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Chapter 26 : Diseases with Long-Term Consequences in Search of a Microbial Agent
Category: Clinical Microbiology
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Host factors that may contribute to long-term consequences as a result of infections include the genetic background of the host (major histocompatibility complex status or genetic defects that increase susceptibility to disease), concomitant infections, age, gender, hormonal status, immune status, nutritional status, environmental factors, and behavioral attitudes. In the present chapter, the symptoms and long-term consequences of chronic diseases, including autism, rheumatoid arthritis (RA), inflammatory bowel disease (IBD), chronic fatigue syndrome (CFS), and multiple sclerosis (MS) are discussed. The diagnosis of CFS is based on clinical criteria; currently, there is no laboratory test for the identification of CFS. It is likely that CFS is due to infection by a heterogeneous group of microbial agents. Secondary progressive MS (SPMS) is seen in approximately 40% of RRMS patients. It starts out like RRMS, but as time progresses, patients show shorter and shorter periods of recovery between attacks. It is probable that a number of microbial agents or environmental insults can trigger the disease. The major neuropathological finding in Parkinson’s disease (PD) is the loss of pigmented dopaminergic neurons. It has been proposed that children who experience tics or obsessive-compulsive disorders are suffering from an autoimmune response to group A β-hemolytic streptococci (GABHS) infections. Tourette’s syndrome probably should be classified as one of the diseases caused by pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) since GABHS infections have been associated with the syndrome.