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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)
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Nosocomial myiasis is myiasis acquired in a hospital setting. It is quite frequent, as patients with open wounds or sores can be infested if flies are present. To prevent nosocomial myiasis, hospital rooms must be kept free of flies.
How myiasis affects the human body depends on where the larvae are located. Larvae may infect dead, necrotic (prematurely dying) or living tissue in various sites: the skin, eyes, ears, stomach and intestinal tract, or in genitourinary sites. They may invade open wounds and lesions or unbroken skin. Some enter the body through the nose or ears. Larvae or eggs can reach the stomach or intestines if they are swallowed with food and cause gastric or intestinal myiasis.
Several different presentations of myiasis and their symptoms:
Clinical presentation of sparganosis most often occurs after the larvae have migrated to a subcutaneous location. The destination of the larvae is often a tissue or muscle in the chest, abdominal wall, extremities, or scrotum, although other sites include the eyes, brain, urinary tract, pleura, pericardium, and spinal canal. The early stages of disease in humans are often asymptomatic, but the spargana typically cause a painful inflammatory reaction in the tissues surrounding the subcutaneous site as they grow. Discrete subcutaneous nodules develop that may appear and disappear over a period of time. The nodules usually itch, swell, turn red, and migrate, and are often accompanied by painful edema. Seizures, hemiparesis, and headaches are also common symptoms of sparganosis, especially cerebral sparganosis, and eosinophilia is a common sign. Clinical symptoms also vary according to the location of the sparganum; possible symptoms include elephantiasis from location in the lymph channels, peritonitis from location in the intestinal perforation, and brain abscesses from location in the brain. In genital sparganosis, subcutaneous nodules are present in the groin, labia, or scrotum and may appear tumor-like.
Ocular sparganosis a particularly well-described type of sparganosis. Early signs of the ocular form include eye pain, epiphora (excessive watering of the eye), and/or ptosis (drooping of the upper eyelid). Other signs include periorbital edema and/or edematous swelling that resembles Romana’s sign in Chagas disease, lacrimation, orbital cellulitis, exophthalmos (protrusion of the eyeball), and/or an exposed cornea ulcer. The most common sign at presentation is a mass lesion in the eye. If untreated, ocular sparganosis can lead to blindness.
In one case of brain infestation by "Spirometra erinaceieuropaei", a man sought treatment on suffering headaches, seizures, memory flashbacks and strange smells. Magnetic resonance imaging (MRI) scans showed a cluster of rings, initially in the right medial temporal lobe, but moving over time to the other side of the brain. The cause was not determined for four years; ultimately a biopsy was performed and a 1 cm-long tapeworm was found and removed. The patient continued to suffer symptoms.
In animal and human hosts, infestation by "Thelazia" may be asymptomatic, though it frequently causes watery eyes (epiphora), conjunctivitis, corneal opacity, or corneal ulcers (ulcerative keratitis). Infested humans have also reported "foreign body sensation"the feeling that something is in the eye.
Diagnosis involves simply examining the eyes and nearby tissues for the worms. Adult "Thelazia" are very active, one author described "T. californiensis" as a "short lively piece of nylon fishing line about 10 mm long."
Head-lice infestation is most frequent on children aged 3–10 and their families. Approximately 3% of school children in the United States contract head lice. Females are more frequently infested than males. Those of African descent rarely suffer infestation due to differences in hair texture.
Head lice are spread through direct head-to-head contact with an infested person. From each egg or "nit" may hatch one nymph that will grow and develop to the adult louse. Lice feed on blood once or more often each day by piercing the skin with their tiny needle-like mouthparts. While feeding they excrete saliva, which irritates the skin and causes itching. Lice cannot burrow into the skin.
Although tapeworms in the intestine usually cause no symptoms, some people experience upper abdominal discomfort, diarrhea, and loss of appetite. Anemia may develop in people with the fish tapeworm. Infection is generally recognized when the infected person passes segments of proglottids in the stool (which look like white worms), especially if a segment is moving.
Rarely, worms may cause obstruction of the intestine, and very rarely, T. solium larvae can migrate to the brain causing severe headaches, seizures and other neurological problems. Neurocysticercosis can progress for years before the patient displays symptoms.
In at least one case, cancer cells from a tapeworm spread to the human host in an immunocompromised man, producing swelling, obstructions, and other conventional symptoms of human-originated cancer.
