DISCLAIMER: I am not a doctor, nor do I play one on TV. I do not hold a current medical license or certification (I let them lapse because I no longer work in the medical field and don't intend to ever again). What I do have is an extensive medical background in various fields. Everything you read here is the result of either education, training, research and interpretation, or personal experience. The information in this post is not to be taken as a substitute for professional medical advice or examination. Seriously, if you're having an immediate medical problem and you're reading this blog for help, get off the damned computer and call an ambulance!
ADDITIONAL DISCLAIMER – IF YOU ARE SQUEAMISH/EASILY SQUICKED OUT BY GRAPHIC DESCRIPTIONS OF GROSS THINGS, YOU SHOULD NOT READ THIS POST. THIS ONE IS GOING TO GET…EW. YOU HAVE BEEN WARNED.
PROBABLY SHOULDN'T BE EATING ANYTHING, EITHER.
We've been talking about infection for quite awhile now in our "Ask Dr. Dina" series. This piece was broken into a few parts because there are many, many different types of infection and I wasn't about to write a book on the subject.
These parts were –
I – Bacterial
II – Viral
III – Fungal
Now we've come to the final installment of this piece – Part IV: Treatment. In this piece I'm going to talk about…you guessed it…the different ways to treat various infections.
Let's start with something everyone (hopefully!) does – cleaning. Cleaning the things that touch the infection is just as important as cleaning the infected area itself.
Killing microbes (commonly called "germs") on something is called "sterilizing." You're making something free of contaminants – making it sterile. There are lots of ways to sterilize things, but I'll only talk about a couple here. Hospitals and other places like laboratories and tattoo parlors use a machine called an autoclave to sterilize their equipment using high heat and pressure. Ever see a movie where they take a lighter or candle and run the flame over a blade or pointy object before sticking it into someone? Same principle (and it works, but you have to do it more than a few times to get the thing sterile).
You know those little bleach wipes you can get for the kitchen and bathroom? Those are awesome! Bleach kills a hell of a lot of things, and you don't need much to do it, either. A 10% solution of bleach mixed with water is enough to kill the HIV virus, tuberculosis, hepatitis and other bloodborne/bodily fluid pathogens.
(Here's a link for the technical medical types from the CDC. Warning: unless you speak Science, this is going to hurt your brain: http://www.cdc.gov/hicpac/disinfection_sterilization/3_2contaminateddevices.html )
Alcohol is another good thing to use to sterilize something. We've all seen movies where a character is injured and someone pours vodka over the wound and the character screams. Yeah, that's about right. It's going to hurt like a bitch to do that. They also pour some over the knife before they begin cutting into the character. Why? To sterilize it! Booze does work if you've got nothing else (the "better than nothing" principle), but there's a lot of other things in booze that aren't so lovely for sterilizing. And it has to be spirits, not beer or wine. Neither beer nor wine have a high enough alcohol content to do anything but wet the wound, make it smell funny, and possibly infect it with some kind of fermenty thing. Best use the beer and wine to get the character intoxicated so they don't whine when you clean their wound with something else. (Note: sarcasm. Alcohol dehydrates you despite it being liquid and shouldn't be given to wounded people. It looks cool, though.) We'll talk more about wound care in another post.
Do you carry a little bottle of sanitizing hand gel (I do!)? If you do, you should make sure it has an alcohol content of at least 60% in order to be effective at killing microbes on your hands. Now this will burn like fire if you get it in an open wound or your eyes, so try not to do that. If you've got a paper cut you're not aware of, I guarantee you the hand gel will tell you all about it. Nothing beats soap, water, and friction (friction is most important believe it or not) for washing your hands (which you should do often, by the way, especially if you touch your face/hair/nose or have small humans in the house), but in a pinch/if those things aren't accessible, hand sanitizer will do.
But all that's just surface stuff. Inanimate objects (called "fomites" in the fancy medical speak) need to be cleaned in order to keep the potential for infection at a minimum. It won't to any good to wash your infected wound in a dirty sink, now will it?
Now that we've talked about cleaning things (treatment!) outside the body, let's talk about how to treat infections on or inside it. Following the order of the previous posts, let's start with bacterial infections.
These are the most common infections, and as we know the most about them, are the easiest to treat. Bacteria are easier to kill than other microbial life for a lot of reasons I'm not going to get into.
I mentioned in the post on bacterial infection that antibiotics are for killing bacteria, not viruses. Now, not every infection needs antibiotics. When your cat scratches you and you get a little red line that gets puffy and stingy for a couple days, yeah, that's likely infected, but it will most likely go away on its own. Your body's natural infection control – your immune system – has that covered. The bouncers will show up and throw the assholes out and send a repair team in to fix the damage Kitty inflicted. It will take a few days, but they'll sort it out. It's when there's more work than your immune system can handle that it needs some help in the form of antibiotics.
Antibiotics come in all sorts of forms. They come in creams and ointments you spread on/in the wound, liquids you pour into the infected area, pills you swallow, and injectables you either shoot directly into the muscle, under the skin, or into a vein through an intravenous line (IV). It just depends on the type of infection you have and where it's located. Most antibiotics aren't over-the-counter except for some creams and ointments (we've all used a triple-antibiotic ointment for a cut or scrape, I'm sure), so if you feel you need an antibiotic for whatever reason, go see your doctor for a prescription. They'll determine if you actually need one. Overprescribing antibiotics is a problem as the things they're trying to kill with them develop resistance to them, which is why if the doctor determines you have a cold VIRUS instead of a bacterial sinus infection, you're (hopefully/probably/most likely) going to be told to go home, take some acetaminophen, drink lots of fluids, and rest.
