General Medical Conditions and Additional Health Concerns

1. General Medical Conditions and Additional Health Concerns

3. General information • Like everyone athletes can become ill. • It is important to recognize these conditions early and refer them for the appropriate medical attention. • The majority of these illnesses and conditions will require referral to a physician for care.

4. General information– Viruses • Small organism that can live only in a cell. • Upon entering cell it may immediately trigger a disease or remain dormant. • Can damage host cell by blocking normal function and using metabolism for own reproduction. • Virus ultimately destroys cell. • They can not be treated by antibiotics.

5. General information– Bacteria • Bacteria are single celled micro-organisms. • Disease development: • Bacterial pathogen enters host. • Growth of bacteria & production of toxic substances occurs. • Host attempts to fight infection. • They can be treated by antibiotics.

6. Skin infections – Herpes • Cause of condition • Herpes simplex: viral infection that tends to occur in the same location (mucus membranes). • Type I (cold sore) • Type II (genitals) • Herpes zoster (Shingles) • Appears in specific pattern on body (innervated by specific nerve root). • Re-appearance of chicken pox virus.

8. Cold sores Shingles

9. Signs of condition • Early indication = tingling or hypersensitivity in an infected area 24 hours prior to appearance of lesions. • Local swelling followed by outbreak of vesicles. • Heal in generally 10-14 days. • Care • If an athlete has an outbreak, they should be disqualified from competition due to contagious nature of condition. • Utilize universal precautions when dealing with herpes virus. • Use of antiviral drugs can reduce recurrence and shorten course of outbreak.

10. Skin infections – Verruca Virus & Warts • Varied forms exist: • Verruca plana (flat wart) • Verruca plantaris (plantar wart) • Condyloma acuminatum (venereal wart) • Different types of human papilloma virus have been identified. • Uses epidermal layer of skin to reproduce and grow. • Wart enters through lesion in skin.

11. Flat warts Plantar warts

12. Signs of condition • Small, round, elevated lesion with rough dry surfaces. • Painful if pressure is applied. • May be subject to secondary bacterial infection. • Care • If vulnerable, they should be protected until treated by a physician. • Use of electrocautery, topical salicylic acid, or liquid nitrogen are common means of managing this condition.

13. Skin infections – Bacterial • Impetigo Contagiosa • Caused by streptococci. • Spread through close contact. • Furuncle (Boils) • Infection of hair follicle that results in pustule formation. • Generally the result of a staph infection. • Become large and painful. • Folliculitis • Inflammation of hair follicle around face/neck or in the groin.

14. Impetigo Contagiosa Furuncle (boil) Folliculitis

15. Symptoms of condition • Mild itching and soreness followed by eruption of small vesicles and pustules that rupture and crust. • Exhibits signs of inflammation. • Care • Cleansing and topical antibacterial agents. • Systemic antibiotics. • Pus filled lesions should be drained. • Minimize the chances of the infection to spread to others.

16. Methicillin-Resistant Staphylococcus Aureus (MRSA) • Cause • Strain of bacteria that is resistant to methicillin and other antibiotics. • Often times occurs in patients in hospitals that are already ill, or have open wounds/bed sores/burns. • Can also infect individuals outside of the hospital. • Symptoms • Broad range of symptoms. • Typically redness, tenderness and swelling. • May carry MRSA without having symptoms. • Care • May require much heavier dose of antibiotics. • Some infections can only be treated with intravenous antibiotics (requires several weeks of treatment).

18. Skin infections – Fungal • Cause of condition: Ringworm fungi (tinea) • Cause of most skin, nail and hair fungal infections. • Tinea of the groin (tinea cruris) • Signs and symptoms • Mild to moderate itching and found bilaterally. • Brownish or reddish lesion resembling outline of butterfly in groin.

20. Care • Treat until cured. • Will respond to many of the non-prescription medications. • Medications that mask symptoms should be avoided. • Failure to respond to normal management may suggest a non-fungal problem (such as bacteria) and should be referred to a physician. • May require additional topical medications and oral prescriptions.

21. Athlete’s Foot (tinea pedis) • Cause of condition • Most common form of superficial fungal infection. • Webs of toes may become infected by a combination of yeast and dermatophytes. • Signs of condition • Extreme itching on soles of feet, between & on top of toes. • Appears as dry scaling patch or inflammatory scaling red papules forming larger plaques. • May develop secondary infection from itching and bacteria. • Care • Topical antifungal agents and good foot hygiene.

23. Respiratory conditions – The common cold • Cause of condition • Attributed to filterable virus that produces infection in upper respiratory tract in susceptible individual. • Susceptible individual • Physical debilitation from overwork or lack of sleep. • Chronic inflammation from local infection. • Inflammation of nasal mucosa from allergy or from breathing in foreign substance. • Sensitivity to stress.

