Day 11: coming soon


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Thailand to Cambodia

After I finished the India course, I then headed over to Thailand for a G adventures tour. So far I've met the group and every seems really friendly, my roommate is from Germany and is in an orthopedics residency. There is a couple on their Honeymoon from New Zealand, others are from South Africa, and England. Our tour guide Andrew, is really personable and super friendly. Arriving in Thailand was not what it was 10 years ago... where many drivers hovered in and around the airport trying to upsell me on hotels, insist they will give me a good price. This time round it went very smoothly, which was nice but not as fun. So far the process form going from Thailand to Cambodia has been really smooth. As we entered Cambodia (where we got our VISAs) I noticed two caucasian girls lying on benches on their backpacks, staring at the ceiling then staring at our group as we walked by towards our air conditioned bus, "I wish I paid a little extra" is what I can imagine they ...
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Day 6: lepto, bucella, anthrax, scrub typhus

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Today’s lectures started with a breakdown of leptospirosis, I think the take away message is that this can look like a vasculitis (in a sense it is – invading endothelial cells), much like Rickettsia diseases. It can enter the body through mucosa, skin cuts/abrasions and the organism has burrowing motility. Just about any organ is fair game – liver, CNS, kidneys, and lungs. The organism is often transmitted from rodents, and can stay in rat kidneys for years. The bacteria can survive in fresh water and soil for many weeks, especially with neutral or alkaline pH, thus people at risk are sewage workers, people that work on rice farms, soldiers, people going rafting, and triathalon-ers. Rodents are the reservoir but there are over 150 animal reservoirs including cattle, pigs, and dogs. Thus it being labelled as the champion of zoonoses. The study above was done in India at several hospitals, the above are a list of undifferentiated fever of people presenting, notic...
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Day 10: tape worms, echinococcus

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Tapeworms: Today we discussed tapeworms, fish tape worm D. latum, pork Tape worm (T. Solium), beef tape worm (T. saginata). Of all of them, probably the most significant is the pork tape worm, not so much because infection with it causes disease, but ingestion of its eggs causes neurocysticercosis.   http://www.nejm.org/doi/full/10.1056/NEJM199209033271004 The article often quoted to demonstrate this point with orthodox Jews in New York who acquired it because their South American workers who were preparing the food had the tape worm themselves. Having tapeworms can be difficult to diagnose, we were told of one patient who was actually given anti-pscyh medications, the take home point being to document (picture and or bring in the worm or proglottids), to help identify it. Thereis a stool antigen (ELISA) for T. solium. Hymenolepsis nana (not to be confused with E. nana) is a dwarf tapeworm causing abdo pain and possibly pruritis, the one reason to check stool O&P in...
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