Which brings us to viruses. As said both above and in the post about bacterial, antibiotics DON'T WORK ON VIRUSES. What does? Well…not a whole lot. There are some antivirals out there, but they're not designed to kill the virus they're treating. They're designed to make it hard for the virus to grow/develop. Not only that, but antivirals are target-specific. You may have heard the term "broad-spectrum antibiotic." What this means is that that antibiotic will kill a whole host of different types of bacteria. Not so with antivirals. There aren't many, and the ones that are out there are for viral infections like HIV or herpes.
Now, as I said above, there are things that kill viruses outside the body, like bleach and other substances, but that's not really a treatment. There are some vaccines against certain viruses (like polio) that are very effective, and some that aren't (like influenza). Medicine continues to search for vaccines for things, but viruses are hard to beat. Prevention is the best medicine for viral infections, because treatment is a complete bitch.
Fungi are also hard to treat, mostly because the duration is so long AND because the little bastards are hard to completely eradicate. Fungi have the unique ability to propagate themselves in almost any environment with only a single spore. They're hardy and like extremes, and even when you think you have it beat, it JUST. WON'T. DIE.
But! They are easier to treat than viruses. Not as easy as bacteria, but we do have ways to deal with them. If you've ever had a cream or other drug that ended in "–zole," you've likely been given an antifungal (or antiparasitic, which I'll toss in here because that's what I did in the post on fungal infections). There are a whole lot more antifungals out there, and all of them work almost exactly like antibiotics – attacking the fungi itself in order to allow your immune system to get a kill strike. Some work like antivirals, and keep the infection from getting anywhere until your immune system has a chance to raise shields and keep it from getting in. Like antibiotics, antifungals come in all different forms (and are often mistakenly called "antibiotics" by health care professionals and laymen alike) with varying degrees of efficacy. Depending on the severity of the infection, an over-the-counter seven-day yeast infection treatment might not work as well as a stronger one prescribed by a doctor. It's the same medication, really, just in a different formula with a more powerful delivery system.
(NOTE: This isn't to say that you should get more of the OTC treatment and use it doubled, because THIS WILL NOT WORK LIKE A PRESCRIPTION. The prescription version is different from OTC for a reason. While most OTC versions work just fine, if you need a prescription version, OTC isn't going to help you. NEVER DOUBLE UP ON OTC DOSAGES OF ANYTHING. "MORE" IS NEVER "BETTER.")
Now, how does all this apply to your character? Well, I'll leave that to you. I've given you post after post as to how infections happen, and now I've told you how they're treated. If you've got a character with a gunshot wound (GSW in the fancy medical speak) and you have them in the back of a car speeding down the street, infection should be the last thing on your mind. Later on, if you have them in a quiet spot, you can have them assess the damage and what to do about it. Hopefully these posts on infection will help you consider the details, like how they're going to sterilize something in that situation (or even if you're going to have them do it).
This concludes the Infection Sequence of the Ask Dr. Dina series. Next time we'll talk about something less gross. Like drowning.
Questions about medical issues with your writing? Leave them in the comments below and I'll get back to you as soon as I can. (THESE MUST APPLY TO FICTIONAL SITUATIONS ONLY. I AM NOT YOUR DOCTOR, NOR A SUBSTITUTE FOR ONE.)
Showing posts with label infection. Show all posts
Showing posts with label infection. Show all posts
Monday, August 12, 2013
Monday, July 29, 2013
Series Post: Ask Dr. Dina - Infection Part III: Fungal
DISCLAIMER: I am not a doctor, nor do I play one on TV. I do not hold a current medical license or certification (I let them lapse because I no longer work in the medical field and don't intend to ever again). What I do have is an extensive medical background in various fields. Everything you read here is the result of either education, training, research and interpretation, or personal experience. The information in this post is not to be taken as a substitute for professional medical advice or examination. Seriously, if you're having an immediate medical problem and you're reading this blog for help, get off the damned computer and call an ambulance!
ADDITIONAL DISCLAIMER – IF YOU ARE SQUEAMISH/EASILY SQUICKED OUT BY GRAPHIC DESCRIPTIONS OF GROSS THINGS, YOU SHOULD NOT READ THIS POST. THIS ONE IS GOING TO GET…EW. YOU HAVE BEEN WARNED.
PROBABLY SHOULDN'T BE EATING ANYTHING, EITHER.
We've come now to the infection portion of our "Ask Dr. Dina" series. This piece is going to be broken into a few parts because there are many, many different types of infection and I'm not going to write a book on the subject.
These parts will be –
I – Bacterial
II – Viral
III – Fungal
IV – Treatment
So far in this portion on infection we've covered bacterial and viral types. There are a lot more of them than I touched on, but the gist was there. I'm going to do the same for this one on fungal infection.
When you hear the word "fungus" or "fungi," what do you think of? Mushrooms, right? Yes, those are types of fungi. ("Fungi" is the plural form of "fungus." I know. That seems backwards as you've been taught that plurals end with "s." That's true for most things, but in case you haven't figured it out by now, medicine/science likes to do things its own way. Why? Because science is a dick, that's why!)
The kind of fungi I'm going to talk about in this post aren't shiitakes or portabellas or chantrelles (shut up, hippies). I'm going to talk about microscopic fungi. While you can (and very likely do) ingest these microscopic fungi, I wouldn't recommend it.