24. Sign of condition • Begins w/ scratchy, sore throat, stopped-up nose, watery discharge and sneezing. • Some may experience a fever. • Various aches and pains. • Nasal discharge becomes thick and discolored from inflammation. • Care • Symptomatic treatment (may last 5-10 days). • Non-prescription cold medications. • Eat a balanced diet, consume 64 oz. of water. • Avoid emotional stress and extreme fatigue.

25. Respiratory conditions – Sinusitis • Cause of condition • Stems from upper respiratory infection caused by a variety of bacteria. • Inflammation of nasal sinuses. • Sign of condition • Nasal mucous swell and block sinuses. • Painful pressure occurring from accumulation of mucus. • Skin over sinus may be swollen and painful to the touch. • Headache and malaise; purulent nasal discharge. • Care • If infection is purulent, antibiotics may be warranted. • Nasal vasoconstrictor may be helpful with drainage.

26. Respiratory conditions – Pharyngitis (sore throat) • Cause of condition • Result of postnasal drip • May be virus or streptococcus bacteria • Symptoms of condition • Pain w/ swallowing, fever, inflamed and swollen glands, malaise, weakness and fever (occasionally) • Throat may appear dark red and swollen with mucous membranes coated • Care • Throat culture • Topical gargles and rest • Antibiotic therapy may be prescribed by a physician

27. Respiratory conditions – Tonsillitis • Cause of condition • Acute inflammation & bacterial infection of tonsil epithelium. • Signs & symptoms • Tonsils appear red, swollen, w/ yellow exudates in pits. • Pain w/ swallowing, high fever and chills, headache and neck pain. • Sinusitis, otitis media, tonsillar abscesses may also develop. • Care • Culture to check for streptococcal bacteria and antibiotics for 10 days. • Gargling w/ saline water, liquid diet, and antipyretic medication. • Frequent bouts of tonsillitis may necessitate removal.

29. Respiratory conditions – Influenza • Cause of condition • Caused by a virus & occurs in various forms as an annual epidemic. • Symptoms of condition • Fever (102-103°F), chills, cough, headache, malaise, and inflamed respiratory mucous membrane w/ non-productive cough, watery eyes. • General aches and pains, headache becomes worse. • Weakness, sweating, fatigue may persist for many days. • Care • Bed rest and supportive care. • Steam inhalation, cough medicines, and gargles. • Flu prevention – avoid contact with someone that has it.

30. Respiratory conditions – Asthma • Cause of condition • Brought on by exercise w/ exact cause unknown • Loss of heat and water (airway reaction), eating certain foods, sinusitis may also trigger • Sign of condition • Airway narrowing due to spasm and excess mucus production • Tight chest, breathlessness, coughing, wheezing, nausea, hypertension, fatigue, headache, and redness of skin

32. Care • Regular exercise, appropriate warm-up and cool down, w/ intensity graduated. • Inhaled bronchodilators may be useful. • Exercise in warm, humid environment. • Coaches should be sure to remind athletes to have inhaler with them at all times.

33. Gastrointestinal disorders: Vomiting • Cause of condition • Result of some irritation, most often in the stomach. • Stimulates vomiting center of the brain, causing a series of forceful diaphragm and abdominal contractions to compress stomach. • Care • Antinausea medications should be administered. • Fluids to prevent dehydration (by mouth or intravenously depending on the situation).

34. Gastrointestinal disorders: Diarrhea • Cause of condition • Acute or chronic. • Caused by a problem in diet, inflammation of the intestinal lining, GI infection, ingestion of certain drugs and psychogenic factors. • Signs of condition • Abnormal, loose stool or passage of fluid, unformed stool. • Abdominal cramps, nausea, vomiting and frequent elimination of stools . • Extreme weakness caused by dehydration.

35. Care • Determine cause (irritant, infection, or emotional upset). • ATC can treat less severe cases by omitting certain foods from athlete’s diet. • Utilizing over the counter medications. • Have athlete consume bland food that does not irritate system. • The BRAT diet (bananas, rice, apples and toast) has also been recommended. • Continue to hydrate.

36. Diabetes • Diabetes- the inability of the body to appropriately metabolize carbohydrates • Moderate exercise that is sustained can decrease blood glucose, while high-intensity bouts of exercise can increase blood glucose • Type 1- Juvenile- Onset; insulin dependent. Requires an external source of insulin to control blood glucose levels • Type 2- Adult- Onset; Involves the body becoming resistant to the insulin produced by the pancreas

37. Diabetes • Hyperglycemia- exceeding high levels of blood glucose • Symptoms develop slowly • Fruity breath • Extreme thirst • Frequent urination • Nausea/ Vomiting • Loss of consciousness • Hypoglycemia- Extremely low levels of blood glucose • Symptoms develops quickly • Unusual behavior (aggression or confusion) • Profuse perspiration • Loss of motor coordination • Extreme hunger *Immediately give athlete food or beverage containing natural sugar (fruit juice or crackers)