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The symptoms of measles rash do not appear immediately and it takes 1-2 weeks for showing the symptoms. First stage : There will not be any symptoms on the body because it is the period when the virus incubates in your body. Second stage : Measles rash begins to appear along with moderate fever, cough and runny nose. Third stage : The symptoms are severe and there will be increased rash with red raised spots. Final stage : The measles rash begins to decline slowly from the face till your feet and it is on this stage the person spreads the rash to others. If your child has not given vaccination for measles, you can take the injection once your child got exposed to measles virus. Meningococcal meningitis is bacterial meningitis that invaded the meninges or the thin layer covering the brain and the spinal cord. The case of meningococcal meningitis is common during the winter and early spring and localized outbreak is common. The rash is the result occurs after a spot similar to the appearance of bruise are formed beneath the skin surface. The onset of rash is usually of little numbers only then rapidly increased and spread in the body over a period of an hour.
Meningitis rash is rapid in onset while the development itself is not a disease but a symptom and distinguishing mark of meningococcal meningitis. Nuchal rigidity or the inability to bend the neck in a forward manner often follows the episode of severe headache. High fever suddenly occurs in most patients and this symptom is among the triad of symptom in meningitis.
Skin rash similar to pinpricks mark usually develop in meningitis that is due to a meningococcal bacterial infection.
Children and infant inflicted with meningitis on the other hand have no classic signs and symptoms that adult patients experience. It is important to recognize the classic signs and symptoms of meningitis associated with rash.
Meningitis from any form of the causative agent is potentially fatal and is regarded as a medical emergency.
Empiric treatment of antibiotics with the ability to penetrate the CNS effectively is given immediately and dosage is usually based on the age of the patient. Normal bowel frequency ranges from three times a day to three times a week in the normal population.
Worldwide, acute diarrhea constitutes a major cause of morbidity and mortality, especially among the very young, very old, and infirm. Diarrhea is more prevalent among adults who are exposed to children and non-toilet-trained infants, particularly in a daycare setting. Approximately 8-9 L of fluid enters the intestines daily – 1-2 L represents food and liquid intake, and the rest is from endogenous sources such as salivary, gastric, pancreatic, biliary, and intestinal secretions. Acute watery diarrhea is most commonly seen with traveler's diarrhea caused by enterotoxigenic E. Exudative diarrhea results from extensive injury of the small bowel or colon mucosa as a result of inflammation or ulceration, leading to a loss of mucus, serum proteins, and blood into the bowel lumen. Noninfectious causes of diarrhea include: inflammatory bowel disease, irritable bowel syndrome, ischemic bowel disease, partial small bowel obstruction, pelvic abscess in the rectosigmoid area, fecal impaction, carcinoid syndrome, food allergies, the ingestion of poorly absorbable sugars such as lactulose, and acute alcohol ingestion. Patients ingesting toxins or those with toxigenic infection typically have nausea and vomiting as prominent symptoms, along with watery diarrhea but rarely have a high fever. Infection with invasive bacteria such as Campylobacter, Salmonella, and Shigella spp., and organisms that produce cytotoxins, such as C. Hemolytic-uremic syndrome and thrombotic thrombocytopenic purpura can occur in infections with enterohemorrhagic E.
Epidemiologic risk factors should be investigated for certain diarrheal diseases and their spread. Conducting a careful interview can provide valuable clues that will aid in diagnosing and choosing the most appropriate and cost- effective investigation. The presence of blood is a useful clue, suggesting infection by invasive organisms, inflammation, ischemia, or neoplasm.
A medical evaluation of acute diarrhea is not warranted in the previously healthy patient if symptoms are mild, moderate, spontaneously improve within 48 hours, and are not accompanied by fever, chills, severe abdominal pain, or blood in the stool. The physical examination in acute diarrhea is helpful in determining the severity of disease and hydration status. The history and physical examination can help lead to a diagnosis but, for treatment of some organisms, a specific diagnosis is required, which will lead to more specific therapy and prevention of unneeded interventions.
