Cutaneous Strongyloides Infection Postchemotherapy

2016 ◽  
Vol 20 (4) ◽  
pp. 337-339 ◽  
Author(s):  
Erica Merman ◽  
Sanjay Siddha ◽  
Jay S. Keystone ◽  
Ayman Al Habeeb ◽  
Danny Ghazarian ◽  
...  
Keyword(s):  
Skin Biopsy ◽  
Clinical Symptoms ◽  
Immunocompromised Patient ◽  
Diagnosis And Treatment ◽  
Larva Currens ◽  
Increased Risk ◽  
Hyperinfection Syndrome ◽  
Disseminated Disease

Background and Objective: While clinical symptoms of strongyloidiasis are often nonspecific, larva currens (with erythematous, serpiginous, and pruritic papules and plaques) should prompt investigation including stool microscopy, serology, and skin biopsy of the lesion. Appropriate diagnosis and treatment with ivermectin is necessary, especially in the immunocompromised patient who is at increased risk for hyperinfection syndrome and disseminated disease. Conclusion: We present a 61-year-old immunocompromised man with presentation of larva currens of cutaneous strongyloides infection without symptoms of hyperinfection or disseminated disease.

scholarly journals ACUTE AND CHRONIC STRONGYLOIDIASIS IN RUSSIAN TOURISTS TRAVELLED TO THAILAND, THE COAST OF BLACK SEA IN RUSSIA AND ABKHAZIA: PROBLEMS OF DIAGNOSIS AND TREATMENT. ANALYSIS OF CASES AND REVIEW

2017 ◽  
Vol 22 (3) ◽  
pp. 156-161
Author(s):  
Aleksandr M. Bronshteyn ◽  
L. V Fedyanina ◽  
N. A Malyshev ◽  
V. Ya Lashin ◽  
S. V Burova ◽  
...  
Keyword(s):  
Black Sea ◽  
Strongyloides Stercoralis ◽  
Abdominal Discomfort ◽  
Peripheral Eosinophilia ◽  
Increased Risk ◽  
Hyperinfection Syndrome ◽  
Risk Patients ◽  
Treatment Analysis ◽  
High Level ◽  
Disseminated Disease

Cases of acute and chronic Strongyloides stercoralis are presented as tourists travelled to Thailand, the coast of Black sea in Russia and Abkhazia. A high level of clinical suspicion is required to make the diagnosis of strongyloidiasis in at-risk patients presenting with peripheral eosinophilia, unexplained intermittent diarrhea, abdominal discomfort and skin rashes. Owing to increased risk of developing disseminated disease or hyperinfection syndrome, early detection and treatment of strongyloidiasis are extremely important. Strongyloidiasis should be routinely investigated in patients with chronic diseases who will undergo immunosuppressive therapy. Ivermectin or thiabendazole currently is the treatment of choice which are more effective than albendazole.

scholarly journals Common Presentation of an Uncommon DiseaseStrongyloidiasis could be Devastating in an Immunocompromised Host

2021 ◽  
Vol 2 (1) ◽  
pp. 47-49
Author(s):  
Mohammad Shohidul Islam
Keyword(s):  
Early Diagnosis ◽  
Immunocompromised Patient ◽  
Parasitic Infection ◽  
Immunocompromised Host ◽  
Strongyloides Stercoralis ◽  
Endoscopic Biopsy ◽  
Common Presentation ◽  
Hyperinfection Syndrome ◽  
Nonspecific Sign ◽  
Disseminated Disease

Strongyloidiasis is a chronic self-limited parasitic infection associated with mostly nonspecific sign symptoms. But in immunocompromised patient’s morbidity and mortality is high due to hyperinfection syndrome and disseminated disease. So early diagnosis is very important. Here we report a case of hyperinfection with Strongyloides stercoralis in an elderly immunocompromised patient diagnosed by endoscopic biopsy who was treated successfully later on. Keywords: Strongyloidiasis; parasitic infection; Immunocompromised host, Hyperinfection Disseminated disease

scholarly journals MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

2012 ◽  
Vol 167 (5) ◽  
pp. 609-618 ◽  
Author(s):  
Bernadette Biondi
Keyword(s):  
Heart Failure ◽  
Thyroid Dysfunction ◽  
Clinical Symptoms ◽  
Systolic Function ◽  
Evidence Synthesis ◽  
The United States ◽  
Antithyroid Drugs ◽  
Cardiac Symptoms ◽  
Appropriate Treatment ◽  
Increased Risk

