Fulminating Health Dictionary

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Fulminating: From 1 Different Sources

(fulminant, fulgurant) adj. describing a condition or symptom that is of very sudden onset, severe, and of short duration.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Yellow Fever

An acute arbovirus (see ARBOVIRUSES) infection caused by a ?avivirus of the togavirus family, transmitted from animals to humans by various species of forest mosquito (jungle/sylvan yellow fever), and from human to human by Aëdes aegypti (urban yellow fever). Mosquito transmission was shown by Walter Reed and his colleagues in 1900. It is ENDEMIC in much of tropical Africa and Central and South America but does not occur in Asia. In the urban cycle, humans constitute the reservoir of infection, and in the jungle/sylvan variety, mammals – especially subhuman primates – are involved in transmission. Historically, yellow fever was enormously important, causing devastating epidemics (see EPIDEMIC); it also carried a high mortality rate in travellers and explorers. Differentiation from other infections associated with JAUNDICE was often impossible.

Clinically, yellow fever is characterised by jaundice, fever, chills, headache, gastrointestinal haemorrhage(s), and ALBUMINURIA. The incubation period is 3–6 (up to 10) days. Differentiation from viral hepatitides, other viral haemorrhagic fevers, severe Plasmodium falciparum malaria, and several other infections is often impossible without sophisticated investigative techniques. Infection carries a high mortality rate. Liver histology (biopsy is contraindicated due to the haemorrhagic diathesis) shows characteristic changes; a fulminating hepatic infection is often present. Acute in?ammation of the kidneys and an in?amed, congested gastric mucosa, often accompanied by haemorrhage, are also demonstrable; myocardial involvement often occurs. Diagnosis is primarily based on virological techniques; serological tests are also of value. Yellow fever should be suspected in any travellers from an endemic area.

Management consists of instituting techniques for acute hepatocellular (liver-cell) failure. The affected individual should be kept in an isolation unit, away from mosquitoes which could transmit the disease to a healthy individual. Formerly, laboratory infections were occasionally acquired from infected blood samples. Prophylactically, a satisfactory attenuated VACCINE (17D) has been available for around 60 years; this is given subcutaneously and provides an individual with excellent protection for ten years; international certi?cates are valid for this length of time. Every traveller to an endemic area should be immunised; this is mandatory for entry to countries where the infection is endemic.... yellow fever

X-linked Lymphoproliferative Syndrome

(XLP syndrome, Duncan’s disease) a hereditary disorder of the immune system caused by a defective *sex-linked gene carried on an *X chromosome. There is uncontrolled proliferation of B-*lymphocytes in response to infection by the Epstein-Barr virus, which can lead to fulminating hepatitis or lymphoma. This condition is due to a defect in a gene, SAP, which encodes a signalling molecule found in the cytoplasm of cells.... x-linked lymphoproliferative syndrome

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