This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!) On episode 2 of season 8 (named “Transplant”), House treats the lungs of an 18-years old man who died in a motorcycle accident. The lungs were donated and planned to be transplanted in one of Wilson’s patients, but went bad just before the transplant, and House’s job was to find out what’s wrong with them. After ruling out cocaine abuse, a tumor in another organ (which affected the lungs) and even peanut allergy and heavy metal poisoning, House and his new and only team member find white blood cells in the lungs, and then diagnose the lungs with eosinophylic pneumonia

Photo by fox

Photo by FOX

Danger level: Medium

What is it?

Eosinophilic pneumonia is a group of diseases in which eosinophils (a type of white blood cells that are responsible for the body’s response in allergies and infections by parasites) accumulate in the lungs and interfere with their function.

Who gets it?

The disease isn’t common, but exactly how rare it is isn’t known. Different diseases in this group can be more common in men or women, and most of them develop in adults (usually not in elderly people).

What causes it?
Eosinophils are cells in our immune system that are active during allergic reactions and parasitic infections. When activated, eosinophils secrete chemicals that can cause inflammation. In people with eosinophilic pneumonia, eosinophils accumulate in the lung, are activated and secrete the chemicals – this causes the symptoms of the disease.
There are many causes for eosinophilic pneumonia. Some cases develop after the person is exposed to something outside the body – certain foods, drugs or even smoke (like in the House episode). Infections by parasites can also cause eosinophilic pneumonia. In other cases, the disease is related to changes inside the body – for example, it can be associated with another disease process. In some cases the reason for the disease is unknown.

An eosinophil, as seen under a microscope. Photo by Akay Miller

How does it feel?

The symptoms can be mild or severe, and include cough, wheezing and shortness of breath. When the disease is severe, it can cause the rate of oxygen in the blood to decrease and sometimes respiratory failure develops.

How is it discovered?

The doctor will suspect eosinophilic pneumonia if symptoms appeared shortly after exposure to foods or drugs that can cause the disease. Tests are performed to approve the diagnosis: blood tests to search for an elevated number of eosinophils in the blood; chest x-ray to see signs of pneumonia, and microscopic examination of lung secretions to search for eosinophils there as well.

How is it treated?

Usually, eosinophilic pneumonia is treated with steroids. If the disease appeared after exposure to foods or drugs – avoiding them will help with recovery, and if the disease is due to a parasitic infection – antibiotics are required.

What happens after treatment?

Most cases respond to medications (or even get better without treatment at all), but sometimes there’s severe lung failure which can be life threatening.

The bottom line – how do I avoid it?

If the disease appeared after exposure to a certain food or drug, avoiding them may prevent the disease from recurring. Also, people who had an attack of the disease should seek medical help right away if symptoms come back.

Related posts:

1. Your Questions Answered – Asbestosis – What Work Exposure Can Do To Your Lungs
2. Pleural Mesothelioma – Cancer of The Lungs Caused by Exposure to Asbestos
3. Deep Vein Thrombosis – Clots in Your Veins Which Can Travel To Your Heart and Lungs

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)

On the first episode of season 8 (named “Twenty Vicodin”, and featuring an interesting guest in the cast!), House is in prison after crashing his car into Cuddy’s living room. One of the prisoners has a fever, joint pain and a rash on his thigh, and House convinces the prison’s doctor that he has lupus. Later, after the prisoner breaks his arm from a minor hit and doesn’t stop bleeding from a small cut, House listens to his chest and discovers an “acoustic shadow”, meaning there is a mass in his lungs. After drinking some coffee the prisoner develops a severe allergic reaction (anaphylaxis) which causes his airway to swell up and almost kills him. House then realizes that the reason for the reaction was the high temperature of the coffee and diagnoses him with mastocytosis

Photo by fox

Danger level: Medium

What is it?

Our immune system is composed of many types of cells and partןcles. Mast cells belong to the immune system and are involved mostly in allergic reactions. These cells produce substances that cause some of the allergy symptoms, the most famous of them is histamine. In systemic mastocytosis  the amount of these mast cells increases significantly, causing the disease.

This is how a mast cell looks. Photo by Ed Uthman

Who gets it?

Systemic mastocytosis is an extremely rare disease – so rare that it’s frequency in the population is not known. It’s a bit more common in men than women, and appears mostly in children, though it may happen to adults (and then the most common age is 55).