ContextHeart failure (HF) is a major cause of morbidity and mortality in Europe and in the United States. The aim of this review article was to assess the results of the prospective studies that evaluated the risk of HF in patients with overt and subclinical thyroid disease and discuss the mechanism of this dysfunction.Evidence AcquisitionReports published with the following search terms were searched:, thyroid, hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, levothyroxine, triiodothyronine, antithyroid drugs, radioiodine, deiodinases, clinical symptoms, heart rate, HF, systolic function, diastolic function, systemic vascular resistance, endothelial function, amiodarone and atrial fibrillation. The investigation was restricted to reports published in English.Evidence SynthesisThe outcome of this analysis suggests that patients with untreated overt thyroid dysfunction are at increased risk of HF. Moreover, persistent subclinical thyroid dysfunction is associated with the development of HF in patients with serum TSH <0.1 or >10 mU/l.ConclusionsThe timely recognition and effective treatment of cardiac symptoms in patients with thyroid dysfunction is mandatory because the prognosis of HF may be improved with the appropriate treatment of thyroid dysfunction.

MO765CENTRAL VEIN STENOSES IN HD PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Aleksei Zulkarnaev ◽  
Andrey Vatazin ◽  
Vadim Stepanov ◽  
Ekaterina Parshina ◽  
Mariya Novoseltseva
Keyword(s):  
Risk Factor ◽  
Vascular Access ◽  
Dwell Time ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Cox Proportional Hazards ◽  
Important Risk Factor ◽  
Central Vein ◽  
Increased Risk ◽  
The Mean

Abstract Background and Aims The prevalence of central vein stenosis (CVS) in patients on hemodialysis (HD) is difficult to be assessed directly. This is mainly caused by the variety of clinical signs and the high frequency of asymptomatic CVS. Aim: to assess the frequency of occurrence of various CVS forms in HD patients. Method The retrospective observational study is based on the results of treatment of 1865 HD patients who underwent diagnostic and therapeutic procedures on vascular access in our center. In case of vascular access dysfunction, patients were examined according to a local protocol: ultrasound of the peripheral (to exclude lesion of peripheral AVF segments) and central veins (over the available length), followed with CT-angiography or percutaneous angiography, if necessary. Results AVF/AVG dysfunction was observed in 29.4% of patients (549 of 1865). 211 patients were diagnosed with CVS. The prevalence of CVS was 11.3% (211 of 1865) among all HD patients and 38.4% (211 of 549) in patients with AVF dysfunction. Among patients with CVS, 37% (78 of 211) had vein lesions without clinical symptoms or with minimal manifestations (a tendency to decrease KT/V). The prevalence of asymptomatic CVS was 4.2% (78 of 1865) in the general population of HD patients and 14.2% (78 of 549) in patients with AVF dysfunction. In case of asymptomatic CVS it was detected by an ultrasound examination during CVC implantation (N=38), during unsuccessful attempts to implant CVC (N=29), in the case of recurrent AVF thrombosis without underlying peripheral segments lesion (N=9) or during echocardiography (N=2). The prevalence of asymptomatic CVS among patients without AVF dysfunction was 5.9% (78 of 1316). True prevalence of subclinical CVS among HD patients without obvious signs of AVF dysfunction may vary widely. A total of 48.8% (103 of 211) of all CVS cases were treated. At the same time, in 10.7% (11 of 103) of cases, patients did not present symptoms of CVS, and surgery was performed due to recurrent AVF thrombosis without damage of the peripheral parts of AVF. Patients with clinically manifest CVS who received endovascular interventions had a significantly higher risk of AVF loss compared to patients with asymptomatic CVS: HR=2.566 [95% CI 1.706; 3.86], log rank p&lt;0.0001. However, patients with an asymptomatic CVS had a higher risk of AVF function loss compared to the general HD population (HR=2,051 [95% CI 1,243; 3,384], log rank p= 0.0004) – fig. 1. The use of CVC is a known risk factor of CVS development. We analyzed the relationship of CVS risk with multiply CVC placements and catheter dwell time using the Cox proportional hazards regression model (fig. 2). In the univariate model, a greater No of CVCs as well as longer time in place increased the risk of CVS. In the multivariate model (χ2=105.516, df=2, p&lt;0.0001), catheter dwell time was no longer associated with an increased risk of CVC, while the mean number of inserted catheters remained an important risk factor. Conclusion The prevalence of both symptomatic and asymptomatic forms of CVS in HD patients is high. Patients with vascular access dysfunction should be carefully examined to identify the asymptomatic CVS. The mean No of catheterizations is a more important risk factor of CVS than longer catheter dwell time.

