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File: 123096_sep96_decls23_0034.txt
Page: 0034
Total Pages: 52

Subject: DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANCE               

Unit: OTSG        

Parent Organization: HSC         

Box  ID: BX003203

Folder Title: DIAGNOSIS AND TREATMENT OF DISEASES  1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS                

Document Number:          1

Folder Seq  #:         88










                                   STREPTOCOCCAL INFECTIONS                                   D.    Impetigo:
                                                                                                    1.   Signs: pustule which enlarges into thickly
                  Communicability:                                                                       crusted shallow skin ulcers, typically occurring
                                                                                                         on exposed skin areas.
                  A.   Route:                                                            IV.  Duration:
                       1.    Person to person, via respiratory or salivary
                             droplets. Crowded living arrangements enhance
                             transmission.                                                    A.    Pharyngitis:  treated I to 4 days; untreated 3 to 5
                       2.    Food and waterborne outbreaks have occurred.                           days.

                  B.   isolation of patient:    not warranted.                                B.    Scarlet Fever:   rash persists 4 to 5 days; subsequent
                                                                                                    desquamation persists 2 to 4 weeks.
                  C.   Contact Prophylaxis; generally not warranted. In an
                       outbreak of streptococcal disease associated with                      C.    Erysipelas/cellulitis: treated; improvement in 24 to
                       rheumatic fever or glomerulonephritis, culture and                           48 hours: untreated; may proceed to fatality.
                       treatment of culture-positive household contacts
                       (barracks or tent mates) can be considered. Alterna-                   D.    Impetigo: treated; improvement within 2 to 3 days.
              untreated: may persist several weeks.
                       employed to interrupt an outbreak.                               V.    Complications:
                  Incubation: 2 to 4 days for pharyngitis.                                    A.    Immunologic:
            111. Diagnosis: clinical streptococcal disease may present as                           I.- Rheumatic fever.
                       pharyngitis, scarlet fever, erysipelas (superficial                          2.   Acute glomerulonephritis.
                       cellulitis), or pyoderma (impetigo).                                   B.    Infection: septicemia, otitis media, sinusitis,
                  A.   Pharyngitis:                                                                 mastoiditis, meningitis, brain abscess, toxic shock
                       1.    Symptoms: sore throat, headache, fever, malaise.                       syndrome (all uncommon).
                       2.    Signs: pharyngeal redness, edema, and lymphoid             VI.   Treatment:
                             hyperplasia; enlarged reddened tonsils with
                             exudate (in 50t), tender submandibular
                             lymphadenopathy; fever > 101'F (38.30C)                          A.    Pharyngitis:
                       3.    Laboratory:   mild leukocytosis, positive pharyn-                      1.   Benzathine Penicillin G, 1.2 million units IN one
                             geal cultures.                                                              dose: preferred; or
                                                                                                    2.   Penicillin V 250 mg PO TID for 10 days (avoid clue
                  B.   Scarlet Fever:                                                                    to compliance problem); or
                       1.    Usually occurs with pharyngitis, but may be seen                       3.   Erythromycin 250 mg PO QID for 10 days (for
        with streptococcal skin infections.                                         penicillin-allergic patients).
                       2.    Symptoms:   those of primary infected site, plus                 B.    Scarlet fever:
                             fever, rash, and occasionally marked systemic                          1.   Treat primary source of infection (e.g. pharyn-
                             toxicity or a toxic-shock like syndrome.
                       3.    Signs:   diffuse blanching red rash, darker at skin                         gitis, skin) as appropriate.
                             creases, normally sparing face, palms, and soles.                      2.   Supportive care,
                             "Sand-paper" texture of skin is due to sweat gland               C.    Erysipelas/cellulitis:
                             occlusion. Palatal petechiae. Yellowish white
                             coating of tongue followed by beefy red appearance                     I    Penicillinase-resistant penicillin (to cross cover
                             of tongue.                                                                  possible staphylococcal etiology) IV or PO depend-
                                                                                                         ing on severity of infection. May switch to oral
                  C.   Erysipelas:                                                                       agent 1 to 2 days after initiating therapy if
                       1.    Symptoms:   chills, fever, systemic toxicity.                               response is good. Ninimum 10 clay course; or,
                       2.    Signs: red, edematous, sharply demarcated,
                             advancing skin lesion.
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Document 52 f:/Week-36/BX003203/DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS/diagnosis and treatment of diseases of importanc:12179609281524
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Folder Seq # = 88
Subject = DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANC
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 17-DEC-1996