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Kitro A, Ngamprasertchai T, Srithanaviboonchai K. Infectious diseases and predominant travel-related syndromes among long-term expatriates living in low-and middle- income countries: a scoping review. Trop Dis Travel Med Vaccines 2022; 8:11. [PMID: 35490249 PMCID: PMC9057062 DOI: 10.1186/s40794-022-00168-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 02/22/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Expatriates working in low-and middle-income countries have unique health problems. Migration leads not only to an increase in individual health risk but also a risk of global impact, such as pandemics. Expatriates with no prior experience living in tropical settings have expressed greatest concern about infectious diseases and appropriate peri-travel consultation is essential to expatriates. The objective of this review is to describe infections and travel-related syndromes among expatriates living in low-and middle-income countries. Methods MEDLINE database since the year 2000 was searched for relevant literature. Search terms were “long-term travel”, “expatriate”, and “health problems”. The additional references were obtained from hand-searching of selected articles. Results Up to 80% of expatriates suffered from gastrointestinal problems followed by dermatologic problems (up to 40%), and febrile systemic infection/vector-borne/parasitic infection (up to 34%) Expatriates living in Southeast Asia were at risk of vector-borne diseases including dengue and non-Plasmodium falciparum (pf) malaria while expatriates living in South Asia had a high prevalence of acute and chronic diarrhea. Staying long-term in Africa was related to an elevated risk for pf malaria and gastrointestinal infection. In Latin America, dermatologic problems were commonly reported illnesses among expatriates. Conclusion Certain health risks for expatriates who are going to depart to specific regions should be the focus of pre-travel consultation. Specific health preparations may reduce the risk of disease throughout their time abroad. Disease and symptom awareness is essential for screening, early diagnosis, and better health outcomes for ill-expatriates.
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Shepard Z, Rios M, Solis J, Wand T, Henao-Martínez AF, Franco-Paredes C, Suarez JA. Common Dermatologic Conditions in Returning Travelers. CURRENT TROPICAL MEDICINE REPORTS 2021; 8:104-111. [PMID: 34458071 DOI: 10.1007/s40475-021-00231-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Purpose of Review Travel medicine practitioners often are confronted with returning travelers with dermatologic disorders that could be of infectious causes or inflammatory or allergic. Some dermatologic processes are the result of exposure to insects or acquired due to environmental exposures. There is a broad range of dermatosis of infectious and non-infectious etiologies that clinicians need to consider in the differential diagnosis of dermatosis in travelers. Recent Findings With increasing international travel to tropical destinations, many individuals may be exposed to rickettsia (i.e., African tick bite fever, scrub typhus, or Mediterranean spotted fever), parasitic infections (i.e., cutaneous larva migrans, cutaneous leishmaniasis, African trypanosomiasis, or American trypanosomiasis), viral infections (i.e., measles or Zika virus infection), bacterial (i.e., Buruli ulcer) or ectoparasites (scabies or tungiasis), and myiasis. Cutaneous lesions provide clinical clues to the diagnosis of specific exposures during travel among returned travelers. Summary Dermatologic disorders represent the third most common health problem in returned travelers, after gastrointestinal and respiratory illness. Many of these conditions may pose a risk of severe complications if there is any delay in diagnosis. Therefore, clinicians caring for travelers need to become familiar with the most frequent infectious and non-infectious skin disorders in travelers.
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Affiliation(s)
- Zachary Shepard
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado Denver, Anschutz Medical Campus, 12700 East 19th Avenue, 11C01, Aurora, CO 80045, USA
| | - Margarita Rios
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panamá
| | - Jamie Solis
- School of Medicine, University of Colorado Denver, Anschutz Medical Campus, 12700 East 19th Avenue, 11C01, Aurora, CO 80045, USA
| | - Taylor Wand
- School of Medicine, University of Colorado Denver, Anschutz Medical Campus, 12700 East 19th Avenue, 11C01, Aurora, CO 80045, USA
| | - Andrés F Henao-Martínez
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado Denver, Anschutz Medical Campus, 12700 East 19th Avenue, 11C01, Aurora, CO 80045, USA
| | - Carlos Franco-Paredes
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado Denver, Anschutz Medical Campus, 12700 East 19th Avenue, 11C01, Aurora, CO 80045, USA
| | - José Antonio Suarez
- Investigador SNI Senacyt Panamá, Clinical Research Department, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panamá
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3
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Malek AE, Ostrosky-Zeichner L. Furuncular myiasis in a traveller to West Africa. J Travel Med 2021; 28:6270856. [PMID: 33969412 DOI: 10.1093/jtm/taab070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/13/2022]
Abstract
Cutaneous myiasis with swarming and oscillatory movement inside the wounds.
