Category: L

What it is:

Listeriosis is a serious infection caused by eating food contaminated with the bacterium Listeria monocytogenes and has recently been recognized as an important public health problem in the United States. 

Symptoms:

A person with listeriosis usually has fever, muscle aches, and sometimes gastrointestinal symptoms such as nausea or diarrhea. If infection spreads to the nervous system, symptoms such as headache, stiff neck, confusion, loss of balance, or convulsions can occur.

Infected pregnant women may experience only a mild, flu-like illness; however, infection during pregnancy can lead to premature delivery, infection of the newborn, or even stillbirth.

Associated foods:

•  Listeria monocytogenes is found in soil and water, so vegetables can become contaminated from the soil or from manure used as fertilizer. 

• Animals can carry the bacterium without appearing ill and can contaminate foods of animal origin such as meats and dairy products.

•  The bacterium has been found in a variety of raw foods, such as uncooked meats and vegetables, as well as in processed foods that become contaminated after processing, such as soft cheeses and cold cuts at the deli counter.

•  Unpasteurized (raw) milk or foods made from unpasteurized milk may contain the bacterium.

•  Listeria is killed by pasteurization, and heating procedures used to prepare ready-to-eat processed meats should be sufficient to kill the bacterium; however, unless good manufacturing practices are followed, contamination can occur after processing.

Prevention:

•  General recommendations:

•  Cook thoroughly raw food from animal sources, such as beef, pork, or poultry.

•  Wash raw vegetables thoroughly before eating.

•  Keep uncooked meats separate from vegetables and from cooked foods and ready-to-eat foods.

•  Avoid raw (unpasteurized) milk or foods made from raw milk.

•  Wash hands, knives, and cutting boards after handling uncooked foods.

•  Recommendations for persons at high risk, such as pregnant women and persons with weakened immune systems, in addition to the recommendations listed above:

•   Avoid soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican-style cheese. (Hard cheesed, processed cheeses, cream cheese, cottage cheese, or yogurt need not be avoided.)

•   Cook until steaming hot left-over foods or ready-to-eat foods, such as hot dogs, before eating.

Although the risk of listeriosis associated with foods from deli counters is relatively low, pregnant women and  immunosupressed persons may choose to avoid these foods or thoroughly reheat cold cuts before eating.

Treatment:

Even with prompt treatment, some infections result in death. This is particularly likely in the elderly and in persons with other serious medical problems. When infection occurs during pregnancy, antibiotics given promptly to the pregnant woman can often prevent infection of the fetus or newborn.  Babies with listeriosis receive the same antibiotics as adults, although a combination of antibiotics is often used until physicians are certain of the diagnosis.

People at risk:

•  Pregnant women – They are about 20 times more likely than other healthy adults to get listeriosis.

•  Newborns – Newborns rather than the pregnant women themselves suffer the serious effects of infection in pregnancy. 

• Persons with weakened immune systems 

• Persons with cancer, diabetes, or kidney disease

•  Persons with AIDS – They are almost 300 times more likely to get listeriosis than people with normal immune systems.

•  Persons who take glucocorticosteroid medications

•  The elderly

Leukemia:  a progressive, malignant disease
of the blood forming organs, marked by distorted proliferation (the reproduction
or multiplication of similar forms, especially cells) and development of
leukocytes (WBC) and their precursors (something that precedes) in the
blood and bone marrow.  It’s most common forms include acute lymphoblastic
(lymphocytic)
leukemia
(ALL), involving abnormal growth of lymphocyte precursors (lymphoblasts);
acute
myeloblastic
(myelogenous) leukemia (AML), involving
rapid accumulation of myeloid precursors (myeloblasts); and acute
monoblastic (monocytic)
leukemia, or Schilling’s
type, involving marked increases in monocyte precursors (monoblasts).

Acute leukemia is most common in children, and ranks 20th as a cause
of cancer related deaths among people of all age groups. Untreated, acute leukemia invariably leads to death, usually the result
of complications that result from leukemic cell infiltration of bone marrow
or vital organs.  With treatment, prognosis varies. (Studies shows)-In
acute lymphoblastic leukemia, treatment induces remissions in 90% of children
(average survival time: 5 years) and in 65% of adults (average survival
time: 1 to 2 years).  Children between ages 2 and 8 have the best
survival rate – about 50% with intensive therapy.  In acute myeloblastic
leukemia, the average survival time is only 1 year after diagnosis, even
with aggressive treatment.  In acute monoblastic leukemia, treatment
induces remissions lasting 2 to 10 months in 40% of children.  Adults
survive only about 1 year after diagnosis, even with treatment.

Causes:  The exact cause of acute leukemia is unknown. 
Risk factors are thought to include some combination of viruses,, genetic
and immunologic factors, and exposure to radiation and certain chemicals.

Symptoms:

Sudden onset of high fever/low grade fever

Abnormal bleeding (example: nosebleeds, gingival bleeding, purpura,
ecchymoses, petechiae)

Bruising (even if it’s a minor trauma)

Prolonged menses (females)

Weakness

Pallor

Dyspnea

Fatigue

malaise

Tachycardia

Palpitations

Abdominal or bone pain.

Headache

Treatment:

Systemic chemotherapy 

Chemotherapy varies with the specific disorder:

Bone marrow transplant is now possible in some cases.

Antibiotic therapy, antifungal, and antiviral drugs may be ordered.

