Internal Medicine

0521779407-B01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:52

242 Bladder Tumors Blastocystis Hominis Infection

or obstruction/pyelonephritis, and possible B12 or absorption (GI)

problems secondary to bowel used for “neobladder/ileal conduit”

complications and prognosis

■Natural History of Bladder TC Ca

➣>70% are low-grade noninvasive or invasion into lamina propria

➣Recurrences and progression are common, especially with grade

III or >T1 stage

➣Life expectancy for metastatic disease - no greater than 12–16

months

➣1–5% of pts with bladder TC Ca can develop upper tract TC Ca;

15–20% for CIS

Blastocystis Hominis Infection..........................

J. GORDON FRIERSON, MD

history & physical

History

■Exposure: Ingestion of contaminated food and water is presumed

mode of infection (full cycle not worked out yet). It is controver-

sial whether Blastocystis hominis is a pathogen, and it is found fre-

quently in absence of symptoms. With careful search, another cause

of symptoms frequently found.

Signs & Symptoms

■Unclear whether it causes any symptoms. If so, mild chronic diarrhea

most often reported. Abdominal examination usually normal.

tests

■Basic tests: blood: normal

■Basic tests: urine: normal

■Specific tests: Stool exam for O&P shows organism.

■Other tests: none

differential diagnosis

■Any cause of mild chronic diarrhea

management

What to Do First

■Determine presence of symptoms. Look for other causes of symp-

toms, as another cause is frequently found.