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Affiliation(s)
- Alexandre E Malek
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, 77030.,Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston 77030, TX
| | - Luis Ostrosky-Zeichner
- Department of Internal Medicine, Division of Infectious Diseases, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, 77030
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4
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Ramondetta A, Ribero S, Quaglino P, Broganelli P. In Vivo Observation of Cutaneous Larva Migrans by Fluorescence-Advanced Videodermatoscopy. Emerg Infect Dis 2021; 27:281-283. [PMID: 33350908 PMCID: PMC7774534 DOI: 10.3201/eid2701.203137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Fluorescence-advanced videodermatoscopy is not a widespread diagnostic technique. Its application in dermatology can facilitate the diagnosis of diseases such as cutaneous larva migrans by enabling us to recognize the precise position of larva in vivo on the skin. Using this noninvasive technique, we detected a case of cutaneous larva migrans in a patient.
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5
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Watkins RR, David MZ. Approach to the Patient with a Skin and Soft Tissue Infection. Infect Dis Clin North Am 2021; 35:1-48. [PMID: 33494872 DOI: 10.1016/j.idc.2020.10.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The diagnosis of a skin and soft tissue infection (SSTI) requires careful attention to a patient's history, physical examination, and diagnostic test results. We review for many bacterial, viral, fungal, and parasitic pathogens that cause SSTIs the clues for reaching a diagnosis, including reported past medical history, hobbies and behaviors, travel, insect bites, exposure to other people and to animals, environmental exposures to water, soil, or sand, as well as the anatomic site of skin lesions, their morphology on examination, and their evolution over time. Laboratory and radiographic tests are discussed that may be used to confirm a specific diagnosis.
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Affiliation(s)
- Richard R Watkins
- Division of Infectious Diseases, Cleveland Clinic Akron General, 224 West Exchange Street, Akron, OH 44302, USA; Department of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Michael Z David
- Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Blockley Hall 707, Philadelphia, PA 19104, USA; Department of Epidemiology, Biostatistics and Informatics, University of Pennsylvania, Philadelphia, PA, USA.
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6
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Ng YS, Gan YK, Tupang L. Severe Orbital Myiasis Caused by Chrysomya bezziana: A Case Report. Turk J Ophthalmol 2021; 51:62-65. [PMID: 33631919 PMCID: PMC7931651 DOI: 10.4274/tjo.galenos.2020.00225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
An 88-year-old woman was brought to the hospital immediately after her neighbours noticed that she was bleeding from her right eye. On examination, her right eye was phthisic with maggot infestation of her right orbit. Over a hundred live maggots were extracted using forceps. Computed tomography scan revealed the infestation was confined to the right orbit. The patient underwent exenteration of the right orbit under general anaesthesia. The species was identified by an entomologist as Chrysomya bezziana, which has aggressive larvae that eat living tissue. This case report demonstrates that orbital myiasis caused by C. bezziana poses a very real risk of intracranial invasion as they feed on living tissues. Adjacent tissue destruction can be very rapid and definitive treatment involves urgent removal of its larvae via surgical debridement. To our knowledge, we are reporting the first case of orbital myiasis from a patient in Malaysia. Therefore, our case report may be helpful in the management of similar case of orbital myiasis.
