Introduction
Years of evolution have led to the fact that every minute is threatened by thousands of infectious agents to cause both small skin irritation and death. Three cohorts of microorganisms, viral, bacterial, and eukaryotic, can be identified as having pathogenic effects on individual health. It seems that the search for medicines and the detailed study of infectious diseases should become fundamental tasks of modern medicine. This creates the need for an in-depth study of the theoretical material on this issue, which is the purpose of this research paper.
R. lyssavirus’ discovery
One of the most dangerous viral diseases, rabies, still does not have universal therapy, so it takes more than 59000 lives annually. Ancient Roman doctor Aulus Celsus wrote about rabies as a disease that affected human’s conscious activity and forced them to hydrophobia (Tarantola 4). In 1885, the microbiologist Louis Pasteur made a scientific breakthrough (Offord). In particular, the scientist made a risky experiment on the primary vaccination of a boy with subsequent infection, as a result of which the child survived, and the man became world-famous.
H. pylori’s discovery
The penetration of bacteria into the body is associated with serious intestinal infections, among which the most common pathogen is H. pylori, which has the potential to develop into inoperable diseases of the digestive system. The history of the study of bacteria associated with stomach gastroenterological research. Two scientists, Marshall and Warren, put the final touch to the bacterial research history, having managed to cultivate and identify H. pylori in 1983 (Marshallc 8). Since the bacteria was isolated and its genome sequenced, scientific research has continued to investigate H. pylori’s pathogenesis.
T. rubrum’s discovery
One of the largest groups of pathogens is eukaryotic cells. Fungal diseases are known to be among the most common diseases, taking up to 1,5 million human lives each year. In particular, the pathogen Trichophyton rubrum is considered to represent colonial fungal microorganisms causing ringworm and skin itching. According to Natalia and Peters, eukaryote was first described by the famous Swedish physician Malmsten in 1845 (1). Since then, medical professionals have studied this colonial fungus thoroughly.
Signalment history
R. lyssavirus
Traditionally, rabies cause panic in public, as it is almost 100% likely to kill a patient. The pathogen infection is zoonotic and is usually transmitted from wild animals to humans. The virus enters the body of an animal: even in the incubation period, R. lyssavirus is contagious, so if an infected animal has bitten a human or otherwise transmitted pathogenic saliva, there is a high probability of infection. According to WHO, 99% of all rabies cases are transmitted through dogs (Rabies). The virus’s main area of increased mortality are countries in Africa and West Asia, especially those with low incomes. These statistics appear to be related to the low availability of medicine in these countries or the unpopularity of vaccination.
Obviously, with the development of medicine, the total number of rabies-related deaths has been steadily declining. While the CDC provides data on the number of known cases among Americans showing that the clinical picture of a patient is male, aged 45 years, the WHO states that most patients are under 15 years old (Human Rabies; Rabies). The data confirm that the epidemic is global and universal and that there is an urgent need for a cure.
H. pylori
The world epidemiological picture for a bacterial disease looks different. First of all, it is essential to recognize that diseases have a high degree of infection caused by the lack of hygiene culture among the population. H. pylori enters the host through the mouth: the primary infection sources are unwashed food, contaminated water, and dirty hands. An unusual situation is formed around the prevalence of the pathogen: according to Bjorkman, more than 50% of the population is infected (Bjorkman). Furthermore, as in the case of R. lyssavirus, the main points of the epidemic are low-income countries, such as Africa and South America. Finally, there is a fantastic pattern in the context of age — with each year, the probability of a positive serological response increases by 0.3-1.0% (Sultan). This suggests that older people are a vulnerable category of the population.
T. rubrum
The highest complexity of demographic analysis is the fungal infection caused by T. rubrum. According to the American Society for Microbiology, about 15% of adults worldwide are exposed to surface fungal infections, although quantitative studies indicate the prevalence of infection among adolescents under 14 (Invasive Fungal Infections; Araya 291). Moreover, Handler reports atypical eukaryotic disease for the Northern European regions and high prevalence in Africa and India. Ringworm is highly contagious and is most often transmitted from street animals to humans by physical contact.
