By Al Gondi
Last week, we discussed upper respiratory tract infections in part one of the infectious diseases in sport. This time, we will discuss skin and water borne infections in sport.
Skin infections are common phenomenon in sports. Their importance has recently been reviewed. The team physician has to be aware of common fungal, bacterial, viral infections and parasitic organisms that can cause skin infections. In particular, the team physician must be aware of infections that are less common but can be transmitted in contact sports such as wrestling and rugby. In most cases once diagnosed, skin infections can be treated by topical application of anti-bacterial agents, and the athlete can continue full activity without a detriment effect on exercise performance.
However, in the case of contagious skin infections the contact to other athletes should be restricted until the infective period is over.
Although not classified as a skin infection, tetanus has to be considered in athletes who may sustain injuries with open wounds. Infection with the tetanus organism can result in the germination of the bacteria and subsequent to the production of the toxin.
In four to 21 days, tetanus can present as lock jaw, inability to swallow, and twitching of the face muscles. Death can result from respiratory failure. Diagnosis is by clinical observation and identifying the bacteria in the laboratory.
Treatment requires hospital admission, and intensive care support and administration of the drugs to neutralise the toxin.
In water borne diseases, the most common infections are the ones that attach themselves to the bladder and the athlete will pass blood with the urine.
This happens more in Africa and it involves the athletes that participate in water where the organisms are prevalent.
Human infection occurs on entry to the shallow fresh water that contains the organism’s larvae, which is commonly known as bilharzia. It causes itching in the skin (swimmers itch), acute fever, and a chronic stage where there is blood in the urine and the stool. The diagnosis is made by examination of the urine and stool.
The other common site is the ears and is more known as the swimmers ear. This inflammation in the ears occur in athletes participating in water sports. The inflammation can be caused by chemical irritation, allergies, or infections.
The infection can either be bacterial or fungal. Water that enters the ear removes the normal protection substances in the ear. The athlete will complain of ear fullness, ear discomfort, and hearing loss. Pain becomes persistent and if not treated promptly there will be discharge of pus.
The athlete should abstain from participation in sport for about one week.
