Tropical Disease in the Immunocompromised Host: Melioidosis and Pythiosis

Musculoskeletal melioidosis: clinical and imaging features

“…Predisposing conditions include diabetes mellitus, chronic renal failure,' alcoholism, malignancy, hemoglobinopathy, immune deficiency, malnutrition, liver cirrhosis, and connective tissue disease. We found that diabetes mellitus was the most commonly associated disease, occurring in 73% of our patients, in contrast to the 24-41% of patients recorded by other investigators [14][15][16][17]. Localized suppurative lesions develop initially and may progress to acute disseminated septicemia if untreated.…”

Development and Evaluation of an In-House Enzyme-Linked Immunosorbent Assay for Early Diagnosis and Monitoring of Human Pythiosis

“…Since 1971, the disease has been recognized in a variety of animals, including cats, dogs, and cattle (8,11,14). In 1985, the first two human pythiosis cases were reported from Thailand (3), and other reports followed afterward (3,6,(14)(15)(16)(17)(18). Three forms of human pythiosis have been observed, and they have been classified as (i) cutaneous or subcutaneous pythiosis affecting the periorbital area, face, or limbs as a granulomatous, ulcerating, abscess-like or cellulitic lesion; (ii) ophthalmic pythiosis affecting eyes as corneal ulcers or keratitis; or (iii) systemic pythiosis affecting vascular tissue and resulting in arterial occlusions or aneurysms leading to gangrene or vascular rupture, respectively (3,6,14,17).…”

Mechanics of Solid Tissue Invasion by the Mammalian Pathogen Pythium insidiosum

“…In the present study, one of the human strains (90586) was isolated from necrotic tissue associated with a spider bite, but there was no evidence of prior trauma in the case history associated with the second strain (200269; Shenep et al, 1998). Other cases of human pythiosis, particularly from Thailand, have been linked to underlying ␣-or ␤-thalassemia (Tanphaichitra, 1989). In the case history described by Thitithanyanont et al (1998), a teenage boy with ␤-thalassemia hemoglobin E disease developed an arteritic infection following skin trauma to the neck while swimming in a flooded area close to a rice field.…”