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Chlamydial [[cervicitis]] in a female patient characterized by [[mucopurulent]] [[cervix|cervical]] discharge, [[erythema]], and [[inflammation]].]] Chlamydia is an asymptomatic disease for about 50-70% of the female population.  Of those who have an asymptomatic infection that is not detected by their doctor, approximately half will develop [[pelvic inflammatory disease]] (PID), a generic term for infection of the [[uterus]], [[fallopian tubes]], and/or [[ovaries]].
PID can cause scarring inside the [[reproductive organ]]s, which can later cause serious complications, including chronic [[pelvis|pelvic]] pain, difficulty becoming [[pregnancy|pregnant]], [[ectopic pregnancy|ectopic (tubal) pregnancy]], and other dangerous complications of pregnancy. Chlamydia causes 250,000 to 500,000 cases of PID every year in the U.S. Women infected with chlamydia are up to five times more likely to become infected with HIV, if exposed.<ref>{{cite web |url=http://www.cdc.gov/std/chlamydia/STDFact-Chlamydia.htm#complications |title=STD Facts - Chlamydia |accessdate=2007-10-26 |format= |work=}}</ref>
Chlamydia is known as the "Silent Epidemic" because in women, it may not cause any [[symptom]]s and will linger for months or years before being discovered. Symptoms that may occur include: unusual [[vagina]]l bleeding or discharge, pain in the abdomen, painful [[sexual intercourse]] ([[dyspareunia]]), [[fever]], painful [[urination]] or the urge to urinate more frequently than usual. Male patients may develop a white, cloudy or watery discharge (shown) from the tip of the [[penis]].]] In men, chlamydia shows symptoms in about 50% of cases. Symptoms that may occur include: a painful or burning sensation when urinating, an unusual discharge from the [[penis]], swollen or tender [[testicle]]s, or fever. Discharge, or the purulent exudate, is generally less viscous and lighter in color than for [[gonorrhea]]. If left untreated, it is possible for Chlamydia in men to spread to the testicles causing [[epididymitis]], which in rare cases can cause [[infertility|sterility]] if not treated within 6 to 8 weeks. Chlamydia causes more than 250,000 cases of epididymitis in the USA each year.
Chlamydia may also cause [[reactive arthritis]], especially in young men.  About 15,000 men develop reactive arthritis due to chlamydia infection each year in the USA, and about 5,000 are permanently affected by it. The triad of reactive arthritis, conjunctivitis and urethritis (inflammation of the urethra) is known as [[Reiter's Syndrome]].  All three entities must be present for this label to be used.  It can occur in both men and women, though is more common in men. 
As many as half of all [[infant]]s born to mothers with chlamydia will be born with the disease. Chlamydia can affect infants by causing spontaneous abortion; [[premature birth]]; [[conjunctivitis]], which may lead to [[blindness]]; and [[pneumonia]]. Conjunctivitis due to chlamydia typically occurs one week after birth (Compare with chemical causes (within hours) or gonorrhea (2-5 days)).


====Acute Sinusitis====
[[Acute (medical)|Acute]] sinusitis is usually precipitated by an earlier [[upper respiratory tract infection]], generally of [[virus|viral]] origin.
Virally damaged surface tissues are then colonized by [[bacteria]], most commonly ''[[Haemophilus influenzae]]'', ''[[Streptococcus pneumoniae]]'', ''[[Moraxella catarrhalis]]'' and ''[[Staphylococcus aureus]]''. Other [[bacterial]] [[pathogen]]s include other [[streptococci]] [[species]], [[Anaerobic organism|anaerobic bacteria]] and, less commonly, [[gram negative]] bacteria.
Another possible cause of sinusitis can be dental problems that affect the maxillary sinus.
[[Acute (medical)|Acute]] episodes of sinusitis can also result from [[fungus|fungal]] invasion.
These [[infection]]s are most often seen in [[patient]]s with [[diabetes]] or other [[immunodeficiency|immune deficiencies]] (such as [[AIDS]] or [[transplant]] [[patient]]s on anti-rejection medications) and can be life threatening. In type I diabetes, ketoacidosis causes sinusitis by [[Mucormycosis]].




====Chronic Sinusitis====
Chronic sinusitis is a complicated spectrum of diseases that share chronic inflammation of the sinuses in common. The causes are multifactorial and may include allergy, environmental factors such as dust or pollution, bacterial infection, and/or fungus (either allergic, infective or reactive). Non allergic factors such as [[Vasomotor rhinitis]] can also cause chronic sinus problems.


Symptoms include: [[Nasal congestion]]; facial pain; [[headache]]; [[fever]]; general [[malaise]]; thick green or yellow [[Rhinorrhea|discharge]]; feeling of facial 'fullness' worsening on bending over; aching teeth. 


Very rarely, chronic sinusitis can lead to [[anosmia]], the inability to [[olfaction|smell]] or detect odors.