What causes it?

The disease develops when a mast cell starts dividing uncontrollably (like in cancer). Since the mast cells keep dividing, there are too many of them – and they can form a tumor, circulate in the blood or accumulate in organs. Also, substances that mast cells produce like histamine are released in larger amounts than usually. All these processes can cause symptoms.

How does it feel?

Symptoms can appear in any organ where mast cells accumulate. This can cause skin rashes, bone pain and problems with the liver, spleen or bone marrow.

Substances that are produced in mast cells and released in large amounts (like histamine) can cause itching, flushing and symptoms in the digestive system (for example: abdominal pain, diarrhea, peptic ulcers and problems with the absorption of food).

Another important symptom is severe allergic reactions (also called anaphylaxis) which can be dangerous and cause difficulty breathing or a very low blood pressure. The most severe allergic reaction in mastocytosis is to bee stings.

In some cases flushing and low blood pressure can develop in response to certain drugs against inflammation (like in the “aspirin test” at the end of the episode), and any symptom can be worsened by these drugs, alcohol or narcotics.

Mastocytosis in toddlers

How is it discovered?

The doctor can suspect mastocytosis based on the symptoms and blood work, but the only definitive test is a bone marrow biopsy, in which a bone sample is taken from the lower back. An important test which can support the diagnosis before performing the biopsy is measuring the levels of histamine in the blood or urine.

How is it treated?

There is no cure for mastocytosis. Treatment is aimed at reducing symptoms, and this is done mostly by different types of pills (for example, anti-histamines which are usually used for allergies).

What happens after treatment?

There are different types of mastocytosis which are dangerous in different levels. In some cases patients have the same life expectancy as the normal population, but in the more violent types (which are, luckily, more rare) patients survive for several months only.

The bottom line – how do I avoid it?

Unfortunately, there is no known way to avoid mastocytosis.

Related posts:

1. Sickle Cell Disease – When the Shape of Your Blood Cells Can Kill You (As Seen On House MD)
2. Astrocytoma (Butterfly Tumor)–A Brain Tumor That Spreads To Both Sides (As Seen On Grey’s Anatomy)
3. Pheochromocytoma – A Rare Tumor That Can Cause Hypertension (As Seen on House MD)

We usually go to the doctor when we don’t feel well or have a symptom that bothers us – and that’s how diseases are discovered most of the time. But – some diseases can be detected before having any symptoms, when they’re on their early stage. Screening tests are meant just for that and  are one of the best ways to protect your health – they are generally simple, performed routinely and can detect serious illnesses. Here ‘s a list of 10 important screening tests that you should know and consider taking.

Photo by Chandra Marsono

1. Colon Cancer Screening: Every person over 50 years old (or younger if a close relative had colon cancer, if they have IBD, or if they have certain genetic syndromes) should have colorectal cancer screening. The screening tests are aimed to find growths inside your colon, called polyps. Polyps have the potential to become cancer – but if detected early, they can be removed, preventing cancer. There are several ways to find polyps:

• Fecal occult blood (recommended once a year) is a simple stool test in which the feces is searched for small amounts of blood (that comes from polyps) which you can’t see on your own.
• During flexible sigmoidoscopy (recommended every 5 years) a short lighted tube is inserted to your rectum and looks for polyps on the lower third of your colon. During this procedure, polyps can also be removed.
• Colonoscopy (recommended every 10 years) is a similar test using a longer tube which can reach the whole length of your colon.

2. Mammography: A mammogram is a used for early detection of breast cancer – which is the most common cancer in women. This is an x-ray of the breasts, which can discover cancer when it’s still too small to feel it on your own. The test is recommended for all women between the ages of 50 to 74, and should be performed every 2 years. Besides that, it’s recommended for all women to have self-exams and clinical exams (by a doctor) of the breasts regularly.

On the left – a normal breast in mammography. On the right – a breast with breast cancer (white). Photo by National Cancer Institute.

3. Mole Exam: In this exam a dermatologist looks at your moles to see if any of them is suspicious to be skin cancer or melanoma. it’s recommended to have this check-up once a year. Besides that, you should try a self check-up every month – look for moles which are asymmetric, don’t have sharp borders, don’t have a constant color or are larger than 6mm (about a quarter of an inch).