What I'm going to talk about today is mycosis, which is fancy medical speak for "fungal infection." Why is it called "mycosis" when that doesn't sound a damned thing like "fungus?" Because mycology is the branch of biology dedicated to the study of fungi. So there you go. I told you - science is a dick.
Let's start with something everyone's heard of. Athlete's foot. You've all seen the commercials or heard about different medications for athlete's foot. You know it's gross and painful and so on. What you may not know is that athlete's foot is so named because athletes' feet are constantly moist from sweat and shoved in the warm, dark environment of a dirty sock and sporting shoe for hours on end, then they walk around barefoot in shower/locker rooms subjecting their feet to even more warmth and moisture, creating the perfect environment for that particular fungus to proliferate. That fungus is one we all carry (part of the natural flora of the human body) called Tricophyton. Now there's a shit-ton of subtypes of this fungus, but you'll most likely know them by their common names – jock itch and ringworm to name a few. (Hint: there's no actual worm involved in "ringworm." It's named that because the little assholes responsible for it [called "tinea" by health care professionals] make lesions that look like a ring/worm under the skin.)
Remember what I said about science/medicine being a dick? Yeah. Why should we call it "athlete's foot" when we can call it something fancy like "tinea pedis?" Your head itches? Tinea capitis! (Ringworm of the scalp! Or, you know, just dry scalp or a fucking itch [dermatitis!]. Don't freak out.) Look, we like our Latin and Greek in the medical community, okay? Medical terminology is a language unto itself and if you want to be in the field, you've got to learn to speak it. No, I mean it. They teach it anywhere medical stuff is on the curriculum.
But I digress.
Now, the above are what are known as "cutaneous" fungal infections; that is, they affect things on the surface/outside of the body like your skin, hair, and nails. When fungus gets inside you, things get a little more difficult to handle.
Yeast infections. Ladies, you know what I'm talking about, right? If you've never had one, consider yourself blessed. Dudes…before you smirk and get all smug, you're not exempt from yeast infections, either. Yeast can affect your bits and bobs, too. Remember what I said earlier about fungus liking moist, dark, warm places to grow? I'll wait…THERE you go. Yeah. That. Now, yeast (called Candida in the fancy medical speak) is part of the body's natural flora. It's when things get thrown off-balance by whatever (stress, medications, diet, what have you) and the little bastards run wild that you have an infection on your hands.
And don't go thinking yeast infections are confined to your lower half. Uh-uh. Parents. Ever had to deal with thrush in your kid? Adults? Ever had thrush for one reason or another? Congratulations. You've had a yeast infection of your mouth. (Warm, dark, moist, remember? The human mouth is utterly filthy. You don't even WANT to know what lives in there, so brush your teeth [and tongue!] often, kids!) Yeast can also infect your skin and even your blood (called fungemia). HCPs (health care professionals, remember?) call yeast infections (no matter where they might be) "Candidasis." Most often the culprit is Candida albicans, but sometimes other species like to play, too.
When fungal infections get even further into the body, things turn really nasty.
Remember our friend meningitis from the bacterial and viral sections? Guess what? Fungus isn't going to be left out of that party. Fungal meningitis isn't contagious or very common, and generally affects people who have been seriously immuno-compromised, like cancer and AIDS patients. A fungus called Cryptococcus is generally responsible for this kind of meningitis. There are a couple of very nasty subtypes of Cryptococcus (NOT to be confused with Cryptosporidium, which is a whole different type of BAMF I'll talk about in a minute), and both are deadly when they set up housekeeping.
Other fungi get into the lungs (pulmonary system) and wreak havoc. One particular nasty is Aspergillosis. Now, normally aspergillis is fine and dandy when it's outside the body. Breathing the stuff in, however…yeah. Warm, dark, moist…you remember how it works. Most people breathe that crap in every day (as it's just in nature/the air) and are utterly fine. It's the same game – your immune system takes care of it if it's healthy. Your immune system is a BAMF too, and works like a boss when it's on the ball. It's when your immune system is compromised for whatever reason (and there are lots of things that screw with your immune system) that things become a problem.
Those of you allergic to "mold" really mean you have a sensitivity to aspergillis or other airborne fungi. (Hint: the "mold" found on bread you may be sensitive to is a fungi also. You might know it as penicillin.) If your character has an allergy to mold, you can't have them working in a bakery, okay? Because yeast has a lot to do with mold. Baking and brewing yeasts are different from the infectious kind, but they do have a tendency to change/ferment/mold, so keep this in mind if you give your character an allergy to mold.
Mildew is the same. Mildew is a common name for types of mold growth. And mold is what? That's right...fungus - usually Penicillium. (In the plant world, mildew refers to a specific type of fungus called Erysiphales, but that's a whole other thing.)
Now while this post is supposed to be about fungal infections, I'm going to touch briefly on parasitic ones as well, mostly because the two are often confused or combined, mostly because they're related. I just mentioned one above.
Cryptosporidium isn't a fungus. It's a parasite. A protozoa, actually, and it's commonly found in contaminated water. It's ubiquitous and worldwide. I had a nasty bout with it on an archaeological expedition once – it's not pretty. Though generally just unpleasant in people with healthy immune systems, crypto (as it's known) can be lethal to the elderly, infants, and others with suppressed immune systems. If you're going to have your character drink from a water source that could be contaminated, chances are they're going to come down with something. You've heard of "Montezuma's Revenge?" Yeah.
Other parasites responsible for infection are helminths (worms, like tapeworm and roundworm) and ectoparasites (things like mites, ticks, and fleas).