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Affiliation(s)
- Yu Siang Ng
- Ministry of Health Malaysia, Hospital Keningau, Department of Ophthalmology, Sabah, Malaysia
| | - Yuen Keat Gan
- Ministry of Health Malaysia, Hospital Keningau, Department of Ophthalmology, Sabah, Malaysia
| | - Leni Tupang
- Entomology & Pest Unit, Public Health Keningau, Ministry of Health Malaysia, Sabah, Malaysia
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7
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Himed S, Muddasani S, Fleischer A. Epidemiology of viral skin disease: An increased burden in childhood and a correlation with atopic dermatitis and gross domestic product. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2021. [DOI: 10.4103/jdds.jdds_23_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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8
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Abstract
The leishmaniases are diseases caused by pathogenic protozoan parasites of the genus Leishmania. Infections are initiated when a sand fly vector inoculates Leishmania parasites into the skin of a mammalian host. Leishmania causes a spectrum of inflammatory cutaneous disease manifestations. The type of cutaneous pathology is determined in part by the infecting Leishmania species, but also by a combination of inflammatory and anti-inflammatory host immune response factors resulting in different clinical outcomes. This review discusses the distinct cutaneous syndromes described in humans, and current knowledge of the inflammatory responses associated with divergent cutaneous pathologic responses to different Leishmania species. The contribution of key hematopoietic cells in experimental cutaneous leishmaniasis in mouse models are also reviewed and compared with those observed during human infection. We hypothesize that local skin events influence the ensuing adaptive immune response to Leishmania spp. infections, and that the balance between inflammatory and regulatory factors induced by infection are critical for determining cutaneous pathology and outcome of infection.
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Villalobos G, Vega-Memije ME, Maravilla P, Martinez-Hernandez F. Myiasis caused by Dermatobia hominis: countries with increased risk for travelers going to neotropic areas. Int J Dermatol 2016; 55:1060-8. [PMID: 27126902 DOI: 10.1111/ijd.13302] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 11/17/2015] [Accepted: 12/27/2015] [Indexed: 11/29/2022]
Abstract
Here, we review the human botfly (Dermatobia hominis), which belongs to a group of Diptera generically known as "myiasis-causing flies," characterized by the ability of their larvae to develop in animal flesh. In addition to its medical and economic importance, there is an academic interest in this botfly because of its peculiar biology, particularly because a phoretic diptera is needed to complete the life cycle. The larvae penetrate the host's skin, causing furuncle-like lesions that are pruritic, painful, and resemble subcutaneous nodules, producing irreversible perforations in the skin. Although D. hominis is distributed from Mexico to Argentina, a review performed by our working group from 1999 to 2015 determined that the countries with the highest infection rates in travelers are Belize, Bolivia, and Brazil. Interestingly, infected men show a higher variation in the distribution of the lesions than in women. Many treatment schemes have been suggested, including the application of highly dense liquids to the lesion to cause anoxia in the D. hominis larvae. We showed, for the first time, a Bayesian inference between D. hominis and other myiasis-causing flies. The flies grouped into two main clusters according to their capacity to produce facultative and obligatory myiasis, and D. hominis was phylogenetically close to Cuterebra spp.
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Affiliation(s)
- Guiehdani Villalobos
- Departamento de Ecología Evolutiva, Instituto de Ecologia, Universidad Nacional Autonoma de Mexico, Mexico
| | | | - Pablo Maravilla
- Departamento de Ecologia de Agentes Patogenos, Hospital General Dr. Manuel Gea Gonzalez, Mexico
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10
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Hirsch G, Jeandel R, Biechler M, Boivin JF, Hillion B. [Furuncular myiasis caused by Dermatobia hominis. Fortuitous diagnosis on extemporaneous macroscopic analysis of an excised cutaneous nodule]. Ann Dermatol Venereol 2015; 142:776-9. [PMID: 26610361 DOI: 10.1016/j.annder.2015.10.586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 06/16/2015] [Accepted: 10/02/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Furuncular myiasis is a parasitic disease caused by the development of human botfly larva in the skin. It affects people living in tropical countries and travelers returning from these countries and concerns a number of medical specialties. One form of treatment involves surgical extraction of the parasites. PATIENTS AND METHODS We report the case of a 47-year-old man returning from Guyana presenting two furuncle-like nodules of the skin on the right buttock and on the right shoulder blade. Extemporaneous intraoperative macroscopic examination of the buttock nodule resulted in diagnosis of myiasis caused by the human botfly, Dermatobia hominis. DISCUSSION The diagnosis of furuncular myiasis is made primarily on clinical grounds and should be suspected on observation of an abscess in subjects returning from a tropical region. It is consequently rare to find D. hominis in biopsy specimens. In the present case, macroscopic examination showed an extremely rare image of the edge of the intact larva in a longitudinal cut, which to our knowledge has never been published to date.
