Acute Glomerulonephritis (AGN) Overview

Acute glomerulonephritis (AGN) is active inflammation in the glomeruli. Each kidney is composed of about 1 million microscopic filtering "screens" known as
glomeruli that selectively remove uremic waste products. The inflammatory process usually begins with an infection or injury (e.g., burn, trauma), then the
protective immune system fights off the infection, scar tissue forms, and the process is complete. There are many diseases that cause an active inflammation
within the glomeruli. Some of these diseases are systemic (i.e., other parts of the body are involved at the same time) and some occur solely in the glomeruli.
When there is active inflammation within the kidney, scar tissue may replace normal, functional kidney tissue and cause irreversible renal impairment.

The severity and extent of glomerular damage—focal (confined) or diffuse (widespread)—determines how the disease is manifested. Glomerular damage can
appear as subacute renal failure, progressive chronic renal failure (CRF); or simply a urinary abnormality such as

Causes of Acute Glomerulonephritis (AGN)

In diffuse glomerulonephritis (GN), all of the glomeruli are aggressively attacked, leading to acute renal failure (ARF). Disorders that attack several organs
and cause diffuse GN are referred to as secondary causes. Secondary causes of diffuse GN include the following:

 Cryoglobulinemia
 Goodpasteur’s syndrome (membranous antiglomerular basement membrane disease)
 Lupus nephritis
 Schönlein-Henoch purpura
 Vasculitis (e.g., Wegener's granulomatosis, periarteritis nodosa)

Primary diseases that solely affect the kidneys and cause AGN, include the following:

 Immunoglobulin A nephropathy (IgA nephropathy, Berger’s disease)

 Membranoproliferative nephritis (type of kidney inflammation)
 Postinfectious GN (GN that results after an infection)

Signs & Symptoms of Acute Glomerulonephritis (AGN)

Patients who have secondary causes of AGN often exhibit these symptoms:

 Cough with blood-tinged sputum

 Fever
 Joint or muscle pain
 Rash

Acute Glomerulonephritis (AGN) Diagnosis

Patients with acute glomerulonephritis (AGN) have an active urinary sediment. This means that signs of active kidney inflammation can be detected when the
urine is examined under the microscope. Such signs include red blood cells, white blood cells, proteinuria (blood proteins in the urine), and "casts" of cells
that have leaked through the glomeruli and have reached the tubule, where they develop into cylindrical forms.

Gastroenteritis
Gastroenteritis is a condition that causes irritation and inflammation of the stomach and intestines (the gastrointestinal tract). The most common symptoms
are

 diarrhea, 

 crampy abdominal pain, 

 nausea, and 

 vomiting.

Many people also refer to gastroenteritis as "stomach flu." This can sometimes be confusing because influenza (flu) symptoms include

 headache, 

 muscle aches and pains, and 

 respiratory symptoms, but influenza does not involve the gastrointestinal tract.
The term stomach flu presumes a viral infection, even though there may be other causes of infection.

Viral infections are the most common cause of gastroenteritis but bacteria, parasites, and food-borne illnesses (such as shellfish) can also be the offending
agents. Many people who experience vomiting and diarrhea that develops from these types of infections or irritations think they have "food poisoning," when
they actually may have a food-borne illness.

Dengue hemorrhagic fever

Dengue hemorrhagic fever is a severe, potentially deadly infection spread by certain species of mosquitoes (Aedes aegypti).

Causes
Four different dengue viruses are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person catches a different type
dengue virus after being infected by another one sometime before. Priorimmunity to a different dengue virus type plays an important role in this severe
disease.

Worldwide, more than 100 million cases of dengue fever occur every year. A small number of these develop into dengue hemorrhagic fever. Most infections
in the United States are brought in from other countries. It is possible for a traveler who has returned to the United States to pass the infection to someone
who has not traveled.

Risk factors for dengue hemorrhagic fever include having antibodies to dengue virus from prior infection and being younger than 12, female, or Caucasian.

Symptoms
Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever, but after several days the patient becomes irritable, restless, and sweaty.
These symptoms are followed by a shock -like state.

Bleeding may appear as tiny spots of blood on the skin (petechiae) and larger patches of blood under the skin (ecchymoses). Minor injuries may cause
bleeding.

Shock may cause death. If the patient survives, recovery begins after a one-day crisis period.