Now I'm only going to touch on these. Parasitism is vast and complex and hugely incestuous when it comes to infection. For example, rats carry a type of flea (as do squirrels and other animals) that carry what's commonly called "plague." This is a vague term for Bubonic plague, AKA "The Black Death," (you know…the thing that wiped out a third of the world's population back in the 1300s) and while the flea (the parasite) is carried by rodentia (what's known in epidemiology as a "vector"), the actual cause of the illness is a bacteria the infected flea carries called Yersinia pestis. Same thing with ticks and Lyme disease. The tick itself is the parasite (or "vector"), but it's the bacteria it carries (Borrelia) that causes the disease.
See what I mean about parasitism being incestuous? It's usually not the parasite itself that causes disease, but the bacteria it carries with it, virus it enables, fungus it promotes, or damage it does while infecting.
Remember what I said about vast and complicated? Yeah. Let's just leave our discussion of parasites as it is, shall we? Just things to keep in mind if you have your character slogging through a field full of chiggers (a type of mite) or a cave full of bats.
This concludes part III of the Infection Sequence of the "Ask Dr. Dina" series. Join us in a couple weeks for the final installment of this sequence, where we'll talk about how the various infections I've talked about are treated.
Questions about medical issues with your writing? Leave them in the comments below and I'll get back to you as soon as I can. (THESE MUST APPLY TO FICTIONAL SITUATIONS ONLY. I AM NOT YOUR DOCTOR, NOR A SUBSTITUTE FOR ONE.)
ADDITIONAL DISCLAIMER – IF YOU ARE SQUEAMISH/EASILY SQUICKED OUT BY GRAPHIC DESCRIPTIONS OF GROSS THINGS, YOU SHOULD NOT READ THIS POST. THIS ONE IS GOING TO GET…EW. YOU HAVE BEEN WARNED.
PROBABLY SHOULDN'T BE EATING ANYTHING, EITHER.
We've come now to the infection portion of our "Ask Dr. Dina" series. This piece is going to be broken into a few parts because there are many, many different types of infection and I'm not going to write a book on the subject.
These parts will be –
I – Bacterial
II – Viral
III – Fungal
IV – Treatment
So far in this portion on infection we've covered bacterial and viral types. There are a lot more of them than I touched on, but the gist was there. I'm going to do the same for this one on fungal infection.
When you hear the word "fungus" or "fungi," what do you think of? Mushrooms, right? Yes, those are types of fungi. ("Fungi" is the plural form of "fungus." I know. That seems backwards as you've been taught that plurals end with "s." That's true for most things, but in case you haven't figured it out by now, medicine/science likes to do things its own way. Why? Because science is a dick, that's why!)
The kind of fungi I'm going to talk about in this post aren't shiitakes or portabellas or chantrelles (shut up, hippies). I'm going to talk about microscopic fungi. While you can (and very likely do) ingest these microscopic fungi, I wouldn't recommend it.
What I'm going to talk about today is mycosis, which is fancy medical speak for "fungal infection." Why is it called "mycosis" when that doesn't sound a damned thing like "fungus?" Because mycology is the branch of biology dedicated to the study of fungi. So there you go. I told you - science is a dick.
Let's start with something everyone's heard of. Athlete's foot. You've all seen the commercials or heard about different medications for athlete's foot. You know it's gross and painful and so on. What you may not know is that athlete's foot is so named because athletes' feet are constantly moist from sweat and shoved in the warm, dark environment of a dirty sock and sporting shoe for hours on end, then they walk around barefoot in shower/locker rooms subjecting their feet to even more warmth and moisture, creating the perfect environment for that particular fungus to proliferate. That fungus is one we all carry (part of the natural flora of the human body) called Tricophyton. Now there's a shit-ton of subtypes of this fungus, but you'll most likely know them by their common names – jock itch and ringworm to name a few. (Hint: there's no actual worm involved in "ringworm." It's named that because the little assholes responsible for it [called "tinea" by health care professionals] make lesions that look like a ring/worm under the skin.)
Remember what I said about science/medicine being a dick? Yeah. Why should we call it "athlete's foot" when we can call it something fancy like "tinea pedis?" Your head itches? Tinea capitis! (Ringworm of the scalp! Or, you know, just dry scalp or a fucking itch [dermatitis!]. Don't freak out.) Look, we like our Latin and Greek in the medical community, okay? Medical terminology is a language unto itself and if you want to be in the field, you've got to learn to speak it. No, I mean it. They teach it anywhere medical stuff is on the curriculum.
But I digress.
Now, the above are what are known as "cutaneous" fungal infections; that is, they affect things on the surface/outside of the body like your skin, hair, and nails. When fungus gets inside you, things get a little more difficult to handle.
Yeast infections. Ladies, you know what I'm talking about, right? If you've never had one, consider yourself blessed. Dudes…before you smirk and get all smug, you're not exempt from yeast infections, either. Yeast can affect your bits and bobs, too. Remember what I said earlier about fungus liking moist, dark, warm places to grow? I'll wait…THERE you go. Yeah. That. Now, yeast (called Candida in the fancy medical speak) is part of the body's natural flora. It's when things get thrown off-balance by whatever (stress, medications, diet, what have you) and the little bastards run wild that you have an infection on your hands.
And don't go thinking yeast infections are confined to your lower half. Uh-uh. Parents. Ever had to deal with thrush in your kid? Adults? Ever had thrush for one reason or another? Congratulations. You've had a yeast infection of your mouth. (Warm, dark, moist, remember? The human mouth is utterly filthy. You don't even WANT to know what lives in there, so brush your teeth [and tongue!] often, kids!) Yeast can also infect your skin and even your blood (called fungemia). HCPs (health care professionals, remember?) call yeast infections (no matter where they might be) "Candidasis." Most often the culprit is Candida albicans, but sometimes other species like to play, too.
