1/136. Disseminated cutaneous protothecosis in an immunocompromised host: a case report and literature review.Protothecosis is an infection caused by achloric algae of the genus prototheca. These organisms have been isolated from water, sewage, soil, and the slime flux of trees, and are a known cause of disease in other mammals. infection in humans occurs after traumatic inoculation, producing localized olecranon bursal or, rarely, systemic disease. Only two previous cases of disseminated cutaneous disease have been reported in patients with defective neutrophil function. We describe a rare case of widespread cutaneous dissemination occurring after an arthropod bite in an immunocompromised patient.- - - - - - - - - - ranking = 1keywords = sea (Clic here for more details about this article) |
2/136. Preventing human rabies before and after exposure.rabies is a viral disease that can be transmitted from animals to humans. Recently, most human deaths from rabies have been caused by transmission from bats, in many cases without a documented bite or exposure. rabies is fatal if untreated prior to onset of symptoms. Deaths from human rabies in the united states are rare, largely because of animal control measures and postexposure prophylaxis of people who have been bitten or exposed to the virus. Primary care providers play a pivotal role in the prevention of rabies. Preexposure prevention involves education and immunization of persons at high risk for rabies exposure. rabies is difficult to diagnose antemortem because of the nonspecific presentation of signs and symptoms that may mimic those of respiratory or abdominal infections. Diagnosing rabies once symptoms begin will not save the victim's life but will help to minimize exposure to others, allow for identification and prophylaxis of those who may have been exposed, and identify the animal vector.- - - - - - - - - - ranking = 0.33333333333333keywords = sea (Clic here for more details about this article) |
3/136. The medusa stage of the coronate scyphomedusa Linuche unguiculata ('thimble jellyfish') can cause seabather's eruption.adult Linuche unguiculata medusae cause seabather's eruption just like that animal's larval form. This observation explains the wide seasonal incidence and the fact that lesions can appear on exposed skin.- - - - - - - - - - ranking = 2keywords = sea (Clic here for more details about this article) |
4/136. Hemolytic uremic syndrome due to capnocytophaga canimorsus bacteremia after a dog bite.The hemolytic uremic syndrome (HUS) is known to have several causes, including infectious diseases, drugs, pregnancy, and malignant disease. We report a patient who developed acute renal failure attributable to HUS in the course of capnocytophaga canimorsus bacteremia. Acute tubular necrosis as well as HUS should be considered as a cause of acute renal failure in the setting of capnocytophaga canimorsus bacteremia.- - - - - - - - - - ranking = 0.66666666666667keywords = sea (Clic here for more details about this article) |
5/136. An unusual stingray injury--the skindiver at risk.Serious abdominal injury following a stingray attack on a skindiver is described. knowledge of the creature's habits and the avoidance of swimming along the seabed are recommended as precautionary measures against such an injury.- - - - - - - - - - ranking = 0.33333333333333keywords = sea (Clic here for more details about this article) |
6/136. Risk to tourists posed by wild mammals in south africa.BACKGROUND: One of south africa's principal tourist attractions is the opportunity to encounter Africa's large mammals in the wild. Attacks by these mammals can be exceptionally newsworthy with potentially deleterious effects on tourism. Little is known about the risk of injury and death caused by wild mammals to visitors to south africa's nature reserves. The aim of this study was to determine the incidence of fatal and nonfatal attacks on tourists by wild mammals in south africa and to ascertain avoidable factors, if any. methods: Commercial press records covering all South African newspapers archived at the Independent newspapers' central library were systematically reviewed for a 10-year period, January 1988 to December 1997 inclusive, to identify all deaths and injuries to domestic and international tourists resulting from encounters with wild mammals in south africa. All of these incidents were analyzed to ascertain avoidable factors. RESULTS: During the review period seven tourists, including two students from thailand and a German traveler, were killed by wild mammals in south africa. Three of the four deaths ascribed to lions resulted from tourists carelessly approaching prides on foot in lion reserves. A judicial inquiry found that the management of a KwaZulu-Natal Reserve was culpable for the remaining death. Tourist ignorance of animal behavior and flagrant disregard of rules contributed to the two fatalities involving hippopotami. The unusual behavior manifested by the bull elephant responsible for the final death, resulted from discomfort caused by a dental problem to this pachyderm. During the same period there were 14 nonfatal attacks on tourists, including five by hippo, three by buffalo, two by rhino, and one each by a lion, leopard, zebra and musth elephant. Only the latter occurred while the visitor was in a motor vehicle. Tourist ethological naivete and failure to determine the experience of trail guides prior to travel, resulted in inadvertent agonistic behavior, unnecessary risk-taking and avoidable injury. CONCLUSIONS: This retrospective study has shown that attacks on tourists by wild mammals in south africa are an uncommon cause of injury and death. Sensible precautions to minimize this risk include remaining in a secure motor vehicle or adequately fenced precincts while in the vicinity of large mammals, rigidly observing nature reserve instructions, never approaching animals that appear ill, malnourished, displaying aggressive behavior traits or female wild mammals with young, and demanding adequately trained and experienced game rangers when embarking on walking trails. Any behavior that might be construed as antagonistic and which could provoke an attack by large mammals should be avoided (e.g., driving directly at a lion). Visitors need to be informed of classic signs of aggression, in particular in elephants, which will allow timely avoidance measures to be taken. The risk-enhancing effect of excessive alcohol intake is undesirable in the game reserve setting, as is driving at high speed after dusk in areas where hippos graze. Local advice on personal safety in wildlife reserves and the credentials of trail guides should be obtained from lodge or reserve management, tourism authorities or the travel industry prior to travel to game reserves.