Clinical signs and symptoms
R. lyssavirus
The first signs are detected at the bite site in the initial period: the wound swells up, turns red, itchy. Patients often have a general malaise, high temperature, and sleep disturbances. The infection progresses, and over time, the patient acquires hydrophobia with painful muscle cramps of the throat and larynx. Then, psychomotor excitement occurs: the patient behaves aggressively, experiencing hallucinations, and increased salivation. Death comes from cardiac arrest or paralysis of the respiratory center.
H. pylori
Since the bacteria entered the patient’s stomach, the stage of active metabolism begins the products of which expose the natural microflora of the body to severe stress. Then, inflammation begins, which can be expressed asymptomatically or develop into more pronounced forms — gastritis, ulcer, or even stomach cancer. The main symptoms that indicate an infection in the body are lower abdominal pain, nausea, heartburn, and increased gas emission.
T. rubrum
Since ringworm is a superficial form of fungal infections, it is possible to detect disease development signs during dermatological examination. T. rubrum is observed as a bright spot with clear boundaries. The lesion area’s morphology looks like a bubbly pink rash, but the ringworm is spreading in the foci. If there was hair at the spot’s growth site, it breaks down and falls out due to the hair follicle’s loss of nourishment. It is worth noting that the stain itches heavily, so patients often tear the focus, which leads to rot and dark crust formation.
Differential diagnosis
R. lyssavirus
Rabies has symptoms that are difficult to confuse with alternative diseases. The final diagnosis depends not only on the physician’s suspicions and the stage of infection but also on histological analysis. However, if the patient has any doubts about their health in the first weeks after the bite, they can consult a doctor — but it is essential to recognize that primary stage symptoms are similar to common diseases such as seasonal flu (What are the Signs). The patient has discomfort, weakness, restlessness, and fever, so the development of R. lyssavirus cannot be unequivocally stated.
H. pylori
Due to the multidimensional nature of the infection caused by H. pylori, it is difficult to speak of a misdiagnosis. It is known that depending on the type of bacteria, the patient’s immune response, and other aggravating circumstances, the infection may develop into a gastric and intestinal ulcer or cancer. However, Furuta et al. suggest that it is not uncommon for clinical practice to have a diagnostic error with autoimmune gastritis (376). In particular, about 1/5 of all patients are misdiagnosed as vectors of H. pylori, while they are not.
T. rubrum
It often makes a misdiagnosis in the case of ringworm, as there are several similar forms of fungal infections. Biggers says, “the red circle on the skin might not be a ringworm.” In other words, instead of T. rubrum, eczema, granuloma, psoriasis contact dermatitis, Lyme disease, and pityriasis rosea may cause itchy skin stains. The likelihood of an error in the case of ringworm is high, so it is necessary to consult a doctor and histological analysis to determine the pathogen.
Diagnostic tests
It is clear from the above that conducting diagnostic tests when determining the pathogen is relevant. Diagnosis of rabies is based on specific laboratory tests, detection of viral antigens, or occipital biopsy by immunofluorescence, detection of rabies virus antibodies, and cerebrospinal fluid PCR. H. pylori diagnostic methods include blood antibodies, a urease breath test, and biopsy. Finally, traditionally ringworm is diagnosed by screening, laboratory, and instrumental testing. Tests include microscopic methods: under the microscope, the skin lesions’ flakes show the winding threads of mycelium.
Specific treatment and prognosis
R. lyssavirus
At present, rabies is considered an incurable disease and therapeutic interventions are palliative and aimed at alleviating the patient’s condition. Patients are prescribed medications to reduce the intensity of symptoms: sleeping pills and anticonvulsants, painkillers, tranquilizers. The experimental treatment, which has proved successful in only one case, was carried out by introducing the patient into an induced coma (Zeiler and Jackson 44). In this condition, the patient was injected with immunostimulating drugs that promoted antibody production. A week after the human nervous system was “shut down,” the immune system collected enough material to fight the virus, but repeated attempts at this technology have produced little or no results.