When fungal infections get even further into the body, things turn really nasty.
Remember our friend meningitis from the bacterial and viral sections? Guess what? Fungus isn't going to be left out of that party. Fungal meningitis isn't contagious or very common, and generally affects people who have been seriously immuno-compromised, like cancer and AIDS patients. A fungus called Cryptococcus is generally responsible for this kind of meningitis. There are a couple of very nasty subtypes of Cryptococcus (NOT to be confused with Cryptosporidium, which is a whole different type of BAMF I'll talk about in a minute), and both are deadly when they set up housekeeping.
Other fungi get into the lungs (pulmonary system) and wreak havoc. One particular nasty is Aspergillosis. Now, normally aspergillis is fine and dandy when it's outside the body. Breathing the stuff in, however…yeah. Warm, dark, moist…you remember how it works. Most people breathe that crap in every day (as it's just in nature/the air) and are utterly fine. It's the same game – your immune system takes care of it if it's healthy. Your immune system is a BAMF too, and works like a boss when it's on the ball. It's when your immune system is compromised for whatever reason (and there are lots of things that screw with your immune system) that things become a problem.
Those of you allergic to "mold" really mean you have a sensitivity to aspergillis or other airborne fungi. (Hint: the "mold" found on bread you may be sensitive to is a fungi also. You might know it as penicillin.) If your character has an allergy to mold, you can't have them working in a bakery, okay? Because yeast has a lot to do with mold. Baking and brewing yeasts are different from the infectious kind, but they do have a tendency to change/ferment/mold, so keep this in mind if you give your character an allergy to mold.
Mildew is the same. Mildew is a common name for types of mold growth. And mold is what? That's right...fungus - usually Penicillium. (In the plant world, mildew refers to a specific type of fungus called Erysiphales, but that's a whole other thing.)
Now while this post is supposed to be about fungal infections, I'm going to touch briefly on parasitic ones as well, mostly because the two are often confused or combined, mostly because they're related. I just mentioned one above.
Cryptosporidium isn't a fungus. It's a parasite. A protozoa, actually, and it's commonly found in contaminated water. It's ubiquitous and worldwide. I had a nasty bout with it on an archaeological expedition once – it's not pretty. Though generally just unpleasant in people with healthy immune systems, crypto (as it's known) can be lethal to the elderly, infants, and others with suppressed immune systems. If you're going to have your character drink from a water source that could be contaminated, chances are they're going to come down with something. You've heard of "Montezuma's Revenge?" Yeah.
Other parasites responsible for infection are helminths (worms, like tapeworm and roundworm) and ectoparasites (things like mites, ticks, and fleas).
Now I'm only going to touch on these. Parasitism is vast and complex and hugely incestuous when it comes to infection. For example, rats carry a type of flea (as do squirrels and other animals) that carry what's commonly called "plague." This is a vague term for Bubonic plague, AKA "The Black Death," (you know…the thing that wiped out a third of the world's population back in the 1300s) and while the flea (the parasite) is carried by rodentia (what's known in epidemiology as a "vector"), the actual cause of the illness is a bacteria the infected flea carries called Yersinia pestis. Same thing with ticks and Lyme disease. The tick itself is the parasite (or "vector"), but it's the bacteria it carries (Borrelia) that causes the disease.
See what I mean about parasitism being incestuous? It's usually not the parasite itself that causes disease, but the bacteria it carries with it, virus it enables, fungus it promotes, or damage it does while infecting.
Remember what I said about vast and complicated? Yeah. Let's just leave our discussion of parasites as it is, shall we? Just things to keep in mind if you have your character slogging through a field full of chiggers (a type of mite) or a cave full of bats.
This concludes part III of the Infection Sequence of the "Ask Dr. Dina" series. Join us in a couple weeks for the final installment of this sequence, where we'll talk about how the various infections I've talked about are treated.
Questions about medical issues with your writing? Leave them in the comments below and I'll get back to you as soon as I can. (THESE MUST APPLY TO FICTIONAL SITUATIONS ONLY. I AM NOT YOUR DOCTOR, NOR A SUBSTITUTE FOR ONE.)
Monday, July 1, 2013
Series Post: Ask Dr. Dina - Infection Part I: Bacteria
DISCLAIMER: I am not a doctor, nor do I play one on TV. I do not hold a current medical license or certification (I let them lapse because I no longer work in the medical field and don't intend to ever again). What I do have is an extensive medical background in various fields. Everything you read here is the result of either education, training, research and interpretation, or personal experience. The information in this post is not to be taken as a substitute for professional medical advice or examination. Seriously, if you're having an immediate medical problem and you're reading this blog for help, get off the damned computer and call an ambulance!
ADDITIONAL DISCLAIMER – IF YOU ARE SQUEAMISH/EASILY SQUICKED OUT BY GRAPHIC DESCRIPTIONS OF GROSS THINGS, YOU SHOULD NOT READ THIS POST. THIS ONE IS GOING TO GET…EW. YOU HAVE BEEN WARNED.
PROBABLY SHOULDN'T BE EATING ANYTHING, EITHER.
Now we have come to the infection portion of our "Ask Dr. Dina" series. This piece is going to be broken into a few parts because there are many, many different types of infection and I'm not going to write a book on the subject.