Early symptoms include:

 Decreased appetite
 Fever
 Headache
 Joint aches
 Malaise
 Muscle aches
 Vomiting

Acute phase symptoms include:

 Restlessness followed by:

o Ecchymosis
o Generalized rash
o Petechiae
o Worsening of earlier symptoms
 Shock-like state
o Cold, clammy extremities
o Sweatiness (diaphoretic)

Exams and Tests

A physical examination may reveal:

 Enlarged liver (hepatomegaly)
 Low blood pressure
 Rash
 Red eyes
 Red throat
 Swollen glands
 Weak, rapid pulse

Tests may include:

 Arterial blood gases

 Coagulation studies
 Electrolytes
 Hematocrit
 Liver enzymes
 Platelet count
 Serologic studies (demonstrate antibodies to Dengue viruses)
 Serum studies from samples taken during acute illness and convalescence (increase in titer to Dengueantigen)
  Tourniquet test (causes petechiae to form below the tourniquet)
 X-ray of the chest (may demonstrate pleural effusion)

Treatment
Because Dengue hemorrhagic fever is caused by a virus for which there is no known cure or vaccine, the only treatment is to treat the symptoms.

 A transfusion of fresh blood or platelets can correct bleeding problems

 Intravenous (IV) fluids and electrolytes are also used to correct electrolyte imbalances
 Oxygen therapy may be needed to treat abnormally low blood oxygen
 Rehydration with intravenous (IV) fluids is often necessary to treat dehydration
 Supportive care in an intensive care unit/environment

Outlook (Prognosis)
With early and aggressive care, most patients recover from dengue hemorrhagic fever. However, half of untreated patients who go into shock do not survive.

Possible Complications

 Encephalopathy
 Liver damage
 Residual brain damage
 Seizures
 Shock

Otitis media (Latin) is inflammation of the middle ear, or a middle ear infection.

 It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two
categories of ear inflammation that can underlie what is commonly called an earache, the other being otitis externa. Diseases other than ear
infections can also cause ear pain, including cancers of any structure that shares nerve supply with the ear and shingles which can lead toherpes
zoster oticus. Though painful, otitis media is not threatening and usually heals on its own within 2–4 weeks.

Measles
Measles, also known as Rubeola or Morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the
genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses. Symptoms
include fever, cough, runny nose, red eyes and a generalized, maculopapular, erythematous rash.
Measles (sometimes known as English Measles) is spread through respiration (contact with fluids from an infected person's nose and mouth, either directly or
through aerosol transmission), and is highly contagious—90% of people without immunity sharing living space with an infected person will catch it. The
infection has an average incubation period of 14 days (range 6–19 days) and infectivity lasts from 2–4 days prior, until 2–5 days following the onset of the
rash (i.e. 4–9 days infectivity in total).[1] An alternative name for measles in English-speaking countries is rubeola, which is sometimes confused
with rubella (German measles); the diseases are unrelated.
Seizures
A seizure is the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain.

See also:

 Generalized tonic clonic seizure

 Partial (focal) seizure
 Petit mal (absence) seizure
 Epilepsy
 Fever (febrile) convulsions  (seizures in children with high fever

Amoebiasis: An infectious disease caused by a free-living amoebic parasite called Entamoeba histolytica. The organism infects the bowel and
causes gastroenteritis. Infection occurs through ingesting contaminated foodor water. It is more common in countries with poor sanitation.
The incubation period may last from days to weeks before symptoms appear

ULCER

A peptic ulcer, also known as PUD or peptic ulcer disease,[1] is an ulcer (defined as mucosal erosions equal to or greater than 0.5 cm) of an area of
the gastrointestinal tract that is usually acidic and thus extremely painful. As many as 70-90% of ulcers are associated withHelicobacter pylori, a spiral-
shaped bacterium that lives in the acidic environment of the stomach; however, only 40% of those cases go to a doctor. Ulcers can also be caused or
worsened by drugs such as aspirin, Plavix (clopidogrel), ibuprofen, and other NSAIDs.
Contrary to general belief, more peptic ulcers arise in the duodenum (first part of the small intestine, just after the stomach) rather than in thestomach. About
4% of stomach ulcers are caused by a malignant tumor, so multiple biopsies are needed to exclude cancer. Duodenal ulcers are generally benign.

CHOLERA
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse waterydiarrhea and vomiting.
Transmission is primarily through consuming contaminated drinking water or food. The severity of the diarrhea and vomiting can lead to
rapid dehydration and electrolyte imbalance. Primary treatment is with oral rehydration solution and if these are not tolerated, intravenous fluids. Antibiotics
are beneficial in those with severe disease. Worldwide it affects 3-5 million people and causes 100,000-130,000 deaths a year as of 2010. Cholera was one
of the earliest infections to be studied by epidemiological methods.

