Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
How soon after an exposure should a person seek medical attention?
Urgency is the key to the timing of obtaining medical attention; if the bite
is not serious (for example, little or no bleeding or tissue disruption), the
individual should have the wound washed with soap and water (or antiseptic
solution) as soon as is possible. In addition, animal-control authorities need
to be contacted and given as much information about the animal as is possible
(for example, the animal type, its description and behavior, its location, the
circumstances that lead to the bite, and any other information requested). This
is important to do immediately as it may give the authorities a chance to
capture the animal. This will allow authorities to observe and test the animal
for rabies. Untrained people should not attempt to approach the animal or to try
to capture any animal suspected of having rabies.
In general, most clinicians and researchers suggest the person bitten or
exposed to rabies be seen and treated (see treatment section below) within about
12 hours of the exposure, but the quicker the better. However, there is some
time span in which treatment may be delayed (but delay in treatment is not
recommended). For example, people adequately treated (see treatment section
below) within 48 hours in the U.S. have never developed a fatal case of rabies to
date (Feb. 2011). Do not worry about timing for stitches. Stitches are not
usually recommended for bites as the stitches may help provide an environment
for some bacteria found in saliva to proliferate. However, this may be modified
if there is extensive tissue disruption; such patients need to be seen
immediately.
How is a rabies infection diagnosed?
Usually, after a history of an animal bite or saliva exposure, the following
questions may be asked:
Was the bite from an animal species that is
susceptible to rabies (rats, mice, hamsters, and gerbils are rarely infected with
rabies)? Wild animal bites, especially from skunks or raccoons, are always
suspected to have rabies.
If a domestic animal was involved, was it acting
strangely (see above)?
Was the animal vaccinated against rabies (most
domesticated animals are)?
If the exposure was from saliva, was it near an
open scratch, wound, or mucous membrane such as the mouth, nose, or eyes of the
individual?
Is rabies known to be present in the area where the person was
exposed?
Answers to these questions will help the clinician decide, usually in
consultation with the public-health officials, if the person has been
presumptively exposed or infected with the rabies virus. In addition, the
animal, if caught can be observed for signs of rabies or killed and the brain
(and other tissue) can be examined by an immunofluorescence test for rabies
virus. If these tests are positive, the patient is presumptively assumed to have
been exposed to rabies. Treatment decisions are begun based on these findings
(see treatment section below) because early treatment (up to about 48 hours post
exposure) has been 100% effective in the U.S. according to several research
sources.
Most people have rabies definitively diagnosed by an immunofluorescence
test that confirms the presence or absence of rabies virus in tissue or saliva.
These tests are usually done on people who develop the severe symptoms of
rabies; they are not done on people who undergo appropriate treatment within 48
hours of exposure. Immunofluorescence tests can be performed on saliva, serum,
spinal fluid, and skin biopsies of hair follicles at the nape of the neck. In
addition, saliva can be tested by virus isolation or reverse transcription
followed by polymerase chain reaction (RT-PCR). Serum and spinal fluid can also
be tested for antibodies to rabies virus. Skin biopsy specimens can also be
examined for rabies antigen in the cutaneous nerves at the base of hair
follicles. Most labs suggest that at least two positive tests from different
body areas are required for a definitive diagnosis. The vast majority of
patients with a definitive diagnosis will die from the disease. However, these
tests are useful because they can help differentiate rabies from other diseases
(for example, tetanus,
viral encephalitis causes, and
poliomyelitis).
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Muscle spasms are involuntary muscle contractions that come on suddenly and are usually quite painful. Dehydration, doing strenuous exercise in a hot environment, prolonged muscle use, and certain diseases of the nervous system may cause muscle spasms. Symptoms and signs of a muscle spasm include an acute onset of pain and a possible bulge seen or felt beneath the skin where the muscle is located. Gently stretching the muscle usually resolves a muscle spasm.
Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching to include: infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Dysphagia or difficulty in swallowing, swallowing problems. Dysphagia is due to problems in nerve or muscle control. It is common, for example, after a stroke. Dysphagia compromises nutrition and hydration and may lead to aspiration pneumonia and dehydration.
There are millions of dogs living in the United States, and thus many cases of dog bites. Annually, hundreds of people seek emergency medical care for dog bites. Treatment for a dog bite depends on how deep the injury is and the amount of tissue damage. Dog bites can be prevented by employing preventative measures.
Tetanus is an often-fatal disease caused by nerve toxins produced by the common bacteria Clostridium tetani. In a seven-day period after infection, a person experiences muscle spasms, restlessness, headache, irritability, then lockjaw, and the lungs stop functioning. Tetanus is treatable with antibiotics and drainage. Sedation is often give to stop muscle spasms.
Insomnia is the perception or complaint of inadequate or poor-quality sleep because of difficulty falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or unrefreshing sleep. Secondary insomnia is the most common type of insomnia. Treatment for insomnia include lifestyle changes, cognitive behavioral therapy, and medication.
Infectious Disease RSS
Healthy Living Tips
