diagnosis of anthrax

Patient usually presents with the following clinical features

Fever acute onset

Edema due to lymphaatic obstruction

Malignant eschar (vesicle ruptures , forms a ulcer and is covered by a scab which is black coloured and is surrounded by erythema ), the eschar is painless and the fluid inside is usually serosanguinous.(blood tinged)

Bleeding manifestaions

Meningitis usually haemorrhagic

Types of manifestation : cutaneous anthrax: which is usually non fatal resolves

                                     intestinal anthrax: due ingestion of the carcasses of the infected animal

                                     pulmonary antharax : due to inalation of the spores

Laboratory diagnosis

Blood culture is very sensitive- colony morphology- Blood agar- non haemolytic greyish dry colonies with serrated edges.

Nutrient agar - Medusa head appearance can be visualized in the edges of the colony with the help of the inverted microscope.

gram stain of the culture -thick gram positive bacilli with bamboo stick appearance

Demonstration of the capsule - polychrome methylene blue staining is done. (thick blue coloured bacilli surrounded by a pale pink coloured amorphous material)

Smear from the in-duration beneath eschar or the fluid from eschar

Smear shows thick gram positive bacilli with bamboo stick appearance

Direct fluroscent antibody testing detection of capsule

ELISA for toxin detection

Typhoid fever

Clinical features

Symptoms
Fever ( usually high grade)
        has a step ladder pattern i.e. temperature keeps on increasing and does not come down.
Vomiting
Abdominal pain

Signs
the patient has a coated tongue 

There is relative bradycardia( meaning high temperature but the heart rate is low)
hepatomegaly
The child usually presents with failure to thrive

Causative agent: Salmonella Typhi, Salmonella Paratyphi A, B, C

Diagnosis

Blood culture is the gold standard

positivity is 80% -90% in 1st week of fever
60%-70% in the 2nd week
<50% in 3rd week
 Bone marrow culture is most sensitive

Widal test Antibody detection( non- specific test)
it is positive by the end of 1st week
Urine culture is positive by the 3rd week of fever

Treatment
Third-generation cephalosporins are the drug of choice
(Tab.cefexime 200 mg twice daily for 7 days )

Complications
Intestinal hemorrhage and perforation
Septicemia
Meningitis

Dengue diagnosis

Diagnosis of Dengue  can made from the following signs and symptoms

Fever
Presence of headache, pain behind the eyes
Body ache, mayalgia
Abdominal pain
Vomiting especially in kids
Bleeding of gums
Presence of petichiae ( these are reddish spots seen in the skin due to low platelet count)

Mode of transmission:
Transmitted by the bite of mosquito Ades aegypti
Lab test
Do a platelet count
Value less than 100000 is suggestive
Do a card test (immunochromatographic test) for NS1 antigen and  IgM and IgG antibodies
To confirm: Some lab have the facility of ELISA for the detection of IgM which is more specific.

Treatment
its mainly symptomatic with IV fluids
platelet transfusion in case of low platelet count (usually when < 20000)