Colon, rectum and anus
Michael Gaunt, Tjun Tang, Stewart Walsh in General Surgery Outpatient Decisions, 2018
Secondary causes can be classified as the following. Fungal infection: secondary infection due to Candida, Trichomonas or Tinea crura.Parasitic infestation: threadworms, scabies etc.Other infections: gonococcal proctitis and Condyloma acuminatum, Herpes simplex.Dermatological disorders: contact dermatitis, psoriasis, lichen planus, eczema.Neoplasia: rectal adenoma, rectal adenocarcinoma, squamous cell anal carcinoma, malignant melanoma, Bowen’s disease, Paget’s disease.Benign anorectal: haemorrhoids, fistula, fissure, prolapse, sphincter dysfunction, incontinence, radiation proctitis, ulcerative colitis.
Pruritus Ani
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
The importance of bacterial and fungal infection in PA is unclear. Certain infections need therapy. Dermatophytes are pathogenic and should be treated.24 Threadworms infect multiple family members and should be eradicated. Erythrasma, a cutaneous infection of the axillae, groin, toes and perineum caused by Corynebacterium minutissimum, should be treated with erythromycin.25 Sexually transmitted diseases invariably have pathognomonic features, such as a syphilitic chancre. However, previous studies have grown multiple species of fungi and bacteria from perianal skin that were thought to be causative of PA.24 Overgrowth of fungi is often seen after systemic antibiotic therapy and in diabetic or obese individuals.26 Equally, the mere presence of bacteria on skin does not constitute an infection, even if the species is considered to be pathogenic. Integrity of the skin is key. Undoubtedly, broken skin is more likely to become infected; however, treatment of the cutaneous infection does not mean that the skin will heal. Return of skin integrity is the critical step with any therapy. We know the gut biome can be altered by diet within three days. Current microbiological thinking suggests that health and diet are the aspects to concentrate on when aiming to control pathogenic organisms until skin integrity is restored. Viral warts, vesicles and ulcers caused by herpes simplex, human papillomavirus and molluscum contagiosum are associated with PA.27,28 However, it is unclear whether the viral infection itself or discharge from the lesions initiates the itch.
Vaginal Discharge
Tony Hollingworth in Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
At the time of EUA, a small hysteroscope can be inserted into the vagina, and the irrigating fluid used may flush the foreign body out and so treat the problem. Poor hygiene again is not uncommon and appropriate advice should be given to the mother. Threadworms may cause intense itching, especially at night. One needs to be cautious if sexual abuse is suspected, in which case the paediatric lead for child protection should be consulted. Each hospital in the UK should now have a named professional for child protection following the Climbié report.1 Sarcoma botryoides is a rare tumour that may present with discharge or bleeding in young girls and would need referral to a cancer centre for further management.
Infectious diseases among Ethiopian immigrants in Israel: a descriptive literature review
Published in Pathogens and Global Health, 2021
Yulia Treister-Goltzman, Ali Alhoashle, Roni Peleg
In the years 1984–1984 the prevalence of intestinal parasites in EI by stool culture was as high as 93%. In over 55% of the culture there were multiple parasites [4]. The most common parasites in stool culture were Schistosoma mansoni (47%), Ascaris Lumbricoides (20%), Necator americanus (54%), Hymenolepsis nana (21%), Trichuris trichiura (19%), Strongyloides stercoralis (4.5%), Giardia lamblia (11%), Entamoeba histolitica (9%), and Fasciola hepatica (0.4%) [58]. Using IgE-specific enzyme-linked immunosorbent analysis for Schistosoma mansoni the infection rate was 69% in EI [4]. This phenomenon led Israeli researchers to look for an effective one-dose drug for Necatoriasis and Albendazole was found to be effective in 81% of the cases [59]. Mass treatment of all EI with 400 mg of Albendazole and 40 mg/kg of Praziquantel cured 84.4% of all intestinal helminths [58].
A holistic approach is needed to control the perpetual burden of soil-transmitted helminth infections among indigenous schoolchildren in Malaysia
Published in Pathogens and Global Health, 2020
Nabil A. Nasr, Hesham M. Al-Mekhlafi, Yvonne A. L. Lim, Fatin Nur Elyana, Hany Sady, Wahib M. Atroosh, Salwa Dawaki, Ahmed K. Al-Delaimy, Mona A. Al-Areeqi, Abkar A. Wehaish, Tengku Shahrul Anuar, Rohela Mahmud
Soil-transmitted helminth (STH) infections remain a major public health problem worldwide especially among underprivileged rural communities in tropical and subtropical regions. These infections are considered the most prevalent among the neglected tropical diseases (NTDs) as they infect about one billion people worldwide [1]. They prevail exclusively in the poorest and most marginalized populations in rural areas, in urban slums or in war zones and refugee camps, but have been largely eliminated elsewhere, and thus have not received as much attention as other diseases [2,3]. The STH group includes Ascaris lumbricoides, Trichuris trichiura, hookworms (Ancylostoma duodenale and Necator americanus), and Strongyloides stercoralis. Ascaris lumbricoides and T. trichiura are transmitted by the ingestion of infective embryonated ova in contaminated food/drink or via contaminated fingers or contaminated eating utensils, while hookworm and S. stercoralis infections occur mainly via skin penetration by the infective filariform larvae that are present in contaminated soil [3]. All STH infections are treated with single or multiple doses of benzimidazole antihelmintic, particularly albendazole. A single dose has been found to be effective against A. lumbricoides and hookworms, whereas a three-to-five-day course of 400 mg albendazole daily is needed for T. trichiura and S. stercoralis [3,4].
Current pharmacotherapeutic strategies for Strongyloidiasis and the complications in its treatment
Published in Expert Opinion on Pharmacotherapy, 2022
Dora Buonfrate, Paola Rodari, Beatrice Barda, Wendy Page, Lloyd Einsiedel, Matthew R. Watts
Strongyloidiasis is labeled as the most neglected of the Neglected Tropical Diseases (NTD), yet an estimated 614 million people are infected worldwide [1]. Categorized under Soil Transmitted Helminths (STH), human strongyloidiasis is usually caused by the remarkably persistent, microscopic helminth Strongyloides stercoralis [2]. The unique autoinfective lifecycle distinguishes S. stercoralis from other STHs. Rather than remaining within the gastrointestinal system, the auto-infective filariform larvae penetrate the intestinal mucosa or perianal skin, randomly migrating on various pathways to the small intestine where they mature to adult females [3–5]. The filariform larvae can transport enteric bacteria, with septicemia and meningitis considered complications of a hyperinfective phase.
Related Knowledge Centers
- Gastrointestinal Tract
- Mucous Membrane
- Parasitism
- Strongyloides
- Pathogen
- Strongyloidiasis
- Pinworm
- Host
- Feces
- Urocanic Acid