Infectious Disease Q & A

Below are our archive of questions and answers in Infectious Disease.

Question 5/14/2002: How can you be sure if your chicken pox is healing properly? The clear blisters have turned to yellow heads with redness around that, is this normal?
Answer: Yes, this is normal for this progression. In fact, next you will see some dark scabs covering the previous blisters. Then the scabs will fall off and you will have a slight red tinge to the skin for several months. However, at this point, the shingles have essentially resolved. NEA Clinic - (870) 935-4150 (for appointment)

Question 5/6/2002: For the last two weeks I have had a tingling sensation down my right arm. Most of the tingling is centralized in my right hand especially the thumb. I can also feel some tingling in the right side of my spine towards the base of my neck. I am 42 and weigh 200 lbs. I have good blood pressure and am normally in good health. Could this be a pinched nerve or cardiovascular?
Answer: It is difficult to say which system is involved without an exam. However, your distribution of discomfort is more suggestive of neuralgia. You need to see your family doctor for an evaluation. You may need a nerve conduction study to see if there is a pinched nerve....or even a CT or MRI scan of the neck region if it appears there is cervical spine disease. NEA Clinic - (870) 935-4150 (for appointment)

Question 5/6/2002: I know that I have hypothyroid. I was diagnosed in 2000 and for about a year I took synthroid. I had to move and lost my insurance and have not been to a Dr. since. I can now tell that I need to do something. I am very tired all the time and by 1:30 or 2:00p.m. I am ready for a nap. Can you please tell what you would recommend I do? Please remember I have no insurance.
Answer: You must restart your thyroid replacement therapy and be followed somewhere to titrate you correct dose. Without insurance, the Church Health Center in Jonesboro is a good place to do this. NEA Clinic - (870) 935-4150 (for appointment)

Question 4/27/2002: I would like to know what a staff infection is. How you can get it and how to get rid of it. And how contagious is it? Just any information you could tell me would be useful. Thank you.
Answer: We assume that you are referring to Staphylococcus species infections. the main agents that we see clinically are S. Epidermis, and S. Aureus. Epidermis is found on the skin, and rarely is much of a problem, unless the patient has a poor immune system. On the other hand S. Aureus is a powerful bacteria, common in skin wounds and often responsible for causing much problems. The variety called MRSA (Methicillin Resistant Staph. Aureus) is the worst of this species. Fortunately, most patients do not have much problem with this infection, unless they are immunocompromised. Therefore, the elderly or the very young are most likely to have problems. Vancomycin has been the workhorse antibiotic in this condition. However, it is only effective in the IV form. Good hand washing in the hospital setting is the most important factor to prevent spread. Unfortunately, some hospitals have problems with these bacteria in the ICU and orthopedic wards.
NEA Clinic - (870) 935-4150 (for appointment)


Question 4/1/2002: My daughter has somehow caught 5th disease at school it is going around the school that she attends. Could you please tell me what this is, how do you get it, and how do you get rid of it. Thank you!

Answer: Fifth Disease is a name given to Parvovirus B19. It is otherwise known as Erythema Infectiosum. It occurs in outbreaks in the winter and early spring, and is spread by intranasal inoculation of the virus. Normally a mild illness, Erythema Infectiosum typically presents as a facial rash with a slapped-cheek appearance that is sometimes preceded by low-grade fever. The rash may develop quickly on the arms and legs and usually has a lacy appearance. The typical rash resolves in about a week, but can recur intermittently for several weeks, particularly after stress, exercise, exposure to sunlight, bathing or change in environmental temperature. Sometimes joint pain may go with this illness. It should resolve with no other specific treatment.
NEA Clinic - (870) 935-4150 (for appointment)

Question 3/20/2002: A good friend of mine just passed away and they said at the hospital that she had scabies, but told us nothing else. Are scabies contagious? If so, what do we do to get rid of them in the house and clothing?
Answer: Scabies is called the human itch mite. This mite may infest as many as 300 million people each year. Close inspection can usually identify the mite or the burrow that may contain the mite or its eggs. Once diagnosed there are some scabicide creams that may be readily used to kill the infection. The application may need to be done on a repeated basis. Washing carefully all contaminated sheets, clothes etc. is also important. If you think that you might have scabies, see your family doctor.
NEA Clinic
(870) 935-4150 (for appointment)

Question 2/13/2002: Are bacterial infections contagious, and what would cause them?
Answer: Obviously, some bacterial infections are contagious. In order to have a bacterial infection, you must have both exposure to the bacterial agent and a host that is able to catch the infection. If your immune system is strong, you obviously have much less chance to have the infection. Because bacteria live in our environment, it is important to practice good hygiene and wash your hands frequently. Eating a balanced diet and vitamin supplements may be of help as well.
NEA Clinic (870) 935-4150 (for appointment)

