professional cleans the area of ​​the arm to be penetrated by the needle
The needle is inserted into the vein. This procedure can be done more than once, until the health professional hits the vein and succeeds in withdrawing the blood
Blood collected in the syringe and placed in a tube
The elastic is removed and a gauze is placed where the healthcare professional inserted the needle to prevent any bleeding. He or she can put pressure on the bandage to stanch blood.
A bandage is placed on the spot.
The diagnostic test for syphilis can also be done with a sample of fluid from the spinal cord.
The VDRL exam takes only a few minutes to complete and may take longer in cases where the health care provider has difficulty hitting the vein to collect blood.
Post-examination recommendations
There are no special recommendations after the examination. The patient can do his / her activities normally. If the blood sample is used for other tests that required fasting, the patient may feed after collection.
Frequency of examination
There is no periodicity to perform the VDRL. Everything will depend on the doctor's guidelines and the presence or absence of diseases that must be accompanied by the examination.
However, it is recommended that this test be done annually, along with research for other types of STDs, such as AIDS.
The risks involved in performing the VDRL exam are extremely rare. At most, there may be a hematoma at the site where blood was withdrawn. In some cases, the vein may become swollen after the blood sample is collected (phlebitis), but this can be reversed by making a compress several times a day.
People who use anticoagulant medications or have coagulation problems may suffer from continuous bleeding after collection. In such cases, it is important to inform the health care professional of the problem prior to collection.
Results
Ideally, the result should be negative for antibodies to syphilis. A negative VDRL result suggests that you do not have the disease. However, it can happen to be a false negative, especially if the infection occurred in less than three months - is the so-called latent phase of the disease, when it has not yet manifested itself.
If the result is positive, you probably have syphilis. The doctor or doctor may ask for more specific tests to confirm the diagnosis. However, the exam can also be a false positive if the person has:
HIV
Lyme disease
Malaria
Pneumonia
Systemic lupus erythematosus.
In addition, the antibodies remain in your body even after syphilis is treated. This means that the results will always be positive after the first infection, even if you are not infected.

hello everybody,
Today I am going to explain  Syphilis: CSF collection shows whether bacteria have reached the nervous system

 by Lucinete Messina Neuroscientist of behavior - USP

Examination is the diagnosis of neurosyphilis and is indicated;

Have you ever had the feeling that you left the doctor's office worse than you did? Some patients, who are worried about the diagnosis of syphilis and the prescription of penicillin injections, are still asked to take the CSF test! But, do you know what it's for? Learn more about syphilis and neurosyphilis and understand when this test should be done.

Although identified thousands of years ago, syphilis persists as a common sexually transmitted disease to this day. According to the STD / AIDS Epidemiological Bulletin, made by the State Secretariat of Health and Health, only 8333 cases of syphilis acquired in 2013 were reported in the state of São Paulo.

Syphilis is a disease transmitted from person to person (or from pregnant to the baby, in congenital syphilis) through any type of contact with mucocutaneous lesions, usually present in the genital and anal regions, but can also be found in the mouth and in the skin. This explains why people who used condoms but practiced unprotected oral sex may be surprised by syphilis.

The infection can occur anywhere there is inoculation of Treponema pallidum, leading to the formation of painless cancer that even untreated and disappears in a few weeks. This stage is called primary syphilis. The incubation period (time between infection and onset of this symptom) ranges from 10 to 90 days.

Syphilis develops in stages, and it is possible to infect sexual partners (or the fetus) at any stage of the disease. After the spontaneous involution of the cancer of the primary syphilis, they pass weeks to months without symptoms. Secondary syphilis occurs, a phase of the disease that can (but is not necessarily) occur with several symptoms: fever, red patches on the body, especially on the palms of the hands and soles of the feet, enlargement of the lymph nodes, asthenia, myalgia, Hair loss and malaise. Even if untreated, these symptoms also regress spontaneously.

Syphilis then passes into the latent phase, with no symptoms and can last for years.

Neurosyphilis

At any stage of the disease there may be central nervous system involvement. The so-called recent neurosyphilis is generally asymptomatic, and only the CSF scan is capable of making this diagnosis. It needs to be treated even when there are no symptoms as it can evolve into symptomatic forms.

Late latent late syphilis can lead to complications of syphilis, which can also affect the central nervous system (late neurosyphilis), eyes, heart and large arteries, bones, skin, and other organs. Such complications may appear after a short period of time or take decades to manifest. Often, late syphilis manifests itself without the person having any symptoms in the primary or secondary phases of the disease.

Patients with recent neurosyphilis may be asymptomatic or present the meningovascular form, with mental confusion, behavioral change, headache, nausea. In late forms, there may be brain involvement (parenchymal syphilis) that may resemble even symptoms of strokes, popularly known as "strokes." Late forms of neurosyphilis may occur with dementia. Paralytic dementia is dramatic and not reversible, even with treatment. The tabes dorsalis is the involvement of the spinal cord by syphilis and develops with alterations in the nerve reflexes and alteration of the motor coordination and walking capacity.

Neurosyphilis may still be accompanied by visual impairment, which may occur concurrently or not with central nervous system problems.

Late forms of neurosyphilis are less frequent than recent forms. It is more common in patients infected with HIV. Nonetheless, people not infected with HIV may also develop neurosyphilis. Considering that in these patients the disease usually occurs a few decades after the infection, it is important to remember that research for syphilis is mandatory in all people, including the elderly, with dementia.

In people infected with HIV, syphilis can progress atypical and faster. For this reason, some authors suggest that all HIV-infected patients diagnosed with syphilis should be screened for neurosyphilis. As clinical neurological examination may be normal, only the CSF examination can safely determine whether or not there is involvement of the central nervous system.

Treatment of syphilis depends on the stage of the disease and whether or not the central nervous system or the eye is involved. Treatment of neurosyphilis or ophthalmic impairment requires hospitalization for at least 14 days with intravenous medication. Blood tests allow the diagnosis and monitoring of treatment.

Thus, medical indication for CSF collection in case of syphilis, even when asymptomatic patients are essential for proper treatment and to avoid complications and severe sequelae.

According to the Handbook for Management of Sexually Transmitted Diseases in People Living with HIV, published by the Secretariat of State for Health in 2011, CSF collection is indicated in the following cases:

Patients infected with HIV and diagnosed with syphilis and who have neurological, ocular or syphilis symptoms in other organs

Patient not responding to treatment

Pictures of syphilis of unknown duration

High serological titles

Uncontrolled immunosuppression.

CSF collection is performed by a physician. It is a relatively simple procedure with minimal discomfort. The puncture is performed outpatient, without need of hospitalization, under local anesthesia. CSF is collected with a fine needle inserted into the spinal canal, usually at the lumbar or, if appropriate, in the suboccipital region. Attending a well-hydrated examination may make it easier to collect. Some people may experience headaches after puncture - if severe or long lasting, it is advisable to seek medical advice.

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P.S. I have this article in portuguese just ask