scholarly journals Parasitic Infections Associated with Unfavourable Outcomes in Transplant Recipients

Medicina ◽  
2018 ◽  
Vol 54 (2) ◽  
pp. 27 ◽  
Author(s):  
Wojciech Wołyniec ◽  
Małgorzata Sulima ◽  
Marcin Renke ◽  
Alicja Dębska-Ślizień
Keyword(s):  
Bone Marrow ◽  
Opportunistic Infections ◽  
Immunosuppressive Treatment ◽  
Parasitic Infection ◽  
Parasitic Infections ◽  
Solid Organ ◽  
Tropical Countries ◽  
Real Risk ◽  
Increased Risk ◽  
Disseminated Disease

Introduction. The immunosuppression used after transplantation (Tx) is associated with an increased risk of opportunistic infections. In Europe, parasitic infections after Tx are much less common than viral, bacterial and fungal ones. However, diseases caused by parasites are very common in tropical countries. In the last years the number of travellers with immunosuppression visiting tropical countries has increased. Methods. We performed a literature review to evaluate a risk of parasitic infections after Tx in Europe. Results. There is a real risk of parasitic infection in patients after Tx travelling to tropical countries. Malaria, leishmaniasis, strongyloidiasis and schistosomiasis are the most dangerous and relatively common. Although the incidence of these tropical infections after Tx has not increased, the course of disease could be fatal. There are also some cosmopolitan parasitic infections dangerous for patients after Tx. The greatest threat in Europe is toxoplasmosis, especially in heart and bone marrow recipients. The most severe manifestations of toxoplasmosis are myocarditis, encephalitis and disseminated disease. Diarrhoea is one of the most common symptoms of parasitic infection. In Europe the most prevalent pathogens causing diarrhoea are Giardia duodenalis and Cryptosporidium. Conclusions. Solid organ and bone marrow transplantations, blood transfusions and immunosuppressive treatment are associated with a small but real risk of parasitic infections in European citizens. In patients with severe parasitic infection, i.e., those with lung or brain involvement or a disseminated disease, the progression is very rapid and the prognosis is bad. Establishing a diagnosis before the patient’s death is challenging.

scholarly journals Sclerosing cholangitis and inflammatory bowel disease: which comes first?

2021 ◽  
Vol 66 (1) ◽  
pp. 39-46
Author(s):  
A. V. Nikitin ◽  
G. V. Volynets
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
Clinical Symptoms ◽  
Cross Reactivity ◽  
Formation Mechanisms ◽  
Malignant Neoplasms ◽  
Increased Risk ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Sclerosing cholangitis is one of the most common hepatologic extraintestinal manifestations of inflammatory bowel disease. The article discusses the phenotype of the combination of sclerosing cholangitis and inflammatory bowel disease. The authors present their theories of the etiopathogenesis of sclerosing cholangitis in patients with inflammatory bowel disease, as well as some features of the phenotype of both mixed and monogenic forms of diseases.Sclerosing cholangitis in combination with inflammatory bowel disease is commonly associated with pancolitis, but the endoscopically visualized activity of inflammatory bowel diseases is significantly lower and clinical symptoms are less pronounced. The authors have established that the patients with the combination of sclerosing cholangitis and inflammatory bowel disease are at the increased risk of developing malignant neoplasms. The formation mechanisms of a combination of inflammatory bowel disease and sclerosing cholangitis remain poorly understood, although this pathology is influenced by lymphocytic cross-reactivity, aberrant recognition of microbiotic epitopes and intestinal microbiota imbalance. New biological agents aimed at correcting the interaction between the immune system and target organs may provide new ways of treatment for sclerosing cholangitis associated with inflammatory bowel disease.

scholarly journals Longest reported case of symptomatic COVID-19 reporting positive for over 230 days in an immunocompromised patient in the United States

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110400
Author(s):  
Bilal Chaudhry ◽  
Lidiya Didenko ◽  
Maaria Chaudhry ◽  
Andrew Malek ◽  
Kirill Alekseyev
Keyword(s):  
Risk Factors ◽  
Polymerase Chain Reaction ◽  
Immunocompromised Patient ◽  
The United States ◽  
Immunocompromised Patients ◽  
Chain Reaction ◽  
Viral Shedding ◽  
Time Period ◽  
Increased Risk ◽  
Polymerase Chain