To diagnose infestation, the entire scalp should be combed thoroughly with a louse comb and the teeth of the comb should be examined for the presence of living lice after each time the comb passes through the hair. The use of a louse comb is the most effective way to detect living lice.
The most characteristic symptom of infestation is pruritus (itching) on the head which normally intensifies 3 to 4 weeks after the initial infestation. The bite reaction is very mild and it can be rarely seen between the hairs. Excessive scratching of the infested areas can cause sores, which may become infected.
Serious infestations and chronic attacks can cause anxiety, stress, and insomnia. Development of refractory delusional parasitosis is possible, as a person develops an overwhelming obsession with bed bugs.
The main symptoms are diarrhea and colicky abdominal pain. Because symptoms are often mild, infections can often be easily overlooked but diagnosis is important. Flukes attach to the wall of the small intestine, but are often asymptomatic unless in large numbers. Infection can occur from eating a single infected fish source. Peripheral eosinophilia is associated especially in early phase. When present in large numbers, can cause chronic intermittent diarrhea, nausea, and vague abdominal pains. Clinical complaints can also include lethargy and anorexia. In acute metagonimiasis, clinical manifestations are developed only 5–7 days after infection. Heavy infection has also been associated with epigastric distress, fatigue, and malaise.
Occasionally, flukes invade the mucosa and eggs deposited in tissue may gain access to circulation. This can then lead to eggs embolizing in the brain, spinal cord, or heart. Granulomas may form around eggs and can cause seizures, neurologic deficits, or cardiac insufficiency.
An interesting case in Japan found Diabetes Mellitus (DM) to be a sign of chronic infection with intracerebral hemorrhages as the acute sign of aggravation. Two months after administering the appropriate drug, Praziquantel, the ICHs were gone, as was the man's Diabetes Mellitus. This unique case shows the potential of additional symptoms associated with metagonimiasis that are still unknown.
Individual responses to bites vary, ranging from no visible effect (in about 20–70%), to small macular spots, to prominent wheals and bullae formations along with intense itching that may last several days. The bites often occur in a line. A central hemorrhagic spot may also occur due to the release of anticoagulants in the saliva.
Symptoms may not appear until some days after the bites have occurred. Reactions often become more brisk after multiple bites due to possible sensitization to the salivary proteins of the bed bug. The skin reaction usually occurs in the area of the bite which is most commonly the arms, shoulders and legs as they are more frequently exposed at night. Numerous bites may lead to an erythematous rash or urticaria.
One third of individuals with pinworm infection are totally asymptomatic. The main symptoms are pruritus ani and perineal pruritus, i.e., itching in and around the anus and around the perineum. The itching occurs mainly during the night, and is caused by the female pinworms migrating to lay eggs around the anus. Both the migrating females and the clumps of eggs are irritating, but the mechanisms causing the intense pruritus have not been explained. The intensity of the itching varies, and it can be described as tickling, crawling sensations, or even acute pain. The itching leads to continuously scratching the area around the anus, which can further result in tearing of the skin and complications such as secondary bacterial infections, including bacterial dermatitis (i.e., skin inflammation) and folliculitis (i.e., hair follicle inflammation). General symptoms are insomnia (i.e., persistent difficulties to sleep) and restlessness. A considerable proportion of children suffer from loss of appetite, weight loss, irritability, emotional instability, and enuresis (i.e., inability to control urination).
Pinworms cannot damage the skin, and they do not normally migrate through tissues. However, in women they may move onto the vulva and into the vagina, from there moving to the external orifice of the uterus, and onwards to the uterine cavity, fallopian tubes, ovaries, and peritoneal cavity. This can cause vulvovaginitis, i.e. an inflammation of the vulva and vagina. This causes vaginal discharge and pruritus vulvae, i.e., itchiness of the vulva. The pinworms can also enter the urethra, and presumably, they carry intestinal bacteria with them. According to Gutierrez (2000), a statistically significant correlation between pinworm infection and urinary tract infections has been shown; however, Burkhart & Burkhart (2005) maintain that the incidence of pinworms as a cause of urinary tract infections remains unknown. Incidentally, one report indicated that 36% of young girls with a urinary tract infection also had pinworms. Dysuria (i.e., painful urination) has been associated with pinworm infection.
The relationship between pinworm infestation and appendicitis has been researched, but there is a lack of clear consensus on the matter: while Gutierres (2005) maintains that there exists a consensus that pinworms do not produce the inflammatory reaction, Cook (1994) states that it is controversial whether pinworms are causatively related to acute appendicitis, and Burkhart & Burkhart (2004) state that pinworm infection causes symptoms of appendicitis to surface.