These parts will be –
I – Bacterial
II – Viral
III – Fungal
IV - Treatment
As it's the most common type of infection, bacteria get the first crack at this subject.
When most people think "infection," they think of a cut that's red and swollen and full of pus, and they would be correct. Any open wound – from a paper cut to a gunshot – is capable of getting infected. Any opening in the skin (I'll leave it to your imagination…there you go….) is capable of acquiring an infection, especially if those openings are dark, moist, and warm. As the human body tends to run anywhere from 96-99 degrees Fahrenheit on average and most of our holes are where the sun don't shine, this makes for an ideal environment for all sorts of bacteria looking to set up housekeeping.
It's commonly thought something needs to be dirty in order to introduce infection. Technically true, but, a brand new nail from the hardware store is just as likely to introduce bacteria to the wound when it pierces your foot as a rusty one that's been left out in the dirt for years. It might not be the same kind of bacteria, but it's still just as likely to cause infection. This is why it's important to have your tetanus shot updated. Tetanus is caused by a bacteria called Clostridium tetani, and that little bastard is not only everywhere, it likes wounds of any kind, especially punctures. Tetanus not only hurts like a motherfucker, it's fatal 40% of the time. I don't know about you, but 40% is too close to 50% for me. More than one-third but less than half. So basically, over one-third but less than half of the people who get tetanus die.
And this is 2013.
I'll leave you to ponder those odds. Then call your doctor and get your damned tetanus shot updated if you haven't had one in the last ten years.
Moving on.
As bacteria goes, Clostridium is a bitch. There's over 100 species of that asshole, some of which I'm sure you've heard of –
- Botulism. (C. botulinum) Some idiots shove botulism in their faces for the paralytic effect. They call it "Botox." It's fucking botulism, people. FOOD POISONING. Botulism is why you don't give honey to a child under a year old. Botulism is bad shit. I don't care if your forehead sags, and I don't care how nice they've dressed it up; unless you've got a legitimate medical reason do to this (and there are a few, believe it or not), don't put food poisoning UNDER YOUR SKIN. Fuck!
- Gas gangrene. (C. perfringens) You've heard of gas gangrene, yeah? That lovely putrefaction/death of tissues, skin-splitting-from-bloating thing that happens to corpses and soldiers in historical romance novels? Well, this is another lovely aspect of Clostridium. (Gas gangrene is not to be confused with "dry" gangrene, which is caused by insufficient blood supply/ischemia and is often found in diabetics, the elderly, and people with circulatory issues such as frostbite victims.)
And more. Loads, loads more of Clostridium types. But like I said, I'm not writing a book here, let alone one on microbiology.
Still, bacterial infections are the ones responsible for those lovely pus-filled wounds your character might sport. Even the little ones like a stye in the eye. Styes are infections of the sebaceous glands of the eyelid. They hurt like a bitch and there's nothing you can do about them except wait for them to go away. Oh, sure, there's some over-the-counter bullshit ointment you can use, but really these are just mineral oil and white petroleum (aka "Vaseline") that make you feel better but don't actually do anything to hurry things up.
Other bacterial infections you may have heard of –
- Acne. Now, we've all had pimples (zits). If you've never had one, congratulations! While not all acne is caused by an infection, there is a bacteria called Propionibacterium acnes that's widely thought responsible for certain types of it. This type of acne is basically a skin infection caused by bacteria. (No, not chocolate, though things like chocolate can exacerbate [this means "make worse"] the oil production in the pores that in turn gets infected by the bacteria that causes the acne.)
- Staph (Staphylococcus). There are some forty strains of staph, and not all of them are bad. We all have staph living on our skin (S. epidermidis). It's part of our natural flora. But when it gets out of hand for one reason or another (disease, immuno-compromised individuals), it gets ugly and a tiny little nick while shaving leads to a Staph infection (including but not limited to cellulitis). Others like MRSA (Methicillin-resistant Staph. aureus) can kill, because they're big, bad, and think your little antibiotics are for pussies. MRSA is most commonly found in hospitals and is a complete bitch to get rid of once it makes itself at home. Keep this in mind if your character ends up in the hospital. Or prison. Prisons are hell for MRSA.
- Strep throat, impetigo, scarlet and rheumatic fever, and toxic shock syndrome are all caused by a bacterium called Streptococcus pyogenes. If you give your character strep throat, well, now you know how they got it.
- Salmonella. There are over 2500 types of this bad boy, but the one most people think of is Enteritis salmonellosis, usually S. enterica, aka "food poisoning." This is the one comes from tainted food, mostly. Raw eggs, improperly handled raw chicken, stuff left out too long (real mayonnaise made with eggs at picnics and so on) – all can be blamed on Salmonella. As can lovely things like typhoid fever. This is a fun one to torment your character with.
- Escherichia coli. Or, more commonly known as E. coli. I'm sure you've all heard of this one. There are some particularly bad strains of this one, but they all come from the same place – shit. No, I mean it. E. coli is found in the intestinal tract of living organisms, and if something was infected with E. coli, that means there's been some kind of fecal contamination, usually via the oral route. Meaning yes, they ate shit. (And since some strains will kill you quick, it kind of gives a whole new meaning to the phrase, "Eat shit and die," doesn't it?) Now, E. coli is a very nice thing to have when it's where it's supposed to be. E. coli helps you with all kinds of things to do with digestion, but when you try and digest it, there's going to be problems. E. coli doesn't like being eaten and is going to fight you on it. This is why it's a very bad idea to shit in your drinking water, yet people do it all the time.
- How about a fun one? Let's talk sex! What? No? Come on! How about a nice dose of Neisseria gonorrhoeae (gonorrhea)? Treponema pallidium (syphilis)? Fine. Chlamydia tractomatis (chlamydia, but you knew that one, right?). Well, okay then. Sexually transmitted bacterium might not be your thing, but that doesn't mean you can't have a party all by yourself with a touch of Candidasis. Wait, that one is a fungal infection. We'll talk about those later, in part three.
- Urinary tract infection. Usually we have Pseudomonas aeruginosa to thank for these. Pseudomonas is also responsible for most burn infections. Remember last time when we talked about burns? Yeah. They get infected too, and Pseudomonas is usually to blame (sorry, Pseudomonas, you bastard). "Blood poisoning" is the colloquially accepted term for "sepsis (or septicemia)" and again…usually (but not always) Pseudomonas. This guy is a real pain in the ass, because it lives everywhere on everything. I SAID EVERYWHERE! EVEN THERE! This boy is badass. But don't hold that against him. I'd be pissed too if my name meant "fake unit."
- Meningitis. Yeah, you've heard of this one. But did you know there are different types? The bacterial one I'll talk about here is the BAMF. This one is the killer. Bacterial meningitis is fast, highly contagious, and deadly. Remember gonorrhea (N. gonnorhoeae)? Yeah. Meet its big brother, Neisseria meningitides. Remember our old friend Strep? He's good friends with N. meningitides. Between N. meningitides and S. pneumoniae, they account for over 80% of the bacterial meningitis cases in adults.
And there are many, many more.
See what I'm saying here? Infection doesn't have to mean a pus-leaking ingrown toenail or a weepy cat scratch or a dirty bandage over a knife wound. It can be an ear infection, food poisoning, or STD.
Now I don't want you going around thinking all microbial life has it in for you. Some bacteria are great. Wonderful even. Necessary for living. Some help you digest food. Some bacteria kill others that would normally kill you (or parts of you). Others make excellent vaccines that keep you from getting infected with other bad things.
Hell, some infections are even beneficial. Infection means just that – something has been infected with something else.
This concludes Part One of the Infection Sequence of the Ask Dr. Dina series. Join us in a couple weeks for Part Two – Viral.
Questions about medical issues with your writing? Leave them in the comments below and I'll get back to you as soon as I can. (THESE MUST APPLY TO FICTIONAL SITUATIONS ONLY. I AM NOT YOUR DOCTOR, NOR A SUBSTITUTE FOR ONE.)
ADDITIONAL DISCLAIMER – IF YOU ARE SQUEAMISH/EASILY SQUICKED OUT BY GRAPHIC DESCRIPTIONS OF GROSS THINGS, YOU SHOULD NOT READ THIS POST. THIS ONE IS GOING TO GET…EW. YOU HAVE BEEN WARNED.
PROBABLY SHOULDN'T BE EATING ANYTHING, EITHER.
Now we have come to the infection portion of our "Ask Dr. Dina" series. This piece is going to be broken into a few parts because there are many, many different types of infection and I'm not going to write a book on the subject.
These parts will be –
I – Bacterial
II – Viral
III – Fungal
IV - Treatment
As it's the most common type of infection, bacteria get the first crack at this subject.
When most people think "infection," they think of a cut that's red and swollen and full of pus, and they would be correct. Any open wound – from a paper cut to a gunshot – is capable of getting infected. Any opening in the skin (I'll leave it to your imagination…there you go….) is capable of acquiring an infection, especially if those openings are dark, moist, and warm. As the human body tends to run anywhere from 96-99 degrees Fahrenheit on average and most of our holes are where the sun don't shine, this makes for an ideal environment for all sorts of bacteria looking to set up housekeeping.
It's commonly thought something needs to be dirty in order to introduce infection. Technically true, but, a brand new nail from the hardware store is just as likely to introduce bacteria to the wound when it pierces your foot as a rusty one that's been left out in the dirt for years. It might not be the same kind of bacteria, but it's still just as likely to cause infection. This is why it's important to have your tetanus shot updated. Tetanus is caused by a bacteria called Clostridium tetani, and that little bastard is not only everywhere, it likes wounds of any kind, especially punctures. Tetanus not only hurts like a motherfucker, it's fatal 40% of the time. I don't know about you, but 40% is too close to 50% for me. More than one-third but less than half. So basically, over one-third but less than half of the people who get tetanus die.
And this is 2013.
I'll leave you to ponder those odds. Then call your doctor and get your damned tetanus shot updated if you haven't had one in the last ten years.
Moving on.
As bacteria goes, Clostridium is a bitch. There's over 100 species of that asshole, some of which I'm sure you've heard of –
- Botulism. (C. botulinum) Some idiots shove botulism in their faces for the paralytic effect. They call it "Botox." It's fucking botulism, people. FOOD POISONING. Botulism is why you don't give honey to a child under a year old. Botulism is bad shit. I don't care if your forehead sags, and I don't care how nice they've dressed it up; unless you've got a legitimate medical reason do to this (and there are a few, believe it or not), don't put food poisoning UNDER YOUR SKIN. Fuck!
- Gas gangrene. (C. perfringens) You've heard of gas gangrene, yeah? That lovely putrefaction/death of tissues, skin-splitting-from-bloating thing that happens to corpses and soldiers in historical romance novels? Well, this is another lovely aspect of Clostridium. (Gas gangrene is not to be confused with "dry" gangrene, which is caused by insufficient blood supply/ischemia and is often found in diabetics, the elderly, and people with circulatory issues such as frostbite victims.)
