The incubation period for the bacteria generally lasts from three-ten days. As the disease progresses. almost half the patients experience migratory polyarthralgias. Mechanism
Although the specific form of pathogenesis is still a subject of ongoing research, the bacteria has been observed to result in morphological symptoms that are atypical of bacterial infection. Autopsy of the victims vividly exhibit erythrophagocytosis, hepatosplenomegaly, interstitial pneumonia, and lymph node sinus hyperplasia. In addition, Myocarditis and Endocarditis have also been demonstrated in such patients. Synovial and serosal surfaces may be more suited for the growth of the bacteria within the body. Furthermore, leukocytoclastic vasculitis has been observed in the skin lesions. Diagnosis
The microaerophilic conditions needed for the bacteria to grow, makes its detection incredibly difficult. Trypticase soy agar or broth enriched with 20% blood, serum, or ascitic fluid is necessary for the optimal growth of the bacteria under laboratory conditions. The organism may take up to seven days to grow and the colonies generally have a circular, grayish and shiny appearance on agar. Once the microbe has grown, primary identification can be carried out via biochemical and carbohydrate fermentation analysis. Biochemical tests such as oxidase, catalase, indole, and nitrate can be used to detect the bacteria. However, S. moniliformis can be biochemically differentiated from similar bacteria by their negative production of indole, catalase, and oxidase, while reduction of nitrate to nitrite. PCR assay specific for Streptobacillus moniliformis can also be used to detect the bacteria in a patient sample with high accuracy.
Dyssomnias are a broad classification of sleeping disorders involving difficulty getting to sleep, remaining asleep, or of excessive sleepiness. Dyssomnias are primary disorders of initiating or maintaining sleep or of excessive sleepiness and are characterized by a disturbance in the amount, quality, or timing of sleep. Patients may complain of difficulty getting to sleep or staying asleep, intermittent wakefulness during the night, early morning awakening, or combinations of any of these. Transient episodes are usually of little significance. Stress, caffeine, physical discomfort, daytime napping, and early bedtimes are common factors. Types
There are over 31 recognized kinds of dyssomnias. The major three groups, along with the group types, include:: 15 Intrinsic sleep disorders: 15 
idiopathic hypersomnia,
narcolepsy,
periodic limb movement disorder,
restless legs syndrome,
obstructive sleep apnea,
central sleep apnea syndrome,
sleep state misperception,
psychophysiologic insomnia,
recurrent hypersomnia,
post-traumatic hypersomnia,
central alveolar hypoventilation syndrome,
Extrinsic sleep disorders – 13 disorders recognized, including: 16 alcohol-dependent sleep disorder,
food allergy insomnia,
inadequate sleep routine. Circadian rhythm sleep disorders, both intrinsic and extrinsic – 6 disorders recognized, including: 16 advanced sleep phase syndrome,
delayed sleep phase syndrome,
jetlag,
shift work sleep disorder. See also
Parasomnia
Sleep problems in women
Somnolence

References


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