4. Pap smear: This is a screening test for cervical cancer – the cervix is lower part of the uterus in women, and can be reached in a vaginal exam. It’s a simple test which is performed in your gynecologist’s office. During the usual gynecologic exam, the doctor will collect some cells from your uterine cervix and the area around it. Later these cells are check under a microscope and pre-cancer cells will be looked for. These cells can be also checked for a virus called HPV which causes cervical cancer. This test is performed once a year after the age of 21 or 3 years after the first time you have sex (whichever comes earlier).

5. Prostate cancer screening: The prostate is an organ that exists only in men. It’s small (about the size of a walnut), located under the bladder and in front of the rectum, and produces part of the semen fluids. Prostate cancer is the most common cancer in men. There are two screening tests for this cancer: a PSA test is a simple blood test to measure the levels of a substance called Prostate specific antigen (PSA) – which will be high in prostate cancer. Another important test is a digital rectal exam – this is done in your doctor’s office – the doctor inserts a finger to your rectum and feels the size and shape of the prostate. Currently there isn’t enough evidence supporting routine testing for prostate cancer, but you can ask your doctor if you should do one of the tests yourself.

6. Bone Density: The purpose of this test is to diagnose osteoporosis – a condition common in older people (mostly women) in which bones become thin and weakened, which makes them susceptible to fractures. This is a special x-ray picture which measures the density of bones in your hips, spine and wrists. Routine screening is recommended for women older than 65 years old.

7. HIV Test: HIV is the virus causing AIDS (Acquired Immunodeficiency Syndrome), which makes your body susceptible to life-threatening infections. It can be transmitted by having unprotected sex or sharing needles with someone who has the disease. The United States Center for Disease Control and Prevention (CDC) recommends that everyone get tested at least once in their life, and afterwards at least once a year if they had new sex partners since the last test (or their partner had sex with someone else), or if they are injecting drugs or steroids with used injection equipment.

8. Abdominal Ultrasound: This test’s purpose is to look for an aortic aneurysm. This is a dilatation of an artery so it looks like a balloon, causing the wall of the artery to become thinner so it might rupture. A common place for such an aneurysm is the abdominal aorta, which is a part of the largest artery in the body – you don’t want this one to rupture. A simple ultrasound test can discover an aneurysm. In the United States, this screening test is recommended for men between ages 65-75 who smoked in the past (or still are) or men above 60 years old with a family history of an aortic aneurysm. This test should be performed only once.

Photo by National Heart, Lung and Blood Institute

8. Abdominal Ultrasound: This test’s purpose is to look for an aortic aneurism. An aneurism is a dilatation of an artery so it looks like a balloon. This causes the wall of the artery to become thinner so it might rupture. A common place for such an aneurism is the abdominal aorta, which is a part of the largest artery in the body – you don’t want this one to rupture. With a simple ultrasound test (which can produce images of your abdomen without any radiation), the doctor can see if there is an aneurism. Sometimes the treatment for that will be surgery. In the United States, this screening test is recommended for men between ages 65-75 who smoked in the past (or still are) or men above 60 years old with a family history of an aortic aneurism. This test should be performed only once.

9. Routine blood tests: You should have a routine blood test once a year. This includes complete blood count (CBC) to check for anemia, fasting glucose levels – which is a screening test for diabetes, and cholesterol levels – high cholesterol raises the risk for heart diseases (and treating it can prevent them).

10. Routine Check-Up with your family doctor: It’s important to visit your family doctor at least once a year when you’re healthy. They will perform a physical exam, measure your blood pressure (high blood pressure doesn’t cause any symptoms but can be dangerous in the long run) and do an EKG (which is a test that checks the activity of your heart) – to look for various heart diseases. This is also a good opportunity to tell the doctor about symptoms or problems that bother you.

Here’s a summary of screening tests mentioned in the article. Find the ones that apply to you and make your appointment today.

Related posts:

1. Common Variable Immunodeficiency (CVID)–When a Cold Can Threaten Your Life (As Seen on House MD)
2. Crohn’s Disease – Inflammation in The Intestines Which Can Influence Your Whole Life

This week, more than 1,000 people got sick and 16 died in an outbreak of HUS – a disease related to the bacteria E. coli. Initially cucumbers imported from Spain were blamed to be contaminated with the bacteria, but today this theory was proved wrong, and the source of the infection remains a mystery. What exactly is HUS, and what can you do to avoid it?