Stool evaluation for fecal leukocytes (or lactoferrin, a byproduct of white blood cells) is a useful initial test because it may support a diagnosis of inflammatory diarrhea.
Indications for stool culture are bloody diarrhea, a toxic-appearing patient (fever, severe abdominal pain), possible epidemic, history of traveler's diarrhea, immunosuppression, or persistent diarrhea. Stool testing for ova and parasites should be done if the patient is at risk for parasitic infection. When organisms are not identified on stool cultures for ova and parasites, a sigmoidoscopy should be performed and biopsies obtained. The principal components of the treatment of acute diarrhea are fluid and electrolyte replacement, dietary modifications, and drug therapy. In most cases of acute diarrhea, fluid and electrolyte replacement are the most important forms of therapy.
Bismuth subsalicylate, somewhat less effective than loperamide, is effective in relieving symptoms of diarrhea, nausea, and abdominal pain in patients with traveler's diarrhea.
Because most patients have mild, self-limited disease caused by viruses or noninvasive bacteria, routine empirical treatment is not warranted.
Diarrhea is one of the most common illnesses in all age groups and is second only to the common cold as a cause of lost days of work or school. Acute diarrhea is a common problem worldwide, with high morbidity and mortality in high-risk groups, such as the very young, older adults, and immunocompromised individuals. Infectious agents are responsible for most cases of acute diarrhea, and may act via numerous mechanisms.
Prevention of dehydration is the most important therapeutic intervention for the management of individuals with acute diarrhea. The use of nonspecific antidiarrheals, especially loperamide, is safe for most cases of acute diarrhea.
It would cause runny nose and rashes all through the skin apart from producing other symptoms.
Some of the signs of measles are fever, sore throat, dry cough, repeated rash marked by scaly blotches and inflammation of eyes.
People who travel frequently and with vitamin A deficiency have increased chance for getting this rash. Meningococcal meningitis is basically a form of meningitis that is caused by a bacterium known as Neisseria meningitidis.
This disease belongs to meningococcal disease that is caused by the most dangerous and hostile bacteria that can be found at the back of the throat. It has been found predominant to people belonging to the African American race and the mortality rate is especially high in developing countries although mortality is relatively high even in some parts of the world including those in the developed countries. The rash can be located in the lower extremities, torso, conjunctiva, mucous membrane and seldom on the palm of the hands.
The rash in effect is reddish to purplish in color with a measurement of less than 3mm and has an irregular outline or pattern.

The formation of the rash is the result of a leak in the capillaries or tiny blood vessels after the toxins from the meningococcal bacteria that has multiplied and invaded the bloodstream are released and damaged the tiny blood vessels.
The rash in meningitis may also appear like freckles and is also harder to recognize in dark skinned individuals. The rash that may develop does not necessarily mean it is some form of meningitis and needs immediate medical attention.
The type of headache is usually incomparable to any other type of headache and the onset is acute. The rash may be observed in torso or in the lower extremities and is usually in the fewest number during the initial onset.
Meningitis mimics the signs and symptoms of flu that it is necessary to determine the difference with meningitis.
Medical confinement in the hospital is necessary to properly monitor the patient while prompt treatment is being applied.
Penicillin is the drug of choice for meningococcal meningitis after it has been established. The symptom varies with the extent and intensity, how fast it grows on the body and how far is resistant to antibiotics. Even a normal course of penicillin is enough to control the growth of this bacterial infection, but many people are taking over dose of antibiotics and become resistant to certain antibiotics. Whenever you have some cuts or wounds on the skin, wash it with soapy water and keep them clean and dry. Increased stooling, with stool consistency less solid than normal, constitutes a satisfactory, if somewhat imprecise, definition of diarrhea. It is also more prevalent in travelers to tropical regions, homosexual males, persons with underlying immunosuppression, and those living in nonhygienic environments who are exposed to contaminated water or foods. Most of the fluid, about 6-7 L, is absorbed in the small intestine, and only about 1-2 L is presented to the colon. Risk factors for this type of transmission include improper disposal of feces, lack of proper hand washing following defecation, and contact with feces before handling food. Increased fecal water and electrolyte excretion results from impaired water and electrolyte absorption by the inflamed intestine rather than from secretion of water and electrolytes into the exudates. Diarrhea is one of the most frequent adverse effects of prescription medications; it is important to note that drug-related diarrhea usually occurs after a new drug is initiated or the dosage increased. Diarrhea caused by small intestine disease is typically high volume, watery, and often associated with malabsorption. Important clinical features include: abrupt versus gradual onset of symptoms, symptom duration, including bowel movement frequency, stool quantities, dysentery with fever, tenesmus, hematochezia or pus in the stool, signs of volume depletion (including thirst, tachycardia,and orthostasis), decreased urine output, skin turgor, and lethargy or confusion.