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Affiliation(s)
- G Hirsch
- Service de dermatologie, centre hospitalier de Marne-La-Vallée, 2-4, cours de la Gondoire, 77600 Jossigny, France.
| | - R Jeandel
- Service de pathologie, centre hospitalier de Marne-La-Vallée, 2-4, cours de la Gondoire, 77600 Jossigny, France
| | - M Biechler
- Service de chirurgie viscérale, clinique Saint-Faron, 1143, rue Charles-de-Gaulle, 77100 Mareuil-les-Meaux, France
| | - J-F Boivin
- Service de pathologie, centre hospitalier de Marne-La-Vallée, 2-4, cours de la Gondoire, 77600 Jossigny, France
| | - B Hillion
- Service de dermatologie, centre hospitalier de Marne-La-Vallée, 2-4, cours de la Gondoire, 77600 Jossigny, France
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11
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Skin Infections and Travelers. INTERNATIONAL JOURNAL OF TRAVEL MEDICINE AND GLOBAL HEALTH 2015. [DOI: 10.20286/ijtmgh-030399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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12
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Lim HY, Huang GKL, Torresi J, Johnson D. Red herring in returned traveler: drug reaction with eosinophilia and systemic symptom (DRESS) syndrome mimicking sepsis. J Travel Med 2014; 21:425-8. [PMID: 25345985 DOI: 10.1111/jtm.12152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/04/2014] [Accepted: 04/08/2014] [Indexed: 11/27/2022]
Abstract
We report a case of a 51-year-old Han Chinese recently returned traveler, who was admitted with a generalized maculopapular rash, fevers, shock, and multi-organ failure. Extensive investigations failed to reveal an infective cause. Skin biopsy findings together with the recent commencement of allopurinol raised a diagnosis of drug reaction with eosinophilia and systemic symptom syndrome. High-dose prednisolone was commenced and the patient made a rapid recovery. This case highlights that not all sepsis-like presentations in returned travelers are due to infective causes and that severe drug reactions need to be considered in the differential diagnosis.
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Affiliation(s)
- Hui Yin Lim
- Department of General Medicine, Austin Health, Heidelberg, Australia
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13
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Zammarchi L, Viligiardi R, Strohmeyer M, Bartoloni A. Dermatobia hominis: Small Migrants Hidden in Your Skin. Ann Dermatol 2014; 26:632-5. [PMID: 25324659 PMCID: PMC4198594 DOI: 10.5021/ad.2014.26.5.632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 11/04/2012] [Accepted: 11/06/2012] [Indexed: 11/16/2022] Open
Abstract
Myiasis is a parasitic infestation of vertebrate animal tissues due to maggots of two-winged flies (Diptera) that feed on living or necrotic tissue. Dermatobia hominis occurs widely in tropical parts of Latin America; it is the most common cause of furuncular myiasis in this region. The continuous increase in international travel has increased the possibility of observing this pathology outside endemic countries, especially in travelers returning from the tropics. If clinicians are aware of the possibility of the disease and its treatment options, this dermatosis can be easily managed. However, diagnostic delay is very common because the disease is often misdiagnosed as a bacterial skin infection. Here, we report 2 cases of furuncular myiasis caused by D. hominis in travelers returning to Italy from Latin America. Surgical and noninvasive treatment approaches are also described.
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Affiliation(s)
- Lorenzo Zammarchi
- Infectious Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Riccardo Viligiardi
- General Surgery Unit, Department of General, Emergency and Mininvasive Surgery, Careggi Hospital, Florence, Italy
| | - Marianne Strohmeyer
- Infectious Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alessandro Bartoloni
- Infectious Diseases Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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14
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Diaz JH. Skin and soft tissue infections following marine injuries and exposures in travelers. J Travel Med 2014; 21:207-13. [PMID: 24628985 DOI: 10.1111/jtm.12115] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/23/2013] [Accepted: 12/01/2013] [Indexed: 01/22/2023]
Abstract
BACKGROUND Bacterial skin and soft tissue infections (SSTIs) in travelers often follow insect bites and can present a broad spectrum of clinical manifestations ranging from impetigo to necrotizing cellulitis. Significant SSTIs can also follow marine injuries and exposures in travelers, and the etiologies are often marine bacteria. METHODS To meet the objectives of describing the pathogen-specific presenting clinical manifestations, diagnostic and treatment strategies, and outcomes of superficial and deep invasive infections in travelers caused by commonly encountered and newly emerging marine bacterial pathogens, Internet search engines were queried with the key words as MESH terms. RESULTS Travel medicine practitioners should maintain a high index of suspicion regarding potentially catastrophic, invasive bacterial infections, especially Aeromonas hydrophila, Vibrio vulnificus, Chromobacterium violaceum, and Shewanella infections, following marine injuries and exposures. CONCLUSIONS Travelers with well-known risk factors for the increasing severity of marine infections, including those with open wounds, suppressed immune systems, liver disease, alcoholism, hemochromatosis, hematological disease, diabetes, chronic renal disease, acquired immunodeficiency syndrome, and cancer, should be cautioned about the risks of marine infections through exposures to marine animals, seawater, the preparation of live or freshly killed seafood, and the accidental ingestion of seawater or consumption of raw or undercooked seafood, especially shellfish. With the exception of minor marine wounds demonstrating localized cellulitis or spreading erysipeloid-type reactions, most other marine infections and all Gram-negative and mycobacterial marine infections will require therapy with antibiotic combinations.
