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Query: UMLS:C0001577 (adnexitis)
 232 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ultrasonography (US) is suitable for diagnosing schistosomiasis-related organic pathology and is particularly useful to assess its evolution after therapy and/or interruption of exposure to the Schistosoma parasites. Evolution of pathology after treatment: Regression of hepatic abnormalities in Schistosma mansoni-infected children and adolescents has been observed already from 7 months post-therapy on. This does, however, not occur in all cases: individual differences are great ranging from spontaneous regression of pathology without treatment to persistence of pathology lasting for years after therapy even without re-infection. Intensity and duration of exposure, different parasite strains, patients' age and genetic background all influence the evolution of pathology. In communities at continuous exposure to S. mansoni infection, repeated re-treatment is required to control hepatosplenic morbidity. In Schistosoma japonicum infection, changes around the portal tree may regress, but characteristic diffuse abnormalities described as 'network pattern' abnormalities do not resolve. In Schistosoma haematobium infection bladder abnormalities and urinary tract obstruction frequently resolve after treatment. Clinically relevant pathology may resurge from 1 year after therapy on if exposure continues. Subjects with more advanced pathology before therapy, appear to be at higher risk of pathology re-appearance. Evolution of pathology after interruption of exposure to schistosomiasis: Knowledge on the evolution of pathology induced by S. mansoni is limited to some reports in emigrants and to the experience of ultrasonographists working in areas, where transmission has been partially interrupted. Due to the longevity of the parasite, infection may last for many years. Even after elimination of the parasites severe pathology may persist for long. In S. haematobium infection spontaneous healing after interruption of re-exposure may occur, but cases have been reported where urogenital lesions led to complications many years after exposure. Contrary to hepatosplenic and urinary pathology, knowlegde on the evolution of other organic abnormalities is very limited: studies on the evolution of biliary abnormalities or intestinal pathology have not been published. Genital pathology may be induced by all Schistosoma spp. Post-therapy evolution of genital schistosomiasis is largely ignored. In some European travellers partial regression of prostatic fibrosis has been described. Schistosomal adnexitis leading to infertility and/or ectopic pregnancy has been reported occurring many years after interruption of exposure. Ultrasonography (US) has never been used to study the influence of schistosomiasis on pregnancy. Concluding, current knowlegde on the evolution of pathology after treatment and/or interruption of exposure is still fragmentary. Frequently, fibrosis reverses after therapy, but advanced pathology may persist for long. Therefore, the possibility of severe clinical complications has to be taken into account, even if the infection is inactive since many years. In interventions aimed at controlling schistosomiasis-related morbidity, evolution of pathology must be monitored by US in representative patient cohorts. Further systematic US-studies are needed not only on the evolution of hepatosplenic and urinary pathology but also on that of intestinal, biliary and genital pathology induced by schistosomiasis, as well as on the influence of schistosomiasis on the outcome of pregnancy.
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PMID:Evolution of schistosomiasis-induced pathology after therapy and interruption of exposure to schistosomes: a review of ultrasonographic studies. 1099 27

A 20-year-old African female was hospitalized several times for diffuse chronic abdominal pain. The following exclusions were made: Acute adnexitis (by laparoscopy), acute appendicitis (by appendectomy), gastric ulcerations (by esophagogastroduodenoscopy) as well as Crohn's disease and ulcerative colitis. However, once taking a closer microscopical look at the mucosa, that otherwise appeared colonoscopically to be normal, multiple eggs of schistosomiasis mansoni (S. mansoni) were found in the colon as well as the rectum. Thus, the diagnosis of an intestinal bilharziosis was finely established. In retrospect even the sample taken for the appendix could have indicated this diagnosis already earlier on. Both the antibodies (ELISA/IFAT) and the specific immunoglobulins (IgE) for S. mansoni proved significantly positive. Therapy of choice was a single oral dosage of praziquantel. Migration and tourism have considerably increased the range of tropical and infectious diseases that need to be included into differential diagnosis. This case report focuses on intestinal bilharziosis as a potential underlying cause of chronic abdominal pain in immigrants of endemically affected areas. Direct diagnosis is the most important diagnostic method. The adult worms are usually inaccessible, so the method of choice to assess both diagnosis and the degree of activity of a chronic infection is evidence of living eggs in the stool. Alternatively, in case of lack of direct evidence diagnosis can be established by endoscopy and rectal biopsy.
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PMID:[Chronic abdominal pain and eosinophilia in a young African patient]. 1107 77

Morbidity data from the dispensary of the district of Sangha, Mali, are analyzed. The morbidity data do not precisely mirror the health situation of the district because some villages located 2 or 3 hours away have less recourse to the dispensary. Data were collected for May, when the dry season ends, and September, when significant rainfall occurs. 578 persons were treated in May. The parasite Schistosoma haematobium, which is present in shallow and stagnant water and around onion fields, was the largest single cause of consultation. Schistosoma haematobium causes genital bilharziasis leading to sterility in women, genitourinary infections, and neoplastic bladder disease. A number of women had combined vaginitis-adnexitis causing tubal obstruction, and some also had uterine fibromas. Almost 20% of consultations were concerned with pathologies of the urinary or genital tracts. In all, 47.2% of consultations were for parasitic diseases including 28.4% for bilharziasis; 17.8% for bacterial diseases including 8.1% for gonorrhea, 5.7% for anemia, 5.3% for gastroenterologic problems, 3.1% for ophthalmologic problems, and 20.9% for other or poorly defined causes. The dusty air in the end of the dry season was the cause of colds which sometimes led to bronchopneumopathies. Intestinal parasites accounted for less than 3% of consultations. There were 537 consultations in September 1991. Parasite infections again accounted for 45.7% of consultations, with 15.1% due to malaria. Bacterial diseases accounted for 16.9%, with gonorrhea responsible for 9.2%. 4.3% of consultations were for anemia, 9.8% for gastroenterological problems, 4.5% for ophthalmologic problems, and 18.8% for other or poorly defined causes.
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PMID:[Aspects of the pathology of the Dogon of Sangha]. 1228 96