Vomiting that begins within 6 hours of ingesting a food should suggest food poisoning caused by preformed toxin from bacteria such as S.
These risk factors include: recent travel to an underdeveloped area, daycare center exposure, consumption of raw meat, eggs, shellfish, and unpasteurized milk products, contact with reptiles or pets with diarrhea, a history of other ill people in a shared dormitory facility, recent antibiotic use, and a history of HIV or medically induced immunosuppression. Acute diarrheas are usually infectious in origin and, for the most part, resolve with or without intervention before a diagnosis is made. Large-volume diarrhea suggests small bowel or proximal colonic disease, whereas small frequent stools associated with urgency suggest left colon or rectal disease.
On the other hand, evaluation is indicated if symptoms are severe or prolonged, the patient appears toxic, there is evidence of colitis (occult or gross blood in the stools, severe abdominal pain or tenderness, and fever), or empirical therapy has failed. Fecal testing should be performed in patients with a history of diarrhea longer than 1 day who have the following symptoms: fever, bloody stools, systemic illness, recent or remote antibiotic treatment, hospital admission, or signs of dehydration as described earlier. If the test is negative, stool culture may not be necessary, but culture is indicated if the test is positive. Multiple stool samples should be collected at different times because shedding of parasites may be intermittent. Mucosal biopsy is helpful in differentiating infectious colitis from inflammatory bowel disease.
All recommendations agree with the guidelines on acute infectious diarrhea in adults published by the American College of Gastroenterology.
If patients are otherwise healthy and are not dehydrated, adequate oral intake can be achieved with soft drinks, fruit juice, broth, soup, and salted crackers. The most effective agents are the opioid derivatives-loperamide, diphenoxylate-atropine, and tincture of opium. Bismuth subsalicylate is contraindicated in HIV-infected patients because it may cause bismuth encephalopathy. Empirical treatment is indicated for those patients with suspected invasive bacterial infection, traveler's diarrhea, or immunosuppression. Diagnostic studies are warranted for patients with fever or bloody diarrhea, or if the affected individual is immunocompromised. Caution in use of these agents is urged when there is fever, chills, or bloody diarrhea, or when Clostridium difficile is suspected (diarrhea occurring after antibiotic use). Antibiotics may also be used for early Campylobacter infection and for suspected or confirmed cases of C.
Hospitalizations involving gastroenteritis in the United States, 1985: the special burden of disease among the elderly. Depending on the biotypes of the above mentioned bacteria the severity of the disease varies. Actually infection develops not all of a sudden but in a series of sequence in 2-3 weeks of infection.
It begins to appear on the face which follows the ears and arms, trunk, thighs and legs and lastly the feet.
The infected droplets from the cough fall on the surface or clothes which then spread to other person if he touches the cloth and rubs his nose or eyes. In severe case, measles rash will lead to pneumonia (virus enters your lungs), encephalitis (it enters your brain) and can also cause throat and ear infection.
Pregnant women can take a shot of immune serum globulin (antibodies) for preventing measles virus. The causative bacteria make this type of meningitis different from others that are caused by the other causative agent. The other form of the disease that is distinguished by the formation of the rash is the meningococcal septicemia which is more dangerous and deadlier than meningococcal meningitis. It can affect almost all people of any age level although it is predominant to individuals aged 3 years to adolescence and rarely occurs in individuals with age of 50 years and above. The onset of rash is usually rapid with redness that does not vanish when pressed with a finger or when used with a glass tumbler.