Pinworm infection, also known as enterobiasis, is a human parasitic disease caused by the pinworm. The most common symptom is itching in the anal area. This can make sleeping difficult. The period of time from swallowing eggs to the appearance of new eggs around the anus is 4 to 8 weeks. Some people who are infected do not have symptoms.
The disease is spread between people by pinworm eggs. The eggs initially occur around the anus and can survive for up to three weeks in the environment. They may be swallowed following contamination of the hands, food, or other articles. Those at risk are those who go to school, live in a health care institution or prison, or take care of people who are infected. Other animals do not spread the disease. Diagnosis is by seeing the worms which are about one centimeter or the eggs under a microscope.
Treatment is typically with two doses of the medications mebendazole, pyrantel pamoate, or albendazole two weeks apart. Everyone who lives with or takes care of an infected person should be treated at the same time. Washing personal items in hot water after each dose of medication is recommended. Good handwashing, daily bathing in the morning, and daily changing of underwear can help prevent reinfection.
Pinworm infections commonly occur in all parts of the world. It is the most common worm infection in the developed world. School aged children are the most commonly infected. In the United States about 20% of people at one point in time develop pinworm. Infection rates among high risk groups may be as high as 50%. It is not considered a serious disease. Pinworms are believed to have affected humans throughout history.
Tapeworm infection is the infestation of the digestive tract by a species of parasitic flatworm (known as a cestode), called tapeworms. Live tapeworm larvae grouped in cysts (coenuri)are sometimes ingested by consuming undercooked meat. Once inside the digestive tract, a larva can grow into a very large adult tapeworm. Additionally, many tapeworm larvae cause symptoms in an intermediate host. For example, cysticercosis is a disease involving larval tapeworms in the human body.
Head lice are generally uncomfortable, but typically do not constitute a serious condition. The most common symptom is itching of the head, which normally worsens 3 to 4 weeks after the initial infestation. The bite reaction is very mild, and it can be rarely seen between the hairs. Bites can be seen, especially in the neck of long-haired individuals when the hair is pushed aside. Swelling of the local lymph nodes and fever are rare. Itching may cause skin breakdown and uncommonly result in a bacterial infection.
In Ethiopia, head lice appear to be able to spread louse-born epidemic typhus and "Bartonella quintana". In Europe, the head lice do not appear to carry these infections.
Hymenolepiasis is infestation by one of two species of tapeworm: "Hymenolepis nana" or "H. diminuta". Alternative names are dwarf tapeworm infection and rat tapeworm infection. The disease is a type of helminthiasis which is classified as a neglected tropical disease.
As larval stages travel through the body, they may cause visceral damage, peritonitis and inflammation, enlargement of the liver or spleen, and an inflammation of the lungs. Pulmonary manifestations take place during larval migration and may present as Loeffler's syndrome, a transient respiratory illness associated with blood eosinophilia and pulmonary infiltrates with radiographic shadowing.
Symptoms of parasites may not always be obvious. However, such symptoms may mimic anemia or a hormone deficiency. Some of the symptoms caused by several worm infestation can include itching affecting the anus or the vaginal area, abdominal pain, weight loss, increased appetite, bowel obstructions, diarrhea, and vomiting eventually leading to dehydration, sleeping problems, worms present in the vomit or stools, anemia, aching muscles or joints, general malaise, allergies, fatigue, nervousness. Symptoms may also be confused with pneumonia or food poisoning.
The effects caused by parasitic diseases range from mild discomfort to death.
The nematode parasites "Necator americanus" and "Ancylostoma duodenale" cause human hookworm infection, which leads to anaemia and protein malnutrition. This infection affects approximately 740 million people in the developing countries, including children and adults, of the tropics specifically in poor rural areas located in sub-Saharan Africa, Latin America, South-East Asia and China.
Chronic hookworm in children leads to impaired physical and intellectual development, school performance and attendance are reduced.
Pregnant women affected by a hookworm infection can also develop aneamia, which results in negative outcomes both for the mother and the infant. Some of them are: low birth weight, impaired milk production, as well as increased risk of death for the mother and the baby.
In populations where worm infections are wide-spread, it is common to find that most people are infected by a small number of worms, while a small number of people are heavily infected. This is characteristic of many types of worm infections. Those people who are infected with only a small number of worms usually have no symptoms.
