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Conjunctival suffusion is an eye finding occurring early in Weil’s disease, which is caused by "Leptospira interrogans". Conjunctival suffusion is characterized by redness of the conjunctiva that resembles conjunctivitis, but it does not involve inflammatory exudates. Swelling of the conjunctiva (chemosis) is seen along the corners of the eye (palpebral fissures).
About 30 percent of patients with Weil's disease develop conjunctival suffusion. When it does occur, it develops towards the end of the early phase of the illness. Even in severe cases, the suffusion occurs in the first phase of the illness.
Conjunctival suffusion may also occur in patients with a Hantavirus infection. In a 1994 study of 17 patients with Hantavirus infections, 3 had conjunctival suffusion.
Leptospiral infection in humans causes a range of symptoms, and some infected persons may have no symptoms at all. Leptospirosis is a biphasic disease that begins suddenly with fever accompanied by chills, intense headache, severe myalgia (muscle ache), abdominal pain, conjunctival suffusion (red eye), and occasionally a skin rash. The symptoms appear after an incubation period of 7–12 days. The first phase (acute or septic phase) ends after 3–7 days of illness. The disappearance of symptoms coincides with the appearance of antibodies against "Leptospira" and the disappearance of all the bacteria from the bloodstream. The patient is asymptomatic for 3–4 days until the second phase begins with another episode of fever. The hallmark of the second phase is meningitis (inflammation of the membranes covering the brain).
Ninety percent of cases of the disease are mild leptospirosis. The rest experience severe disease, which develops during the second stage or occurs as a single progressive illness. The classic form of severe leptospirosis is known as Weil's disease, which is characterized by liver damage (causing jaundice), kidney failure, and bleeding. Additionally, the heart and brain can be affected, meningitis of the outer layer of the brain, encephalitis of brain tissue with same signs and symptoms; and lung affected as the most serious and life-threatening of all leptospirosis complications. The infection is often incorrectly diagnosed due to the nonspecific symptoms.
Other severe manifestations include extreme fatigue, hearing loss, respiratory distress, and azotemia.
There are a number of symptoms of the virus. In the first 1–8 days the first phase begins. The symptoms in this phase are:
- chills
- headache
- pain in the lower and upper extremities and severe prostration
- a rash on the soft palate
- swollen glands in the neck
- appearance of blood in the eyes (conjunctival suffusion)
- dehydration
- hypotension
- gastrointestinal symptoms (symptoms relating to the stomach and intestines)
- patients may also experience effects on the central nervous system
In 1–2 weeks, some people may recover, although others might not. They might experience a focal hemorrhage in mucosa of gingival, uterus, and lungs, a papulovesicular rash on the soft palate, cervical lymphadenopathy (it occurs in the neck which that enlarges the lymph glandular tissue), and occasional neurological involvement. If the patient still has OHF after 3 weeks, then a second wave of symptoms will occur. It also includes signs of encephalitis. In most cases if the sickness does not fade away after this period, the patient will die. Patients that recover from OHF may experience hearing loss, hair loss, and behavioral or psychological difficulties associated with neurological conditions.
Leptospirosis is an infection caused by corkscrew-shaped bacteria called "Leptospira". Signs and symptoms can range from none to mild such as headaches, muscle pains, and fevers; to severe with bleeding from the lungs or meningitis. If the infection causes the person to turn yellow, have kidney failure and bleeding, it is then known as Weil's disease. If it also causes bleeding into the lungs then it is known as severe pulmonary hemorrhage syndrome.
Up to 13 different genetic types of "Leptospira" may cause disease in humans. It is transmitted by both wild and domestic animals. The most common animals that spread the disease are rodents. It is often transmitted by animal urine or by water or soil containing animal urine coming into contact with breaks in the skin, eyes, mouth, or nose. In the developing world the disease most commonly occurs in farmers and poor people who live in cities. In the developed world it most commonly occurs in those involved in outdoor activities in warm and wet areas of the world. Diagnosis is typically by looking for antibodies against the bacterium or finding its DNA in the blood.
Efforts to prevent the disease include protective equipment to prevent contact when working with potentially infected animals, washing after this contact, and reducing rodents in areas people live and work. The antibiotic doxycycline, when used in an effort to prevent infection among travellers, is of unclear benefit. Vaccines for animals exist for certain type of "Leptospira" which may decrease the risk of spread to humans. Treatment if infected is with antibiotics such as: doxycycline, penicillin, or ceftriaxone. Weil's disease and severe pulmonary haemorrhage syndrome result in death rates greater than 10% and 50%, respectively, even with treatment.
It is estimated that seven to ten million people are infected by leptospirosis per year. The number of deaths this causes is not clear. The disease is most common in tropical areas of the world but may occur anywhere. Outbreaks may occur in slums of the developing world. The disease was first described by physician Adolf Weil in 1886 in Germany. Animals which are infected may have no symptoms, mild symptoms, or severe symptoms. Symptoms may vary by the type of animal. In some animals "Leptospira" live in the reproductive tract, leading to transmission during mating.
Omsk hemorrhagic fever is a viral hemorrhagic fever caused by a Flavivirus.
It is found in Siberia. It is named for an outbreak in Omsk.