H. pylori
When discussing the effectiveness of therapy, it must be noted that this bacteria is extremely common among the world’s population. Despite the success of therapy, in some cases, it is not recommended to treat a bacterial infection, because experts believe that the bacteria can become a natural part of the microflora (Chey 1829). In case of the treatment, the patient is prescribed antibiotic drugs in addition to the proton-pump inhibitors. The inhibitor molecules prevent the production of a hydrochloric acid. Meanwhile, prescription antibiotics include Azithromycin and Levofloxacin, but Amoxicillin is more effective (Helicobacter pylori). The actions of the drugs are bactericidal, so there is a disturbance of the cell wall, leading to the pathogen’s destruction. Side effects are expressed in allergic reactions, nausea, and palpitations. Moreover, to normalize the functioning of GIT, the patient must follow a special therapeutic diet that excludes fatty, salty, and spicy foods throughout the treatment.
T. rubrum
The ringworm is supposed to treat the hearths both locally with ointments and by taking medication inside. The mechanism of action of antifungal drugs, such as Gris-PEG or Terbinafine, is aimed at destroying the fungus and colonies. Typically, antibiotics specifically inhibit early cell biosynthesis, which leads to fungus death (Dock and Nall). Side-effects are rare when taking medication, although headaches and taste disorders may be noticeable. Ringworm is a cured form of infections, consequently, with adequate intake of antimicrobial agents, the patient has an excellent chance to get rid of the illness.
Preventing and control
First of all, persons suspected of viral infection carry out local wound treatment with soapy water washing and concentrated iodine alcohol. The prevention of rabies in humans is carried out with anti-rabies vaccines. The developed course of vaccination against virus is appointed only based on clinical and epidemiological data, which are later joined by laboratory examination results of the bitten animal, if any. In order to prevent the development of bacteria, the population is advised to observe hygienic rules and diets. It is essential to wash hands thoroughly before eating, use only personal hygiene items and fully cure existing gastrointestinal pathologies. If the infection is suspected, fried, smoked, salty, fatty, and pickled dishes and any spices should be avoided. Meanwhile, if a family member has been infected with ringworm, it is recommended that the room be disinfected. The patient should not contact any until they are fully recovered, as the disease is extremely contagious. To protect oneself, it is necessary to observe hygiene rules and not to come into contact with street animals. Finally, it is critical to undergo routine preventive medical examinations.
New research
The development of medicine continues, so new experimental methods of treatment of patients are still being identified. In 2019, clinical trials on Favipiravir’s prescription for laboratory mice infected with rabies (Banyard 4687) were completed. The results demonstrated high efficacy of the antiviral drug, although questions remain on how to scale this effect on the human. However, scientific sources’ literary analysis did not reveal experimental methods of treatment of bacterial and eukaryotic disease.
Conclusion
To sum up, it is worth noting that the spectrum of infectious diseases that can cause harm to human health is extensive. In the case of care for a patient with rabies, it would be necessary to ensure immediate hospitalization in the room with limited light and noise penetration. The patient should be given a drink, although they have hydrophobia. Medical personnel work with the patient wearing gloves and a mask, as the patient’s saliva contains the virus. Patients with H. pylori and T. rubrum should be told about the importance of following medical rules, the diet, and the course of medication. Specific care would include monitoring antibiotics, encouraging smoking cessation, and necessary nursing procedures such as catheter setting, physiological measurements, and condition assessment.
Five questions
As a nurse, it is vital to properly approach the procedure of patient care and interaction with their family. In order to ensure proper and sufficient care for patients with rabies, stomach upset, or deprived of life, there are five questions that may be applicable in clinical practice. For ease of reference, the questions are given in Table 1.
Table 1. A list of questions that can be asked by the patient and their family in clinical practice:
Works Cited
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Araya, Shambel, Betelhem Tesfaye, and Desalegn Fente. “Epidemiology of Dermatophyte and Non-Dermatophyte Fungi Infection in Ethiopia.” Clinical, Cosmetic and Investigational Dermatology, vol. 13, 2020, pp. 291-297.
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