Transfusions 

Chronic Myelogenous Myelocytic) Leukemia
(CML):  Known also as: Granulocytic Leukemia,
produces abnormal overgrowth of granulocyte precursors (myeloblasts, promyelocytes,
metamyelocytes, and myelocytes) in bone marrow, peripheral blood, and body
tissues. 

CML progresses in three distinct phases: 
the insidious chronic phase, with anemia and bleeding abnormalities;
an accelerated phase; and, eventually, the acute phase (blastic
crisis), in with myeloblasts, the most primitive granulocyte precursors,
proliferate rapidly.  This disease is invariably fatal. Studies shows
average survival time is 3 to 4 years after onset of the chronic phase
and 3 to 6 months after onset of the acute phase.

Causes:  Just about 90% of patients
with CML have the Philadelphia (Ph1) chromosome.  Radiation and carcinogenic
chemicals may induces this chromosome abnormality.  Myeloproliferative
diseases also seem to increase the incidence of this disease.  Also
believe to be a cause is that of an unidentified virus.

Symptoms:

Anemia

Fatigue

Weakness

Decreased exercise tolerance

Pallor

Dyspnea

Tachycardia

Headache

Thrombocytopenia  (decrease in number of
platelets in circulating blood – resulting in bleeding and clotting disorders,
such as retinal hemorrhage, ecchymosis, hematuria, melena, bleeding gums,
nosebleeds, and easy bruising).

Hepatosplenomegaly (enlargement of the liver
and spleen), with abdominal discomfort and pain.

Sternal and rib tenderness

Low grade fever

Weight loss

Anorexia

Prolonged infection and ankle edema

Treatment:

Chemotherapy

Radiation therapy

Splenectomy (controversial)

Legionnaires’ Disease  or Legionella
pneumophila :  It derives its name and notoriety from the peculiar,
highly publicized disease that struck 182 people ( 29 of whom died) at
na American Legion convention in Philadelphia in July 1976.

Legionnaires’ disease is an acute bronchopneumonia produced by a gram-negative
bacillus.  This disease may occur epidemically or sporadically, usually
in late summer or early fall.  Its severity ranges from a mild illness,
with or without pneumonitis, to multilobar pneumonia, with a mortality
as high as 15%.  Pontiac syndrome mimics Legionnaires’ disease but
produces few or no respiratory symptoms, no pneumonia, and no fatalities,
but it leaves the patient fatigued for several weeks.

Cause:  Legionnaires’ disease bacterium (LDB), is an aerobic,
gram-negative bacillus that probably is transmitted by an airborne route. 
In may be spread through cooling towers or evaporation condensers in air-conditioning
systems, in soil and excavation sites. (it is not spread from person to
person).

LDB, usually affects more often in men than in women and is most likely
to affect:

Middle aged and elderly persons

Immunocompromised patients

Patients with a chronic underlying disease

Alcoholics

Symptoms:

Onset of the disease may be gradual or sudden

After a 2 to 10 day  incubation period, nonspecific, prodromal
signs and symptoms appear, including:

Diarrhea

Anorexia

Malaise

Diffuse myalgias and generalized weakness

Headache

Recurrent chills

Unremitting fever ( which may develop within 12 to 48 hours with a
temperature that may reach 105 degree F

Cough – initially nonproductive but eventually may produce grayish,
nonpurulent and occasionally blood streaked sputum.

Nausea & vomiting

May become disorientated, confused and may have mild temporary amnesia

Pleuritic chest pain

Tachypnea

Dyspnea

May experience bradycardia

Patient who develop pneumonia may also experience hypoxia

Other complication include hypotension, delirium, acute respiratory
failure, renal failure, and shock (usually fatal).

**  See your doctor promptly if you have the above symptoms.

Treatment:

Antibiotic therapy

Antipyretics

Fluid replacement

May require oxygen therapy

Larynx:  the organ of voice; the air passage
between the lower pharynx and the trachea, containing the vocal cords and
formed by nine cartilages.

Laryngitis:  inflammation of the larynx

Acute laryngitis may occur as an isolated infection or as part of a
generalized bacterial or viral upper respiratory tract infection. 

Cause:  Acute laryngitis results from infection, excessive use
of the voice, inhalation of smoke and or fumes, and aspiration of caustic
chemicals.

Chronic laryngitis results from upper respiratory tract infection such
as, sinusitis, bronchitis, allergy, and nasal polyps. It is also associated
with constant exposure to dust or other irritants, smoking, alcohol abuse,
and mouth breathing.

Symptoms: 

Hoarseness

Pain – especially when swallowing and or speaking

Fever

Dry cough

Malaise

Laryngeal edema

Chronic laryngitis – A persistent cough

Treatment:

Resting the voice would be the primary treatment.

Analgesics and throat lozenges for pain – for viral infection

Antibiotic therapy – for bacterial infection

May require hospitalization – for severe, acute laryngitis

Occasionally, when laryngeal edema results in airway obstruction, a
tracheotomy (incision of an opening into the trachea through the skin and
the muscles of the neck) may be necessary.

In chronic laryngitis, effective treatment must eliminate the underlying
cause.

Suggestion:  Patient should maintain adequate humidification by
using a vaporizer or humidifier during the winter, by avoiding air conditioning
during the summer (because it dehumidifies), by using medicated throat
lozenges, and by not smoking.  Completing the prescribed antibiotic
therapy.  Modification of predisposing habits.