Immunology Overview and Tuberculosis Management

Antibodies

• IgM: The first immunoglobulin produced in response to bacterial and viral infections.
• Activates the complement system.
• IgE: Binds to mast cells and basophils.
• Responsible for allergic and antiparasitic activity.
• Involved in allergic and hypersensitivity reactions.
• Combats parasitic infections.
• IgD: Acts as a B-cell receptor.
• Stimulates the release of IgM.
• Possibly influences B-lymphocyte differentiation, but its role is unclear.

The Spleen

• Acts as a filter.
• Red pulp: Site where old and injured red blood cells (RBCs) are destroyed.
• White pulp: Contains concentrations of lymphocytes.

Effector Helper T Cells

• Activated on recognition of antigens and stimulate the rest of the immune system.

Tuberculosis Management

• Ethambutol (Myambutol): 15-25 mg/kg (1.6 g maximum daily dose).
• May lead to blindness, skin rash, and optic neuritis.
• Use with caution in patients with renal disease or when eye testing is not feasible.
• Monitor visual acuity, colour, and discrimination.

Middle East Respiratory Syndrome (MERS)

• Pneumonia is a common finding.
• MERS patients may or may not develop pneumonia.

COVID-19 - Clinical Manifestation

• Most common symptoms include: fever, chills, sore throat, runny or blocked nose, sneezing, sore eyes, dizziness, new and persistent cough.
• Less common symptoms include: muscle aches, severe fatigue, tight chest, shortness of breath, hoarse voice, numbness or tingling, appetite loss, nausea, vomiting, abdominal pain, diarrhea, loss or change of sense of taste or smell, difficulty sleeping.

COVID-19 - Treatment

• People with severe disease and those needing hospital treatment should receive treatment as soon as possible.
• Severe COVID-19 consequences include death, respiratory failure, sepsis, thromboembolism (blood clots), and multiorgan failure, including injury of the heart, liver, or kidneys.

Guillain-Barré Syndrome (GBS)

• Myelin: Speeds up the conduction of impulses from the cell body to the dendrites.
• Schwann cell: Produces myelin. Schwann cells can be spared, allowing for remyelination.
• GBS: Results from a cell-mediated and humoral immune attack on peripheral nerve myelin proteins, causing inflammatory demyelination.
• Begins with muscle weakness and diminished reflexes of the lower extremities.
• Hyporeflexia and weakness may progress to tetraplegia.
• Paresthesia of the hands and feet and pain.

Nursing Interventions for Guillain-Barré Syndrome (GBS)

• Provide temporary relief of symptoms with sitz baths.
• Wear cotton underwear and avoid douching.
• Promote adequate rest, reduce life stress, and maintain a healthy diet low in refined sugars.
• Abstain from sexual intercourse when infected.
• Consult medical professionals for treatment and inform sexual partners of the infection.

Candidiasis (Yeast Infection)

• Tight undergarments, long-term or repeated use of broad-spectrum antibiotics, low estrogen levels, and oral-genital contact.

Human Papillomavirus

• Infections are self-limiting and often asymptomatic.
• Some infections can cause cervical and anogenital cancers.
• HPV lesions can be found in the skin, cervix, vagina, anus, penis, and oral cavity.
• HPV types 6 and 11 usually cause condylomata (warty growths).
• HPV types 16 and 18 account for 66% of cervical cancer.

Human Papillomavirus (HPV) Prevention

• Abstain from sexual intercourse during treatment.
• Practice appropriate hygiene, including hand hygiene, perineal cleanliness, gentle washing of lesions with mild soap and running water, drying the lesions lightly.
• Use barrier methods during sexual contact.
• Inform sexual partners of acquired STI.
• Wear loose, comfortable clothing, eat a balanced diet, drink adequate fluids, and get adequate rest during outbreaks.

Herpes Simplex Virus (HSV)

• No cure for genital herpes infection.
• Cyclovir (Zovirax) can be used for treatment.

Human Immunodeficiency Virus (HIV)

• Estimated 215,400 Filipinos living with HIV in 2024.
• This number is projected to increase to 401,700 by 2030.
• HIV can cause swollen lymph nodes, weight loss, fever, diarrhea, and cough.

Risk Factors for HIV

• Anal or vaginal sex without a condom.
• Other sexually transmitted infections (STIs), such as syphilis, herpes, chlamydia, gonorrhoea, and bacterial vaginosis.
• Harmful use of alcohol or drugs in the context of sexual behavior.
• Sharing contaminated needles, syringes, and other injecting equipment or drug solutions when injecting drugs.
• Unsafe injections, blood transfusions, or tissue transplantation.
• Medical procedures involving unsterile cutting or piercing, or accidental needle stick injuries, including among health workers.