Initially, Germans have been warned not to eat cucumbers. (Photo by kobiz7)

Danger Level: High

What is it?

Hemolytic Uremic Syndrome (HUS) is a disease that causes anemia, renal failure and a low platelet count in the blood.

Who gets it?

Most cases of HUS develop in young children, but it can certainly happen in adolescents and adults as well.

It can affect men and women alike.

It’s usually not very common, occurring to 0.5-2 people out of 100,000 in the US per year.

What causes it?

The most common cause for HUS is infection with E. Coli bacteria. E. coli (or by its full name, Escherichia coli) is actually a large group of germs, some of them live in the intestines of healthy people. The type of E. coli which causes HUS is a violent type, which produces a toxin called Shiga-Like Toxin. The toxin is absorbed to the blood through the intestines, and damages the cells that create the most internal layer of blood vessels – especially in the kidney but also in other organs. This damage causes all the symptoms of HUS.

You can get infected with this type of E. coli by eating contaminated and undercooked meat or produce, drinking unpasteurized contaminated milk or swimming in contaminated pools and lakes. It can also be transferred by contact with infected people, for example – in day-cares.

E. coli (Photo by Phil Moyer)

There are other not-common causes for HUS, including:

• Other infections: Some other bacterial and viral infections can also cause HUS, but this is much less common.
• Medications: Several medications can (rarely) cause HUS, including birth control pills, some chemotherapy drugs and cyclosporine – which is used to suppress the immune system (for example after an organ transplant).
• Other diseases: Systemic Lupus Erythematosus (SLE), Preeclampsia and inflammation in the kidneys after radiation treatments.
• Some cases are genetic.

How does it feel?

1. Food Poisoning: The first symptoms are food-poisoning symptoms caused by the E. coli bacteria themselves. This can include abdominal pain, a fever, vomiting and diarrhea which usually becomes bloody at some point. these symptoms appear 5-10 days before all the other symptoms.
2. Anemia: This causes the sick person to look pale and be pretty tired, weak and irritable.
3. Bleeding: There might be external bleeding (from the nose of mouth) or bleeding under the skin, which looks like small unexplained bruises. this is caused by a low number of platelets, which are the cells in our body responsible for blood clots.
4. Kidney Failure: Can cause the body to produce less urine.

The story of 16-year-old Aly, who recovered from HUS

How is it discovered?

When suspecting HUS, the doctors will draw some blood. They will check several things: Complete Blood Count will let them know if there is anemia or low platelets, and kidney function tests will determine if there is kidney failure. They will also look at the blood under a microscope. Other tests that might be needed are a urine test (to look for blood in the urine) and a stool sample (to look for the germs).

How is it treated?

The treatment is given in the hospital, and the goal is to relieve the symptoms:

• The most important part of the treatment is dialysis treatments until the kidneys start working again. If the disease is diagnosed early enough, dialysis might not be needed. The doctors can save the kidneys from failing by giving a lot of fluids.
• The anemia is treated with blood transfusions, and the bleeding problems with platelet transfusions.
• Another possible treatment is plasma-exchange (also called plasmapheresis) – in which blood is removed from the body and blood from a donor is returned back. This is used to remove elements that cause the disease from the blood.

Although the cause is an infection, antibiotics are not part of the treatment.

Dialysis treatment.

What happens after treatment?

In most cases (about 90%, and especially in children), if the disease is discovered early enough and treated correctly, the patient recovers. The other 10% might die or remain with chronic kidney failure which will require dialysis treatments for the rest of their life or a kidney transplant. Some of the people who recover will develop kidney problems or hypertension later in life.

The bottom line – how do I avoid it?

The best way to avoid HUS is to avoid food-poisoning with E. coli – this can be done in several ways:

• Treating foods carefully: You should wash hands often when cooking, keep meat in the refrigerator or freezer, wash fruit and vegetables under running water, cook meat thoroughly without leaving pink areas (if you have a thermometer for cooking, cook to a temperature of at least 160°F [70°C]).
• Avoiding certain foods: Especially undercooked meat, unpasteurized milk and cider. Drink only clean water. Remember that the contaminated food will not necessarily look spoiled of taste bad.
• Avoid swimming in dirty lakes and pools.
• If you have diarrhea – wash hands often.