Coronavirus 2019 (COVID-19) pneumonia was first noted in Wuhan, China. Since the start of the pandemic, there have been millions of cases diagnosed. The average time from onset of symptoms to testing negative SARS-CoV-2 via reverse transcription polymerase chain reaction is roughly 25 days. In patients who continually test positive for COVID-19, it is essential to determine precisely which risk factors contribute to the increase in viral shedding duration. We present a case about a 62-year-old man who has persistently tested positive for COVID-19 for more than 230 days. We followed his treatment course, in which he had been hospitalized multiple times since the onset of symptoms back in April 2020. We have determined that patients with immunosuppression, especially those taking corticosteroids, are at increased risk of prolonged viral shedding. It is essential to continually monitor these immunocompromised patients as they required a greater time period in order to have an appropriate immune response in which antibodies are created.

scholarly journals Benchmarking of Machine Learning Models to Assist the Prognosis of Tuberculosis

2021 ◽  
Author(s):  
Maicon Herverton Lino Ferreira da Silva Barros ◽  
Geovanne Oliveira Alves ◽  
Lubnnia Morais Florêncio Souza ◽  
Élisson da Silva Rocha ◽  
João Fausto Lorenzato de Oliveira ◽  
...  
Keyword(s):  
Machine Learning ◽  
Clinical Symptoms ◽  
Treatment Decision ◽  
Gradient Boosting ◽  
Original Form ◽  
Learning Models ◽  
Data Set ◽  
Risk Of Death ◽  
Increased Risk ◽  
Machine Learning Models

Tuberculosis (TB) is an airborne infectious disease caused by organisms in the Mycobacterium tuberculosis (Mtb) complex. In many low and middle-income countries, TB remains a major cause of morbidity and mortality. Once a patient has been diagnosed with TB, it is critical that healthcare workers make the most appropriate treatment decision given the individual conditions of the patient and the likely course of the disease based on medical experience. Depending on the prognosis, delayed or inappropriate treatment can result in unsatisfactory results including the exacerbation of clinical symptoms, poor quality of life, and increased risk of death. This work benchmarks machine learning models to aid TB prognosis using a Brazilian health database of confirmed cases and deaths related to TB in the State of Amazonas. The goal is to predict the probability of death by TB thus aiding the prognosis of TB and associated treatment decision making process. In its original form, the data set comprised 36,228 records and 130 fields but suffered from missing, incomplete, or incorrect data. Following data cleaning and preprocessing, a revised data set was generated comprising 24,015 records and 38 fields, including 22,876 reported cured TB patients and 1,139 deaths by TB. To explore how the data imbalance impacts model performance, two controlled experiments were designed using (1) imbalanced and (2) balanced data sets. The best result is achieved by the Gradient Boosting (GB) model using the balanced data set to predict TB-mortality, and the ensemble model composed by the Random Forest (RF), GB and Multi-layer Perceptron (MLP) models is the best model to predict the cure class.

scholarly journals Association of Serum Uric Acid Levels in Meige’s Syndrome

2021 ◽  
Vol 15 ◽  
Author(s):  
Haochen Guan ◽  
Zhi Geng ◽  
Weijie Yuan ◽  
Bowen Chang
Keyword(s):  
Uric Acid ◽  
Protective Factor ◽  
Rating Scale ◽  
Clinical Symptoms ◽  
Normal Subjects ◽  
Logistic Regression Models ◽  
Linear Relationships ◽  
Increased Risk ◽  
Low Levels ◽  
The Impact

Uric acid (URIC) is a natural antioxidant, and it has been shown that low levels of URIC could be a risk factor for the development of Parkinson’s disease. Our aim was to investigate whether URIC also plays a role in Meige’s syndrome (MS). We conducted a cohort study to compare serum URIC levels between patients with MS and healthy controls. In addition, we analyzed the impact of URIC on the risk of MS and symptom severity. Compared with normal subjects, URIC content was remarkably decreased in MS patients. In addition, URIC was regarded as a protective factor for MS, as verified by multivariate logistic regression models. We also found non-linear relationships between the levels of serum URIC and the incidence rate of MS and the Burke-Fahn-Marsden dystonia rating scale score. Our study is the first to show a connection between serum URIC levels and MS. Low serum URIC levels indicate an increased risk of MS incidence and more severe clinical symptoms. Our findings provide new insights into the prevention and treatment of MS.

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