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Affiliation(s)
- James H Diaz
- Environmental and Occupational Health Sciences, School of Public Health; Department of Anesthesiology, School of Medicine, Louisiana State University Health Sciences Center (LSUHSC), New Orleans, LA, USA
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15
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Abstract
Malaria, diarrhea, respiratory infections, and cutaneous larva migrans are common travel-related infections observed in children and adolescents returning from trips to developing countries. Children visiting friends and relatives are at the highest risk because few visit travel clinics before travel, their stays are longer, and the sites they visit are more rural. Clinicians must be able to prepare their pediatric-age travelers before departure with preventive education, prophylactic and self-treating medications, and vaccinations. Familiarity with the clinical manifestations and treatment of travel-related infections will secure prompt and effective therapy.
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16
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Kantele A, Mattila L, Ott K, Davidkin I, Siikamäki H. Fever with rash in patients returning from popular tourist resort Phuket, Thailand: dengue--or measles? J Travel Med 2012; 19:317-9. [PMID: 22943274 DOI: 10.1111/j.1708-8305.2012.00639.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 06/12/2012] [Accepted: 06/19/2012] [Indexed: 11/29/2022]
Abstract
We report three recent cases of measles in travelers to a popular vacation resort, Phuket, Thailand, two initially diagnosed clinically as dengue, one as drug reaction. In countries with no indigenous measles, clinicians may no longer recognize the disease. When left misdiagnosed, the patients continue to be potential transmitters.
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Affiliation(s)
- Anu Kantele
- Department of Medicine, Division of Infectious Diseases, Helsinki University Central Hospital, Helsinki, Finland.
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17
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Brogden NK, Mehalick L, Fischer CL, Wertz PW, Brogden KA. The emerging role of peptides and lipids as antimicrobial epidermal barriers and modulators of local inflammation. Skin Pharmacol Physiol 2012; 25:167-81. [PMID: 22538862 DOI: 10.1159/000337927] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 03/01/2012] [Indexed: 12/17/2022]
Abstract
Skin is complex and comprised of distinct layers, each layer with unique architecture and immunologic functions. Cells within these layers produce differing amounts of antimicrobial peptides and lipids (sphingoid bases and sebaceous fatty acids) that limit colonization of commensal and opportunistic microorganisms. Furthermore, antimicrobial peptides and lipids have distinct, concentration-dependent ancillary innate and adaptive immune functions. At 0.1-2.0 μM, antimicrobial peptides induce cell migration and adaptive immune responses to coadministered antigens. At 2.0-6.0 μM, they induce cell proliferation and enhance wound healing. At 6.0-12.0 μM, they can regulate chemokine and cytokine production and at their highest concentrations of 15.0-30.0 μM, antimicrobial peptides can be cytotoxic. At 1-100 nM, lipids enhance cell migration induced by chemokines, suppress apoptosis, and optimize T cell cytotoxicity, and at 0.3-1.0 μM they inhibit cell migration and attenuate chemokine and pro-inflammatory cytokine responses. Recently, many antimicrobial peptides and lipids at 0.1-2.0 μM have been found to attenuate the production of chemokines and pro-inflammatory cytokines to microbial antigens. Together, both the antimicrobial and the anti-inflammatory activities of these peptides and lipids may serve to create a strong, overlapping immunologic barrier that not only controls the concentrations of cutaneous commensal flora but also the extent to which they induce a localized inflammatory response.