Related posts:

1. Everything You Need To Know About Fast Food – An Infographic
2. In the News – Hodgkin’s Disease
3. Naphthalene Poisoning – When Mothballs Kill More Than Just Moths (As Seen on House MD)

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)
On episode 23 of season 7 (the season finale, named “Moving On”), Afsoun Hamidi, a performance artist, collapses during filming one of her projects. Later she has pancreatitis, something resembling a tumor in her brain, and a skin rash. Biopsy of the rash reveals that her symptoms are related to a condition called Wegener’s granulomatosis.

Photo by NBCUniversal

Danger level: High

What is it?

Wegener’s Granulomatosis (WG for short) is an inflammation of blood vessels, restricting blood flow to various organs in the body.

Who gets it?

WG is quite rare. In the United States, for example, it’s estimated that about 3 out of every 100,000 people are sick with it. It’s more common in people of Northern European origins, and is less common in black people. It can occur in any age, but is most common in middle age (the average age when it appears is around 40). Men and women are affected equally.

What causes it?

In WG there is an inflammation of blood vessels in the body, meaning it’s a vasculitis (the medical term for inflammation of blood vessels. There are other diseases in this group – such as temporal arteritis and kawasaki, which we covered before).

Our blood vessels generally come in 3 sizes, much like clothing. Small, medium and large. WG is an inflammation of small and medium sized blood vessels.

It happens because the body actually attacks its own blood vessels. The process isn’t completely understood, but probably involves a change in the body’s immune system which triggers the body destroying its own blood vessels.

WG tends to affect mostly 3 systems in the body: The upper airways, the kidney, and the lungs. They are affected since the arteries that supply them with blood are damaged in the disease.

How does it feel?

There are some general symptoms in WG which include loss of appetite, fever, fatigue, and even weight loss.

Usually the first specific symptoms involve the upper airways and can include nosebleeds, nasal congestion, collapse of the bridge of the nose (causing a deformity called saddle nose, seen in this picture), a hole in the nasal septum (which separates our right side of the nose from the left), inflammation of the sinuses (sinusitis), ear infections, difficulty breathing, and coughing (sometimes a bloody cough).

When the disease is in the lungs people may feel shortness of breath (which may be caused by bleeding in the lungs), or cough. When the kidneys are involved, kidney failure can occur, which may be life threatening.

Other organs may be involved, such as the skin (a rash may appear, like the one on House), the joints – which can become inflamed as well, and the nerves (something which can also affect vision – like the patient on House told that had happened to her).

Believe it or not, but there are even more possible symptoms, into which we won’t get here (including, rarely, pancreatitis, which for some reason was a main manifestation on House).

How is it discovered?

The disease resembles many other diseases, making the diagnosis difficult. A blood test checking for a component in the body called ANCA can be used, since it’s elevated in the disease. A physical exam, x-ray, and urine test, among others, can help with the diagnosis. The definitive way is performing a biopsy (taking a piece of an organ to look at under a microscope) on one of the involved organs, which will show something like this:

WG under a microscope. The round area on the left is called a granuloma, which is a mass of immune cells (that’s how the disease got its name). Photo by Nephron.

How is it treated?

Drugs that suppress the immune system (which attacks the body here) are used in WG. This includes steroids and chemotherapy.

What happens after treatment?

With treatment given on time, symptoms may disappear altogether. Still, in about half of patients, the disease may return. Before the disease was understood and the right treatments were given, about half of all patients died within 5 months. Today more than 75% get to live longer.

The bottom line – How do I avoid it?

Unfortunately, there is no known way to prevent WG.

Related posts:

1. Behçet’s Disease – Inflammation of Your Blood Vessels, Throughout the Body (As Seen on House MD)
2. Waldenström’s macroglobulinemia – A Rare Blood Cancer That Can Lead To Strokes
3. Peripheral Arterial Disease – A Narrowing of Blood Vessels that Will Shorten Your Life

This is part of our House MD Project series.

Make sure to tune in tomorrow for a medical recap of tonight’s finale!

Click here to read the connection to the episode (spoiler alert!)


On episode 22 of season 7, named “After Hours”, a woman named Darrien is bleeding after a stabbing to her body. Her blood pressure and heart rate are almost missing on one side of her body, meaning something is blocking one of the arteries there. She then starts hallucinating due to an interruption of blood flow to her brain. Fever also develops, hinting at an infection. Turns out her symptoms were due to an infection with entamoeba, a parasite, which was released to her bloodstream by the stabbing.