And more. Loads, loads more of Clostridium types. But like I said, I'm not writing a book here, let alone one on microbiology.
Still, bacterial infections are the ones responsible for those lovely pus-filled wounds your character might sport. Even the little ones like a stye in the eye. Styes are infections of the sebaceous glands of the eyelid. They hurt like a bitch and there's nothing you can do about them except wait for them to go away. Oh, sure, there's some over-the-counter bullshit ointment you can use, but really these are just mineral oil and white petroleum (aka "Vaseline") that make you feel better but don't actually do anything to hurry things up.
Other bacterial infections you may have heard of –
- Acne. Now, we've all had pimples (zits). If you've never had one, congratulations! While not all acne is caused by an infection, there is a bacteria called Propionibacterium acnes that's widely thought responsible for certain types of it. This type of acne is basically a skin infection caused by bacteria. (No, not chocolate, though things like chocolate can exacerbate [this means "make worse"] the oil production in the pores that in turn gets infected by the bacteria that causes the acne.)
- Staph (Staphylococcus). There are some forty strains of staph, and not all of them are bad. We all have staph living on our skin (S. epidermidis). It's part of our natural flora. But when it gets out of hand for one reason or another (disease, immuno-compromised individuals), it gets ugly and a tiny little nick while shaving leads to a Staph infection (including but not limited to cellulitis). Others like MRSA (Methicillin-resistant Staph. aureus) can kill, because they're big, bad, and think your little antibiotics are for pussies. MRSA is most commonly found in hospitals and is a complete bitch to get rid of once it makes itself at home. Keep this in mind if your character ends up in the hospital. Or prison. Prisons are hell for MRSA.
- Strep throat, impetigo, scarlet and rheumatic fever, and toxic shock syndrome are all caused by a bacterium called Streptococcus pyogenes. If you give your character strep throat, well, now you know how they got it.
- Salmonella. There are over 2500 types of this bad boy, but the one most people think of is Enteritis salmonellosis, usually S. enterica, aka "food poisoning." This is the one comes from tainted food, mostly. Raw eggs, improperly handled raw chicken, stuff left out too long (real mayonnaise made with eggs at picnics and so on) – all can be blamed on Salmonella. As can lovely things like typhoid fever. This is a fun one to torment your character with.
- Escherichia coli. Or, more commonly known as E. coli. I'm sure you've all heard of this one. There are some particularly bad strains of this one, but they all come from the same place – shit. No, I mean it. E. coli is found in the intestinal tract of living organisms, and if something was infected with E. coli, that means there's been some kind of fecal contamination, usually via the oral route. Meaning yes, they ate shit. (And since some strains will kill you quick, it kind of gives a whole new meaning to the phrase, "Eat shit and die," doesn't it?) Now, E. coli is a very nice thing to have when it's where it's supposed to be. E. coli helps you with all kinds of things to do with digestion, but when you try and digest it, there's going to be problems. E. coli doesn't like being eaten and is going to fight you on it. This is why it's a very bad idea to shit in your drinking water, yet people do it all the time.
- How about a fun one? Let's talk sex! What? No? Come on! How about a nice dose of Neisseria gonorrhoeae (gonorrhea)? Treponema pallidium (syphilis)? Fine. Chlamydia tractomatis (chlamydia, but you knew that one, right?). Well, okay then. Sexually transmitted bacterium might not be your thing, but that doesn't mean you can't have a party all by yourself with a touch of Candidasis. Wait, that one is a fungal infection. We'll talk about those later, in part three.
- Urinary tract infection. Usually we have Pseudomonas aeruginosa to thank for these. Pseudomonas is also responsible for most burn infections. Remember last time when we talked about burns? Yeah. They get infected too, and Pseudomonas is usually to blame (sorry, Pseudomonas, you bastard). "Blood poisoning" is the colloquially accepted term for "sepsis (or septicemia)" and again…usually (but not always) Pseudomonas. This guy is a real pain in the ass, because it lives everywhere on everything. I SAID EVERYWHERE! EVEN THERE! This boy is badass. But don't hold that against him. I'd be pissed too if my name meant "fake unit."
- Meningitis. Yeah, you've heard of this one. But did you know there are different types? The bacterial one I'll talk about here is the BAMF. This one is the killer. Bacterial meningitis is fast, highly contagious, and deadly. Remember gonorrhea (N. gonnorhoeae)? Yeah. Meet its big brother, Neisseria meningitides. Remember our old friend Strep? He's good friends with N. meningitides. Between N. meningitides and S. pneumoniae, they account for over 80% of the bacterial meningitis cases in adults.
And there are many, many more.
See what I'm saying here? Infection doesn't have to mean a pus-leaking ingrown toenail or a weepy cat scratch or a dirty bandage over a knife wound. It can be an ear infection, food poisoning, or STD.
Now I don't want you going around thinking all microbial life has it in for you. Some bacteria are great. Wonderful even. Necessary for living. Some help you digest food. Some bacteria kill others that would normally kill you (or parts of you). Others make excellent vaccines that keep you from getting infected with other bad things.
Hell, some infections are even beneficial. Infection means just that – something has been infected with something else.
This concludes Part One of the Infection Sequence of the Ask Dr. Dina series. Join us in a couple weeks for Part Two – Viral.
Questions about medical issues with your writing? Leave them in the comments below and I'll get back to you as soon as I can. (THESE MUST APPLY TO FICTIONAL SITUATIONS ONLY. I AM NOT YOUR DOCTOR, NOR A SUBSTITUTE FOR ONE.)
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