In a small number of cases, chronic [[maxillary]] sinusitis can also be brought on by the spreading of bacteria from a dental infection.


Attempts have been made to provide a more consistent nomenclature for subtypes of chronic sinusitis. A task force for the American Academy of Otolaryngology - Head and Neck Surgery / Foundation along with the Sinus and Allergy Health Partnership broke Chronic Sinusitis into two main divisions, Chronic Sinusitis without polyps and Chronic Sinusitis with polyps (also often referred to as Chronic Hyperplastic Sinusitis). Recent studies which have sought to further determine and characterize a common pathologic progression of disease have resulted in an expansion of proposed subtypes. Many patients have demonstrated the presence of [[Eosinophil granulocyte|eosinophils]] in the mucous lining of the nose and paranasal sinuses. As such the name Eosinophilic Mucin RhinoSinusitis (EMRS) has come into being. Cases of EMRS may be related to an allergic response, but allergy is often not documentable, resulting in further subcategorization of allergic and non-allergic EMRS.


 
A more recent, and still debated, development in chronic sinusitis is the role that [[fungus]] may play. Fungus can be found in the nasal cavities and sinuses of most patients with sinusitis, but can also be found in healthy people as well. It remains unclear if fungus is a definite factor in the development of chronic sinusitis and if it is, what the difference may be between those who develop the disease and those who do not.
 
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|valign=top|
|+
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Subtypes of Myocarditis}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Histological Findings}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Clinical Presentation}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
:Fulminant
| style="padding: 5px 5px; background: #F5F5F5;" |
*Multiple foci of inflammation
| style="padding: 5px 5px; background: #F5F5F5;" |
*Acute severe cardiovascular compromise with ventricular dysfunction
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Acute
| style="padding: 5px 5px; background: #F5F5F5;" |
*''IDH1''
*''[[p53]]''
*Gene on chromosome 10q
*Gene on chromosome 17p
*Gene on chromosome 19q
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Chronic Active
| style="padding: 5px 5px; background: #F5F5F5;" |
*''[[EGFR]]''
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
:Chronic Persistent
| style="padding: 5px 5px; background: #F5F5F5;" |
*''[[TP53]]''
*''PDGFRA''
*''IDH1''
|-
|}

Latest revision as of 20:41, 8 March 2016

Acute Sinusitis

Acute sinusitis is usually precipitated by an earlier upper respiratory tract infection, generally of viral origin. Virally damaged surface tissues are then colonized by bacteria, most commonly Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis and Staphylococcus aureus. Other bacterial pathogens include other streptococci species, anaerobic bacteria and, less commonly, gram negative bacteria. Another possible cause of sinusitis can be dental problems that affect the maxillary sinus. Acute episodes of sinusitis can also result from fungal invasion. These infections are most often seen in patients with diabetes or other immune deficiencies (such as AIDS or transplant patients on anti-rejection medications) and can be life threatening. In type I diabetes, ketoacidosis causes sinusitis by Mucormycosis.


Chronic Sinusitis

Chronic sinusitis is a complicated spectrum of diseases that share chronic inflammation of the sinuses in common. The causes are multifactorial and may include allergy, environmental factors such as dust or pollution, bacterial infection, and/or fungus (either allergic, infective or reactive). Non allergic factors such as Vasomotor rhinitis can also cause chronic sinus problems.

Symptoms include: Nasal congestion; facial pain; headache; fever; general malaise; thick green or yellow discharge; feeling of facial 'fullness' worsening on bending over; aching teeth.

Very rarely, chronic sinusitis can lead to anosmia, the inability to smell or detect odors.

In a small number of cases, chronic maxillary sinusitis can also be brought on by the spreading of bacteria from a dental infection.

Attempts have been made to provide a more consistent nomenclature for subtypes of chronic sinusitis. A task force for the American Academy of Otolaryngology - Head and Neck Surgery / Foundation along with the Sinus and Allergy Health Partnership broke Chronic Sinusitis into two main divisions, Chronic Sinusitis without polyps and Chronic Sinusitis with polyps (also often referred to as Chronic Hyperplastic Sinusitis). Recent studies which have sought to further determine and characterize a common pathologic progression of disease have resulted in an expansion of proposed subtypes. Many patients have demonstrated the presence of eosinophils in the mucous lining of the nose and paranasal sinuses. As such the name Eosinophilic Mucin RhinoSinusitis (EMRS) has come into being. Cases of EMRS may be related to an allergic response, but allergy is often not documentable, resulting in further subcategorization of allergic and non-allergic EMRS.

A more recent, and still debated, development in chronic sinusitis is the role that fungus may play. Fungus can be found in the nasal cavities and sinuses of most patients with sinusitis, but can also be found in healthy people as well. It remains unclear if fungus is a definite factor in the development of chronic sinusitis and if it is, what the difference may be between those who develop the disease and those who do not.