Photo by NBCUniversal

Danger level: Medium

What is it?

Entamoeba histolytica is a parasite which can infect humans. It can infect the large intestine and sometimes the liver and other organs, causing a condition called amebiasis.

Who gets it?

It’s estimated that about 10% of the world’s population are infected with Entamoeba histolytica. It’s more common in some areas of the world where sanitation is poor, such as Central and South America, Africa, and Asia. In the United States it is estimated that about 4% of the population are infected – most of them are immigrants or people who have traveled to countries where it’s more common.

What causes it?

The infection, as mentioned above, is caused by a parasite – an ameba named Entamoeba histolytica, seen under a microscope in this photo:

The parasite can exist in 2 forms: One active (called a trophozoite) and one dormant – called a cyst. Infection occurs when a person swallows cysts. They hatch in the body, releasing trophozoites. These in turn start multiplying and can cause wounds in the lining of the intestines. They can also spread to the liver and other places.

Some trophozoites become cysts again, and are excreted in the feces, helping the infection spread.

Now how do people actually get to swallowing the parasite, or how do they infect themselves? The cysts can spread from person to person or through food or water. In places where there is poor sanitation, food and water can be contaminated with feces containing the ameba. If soil is polluted by human feces, fruits and vegetables growing in it will be infected as well. If someone doesn’t wash hands properly after going to the toilet, the infection can spread. You’re getting the idea…

How does it feel?

In many people (about 80%), the infection isn’t felt at all. When it is felt, symptoms start within about 2-4 weeks of ingesting the parasite, and can include flatulence, abdominal pain, diarrhea, or constipation. In some cases a dysentery may be caused, meaning there is blood and mucus in the feces. Fever may also develop. Blockage as well as perforation of the intestines can occur.

Sometimes the ameba may spread to the liver, causing an abscess (a localized collection of pus). The person would feel fever and chills, sweating, nausea and vomiting, and weight loss. Rarely, the ameba can spread to other areas of the body (even the brain).

This vivid video sums it up:

How is it discovered?

A stool sample has to be examined to find the ameba. Sometimes a tube with a camera (colonoscope) can be inserted to the colon to collect a sample from a wound caused by the ameba, to look at under a microscope.

To find a liver abscess, an imaging method such as an ultrasound, CT or MRI can be used. Blood tests can also help with the discovery of the parasite.

How is it treated?

An antibiotic is given that can kill the ameba. An example of such a drug is metronidazole (which was mentioned on House).

The bottom line – How do I avoid it?

When travelling to an area known to have poor sanitary conditions, make sure to drink only bottled water, tap water that’s been boiled for at least 1 minute, or bubbly water or soda drinks from sealed cans.

Do not drink fountain drinks or any drinks with ice cubes. Do not eat fresh fruit or vegetables you didn’t peel yourself. Do not eat dairy products that may not have been pasteurized. And don’t eat anything sold by street vendors.

If you have been infected, you can minimize risk of infection to others by washing your hands with soap and water after using the toilet, after changing diapers, and before handling food.

Related posts:

1. Malaria – A Deadly Infection Passed On By Mosquitoes (As Seen on House MD)
2. Gas Gangrene – An Infection That Can Rapidly Kill Your Muscles (As Seen on House MD)
3. Common Variable Immunodeficiency (CVID)–When a Cold Can Threaten Your Life (As Seen on House MD)

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


This episode (episode 21 of season 7, named “The Fix”) is a little tricky, since there were two major diseases here. First, Wendy Lee, a weapons designer, has a seizure, abdominal pain, inflammation around the kidney, a heart attack, rectal and vaginal bleeding, burning and bleeding gums and swollen genitals. She was poisoned with Spanish Fly (containing cantharidin, a toxin). The other story involved a boxer who passed out way too early during a fight. House discovers he has a glomus tumor in the back of his neck, which when pressed during the fight caused him to collapse.
We’ll be more brief about each condition here, since there are two of them.

Photo by FOX

Spanish Fly

It all starts with a green beetle called the Spanish Fly, pictured below.

Photo by Franco Christophe

The beetle contains a material called cantharidin. The beetle is usually crushed into powder form, which has many uses. One of them is getting farm animals to mate.

Throughout history, it’s also been used as a means of keeping an erection. This happens since, when it’s excreted in the urine, it causes swelling of the genitals (like was seen on House), and also an erection.

