1/8. Cryptogenic rabies, bats, and the question of aerosol transmission.Human rabies is rare in the united states; however, an estimated 40,000 patients receive rabies postexposure prophylaxis each year. Misconceptions about the transmission of rabies are plentiful, particularly regarding bats. Most cases of human rabies caused by bat variants have no definitive history of animal bite. Three hypotheses are proposed and reviewed for the transmission of rabies from bats to human beings. They include nonbite transmission (including aerosol transmission), the alternate host hypothesis (an intermediate animal host that acquires rabies from a bat and then transmits rabies to human beings), and minimized or unrecognized bat bites. Nonbite transmission of rabies is very rare, and aerosol transmission has never been well documented in the natural environment. The known pathogenesis of rabies and available data suggest that all or nearly all cases of human rabies attributable to bats were transmitted by bat bites that were minimized or unrecognized by the patients.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/8. Household papular urticaria.BACKGROUND: Papular urticaria often occurs after bites of insects such as mosquitoes, sandflies, bed bugs and fleas. Multiple bites and local pruritus are characteristic symptoms. Treatment is usually symptomatic and includes antihistamines and corticosteroids. The reappearance of the symptoms can be prevented by successful control of the parasite. OBJECTIVES: To find the causative agent of papular urticaria in afflicted households with involvement of numerous family members, all in a narrow geographic area. patients: We describe the cases of 20 patients belonging to seven families, who presented to the local primary clinic, suffering from papular urticaria. RESULTS: The cat flea, ctenocephalides felis, was the hematophagous insect responsible for all infestations. The pruritus and the papular urticaria were treated symptomatically with calamine lotion, topical corticosteroids or oral antihistamines. All clinical symptoms disappeared within a few weeks after effective control of the parasites by spraying and fumigating the infested locations. CONCLUSIONS: Thorough investigation--including, at times, environmental inspection--is necessary to reach the rewarding discovery of the etiology of household papular urticaria. This condition may arise in other environments of similar character.- - - - - - - - - - ranking = 2keywords = environment (Clic here for more details about this article) |
3/8. Severe dyspnea due to jellyfish envenomation.During the summer, jellyfish stings are the most common envenomation situations encountered by humans in the marine environment. The more people swim, scuba dive, or snorkel, the more necessary it is to know what should be done immediately, how life can be saved, how to prevent early and late complications, and how to facilitate convalescence in the event of jellyfish envenomation. We describe an atypical case of a 14-year-old boy with severe dyspnea due to upper airway obstruction caused by a jellyfish sting to the face and outline a practical approach to the treatment of jellyfish stings.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/8. Hypovolaemic shock by rat bites. A paradigmatic case of social deprivation.This report describes an unusual complication of a comparatively common problem of rat bites, causing a near fatal case of hypovolaemic shock. An 8 month old girl was bitten on her head and hands by norway rats (Rattus norvegicus) while sleeping after falling from her parent's bed. She could not be attended to because of her parents' alcoholic condition. She was found in hypovolaemic shock. She required ventilatory and haemodynamic support for five days. At late follow up, the child had no medical problem. In this case, evident social risk factors include extreme poverty, poor hygiene, and rat infested environment, which are frequently associated in potential rat bite victims.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/8. Dog bite of the face in an adult Nigerian--a case report.BACKGROUND: Dog bite of the face is uncommon in adults. This is, in fact very rare in our environment and presentation of this single case to our centre led to our desire to discuss both the presentation and management of the patient in this paper. methods: An adult female Nigerian who had dog bite to her face involving both lips and the commisure is presented. The folder of the patient and the operation note were the sources of the information. RESULTS: She had minimal debridement of the wound with Abbe-Estlander flap cover of the wound. The dog was also placed under surveillance for a period of 2 weeks. The wound healed perfectly with no complication. The involved dog remained healthy 2 weeks after the injury. CONCLUSION: Dog bite of the face, though uncommon, can present in an adult. Sometimes the challenges of reconstruction of such defect could be great. Wound management with minimal debridement and closure gives good results on the face.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/8. Anaphylactic shock to argas reflexus bite.anaphylaxis is a severe, life-threatening allergic reaction, affecting both children and adults. The occurrence of anaphylaxis is not as rare as generally believed (1.21% to 15.04% of the US population). Often the cause of this reaction remain unknown, mainly due to the difficulty in defining the outbreaking causes. Herein, we describe an interesting case of a patient, who developed an anaphylactic reaction after the bite of a pigeon tick. During the last 2 years, in wintertime, the patient often came to the emergency room for general rash and swelling, hypotension and tachycardia preceded by itching and general distress. Notably, the symptoms manifested themselves as night fell. In two particular occasions the patient reached the hospital in a state of shock. After another episode of general swelling, the patient was invited to examine her domestic environment. She brought us some parasites, collected at home, particularly on the bed. A morphological examination by entomologists proved these parasites to belong to argas reflexus (Arg.r.), one of the 31 species of soft ticks. The presence of specific IgE to a protein secreted by the Arg.r. salivary glands was in favour of immediate-type systemic reaction, as supposed by the clinical history.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/8. The therapy of genital trauma by dog bite.Genital trauma by dog bite rarely is reported. We present 2 cases of dog bite to the external genitalia involving male infants. rabies precautions, tetanus prophylaxis and antimicrobial therapy are reviewed. Both children required surgical debridement and split thickness skin grafts for repair. Since pediatric genital trauma may be the result of negligence or even deliberate abuse, a thorough investigation of the child's environment is mandatory in such situations.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/8. anaphylaxis after laboratory rat bite: an occupational hazard.Workers exposed to laboratory animals are at risk of developing asthma, rhinitis, angioedema, conjunctivitis, and urticaria. Approximately one in five scientists and technicians handling small animals will develop laboratory animal allergy symptoms within three years of employment, many of whom will have severe symptoms requiring a change of occupation. Individuals suffering from allergy to environmental allergens, such as pollen and ragweed, are more likely to develop allergic reactions to animals, and are more likely to develop asthma. We report a case of life-threatening anaphylaxis secondary to a rat bite in a laboratory research director with known allergies to rat urinary protein. While rodent bites are common in research settings, such severe reactions are extremely rare.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |