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Over one-third of the world's population now has the TB bacterium in their bodies and new infections are occurring at a rate of one per second.Not everyone who is infected develops the disease and asymptomatic latent TB infection is most common. However, one in ten latent infections will progress to active TB disease which, if left untreated, kills more than half of its victims. In 2004, 14.6 million people had active TB and there were 8.9 million new cases and 1.7 million deaths,
mostly in developing countries . A rising number of people in the developed world contract tuberculosis because their immune systems are compromised by immunosuppressive drugs , substance abuse or HIV / AIDS .
السل الرئوي: Tuberculosis classification In the patients where TB becomes an active disease, 75% of these cases affect the lungs, where the disease is called pulmonary TB. Symptoms include a productive, prolonged cough of more than three weeks duration, chest pain and coughing up blood. Systemic symptoms include fever, chills, night sweats , appetite loss , weight loss and paling, and those afflicted are often easily fatigued.
When the infection spreads out of the lungs, extrapulmonary sites include the pleura , central nervous system in meningitis , lymphatic system in scrofula of the neck, genitourinary system in urogenital tuberculosis, and bones and joints in Pott's disease of the spine. An especially serious form is disseminated, or miliary tuberculosis . Extrapulmonary forms are more common in immunosuppressed persons and in young children. Infectious pulmonary TB may co-exist with extrapulmonary TB, which is not contagious.
TB is spread by aerosol droplets expelled by people with the active disease of the lungs when they cough, sneeze, speak, kiss, spit or use the unsterilized eating utensils of the infected person. These infectious droplets are 0.5 to 5 µm in diameter and about 40,000 can be produced by a single sneeze.
People with prolonged, frequent, or intense contact are at highest risk of becoming infected, with an estimated 22% infection rate. A person with untreated, active tuberculosis can infect 10-15 other people per year.
Others at risk include those from areas where TB is common, patients immunocompromised by conditions such as HIV / AIDS , residents and employees of high-risk congregate settings, health care workers who serve high-risk clients, medically under served, low-income populations, high-risk racial or ethnic minority populations, children exposed to adults in high-risk categories, and people who inject illicit drugs.
Symptomsأعراض الملاريا
Symptoms of malaria include fever , shivering , arthralgia (joint pain), vomiting , anemia caused by hemolysis , hemoglobinuria , and convulsions . There may be the feeling of tingling in the skin, particularly with malaria caused by P. falciparum. The classical symptom of malaria is cyclical occurrence of sudden coldness followed by rigor and then fever and sweating lasting four to six hours, occurring every two days in P. falciparum, P. vivax and P. ovale infections, while every three for P. malariae.
For reasons that are poorly understood, but which may be related to high intracranial pressure , children with malaria frequently exhibit abnormal posturing , a sign indicating severe brain damage.
Malaria has been found to cause cognitive impairments, especially in children. It causes widespread anemia during a period of rapid brain development and also direct brain damage. This n****logic damage results from cerebral malaria to which children are more vulnerable.
Severe malaria is almost exclusively caused by P. falciparum infection and usually arises 6-14 days after infection.
Consequences of severe malaria include coma and death if untreated—young children and pregnant women are especially vulnerable. Splenomegaly (enlarged spleen), severe headache , cerebral ischemia , hepatomegaly (enlarged liver), hypoglycemia , and hemoglobinuria with renal failure may occur. Renal failure may cause blackwater fever , where hemoglobin from lysed red blood cells leaks into the urine. Severe malaria can progress extremely rapidly and cause death within hours or days.
In the most severe cases of the disease fatality rates can exceed 20%, even with intensive care and treatment.
In endemic areas, treatment is often less satisfactory and the overall fatality rate for all cases of malaria can be as high as one in ten.
Over the longer term, developmental impairments have been documented in children who have suffered episodes of severe malaria.
Chronic malaria is seen in both P. vivax and P. ovale, but not in P. falciparum. Here, the disease can relapse months or years after exposure, due to the presence of latent parasites in the liver. Describing a case of malaria as cured by observing the disappearance of parasites from the bloodstream can therefore be deceptive. The longest incubation period reported for a P. vivax infection

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