Another use is as an aphrodisiac (a substance that increases sexual desire).

Unfortunately, if the concentration of catharidin isn’t low enough, more than sexual arousal can occur – it can lead to actual poisoning.

How does it feel?

Catharidin poisoning can lead to burning of the mouth, pain while swallowing, nausea, vomiting blood, urinating blood, and painful urination. It can lead to bleeding of the upper gastrointestinal tract and its erosion. It can damage the kidneys. It can also, as was seen on House, lead to seizures and to problems with the heart. And last but not least, it can lead to an uncontrollable erection.

How is it treated?

There is no antidote. The only way to treat someone poisoned with Spanish Fly is through supportive treatment, which means treating the various symptoms.

Glomus Tumor

These are rare tumors belonging to a group of tumors called paragangliomas. Those of you with good memories will recall that we’ve also featured an article about a disease called pheochromocytoma, which usually occurs in the adrenal gland. When it occurs outside the gland, it’s called a paraganglioma.

When paragangliomas occur in the area of the base of the skull they are called glomus tumors.

And how does this all come together?

Pheochromocytomas, and paragangliomas, are tumors that secrete substances called catecholamines (such as epinephrine). When these are secreted, they can lead to hypertension, headaches, palpitations, sweating, nervousness, and even weight loss (the boxer on the House episode was so overworked when his tumor was pressed and released these substances, that he has lost consciousness).

Photo by mitopencourseware

How is it discovered?

The tumor can be discovered by taking a urine sample for catecholamines, which will be higher than normal. A CT, MRI, or other form of imaging technique can discover where in the body the tumor is located.

How is it treated?

The tumor is usually taken out in surgery, although in some cases radiation therapy is used.

Related posts:

1. Sleeping Sickness – A Fly Bite That Ends in A Coma (As Seen on House MD)
2. Carcinoid Tumors – A Rare Tumor Often Not Found On Time
3. Nesidioblastoma – A Tumor of the Pancreas That Can Secrete Hormones (As Seen on House MD)

Fibromyalgia is a chronic syndrome characterized by muscle and joint pain, stiffness and fatigue. About 3.4% of US women experience the disease (as you can read in our full article – Fibromyalgia – Chronic pain and fatigue). One such woman is Julie Wendell, and she chose to share her story with us.

Have a story of your own to share? Feel free to contact us anytime

“Mommy, open this, please?”, my 3 year old son asked as he handed me a cereal bar early one morning. I tried to tear off the top of the wrapper, but my fingers would not move or grasp the wrapper! Terrified, I tried opening it again, but to no avail. I had lost all strength in both of my hands! As calmly as I could, I asked my 7 year old son to open the cereal bar for his brother. But inside, I was panicking because the weakness in my hands persisted for about an hour. What was happening to me??? Little did I know that the morning of February 10th, 2008 marked the beginning of a myriad of severely painful symptoms. My life was about to drastically change.

Over the course of the next few weeks, I started to experience alarming new symptoms. In addition to the weakness in my hands, I noticed that the joints in my hands were very swollen and stiff. I even took pictures of my hands from all angles to make sure that their odd shape was not just my imagination. I would often feel sharp zinging pains in my extremities, especially in my hands, wrists, knees, and ankles. My muscles and joints ached like I had the flu. There were times when I would be convinced I had a temperature of at least 101, just to find out it was completely normal every time I checked.

My level of fatigue went from “full time single working mother” to “full time single working mother who also ran 100 miles a day”. I was physically exhausted from dealing with so much pain every day. To make matters worse, I started noticing that when I woke up each morning, I would not feel refreshed, even after a full straight 6-8 hours of sleep. Instead, it felt like I only slept for one hour each night. So not only was I physically exhausted, I was emotionally drained as well. The overall level of exhaustion was indescribable, the worst I have ever experienced in my life! But I was hoping that whatever was plaguing me would just stop on its own.

One afternoon in April 2008, after I got off work and picked up my kids, I couldn’t get home fast enough. My body was overwhelmed with pain like I never felt before. As soon as we walked through the door, I immediately headed for the couch, where I spent the next four days. I had to call my mom to help me take care of the kids. In addition to my existing symptoms, I also suffered from oppressive chest pain, muscles/joints that felt bruised, extreme coldness in my arms and face, and TMJ-like jaw pain. I also had the sensation that my aching spine and pelvis were going to slide out of my body. I cried often, because I had no idea how to cope with these bizarre symptoms. I tried heating packs, ice packs, Tylenol/Advil, but nothing even remotely helped me. My temperature was still normal at 98.6. My mom, who is a nurse, thought maybe I had a virus, but most of the symptoms did not even resemble any virus I had ever had in the past, plus I was not running a fever. Even after the four worst days of feeling severely “sick”, most of my symptoms never fully disappeared.

