Fungal origins of ADL Sample Clauses

Fungal origins of ADL episodes In addition to the bacterial and filarial causes of ADL episodes, the role of fungal infection has also been explored. Fungal infections can cause entry lesions, often found in between the toes, in between deep skin folds, and other places of warmth [51]. These entry lesions then serve as the point of entry for bacteria ultimately leading to an acute attack. A study of randomly selected women from Léogâne, Haiti [63] included three distinct patient groups: 1) women with lymphedema; 2) microfilaria-negative and antigen-negative women with no lymphedema; 3) asymptomatic microfilaria-positive and antigen-positive women. The authors compared cellular and humoral reactivity to a panel of bacterial, fungal, and filarial antigens among the three groups of women. DTH skin testing was performed for seven antigens. The lymphedema group had an increased reactivity to the bacterium Proteus. Women who had experienced 3 or more acute attacks in the last 18 months were more responsive Trichophyton (a fungal pathogen) antigen (P = 0.0006) than those with fewer attacks. There was no association between number of acute attacks and the other skin test antigens. The authors also found that women with lymphedema had significantly increased responses to IgG for strepsolysin-O (SLO), indicating that this group experiences an increased number of Streptococcus infection, but there was no relationship found between the frequency of and time interval since the last acute attack and reactivity to SLO. These findings indicate that either SLO is not the best measure of Streptococcal infection or that it is not the only cause of ADL. Other bacterial pathogens and fungi may be contributing causes to ADL episodes. Additionally, a study in Sao Paulo, Brazil [64] obtained swab specimens from 21 lymphedema patients. Of these, 13 contained lesions suggesting infection with the fungus Tinea pedis. Furthermore, fungal infection was the lone agent in 7 out of the 13 patients. This was accompanied by a high prevalence of the bacterium Corynebacterium minutissimum. These patients were not known to be experiencing an ADL episode when the swab specimens were obtained. A case-control study in Georgetown, Guyana exploring the relationship between inter-digital lesions and number of ADL attacks [47] found evidence of fungal infections in a low proportion of skin and nail abnormalities among the patients, but regardless of etiology, the presence of inter-digital lesions was the most significant...