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Affiliation(s)
- N K Brogden
- Department of Pharmaceutical Sciences, University of Kentucky, Lexington, Kentucky, USA.
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18
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Abstract
Myiasis is defined as the infestation of live vertebrates (humans and/or animals) with dipterous larvae. In mammals (including humans), dipterous larvae can feed on the host's living or dead tissue, liquid body substance, or ingested food and cause a broad range of infestations depending on the body location and the relationship of the larvae with the host. In this review, we deeply discuss myiasis as a worldwide infestation with different agents and with its broad scenario of clinical manifestations as well as diagnosis techniques and treatment.
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Solomon M, Benenson S, Baum S, Schwartz E. Tropical skin infections among Israeli travelers. Am J Trop Med Hyg 2011; 85:868-72. [PMID: 22049040 DOI: 10.4269/ajtmh.2011.10-0471] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Infectious skin disorders are common dermatologic illnesses in travelers. Knowledge of post-travel-related infectious skin disorders will allow for effective pre- and post-travel counseling. All cases of returning travelers seen in our center seeking care for infectious skin diseases were included in this study. For a comparison, data on returned travelers with non-infectious skin diseases and healthy travelers who had pre-travel consultations in our institution were also analyzed. Altogether, skin-related diagnosis was reported in 540 ill travelers, and among them, 286 (53%) had infectious skin diseases. Tropical skin infection was diagnosed in 64% of the infectious cases. Travelers returning from Latin America were significantly more ill with tropical skin infections than those traveling to Asia and Africa, The most common diagnoses were cutaneous leishmaniasis, myiasis, and cutaneous larva migrans. In conclusion, tropical skin infections are common among Israeli travelers, especially among those who visited Latin America.
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Affiliation(s)
- Michal Solomon
- Department of Dermatology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
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20
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van Aalsburg R, de Pagter APJ, van Genderen PJ. Urticaria and periorbital edema as prodromal presenting signs of acute hepatitis B infection. J Travel Med 2011; 18:224-5. [PMID: 21539670 DOI: 10.1111/j.1708-8305.2011.00507.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A 34-year-old patient presented with giant, transient urticarial skin lesions and periorbital edema after a 3-month stay in DR Congo. Retrospective analysis of stored samples revealed that these signs were prodromal manifestations of acute hepatitis B infection. The hepatitis B infection was spontaneously cleared; the skin lesion did not recur.
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Angheben A, Mistretta M, Gobbo M, Bonafini S, Iacovazzi T, Sepe A, Gobbi F, Marocco S, Rossanese A, Bisoffi Z. Acute strongyloidiasis in Italian tourists returning from Southeast Asia. J Travel Med 2011; 18:138-40. [PMID: 21366799 DOI: 10.1111/j.1708-8305.2010.00496.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Strongyloidiasis is a soil-transmitted helmithiasis with worldwide distribution. Contrary to chronic form, hyperinfestation and life-threatening dissemination, first (invasive) stages of the disease are not well characterized. This paper describes two cases of acute strongyloidiasis in travelers returning from Southeast Asia and highlights the need to take strongyloidiasis into account also among acute travel-related illnesses.
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Affiliation(s)
- Andrea Angheben
- Centre for Tropical Diseases, Hospital S. Cuore-Don Calabria, Negrar, Italy.
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Abstract
Imported tropical diseases are among the top three leading causes for morbidity and may affect up to 8% of returning travelers. Because the spectrum of dermatological manifestations seen in travelers is broad, it can be challenging for physicians to recognize and treat such conditions in a timely and efficient manner. Therefore, the present review highlights common imported tropical diseases with a focus on treatment regimens. Specifically, cutaneous larva migrans, myiasis, swimmer's itch, mycetoma, Chagas disease, and leishmaniasis are discussed. As awareness increases among travelers, immigrants, and health care providers regarding imported tropical diseases, early intervention and proper diagnosis can ensue, thus reducing morbidity and mortality in affected individuals.
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Affiliation(s)
- Shaily Patel
- Section of Dermatology, University of Chicago Medical Center, Chicago, IL 60637, USA
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A practical approach to common skin problems in returning travellers. Travel Med Infect Dis 2009; 7:125-46. [DOI: 10.1016/j.tmaid.2009.03.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Accepted: 03/09/2009] [Indexed: 11/22/2022]
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