Close monitoring of rash development is essential and individuals with dark skin tone can be checked for rash in the areas like the conjunctiva, soles of the feet or in the palm of the hands.
The rash is among the symptoms of meningococcal meningitis and the onset of symptoms of the latter is what account for an emergency situation. This is true in exposure to closed populations and communities without the proper protection or protective bactericidal immunization. Suspicion of the disease needs an immediate management of wide spectrum antibiotics to prevent poor outcomes while confirmatory tests are being carried out prior to prescribe treatment. The infection is possible when you have small cut or wound in the foot or other body parts. Do not share towels and soaps with others since you can get infected easily by sharing them. Acute diarrhea is defined as three or more stools per day of decreased form from the normal, lasting for less than 14 days. Other risk factors include improper food hygiene, inadequate food refrigeration, food exposure to flies, and consumption of contaminated water.

Yersinia infection and other enteric bacterial infections may be accompanied by Reiter's syndrome (arthritis, urethritis, and conjunctivitis), thyroiditis, pericarditis, or glomerulonephritis.
In cases of homosexual males, in addition to immunosuppression, there are two other disease transmission routes that lead to an increased susceptibility to infectious agents that cause diarrhea.
All current and recent medications should be reviewed, specifically new medications, antibiotics, antacids, and the possibility of alcohol abuse. Vital signs (including temperature and orthostatic evaluation of pulse and blood pressure) and signs of volume depletion (including dry mucous membranes, decreased skin turgor, and confusion) should be carefully evaluated.
However, clinicians should remember that inflammatory diarrhea with a noninfectious cause, such as inflammatory bowel disease, ischemic or radiation-induced colitis, and diverticulitis, can be positive for stool leukocytes. Multiple stool cultures are usually not necessary because bacteria usually shed continuously. Imaging studies may be required in patients with severe disease in order to rule out intestinal perforation, ileus or evidence of colitis. In those with excessive fluid losses and dehydration, more aggressive measures such as IV fluids or oral rehydration therapy with isotonic electrolyte solutions containing glucose or starch should be instituted.
Patients should be encouraged to take frequent feedings of fruit drinks, tea, flat carbonated beverages, and soft, easily digested foods such as bananas, applesauce, rice, potatoes, noodles, crackers, toast, and soup.
These agents inhibit intestinal peristalsis, facilitating intestinal absorption, and have antisecretory properties. Since this disease is infectious it can spread by respiratory droplets or by contact with the infected person.
The incidence of meningococcal meningitis is more predominant in male gender than in the female gender. It is important to recognize these symptoms that may be associated with the rash development to prompt one to seek medical attention and intervention.
These bacteria are commonly found at the back of the throat and can also be found in the urinary tract and anal canal. The bacteria that are transmitted can enter the body and the bloodstream and replicate rapidly subsequently the disease. The proper management is usually applied after suspicion of meningitis is confirmed and the rest of management is also directed towards relief of symptoms aside from the cure of the disease itself. Swelling, red scaly patches on the skin and redness are some of the signs of staph infection. Although many organisms simply impair the normal absorptive processes in the small intestine and colon, others organisms, such as Vibrio cholerae, secrete a toxin that causes the small intestinal cells to secrete, rather than absorb, fluid and electrolytes.
Multiple host factors that determine the level of illness once exposure to infectious agents has occurred include: age, personal hygiene, gastric acidity and other barriers, intestinal motility, enteric microflora, immunity, and intestinal receptors. Diarrhea caused by colonic involvement is more often associated with frequent small-volume stools, the presence of blood, and a sensation of urgency. Yersinia organisms often infect the terminal ileum and cecum and manifest with right lower quadrant pain and tenderness suggesting acute appendicitis. Enteric fever, caused by Salmonella typhi or Salmonella paratyphi, is a severe systemic illness manifested initially by prolonged high fevers, prostration, confusion, and respiratory symptoms, followed by abdominal tenderness, diarrhea, and rash. These include an increased rate of fecal-oral transmission of all infectious agents spread by this route, including Shigella, Salmonella, Campylobacter, and intestinal protozoa and anal intercourse.