Question 2/4/2002: What are the symptoms of anthrax? When should I be worried that I've been infected with anthrax?
Answer: Anthrax is a disease caused by bacteria, Bacillus Anthracis that has 3 forms in humans, inhalation, cutaneous, and gastrointestinal. Disease generally starts 4 to 10 days after exposure to anthrax spores. The most common form, including during the current U.S. outbreak, is cutaneous and is characterized by a blister on the skin that pops after a few days and forms an ulcer with a black, necrotic center. This form is easily treated with antibiotics and is almost always cured. Gastrointestinal anthrax occurs when spores are eaten. It is a rare form of the disease, even in countries in which anthrax is still common. The symptoms are abdominal pain, vomiting and diarrhea, often with blood. Inhalation anthrax occurs when the spores are breathed into the lungs. The first symptoms are indistinguishable from that of the flu, i.e., headache, non-productive cough, fever, and fatigue. Inhalation anthrax does not resemble the common cold, i.e., sinus congestion, runny nose, and fever with or without cough. Inhalation and gastrointestinal anthrax are difficult to treat, even with antibiotics, although 2 cases of gastrointestinal disease (the only 2 in U.S. history) that occurred last year were mild and did improve with antibiotics. Flu season is just around the corner and many people will have its symptoms. Remember, exposure to anthrax spores, as a white powder is the common thread in almost all of the cases so far. If you have not been exposed, your risk is zero. The flu does not need specific treatment and in those that are healthy, usually responds to TLC and chicken soup. The flu is a virus, and it does not respond to antibiotics directed against bacteria. What\'s more, the indiscriminant use of antibiotics will likely render them ineffective as bacteria become resistant to them. The best way to avoid the flu is to get the flu shot. Call you physician. Those over 65 or those with chronic illness can get the vaccine now, and everyone else can get it in December. Egg allergy is a contraindication. The Center for Disease Control and Prevention predicts that there will be enough vaccine for everyone who wants it this year. I highly recommend it.
NEA Clinic (870) 935-4150 (for appointment)


Question 1/14/2002: My stepson contracted tuberculosis at work. The health dept. has given him a once daily medication to take for nine months. They say there is no cure. Is this correct?
Answer: If this is Mycobacteria tuberculi (the typical form of tuberculosis), then there certainly is a cure. The medication used now for this disease is able to kill the offending bacteria. However, some forms of atypical tuberculosis are much more difficult to cure.
NEA Clinic (870) 935-4150 (for appointment)


Question 1/11/2002: I have had a nasty barking cough now for almost 3 months. I have been to the Dr. 3 times with different medicine every time. The symptoms went away finally after 2-1/2 months. After about 2 weeks, the cough is back. The cough is so bad that it usually makes me sick because I get choked. I have asked about the Whooping Cough that I have heard was going around but he just changed the subject. How do you know if it is Whooping Cough, and how do you treat it?
Answer: Whooping cough is an acute infection of the respiratory tract caused by the bacteria Bordetella pertussis. The name pertussis means violent cough. A dramatic inspiratory whoop following a paroxysmal cough is a hallmark of severe pertussis in children but is frequently lacking in adults. Pertussis is typically a prolonged illness, with an average duration of 6 to 8 weeks. Significant spasms associated with coughing may be seen. The standard diagnostic test is the isolation of the bacteria from the nasopharyngeal swab culture. It takes 3 to 5 days for the culture to grow out. However the chance of having a positive culture decreases with duration of the disease. Therefore, by 4 weeks, it is quite difficult to isolate any bacteria. Therefore some serological tests have been developed, but we are unsure if these are very accurate. So, if we suspect pertussis, we will give erythromycin empirically with cough suppressants. Fortunately pertussis is still quite rare. NEA Clinic (870) 935-4150 (for appointment)

Question 1/9/2002: My 2 year old daughter will get a fever late at night , it goes from 98.7 up to 104/105 all at once. She has no other symptoms. What could be causing this and could she end up having a seizure due to the suddenly high fever. How can I bring the fever down because her skin turns red, she gets flushed and she acts like it hurts her to be touched?
Answer: Without other symptoms, it is very difficult to know what is going on. Most likely, there is some occult infection, such as an ear infection causing this. She needs to be evaluated by your pediatrician or by a family medicine doctor soon.
NEA Clinic (870) 935-4150 (for appointment)

Question 1/5/2002: How contagious is TB and after treatment is started will you no longer be contagious?
Answer: Tuberculosis is more contagious to the very young, the very old or those with immune problems such as HIV disease. By 10 days to 14 days after starting therapy with multiple drug therapy for tuberculosis, the patient is no longer considered contagious.
NEA Clinic (870) 935-4150 (for appointment)