Sparganosis is a parasitic infection caused by the plerocercoid larvae of the genus "Spirometra" including , "S. ranarum", "S. mansonoides" and "S. erinacei". It was first described by Patrick Manson from China in 1882, and the first human case was reported by Charles Wardell Stiles from Florida in 1908. The infection is transmitted by ingestion of contaminated water, ingestion of a second intermediate host such as a frog or snake, or contact between a second intermediate host and an open wound or mucous membrane. Humans are the accidental hosts in the life cycle, while dogs, cats, and other mammals are definitive hosts. Copepods (freshwater crustaceans) are the first intermediate hosts, and various amphibians and reptiles are second intermediate hosts.
Once a human becomes infected, the plerocercoid larvae migrate to a subcutaneous location, where they typically develop into a painful nodule. Migration to the brain results in cerebral sparganosis, while migration to the eyes results in ocular sparganosis. Sparganosis is most prevalent in Eastern Asia, although cases have been described in countries throughout the world. In total, approximately 300 cases have been described in the literature up to 2003. Diagnosis is typically not made until the sparganum larva has been surgically removed. Praziquantel is the drug of choice, although its efficacy is unknown and surgical removal of the sparganum is generally the best treatment. Public health interventions should focus on water and dietary sanitation, as well as education about the disease in rural areas and discouragement of the use of poultices.
Metagonimiasis is a disease caused by an intestinal trematode, most commonly "Metagonimus yokagawai", but sometimes by "M. takashii" or "M. miyatai". The metagonimiasis-causing flukes are one of two minute flukes called the heterophyids. Metagonimiasis was described by Katsurasa in 1911–1913 when he first observed eggs of "M. yokagawai" in feces (date is disputed in various studies). "M. takahashii" was described later first by Suzuki in 1930 and then "M. Miyatai" was described in 1984 by Saito.
Stained adult fluke causing metagonimiasis
Thelaziasis (occasionally spelled "thelaziosis") is the term for infestation with parasitic nematodes of the genus "Thelazia". The adults of all "Thelazia" species discovered so far inhabit the eyes and associated tissues (such as eyelids, tear ducts, etc.) of various mammal and bird hosts, including humans. Thelazia nematodes are often referred to as "eyeworms."
The characteristic symptoms of a scabies infection include intense itching and superficial burrows. The burrow tracks are often linear, to the point that a neat "line" of four or more closely placed and equally developed mosquito-like "bites" is almost diagnostic of the disease. Because the host develops the symptoms as a reaction to the mites' presence over time, typically a delay of four to six weeks occurs between the onset of infestation and the onset of itching. Similarly, symptoms often persist for one to several weeks after successful eradication of the mites. As noted, those re-exposed to scabies after successful treatment may exhibit symptoms of the new infestation in a much shorter period—as little as one to four days.
Although organisms such as bacteria function as parasites, the usage of the term "parasitic disease" is usually more restricted. The three main types of organisms causing these conditions are protozoa (causing protozoan infection), helminths (helminthiasis), and ectoparasites. Protozoa and helminths are usually endoparasites (usually living inside the body of the host), while ectoparasites usually live on the surface of the host. Occasionally the definition of "parasitic disease" is restricted to diseases due to endoparasites.
The superficial burrows of scabies usually occur in the area of the finger webs, feet, ventral wrists, elbows, back, buttocks, and external genitals. Except in infants and the immunosuppressed, infection generally does not occur in the skin of the face or scalp. The burrows are created by excavation of the adult mite in the epidermis.
In most people, the trails of the burrowing mites are linear or S-shaped tracks in the skin often accompanied by rows of small, pimple-like mosquito or insect bites. These signs are often found in crevices of the body, such as on the webs of fingers and toes, around the genital area, in stomach folds of the skin, and under the breasts of women.
Symptoms typically appear two to six weeks after infestation for individuals never before exposed to scabies. For those having been previously exposed, the symptoms can appear within several days after infestation. However, symptoms may appear after several months or years. Acropustulosis, or blisters and pustules on the palms and soles of the feet, are characteristic symptoms of scabies in infants.
The signs and symptoms of helminthiasis depend on a number of factors including: the site of the infestation within the body; the type of worm involved; the number of worms and their volume; the type of damage the infesting worms cause; and, the immunological response of the body. Where the burden of parasites in the body is light, there may be no symptoms.
Certain worms may cause particular constellations of symptoms. For instance, taeniasis can lead to seizures due to neurocysticercosis.