Diseases

Chronic fatigue syndrome (CFS) is characterized primarily by profound fatigue, in association with multiple systemic and neuropsychiatric symptoms, lasting at least 6 months. The fatigue must have a new or definite onset (i.e., not lifelong), is not relieved by rest, and results in a substantial reduction in previous activities (occupation, education, social, and personal).

The usual incubation period is 14-16 days (range 11-21). Patients are infectious from approximately 48 hours before appearance of the rash until the final lesions have crusted. Most people acquire chickenpox during childhood and develop long immunity.

Several other drugs have been evaluated, including tetracycline, primaquine, sulfadiazine (Microsulfon) and pyrimethamine (Fansidar). Results have varied. Pentamidine (Pentam) has proved to be moderately effective in diminishing symptoms and decreasing parasitemia. Others: High-level parasitemia is more common in asplenic patients.

Condyloma acuminata are soft skin colored, fleshy warts that are caused by the HPV (human papilloma virus). There are now > 100 known types of HPV and types 6, 11,16,18, 31, 33, 35 have been associated with condyloma acuminata. The disease is highly contagious, can appear singly or in groups, small or large. They appear in the vagina, on the cervix, around the external genitalia and rectum, in the urethra, anus, also conjunctival, nasal, oral and laryngeal warts and occasionally, the throat.

Infectious diseases comprise those illnesses that are caused by microorganisms or their products. Clinical manifestations of infection occur only when sufficient tissue injury has been inflicted directly by microbial products (e.g., endotoxins and exotoxins), or indirectly by host responses (e.g., cytokines and hydrolytic enzymes released by polymorphonuclear leukocytes). Despite the extraordinary recent advances that have occurred in therapeutics for infectious diseases, a number of basic principles should be followed to prescribe antimicrobials and vaccines is an optimal manner.

Before appropriate therapy can be given for an infectious disease, consideration of epidemiologic factors is essential. This section does not fully discuss the epidemiology (the determinants, occurrence, distribution, and control of health and disease) of infectious diseases. However, a number of basic principles and historical points are worth emphasizing.

Toxic shock is an acute disease characterized by fever, mucous membrane hyperemia, subcutaneous edema, desquamating erythroderma, hypotension, and multisystem organ involvement. A decade ago it was widely described as an illness affecting young women, associated with vaginal colonization by Staphylococcus aureus and the use of tampons. Subsequent studies demonstrated that S. aureus produces several related enterotoxins — including toxic shock syndrome toxin-1 (TSST-1) — that are thought to cause the disorder by activating host inflammatory responses and by triggering the release of cytokines. Not all cases of toxic shock are associated with menstruation, however, and not all cases are associated with S. aureus.