Tropical Lung Disease PDF

Preface

Social, political, and economical upheavals of the modern era have smudged Nature's boundaries that demarcate tropical, subtropical, temperate, and the arctic land masses. With increasing intercontinental migration, rapid and unplanned industrialization, breakdown in sanitation and public health, and persistent human misery, physicians and other health workers in the developed countries encounter previously unfamiliar diseases that once occurred in tropical and subtropical areas. Several of these illnesses manifest in the lungs; whereas, others involve the respiratory organs only in conjunction with other tissue systems of the body. The modern clinician is now forced to recognize, diagnose, and treat tropical lung disease.

The authors of these 22 chapters on various aspects of Lung Disease in the Tropics include national and international authorities specializing in tropical pulmonary medicine. Dr. Shanu Gupta and Dr. D. G. James reinforce the importance of history and physical examination required, perhaps, more in tropical medicine than any other medical specialty. The authors provide a succinct and pragmatic account of the methods pursued in analyzing and assessing patients with tropical pulmonary disease. Dr. Om P. Sharma traces the history of zoonotic illnesses and their impact on human civilization. There are many zoonotic diseases besides HIV syndrome that have appeared or reappeared during the last few decades including Lassa fever, Marburg and Hanta virus infections, Q fever, Brucellosis, Babesiosis, and most recently, severe acute respiratory syndrome (SARS) and chicken flu. Dr. Carlos Luna and his team from Argentina provide a refreshing insight into these unusual pneumonias.

Dr. Chaim Jacob paints a clear picture of the complex immune responses generated by the mammalian immune system in order to protect itself from exceedingly evasive and sophisticated microorganisms and parasites.

Malaria remains a threat. Annually, more than a million people die of the illness. The estimated number of infected individuals varies from 150 to 500 million. Treatment of malaria remains inadequate and inadequately available to those who need it the most. Dr. S. K. Jindal has condensed enormous information of immuno-pathogenesis of malaria into a succinct and easy to understand review. Dr. Fein and his colleagues, on the other hand, delve in the issues pertaining to respiratory failure in malaria. Eosinophilic diseases abound in tropical and subtropical countries. Dr. Vannan Kandi Vijayan from Vallabhbhai Patel Chest Institute, Delhi, gives an authoritative account of the pulmonary eosinophilic syndromes.

Endemic in 70 countries, schistosomiasis affects more than 200 million people in the world. Dr. Eli Schwartz describes two types, early and late, of pulmonary schistosomiasis. Artemether, a new Chinese antimalarial drug, has been shown to be active against the early or juvenile form of the disease; whereas, praziquantel remains the drug of choice for the late or chronic type. Dr. Bruno Gottstein describes diagnosis and pathogenesis of hydatid lung disease. Although chemotherapy is used, removal of the cyst remains the cornerstone of therapy.

Behc¸et's disease was first described by Hulusi Behc¸et, a Turkish ophthalmologist. It is also called Silk Road or Silk Route disease because of its distribution in the area of the old Silk Road between China and the Middle East. Dr. Ahmet Gu¨ l and colleagues have amassed impressive data on this disease. Their review is pragmatic and educational.

Paragonimiasis caused by lung flukes of genus Paragonimus has a wide distribution including most of Asia, Russia, Indonesia, Papua New Guinea, Mexico, Central and South America, and Nigeria. Because of its complex life history, its eradication has been unsuccessful so far. The disease is often confused with tuberculosis and lung cancer. Drs. Fukumi Nakamura- Uchiyama and Yukifumi Nawa discuss this complex topic. Various forms of granulomatous diseases occur and have different forms in the tropics, Drs. Mihailovic-Vucinic and Sharma provide a discussion of how to diagnose these disorders. Dr. Tshibwabwa and colleagues in an overview of imaging services in the developing countries emphasize variations in radiological features of the common conditions seen in tropical and temperate areas of the world. Dr. Avi Livneh updates the recent advances in diagnosing and treating Familial Mediterranean fever (FMF), a fascinating multisystem disease. Dr. Carla Lamb stresses the importance of  bronchoscopy, bronchoalveolar lavage, and transbronchial lung biopsy in diagnosing tropical lung diseases.

Pulmonary leptospirosis used to be a relatively mild illness. Dr. Eduardo Bethlem, however, tells us that the disease has begun to show its ugly face. The disease can cause fatal respiratory failure. He provides an insight into its immuno-pathogenesis and genetic transmission. Dr. Patricio Escalante and Brenda Jones inform that approximately 1.8 million people die of tuberculosis every year with a global fatality rate of about 23%, but this figure doubles in some African countries. The main goal of global tuberculosis control is to reduce this spiraling mortality by prompt and judicious use of directly observed treatment, short course (DOTS), particularly in areas of high prevalence of tuberculosis and HIV infection. As yet, there is no vaccine universally effective against the disease. Dr. George Sarosi points out that the fungal infections of the lung are as prevalent in the tropics as they are in temperate zones. Acute pulmonary disease is a common complication of the sickling disorders, with a frequency of several hundred times than that of the general population. Dr. Cage Johnson charts the clinical course of the acute chest syndrome in children and adults and provides an algorithm to diagnose and treat the illness. Amebiasis has a worldwide distribution and the number of cases seen in some of the large metropolitan county hospitals in this country is impressive. Dr. Alejandro Sanchez and his team emphasize the importance of including pleuro-pulmonary amebiasis in the differential diagnosis of patients with unexplained pleural effusion or consolidation, particularly individuals who either live in or have come from an endemic area.

Pleural inflammation with or without effusion is a common malady in the tropics. Dr. Arunabh Talwar and his colleagues provide a logical algorithm to diagnose common and uncommon illnesses that cause pleural effusion.

This collection of highly selected topics provides a succinct and clear description of those conditions that affect significant numbers of people. I sincerely hope that this effort will assist those who face practical pulmonary and pleural problems related to tropical medicine, whatever their station may be.