What Is A Whit More Disease?

March 22 20:57 2019 Print This Article

It is defined as a disorder in which there is an infection caused by the gram negative bacteria. It is also known as Meliodosis. The bacteria responsible for it are B Mallei. It is found in the soil as well as water. It can be acute or chronic. The bacterium is member of pseudomonas and this condition is like a glanders. The melis means a collection of asses. In endemic areas it is of public health importance. It is quite prominent in the areas of Thailand as well as northern Australia. It may lead to pain in the chest, bones, cough as well as skin. It can also involve the lungs and can lead to pneumonia.

What are the signs and symptoms of Whit more disease?

It includes the pain in the chest, bones, cough as well as skin. It can also involve the lungs and can lead to pneumonia. The condition can be acute or chronic. In the acute phase there is an incubation period of 9 days. In the latent phase this is asymptomatic. One can also go for the ultra sound or a CT scan. The incubation is referred as the Vietnamese time bomb. The time of the incubation is quite long. In the chronic presentation there are number of symptoms which can last for many months and are linked with the near drowning. In the later stages there may be cough along with a pain in the chest. There is a pain in the joint as well as bone. In the histological section one sees a swiss cheese or honey comb pattern. There is an infection in the abdomen. In the thai children there is a parotid abscess and it is quite common in Australia. This disease can affect any organ of the body. In one fourth of the patient there is no focus of infection. The duration of symptom defines the chronic meliodosis.

One must also look for the prostatic abscess. The other risk factors for the disease are diabetes, thalassemmia as well as the use of alcohol. There can be any kidney disease also. Sometimes healthy patient can also have this disorder and it may involve the children. It is also known as Vietnam tuberculosis. The chronic form resembles tuberculosis and it involves not more than one tenth of the patient. It can involve any organ of the body and the diagnosis can be done with the help of throat swabs or cultures. One must take a definite history. It can lead to intra vascular infection, lymph node abscess as well as scrotal and eye infection.

How Whit more disease can be diagnosed?

The diagnosis can be done with the help of throat swabs or cultures. One must take a definite history. This disease is not active for many years and it remains inactive. One must also keep a check on the travelers. The chances of this disease are more in the case of febrile patient. One must go for sputum culture, blood culture, throat swab as well as urine culture. One must aspirate pus with a possible chance of infection. One can go down for the ash down medium as well as blood agar medium. In order to grow the organism a definite diagnosis can be made. Sensitivity is not seen in the case of throat swab but is very specific.

The urine culture sensitivity is increased in case if there is a culturing of bacteria. It must be below 10 raise to power 4 organisms. In few cases the bone marrow culture is positive. It is done in the case of negative blood cultures in case where it is not recommended. The most common error made by clinicians is that the specimen is not taken from the affected site. One must go for the serological tests which are also known as the indirect hem agglutination. It is not available commercially. A direct immune fluorescent test can also be done. One must not rely on the x rays or CT scans. One must go for imaging as soon as possible. It is done with the help of CT scan or ultrasound. The imaging of the prostrate leads to the formation of prostatic abscess in the honey comb pattern but it is not diagnostic.

How Whit more disease can be treated?

The treatment phase is divided into two parts one is the intra venous high intensity and is the oral maintenance stage. It prevents the recurrence. The intra venous intensive phase uses the drug ceftazidime and one can use it in the acute phases. There are other drugs which are also used and include the meropenem as well as suilbactam. One can also use few combinations of the drugs such as co amoxiclav. One can use intra venous antibiotics for 1 to 2 weeks. They must be given until the temperature of patient becomes normal. There is also a need of parenteral treatment. It must be used for more than 30 days. One can also use intra venous meropenem. It is used in the developed countries. It is used along with a ceftazidime. There are few drugs which are not effective in the vitro and include the cefepime as well as ertapenem. The meropenem has higher MCI as compared to other drugs. There are few drugs which are effective in vitro and include the piperacillin and biapenem. There is no requirement of the clinical experience. The adjunctive treatment can also be done with the help of co trimoxazole as well as GCSF.

This is followed by the eradication phase and is also known as the maintenance phase. In this a combination of cotrimoxazole as well as doxycycline is used. It is used for 3 to 4 months. One must not use chloramphenicol in daily. The patient who is not able to take cotrimoxazole as well as doxycycline one must take fluoro quinolone. The other option is doxycycline but they are not much effective.

In the developed countries one can also use cotrimoxazole. It gives few relapse rates as compared to the other drugs. One must also have a good follow up and there is a need for good knowledge about this therapy. The other options are the surgical treatment as well as the historical treatment. The surgical drainage is done in the cases of arthritis as well as in the cases where there is a formation of the abscess. It is not done in the case of hepato spleenic abscess. This disorder does not respond much to antibiotic therapy which is intra venously given. One can also go for the removal of spleen.
In the historical treatment mainly in the acute phase one goes for the combination of three drugs which include the chloramphenicol as well as doxycycline.

One can also use cotrimoxazole. But now days it is not used as it is in link with quite high mortality rates around 80 percent. These drugs have the ability to stop the growth of bacteria but not to kill it so they must not be used. The cotrimoxazole acts against the chloramphenicol as well as doxycycline.

How Whit more disease can be prevented?

The transmission from one to other person must be prevented and the people must not be contagious. The organism must be handled in the isolation conditions properly. One can also go for the post exposure prophylaxis with the help of a cotrimoxazole.

In the rice as well as paddy farms people must not come in direct contact with the organism. One must avoid mud, soil as well as surface water. After flooding and cyclones case clusters have come into the picture. No vaccine is available till date to counter react it. There are a few populations which is at risk and includes the diabetic, lung as well as kidney patient. There is decrease in the immunity also.

The post exposure prophylaxis includes the combination of treatment the chloramphenicol as well as doxycycline. One can also use cotrimoxazole. But now days it is not used as it is in link with quite high mortality rates around 80 percent. These drugs have the ability to stop the growth of bacteria. It can also be used in the case of biological warfare.

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