2012-04-03

desert diabetics at risk of fungal infection #HFCS #hormonics

4.2: web.health/diabetics at risk
of deadly, desert fungal infection:
summary:
. the Mayo clinic (in az's Phoenix suburbs)
has released a report of an invasive fungus,
Basidiobolus ranarum,
that is partial to deserts (Arizona and Saudi Arabia);
and, it grows tumor-like masses around the intestines;
but it's very rare, because it prefers diabetics,
other metabolic disorders, or the immune compromised .
. a systemic fungal infection that is partial to deserts?
that reminds of valley fever .
. I got very sore knees from valley fever in Tucson
after tilling the ground during the fungal infection's
favorite growth period: after a long-needed rain .
. Basidiobolus ranarum starts from ingesting the feces
of some animal whose intenstines usually contain it .
. the CDC had no clues as to how the very few victims
could have possibly ingested feces,
but they may not be aware of the desert's
ferocious dust storms:
they can dig deep for fresh feces,
and fling it into a breathing mouth or nose .

. mayo's blog of the report,
and mayo's references to a medical journal
and an oral presentation of report (video) .

Mayo's Gastrointestinal Basidiobolomycosis report:
"( Emergence of Gastrointestinal Basidiobolomycosis in the United States,
With a Review of Worldwide Cases):

Gastrointestinal basidiobolomycosis
is an emerging invasive fungal infection
in desert regions of the US Southwest.
Of 44 patients (mean age, 37 years [range, 2–81 years])
with gastrointestinal basidiobolomycosis,
most were from the United States (19 patients [43%],
of whom 17 [89%] were from Arizona)
or Saudi Arabia (11 [25%]).
Most (28 [64%]) were previously healthy.
Common chronic medical conditions
among 15 patients (34%) were
diabetes mellitus (8 patients [18%])
and gastric disorders (7 [16%]).
Common findings were
abdominal pain (37 patients [84%])
and a palpable abdominal mass (19 [43%]).
Intraabdominal malignancy was the leading
provisional diagnosis (19 patients [43%]).
The large bowel was involved in 36 (82%),
the small intestine in 16 (36%),
and the liver or gallbladder in 13 (30%).
Characteristic histopathologic findings
were observed in 43 (98%).
Eight patients (18%) died.
Combined surgical intervention and antifungal therapy
was the preferred treatment.
. the medical society of Turkey
had done such a report in 2006:
Turk J Med Sci 2006; 36 (4): 239-241
"( Gastrointestinal Basidiobolomycosis as a
Rare Etiology of Bowel Obstruction )