- - - - - - - - - - ranking = 56.9540626289keywords = lion (Clic here for more details about this article) |
7/136. A functional variant of lower lip reconstruction.A functional variant of lower lip reconstruction is reported, in which a nasolabial skin flap was combined with upward transposition of the inferior part of the orbicularis oris muscle in a 'bucket-handle' fashion. The tongue was split to provide both an intraoral lining to the lip and a new vermilion.- - - - - - - - - - ranking = 14.238515657225keywords = lion (Clic here for more details about this article) |
8/136. Delayed cutaneous reaction to jellyfish.A 57-year-old woman presented with a widespread papulonodular eruption. The dermatitis had appeared about 1 week after her return from a trip to the Red Sea, where she had come into contact with a shoal of unidentified jellyfish; however, that contact had not been followed by cutaneous lesions and/or symptoms. The patient also stated that she had had previous contacts with jellyfish during other trips to exotic seaside resorts. The dermatitis was characterized by papulonodular lesions, round or oval in shape, of a few millimeters in diameter, with a color ranging from pink to red to brown, and with a smooth and regular surface. The lesions were grouped in an apparently random fashion (Fig. 1) or arranged linearly (Fig. 2). The patient complained of pruritus and burning. Histopathologic examination showed the presence of some necrotic keratinocytes; in the upper and mid dermis, edema and a predominantly perivascular and periadnexal lymphohistiocytic infiltrate, with numerous neutrophils and eosinophils, were observed (Fig. 3). The patient was treated with hydroxyzine (37.5 mg/day) and hydrocortisone butyrate, which resulted in the rapid disappearance of the symptoms; however, the cutaneous lesions persisted for about 3 weeks.- - - - - - - - - - ranking = 0.33333333333333keywords = sea (Clic here for more details about this article) |
9/136. Sea urchin puncture resulting in PIP joint synovial arthritis: case report and MRI study.Of the 600 species of sea urchins, approximately 80 may be venomous to humans. The long spined or black sea urchin, Diadema setosum may cause damage by the breaking off of its brittle spines after they penetrate the skin. synovitis followed by arthritis may be an unusual but apparently not a rare sequel to such injury, when implantation occurs near a joint. In this case report, osseous changes were not seen by plain x-rays. magnetic resonance imaging (MRI) was used to expose the more salient features of both soft tissue and bone changes of black sea urchin puncture injury 30 months after penetration. In all likelihood, this type of injury may be more common than the existing literature at present suggests. It is believed to be the first reported case in this part of the world as well as the first MRI study describing this type of joint pathology. Local and systemic reactions to puncture injuries from sea urchin spines have been described previously. These may range from mild, local irritation lasting a few days to granuloma formation, infection and on occasions systemic illness. The sea urchin spines are composed of calcium carbonate with proteinaceous covering. The covering tends to cause immune reactions of variable presentation. There are only a handful of reported cases with sea urchin stings on record, none of them from the Red Sea. However, this condition is probably more common than is thought and can present difficulty in diagnosis. In this case report, the inflammation responded well to heat treatment, mobilization and manipulation of the joint in its post acute and chronic stages. As some subtle changes in soft tissues and the changes in bone were not seen either on plain x-rays or ultrasound scan, gadolinium-enhanced MRI was used to unveil the marked changes in the joint.- - - - - - - - - - ranking = 2keywords = sea (Clic here for more details about this article) |
10/136. Injuries to avian researchers at Palmer Station, Antarctica from penguins, giant petrels, and skuas.This paper describes 5 cases of injury to seabird researchers between 1996 and 1999 at Palmer Station, Antarctica. The injuries were inflicted by 3 seabird species: the Adelie penguin (Pygoscelis adeliae); the southern giant petrel (Macronectes giganteus); and the brown skua (Catharacta lonnbergi). All injured parties were biologic researchers with previous field experience working under National science Foundation research grants; all sought medical evaluation and treatment voluntarily. The nature and frequency of such injuries seems not to have been greatly reported in the medical literature. Although these cases were largely soft tissue injuries that healed without serious complications, the possibility of exotic infections is considered. We have dubbed this constellation of injuries AVES (Antarctic Vogel [German for bird] Encounter syndrome).- - - - - - - - - - ranking = 3keywords = sea (Clic here for more details about this article) |
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