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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
In humans, it can cause arteritis, keratitis, and periorbital cellulitis. This has previously been thought to be a rare disease with only 28 cases reported in the literature up to 1996. However, keratitis due to Pythium may be more common than previously thought, accounting for a proportion of cases that were due to unidentified pathogens. Although this disease was first reported in 1884 the species infecting humans - "Pythium insidiosum" - was only formally recognised in 1987. Diagnosis can be difficult in part because of a lack of awareness of the disease. It does not appear to be transmissible either animal to animal or animal to human. There appear to be three clades of this organism: one in the Americas, a second from Asia and Australia and a third with isolates from Thailand and the USA. The most probable origin of the organism seems to be in Asia.
Most human cases have been reported in Thailand, although cases have been reported elsewhere. In humans, the four forms of the disease are: subcutaneous, disseminated, ocular, and vascular. The ocular form of the disease is the only one known to infect otherwise healthy humans, and has been associated with contact lens use while swimming in infected water. This is also the rarest form with most cases requiring enucleation of the eye. The other forms of the disease require a pre-existing medical condition, usually associated with thalassemic hemoglobinopathy. Prognosis is poor to guarded and treatments include aggressive surgical resection of infected tissue, with amputation suggested if the infection is limited to a distal limb followed by immunotherapy and chemotherapy. A recently published review lists nine cases of vascular pythiosis with five survivors receiving surgery with free margins and all except one requiring amputation. The same review lists nine cases of ocular pythiosis with five patients requiring enucnleation of the infected eye and four patients requiring a corneal transplant.
Pythiosis occurs in areas with mild winters because the organism survives in standing water that does not reach freezing temperatures. In the United States, it is most commonly found in the Southern Gulf states, especially Louisiana, Florida, and Texas, but has also been reported as far away as California and Wisconsin. It is also found in southeast Asia, eastern Australia, New Zealand, and South America.
Treatment for phycomycosis is very difficult and includes surgery when possible. Postoperative recurrence is common. Antifungal drugs show only limited effect on the disease, but itraconazole and terbinafine hydrochloride are often used for two to three months following surgery. Humans with "Basidiobolus" infections have been treated with amphotericin B and potassium iodide. For pythiosis and lagenidiosis, a new drug targeting water moulds called caspofungin is available, but it is very expensive. Immunotherapy has been used successfully in humans and horses with pythiosis. Treatment for skin lesions is traditionally with potassium iodide, but itraconazole has also been used successfully.
Entomophthoramycosis (or Entomophthoromycosis) is a mycosis caused by Entomophthorales.
Examples include basidiobolomycosis and conidiobolomycosis.
Pathogenic zygomycosis is caused by species in two orders: Mucorales or Entomophthorales, with the former causing far more disease than the latter. These diseases are known as "mucormycosis" and "entomophthoramycosis", respectively.
- Order Mucorales (mucormycosis)
- Family Mucoraceae
- "Absidia" ("Absidia corymbifera")
- "Apophysomyces" ("Apophysomyces elegans" and "Apophysomyces trapeziformis")
- "Mucor" ("Mucor indicus")
- "Rhizomucor" ("Rhizomucor pusillus")
- "Rhizopus" ("Rhizopus oryzae")
- Family Cunninghamellaceae
- "Cunninghamella" ("Cunninghamella bertholletiae")
- Family Thamnidiaceae
- "Cokeromyces" ("Cokeromyces recurvatus")
- Family Saksenaeaceae
- "Saksenaea" ("Saksenaea vasiformis")
- Family Syncephalastraceae
- "Syncephalastrum" ("Syncephalastrum racemosum")
- Order Entomophthorales (entomophthoramycosis)
- Family Basidiobolaceae
- "Basidiobolus" ("Basidiobolus ranarum")
- Family Ancylistaceae
- "Conidiobolus" ("Conidiobolus coronatus/Conidiobolus incongruus")
The term oomycosis is used to describe oomycete infections. These are more common in animals, notably dogs and horses. These are heterokonts, not true fungi. Types include pythiosis (caused by "Pythium insidiosum") and lagenidiosis.
Zygomycosis has been described in a cat, where fungal infection of the tracheobronchus led to respiratory disease requiring euthanasia.