. Basidiobolomycosis is a rare fungal infection caused by
Basidiobolus ranarum, an environmental saprophyte .
B. ranarum is a member of the order
Entomophthorales of the class Zygomycetes .
Basidiobolomycosis is usually a subcutaneous infection
--[ not a systemic infection ]--
that affects mostly young males,
and it is transmitted through traumatic inoculation.
[ fungus enters through a skin abrasion ]
Basidiobolus ranarum was first isolated in 1955
from decaying plants in the United States
and subsequently has been found in soil
and vegetations throughout the world .
B. ranarum is sometimes present as a commensal
[ a non-harmful parasite like rectal bacteria ]
in the intestinal tracts of frogs, toads, turtles, chameleons,
horses and dogs .
. the first human case of Subcutaneous mycosis
was recognized in Indonesia in 1956 .
In 1978, the first culture proving invasive basidiobolomycosis
of the maxillary sinus and palate
was reported in the United States .
There are only 21 case reports of gastrointestinal
basidiobolomycosis in the literature:
8 from the United States,
6 from Saudi Arabia,
4 from Brazil, 2 from Nigeria,
[ brazil is one of the few other places with Valley Fever too ]
and 1 from Kuwait .
All patients had abdominal pain and fever
as their main symptoms, as in our case,
with no response to conventional therapy.
. most cases [of the more common subcutaneous form]
have been reported from tropical and subtropical regions .
While the diagnosis of subcutaneous disease is easy,
the diagnosis of gastrointestinal basidiobolomycosis
is more difficult; because
its clinical presentation is nonspecific;
[but,
here is how they made the diagnosis in a toddler ]
(1.5-year-old male (Iran's Kerman province)):
relapse of fever and inflammatory rectal mass,
laboratory findings of eosinophilia and elevated ESR,
and characteristic broad septate fungal elements
with granuloma in pathology .
. Mayo also did a 2004 report of
Gastrointestinal basidiobolomycosis:
Clin. Microbiol. March 2004 vol. 42 no. 3 1367-1369
. The portal of entry is believed to be the skin,
after insect bites, scratches, and minor cuts.
It is most common in young children
as a disease of the skin and subcutaneous tissues,
involving the thighs and buttocks.
Most cases have been reported in tropical and south-tropical climates,
mainly in Indonesia and East and West Africa .
Gastrointestinal basidiobolomycosis is exceedingly rare;
only 15 cases have been reported worldwide
(2 cases from Nigeria, 4 cases from Brazil,
1 case from Kuwait, and 7 cases from the United States,
all from the state of Arizona so far) .
Here we report the first case of
disseminated basidiobolomycosis
in an immunocompetent woman
in which the first clinical manifestations were related to
lung involvement associated with eosinophilia.
Based on the observations of Marshall Lyon et al. (14),
visceral involvement in basidiobolomycosis is being
increasingly recognized in industrialized countries,
and the reasons for this are unclear.
--[ . but try this for a reason:
increasing severity of widespread metabolic disorder,
after sugar was replaced with high-fructose corn syrup .
. not only does HFCS create brief spikes of high blood sugar,
but also, it reduces to the level of immunocompetency
by causing insulin resistance
and chronically raising cortisol . ]
Probably this peculiar geographic distribution
should be related to a specific
style of life and dietetic behavior.
Case patients in Arizona had amphibians or reptiles
outside their homes (five patients),
fewer case patients washed vegetables
before eating them (four patients)
and camped near a lake or river
during the previous year (three patients);
however, the patients had a history of
diabetes mellitus (in three patients),
peptic ulcer disease (in two), or pica (in one) (16).
The patient presented
had nothing in her history to suggest
any predilection for infection by
this very unusual organism.
The common denominator for this case
and the series reported from Arizona
appears to be involvement of the gastrointestinal tract.
. here is a 2001 report of Arizona:
ClinInfect Dis.(2001) 32 (10): 1448-1455
. We reviewed the clinical characteristics of
the 11 patients in 1994-1999 Arizona
with Gastrointestinal basidiobolomycosis:
Five patients were male (37–59 years)
and had a history of diabetes mellitus (in 3 patients),
peptic ulcer disease (in 2), or pica (in 1).
Potential risk factors included prior ranitidine* use
and longer residence in Arizona.
*[. what would Ranitidine have to do with it?
it is stomach acid blocker used to treat GERD
(gastroesophageal reflux disease),
which as associated with nerve damage due to
metabolic disorders similar to diabetes;
or, having a lack of stomach acid would
help the fungus gain entry through an ulcer .]

. the CDC's summary of the emerging infection:
. U.S. Ecologic studies have identified B. ranarum
in reptiles and amphibians .
GIB (Gastrointestinal basidiobolomycosis)
presumably is acquired through ingestion.
fHowever, except for the patient with a history of pica,
it is unclear how the other patients acquired the infection.
--[. they lived in the desert with dust storms
which blew the feces into mouth or nose .]
Possible exposures include
unintentional ingestion of contaminated soil,
especially near rivers or lakes,
or eating fruits or vegetables contaminated with
soil or feces from reptiles or amphibians.
The findings in this report indicate that
decreased acidity and other host factors
(e.g., underlying disease and use of medication)
may increase the risk for acquiring GIB.
. besides our devolving food quality,
another possible reason for increased infection rates
is the evolving of fungal defense systems:

Conserved fungal LysM effector Ecp6
prevents chitin-triggered immunity in plants.

Science, 2010; 329 (5994):
Once a fungus like leaf mould starts to infect,
a plant like the tomato would recognise the fungus
based on the presence of chitin fragments
that are derived from the fungal cell wall.
However, nearly all fungi carry a secret weapon:
the secretion of Ecp6 (extracellular protein 6)
that binds to the chitin fragments,
and makes them undetectable by the plant's immune system .