Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital
The Unseen World, Continued
We will now discuss another type of microscopic creatures Protozoa. These little beings are more developed than bacteria, but are still invisible to the naked eye. While they commonly cause problems in the third world, they are rare in the countries where most of my readers dwell, so I will spend little time on them.
However since they cause diseases by living off of humans, I will take this opportunity to discuss parasites, that is, animals that live off of people.
The most common disease in the world is malaria, which is both microscopic and a parasite. Travelers to regions that have malaria should get medicine before they go. All health authorities have guidelines for this. It is spread by a particular mosquito, and usually has high fevers that come and go. There is no malaria in Israel or the U.S.A., but it is rampant in Asia and Africa. Be careful if you travel to these countries.
Giardia is a consequence of poorly treated water and can be seen in campers who drink from streams, and occasionally in large metropolitan areas where water treatment mistakes have happened. This has occurred in Scranton, Pennsylvania and in Wisconsin. It presents with bad diarrhea.
Babesia is yet another disease that one gets from ticks, like Lyme disease. Fever and weakness are common. I would basically advise anyone who has been bitten by a tick to tell his doctor about it if he has fever within three weeks of the bite.
Toxoplasma is a small parasite that can cause serious diseases in the eye and brain. The biggest problem is that it can cause birth defects. Since cats spread the disease, pregnant women must avoid cats, even domestic ones.
Pinworm is extremely common. This worm travels down the intestinal tract and comes out at night causing severe itching. This worms are visible, and may be seen in the child's diaper. Treatment of bedding and meticulous hand washing are necessary.
Lice we have discussed in a previous column.
Trichomonas is a protozoa which only causes problems for women, but requires men to be treated if their wife has it.
Scabies like skin folds, and they are a small mite. Occasionally we can see the burrow holes they make in the skin, but usually they cause so much itching that we don't see much more than reddened skin. Treatment requires head to toe lotions.
Fungi are plants that grow in moist places. While they can cause death and serious problems, this is usually in those with an impaired ability to fight disease, such as the elderly.
Yeast infections in women are caused by a fungus and this causes severe itching. We have many good medicines to treat this disorder. There is now a one-dose oral regimen for this disorder. Creams and suppositories are also very effective. The overuse of antibiotics can be a cause of this disorder.
Skin fungi are very common and includes athlete's foot, which presents with scaling, itching and skin cracking, especially between the fifth and fourth toes. Creams work well here too. Funny colored skin patches, and small areas of baldness in children may be caused by fungi, and respond best to oral anti-fungals. Finger and toenail fungi are a real problem. They require long treatments, and occasional removal of the nail. Newer creams may provide an easier solution to this problem but they are very expensive.
Write me in care of the Yated.