Nutritional supplements should also be reviewed, including the intake of sugar-free foods (containing nonabsorbable carbohydrates), fat substitutes, milk products, shellfish, and heavy intake of fruits, fruit juices, or caffeine.
A careful abdominal examination, to evaluate for tenderness and distention, and a stool examination to evaluate for grossly bloody stools are warranted.
Further investigations will depend on the results of sigmoidoscopy, severity of diarrhea, immune status of the host, and presence of systemic toxicity.
Oral rehydration therapy is less expensive, often just as effective, and more practical than intravenous fluids. Dairy products should be avoided, because transient lactase deficiency can be caused by enteric, viral, and bacterial infections. Loperamide may reduce the duration of diarrhea in those with traveler's diarrhea and bacillary dysentery. Empirical antibiotic treatment is also appropriate specifically for early Campylobacter infections and C. Reported fatality with meningococcal meningitis is high although there are some who survived the disease without a long-term after effects and there are those who recovered but are left with disabilities that affected and diminished the quality of their lives.
The rash alone is not the basis for immediate medical intervention but the underlying condition that caused its development. Food and waterborne outbreaks involving a relatively small subset of population and recurrent bouts of illness in others comprise most cases.
Bacillus cereus, Clostridium perfringens, Staphylococcus aureus, Salmonella spp., and others cause food poisoning.
Anal intercourse can lead to a direct rectal inoculation, resulting in proctitis associated with rectal pain, tenesmus, and passage of small-volume, bloody, mucous stools. A general algorithm for the evaluation and management of acute diarrhea is shown in Figure 11. A number of oral rehydration solutions are available, including Pedialyte, Rehydralyte, Ricelyte (Infalyte), Resol, the World Health Organization formula, and the newer reduced osmolarity formula for children. Caffeinated beverages and alcohol, which can enhance intestinal motility and secretions, should be avoided.
These agents should be avoided in patients with fever, bloody diarrhea, and possible inflammatory diarrhea because they may be associated with prolonged fever in patients with shigellosis, toxic megacolon in patients with C. Most patients with acute diarrhea have a mild and self-limited illness; most treat their illness at home and usually get better without medical intervention. Symptoms of respiratory diphtheria include fever, difficulty in breathing and swallowing and further spread of the disease can cause heart and neurological problems such as paralysis. The history should include place of residence, drinking water (treated city water or well water), rural conditions, consumption of raw milk, consumption of raw meat or fish, and exposure to farm animals that may spread Salmonella or Brucella organisms. Empirical treatment for Giardia can be prescribed for those with a 2-week or longer history of diarrhea.
After the diagnosis of the infected patient, proper treatment should be taken including diphtheria antitoxin which reduces the progression of the disease and later antibiotics like penicillin and erythromycin should be applied to eradicate it completely. Patients therefore often present with watery diarrhea, followed within hours or days by bloody diarrhea. When the incubation period is longer than 14 hours and vomiting is also a significant symptom, accompanied by diarrhea, viral agents should be considered. Sexual history is important, because specific organisms can cause diarrhea in homosexual men and HIV-infected patients. Diarrhea and related complications can cause severe illness, especially in high-risk groups, such as patients with severe comorbid conditions, underlying immunosuppression, and advanced age. Vaccination and immunization of infants at the age of 2,4 ,6 months is the finest way to prevent this disease. Bacteria that produce inflammation from cytotoxins include Clostridium difficile and hemorrhagic E.
Parasites that do not invade the intestinal mucosa, such as Giardia lamblia and Cryptosporidium, usually cause only mild abdominal discomfort.
Hand washing is important for prevention; soap and water is more effective than alcohol-based hand sanitizers because alcohol-based sanitizers may not kill viruses.
In patients with bloody diarrhea or hemolytic-uremic syndrome, the stool should be evaluated for E.

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