LEPTOSPIROSIS
Leptospirosis (also known as Weil's disease, Weil's syndrome, canicola fever, canefield fever, nanukayami fever, 7-day fever, Rat Catcher's
Yellows, Fort Bragg fever, and Pretibial fever[1]:290) is a bacterial zoonotic disease caused by spirochaetes of the genusLeptospira that affects humans and
a wide range of animals, including mammals, birds, amphibians, and reptiles. The disease was first described by Adolf Weil in 1886 when he reported an
"acute infectious disease with enlargement of spleen, jaundice and nephritis".Leptospira was first observed in 1907 from a post mortem renal tissue slice.[2] In
1908, Inada and Ito first identified it as the causative organism [3] and in 1916 noted its presence in rats.[4]
Though recognised among the world's most common zoonoses, leptospirosis is a relatively rare bacterial infection in humans. The infection is commonly
transmitted to humans by allowing water that has been contaminated by animal urine to come in contact with unhealed breaks in the skin, the eyes, or with
the mucous membranes. Outside of tropical areas, leptospirosis cases have a relatively distinct seasonality with most of them occurring August–
September/February–March.
MENINGITIS
Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges.[1] The inflammation may be
caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs.[2] Meningitis can be life-threatening because of the
inflammation's proximity to the brain and spinal cord; therefore the condition is classified as a medical emergency.[1][3]
The most common symptoms of meningitis are headache and neck stiffness associated with fever, confusion or altered consciousness, vomiting, and an
inability to tolerate light (photophobia) or loud noises (phonophobia). Sometimes, especially in small children, onlynonspecific symptoms may be present,
such as irritability and drowsiness. If a rash is present, it may indicate a particular cause of meningitis; for instance, meningitis caused by meningococcal
bacteria may be accompanied by a characteristic rash.
A lumbar puncture may be used to diagnose or exclude meningitis. This involves inserting a needle into the spinal canal to extract a sample of cerebrospinal
fluid (CSF), the fluid that envelops the brain and spinal cord. The CSF is then examined in a medical laboratory. [3] The usual treatment for meningitis is the
prompt application of antibiotics and sometimes antiviral drugs. In some situations, corticosteroid drugs can also be used to prevent complications from
overactive inflammation.[3][4] Meningitis can lead to serious long-term consequences such asdeafness, epilepsy, hydrocephalus and cognitive deficits,
especially if not treated quickly.[1][4] Some forms of meningitis (such as those associated with meningococci, Haemophilus influenzae type
B, pneumococci or mumps virus infections) may be prevented byimmunization.

Tonsillitis (also pharyngotonsillitis or tonsillopharyngitis) is an inflammation of the tonsils most commonly caused by viral or bacterial infection. It is a

type of pharyngitis.[1] Symptoms of tonsillitis include sore throat and fever. While no treatment has been found to shorten the duration of viral tonsillitis,
bacterial causes may be treatable with antibiotics.

Laryngitis
Laryngitis is an inflammation of the larynx. It causes hoarse voice or the complete loss of the voice because of irritation to the vocal folds(vocal
cords). Dysphonia is the medical term for a vocal disorder, of which laryngitis is one cause.
Laryngitis is categorized as acute if it lasts less than a few days. Otherwise it is categorized as chronic, and may last over 3 weeks.
Bronchopneumonia
Bronchopneumonia or bronchial pneumonia or "Bronchogenic pneumonia" (not to be confused with lobar pneumonia)[1] is the acute inflammation of the
walls of the bronchioles. It is a type of pneumonia characterised by multiple foci of isolated, acute consolidation, affecting one or more pulmonary lobules.
It is one of two types of bacterial pneumonia as classified by gross anatomic distribution of consolidation (solidification), the other being lobar pneumonia.
Typhoid fever
Typhoid fever, also known as typhoid,[1] is a common worldwide illness, transmitted by the ingestion of food or water contaminated with the feces of an
infected person, which contain the bacterium Salmonella enterica enterica, serovar Typhi.[2][3] The bacteria then perforate through the intestinal wall and
are phagocytosed by macrophages. The organism is a Gram-negative short bacillus that is motile due to its peritrichous flagella. The bacterium grows best at
37 °C/99 °F – human body temperature.
This fever received various names, such as gastric fever, abdominal typhus, infantile remittant fever, slow fever, nervous fever,pythogenic fever, etc.
The name of "typhoid" was given by Louis in 1829, as a derivative from typhus.
The impact of this disease falls sharply with the application of modern sanitation techniques.