At this point, I was at my wits’ end, so I finally decided to get some help. So even though I was terrified of the possible outcomes, I made an appointment to see my primary care physician. After reviewing my list of symptoms and seeing the pictures of my hands, he thought it was very likely that I had rheumatoid arthritis. He immediately referred me to a rheumatologist, who wanted to test me for not only rheumatoid arthritis, but also lupus, mononucleosis, and multiple sclerosis. He ordered some x-rays of my hands and a lot of blood work. He also prescribed a week’s worth of steroids to see if that would help.

My daily life started becoming a real chore for me. Everything and anything I usually did without a problem was now unbearable or overwhelming. The mornings and evenings were the worst times of day for my pain, fatigue, and weakness. I tried to stay strong, especially for my children, but there were days where I felt like giving up on everything. I tried talking to a few friends and family members about how I was feeling, but they would just say that I was complaining too much and/or accuse me of being a hypochondriac. I had never felt so alone in my life.

The results of the blood tests and x-rays came back the following week and were completely normal. Also, the steroids ended up not helping me at all. Based on these findings, the rheumatologist suggested that I may have fibromyalgia. He prescribed an NSAID called Mobic to help with my muscle/joint pain and an anti-convulsant/anti-neuropathy medication called gabapentin to help with my nerve pain. The doctor said that diagnosing fibromyalgia was very tricky because there are no actual diagnostic tools. Instead, the diagnosis is made after everything else has been ruled out. He also wanted to wait and see how the next few months went with the new medications before confirming the suspected diagnosis.

During the following months, both of the medications had made a difference to where my daily activities became more tolerable. I still felt very fatigued, but my quality of sleep seemed to be more restorative (due to the gabapentin). My muscle and joint pain were definitely persistent but they were on more manageable levels (due to the Mobic).

When I went back to the doctor in August 2008, he reviewed all of my test results and evaluated me again, then officially diagnosed me with fibromyalgia, a syndrome characterized by chronic pain, stiffness, and tenderness of muscles, tendons, and joints. The treatment for fibromyalgia includes pain medication and exercise. The doctor advised me to continue with the medications I was currently taking and to try doing light exercise when possible. He also warned me that my medication combination was not always going to be perfect. He said it may take a few tries with various medications before reaching optimal pain management, and what works for me now may not work for me in a few years. I was completely devastated, knowing that I was going to live with unrelenting complicated pain and severe fatigue for the rest of my life.

Sometimes, in addition to medication and exercise, doctors recommend a gluten free diet to help alleviate fibromyalgia symptoms. Coincidentally, I had already been on a gluten free diet for 4 years already, due to having an auto-immune digestive disorder called Celiac Disease. Unfortunately, being on this diet did not stop me from having fibromyalgia nor had it eased its symptoms. My doctor said that I’m one of the unlucky fibromyalgia patients who was not positively affected by a gluten free diet. Sometimes I like to think that being gluten free has stopped my fibromyalgia symptoms from becoming uncontrollable.

A diagnosis of fibromyalgia carries a negative stigma in society because the symptoms are very vague and are not so clear-cut as other diseases/conditions. I have actually heard people say that there is no such thing as fibromyalgia, or that the symptoms are fake and they are all in the person’s head. It is also widely believed that people who have fibromyalgia just want attention and/or medication. There are many doctors do not recognize fibromyalgia as an actual medical condition. Therefore, people who do have fibromyalgia usually have to see numerous doctors before receiving a diagnosis. Luckily for me, reaching a diagnosis for my symptoms only took 6 months and involved seeing only 2 doctors. Some people suffer for years before finding an answer.

Since my diagnosis, additional symptoms have added themselves onto the original list, such as hypersensitivity to stimuli. For example, if there is too much light or sound, I start feeling very overwhelmed and need to remove myself from the situation. There are times where I cannot be touched, when even my clothes feel like too much overload on my skin and receiving a hug actually HURTS. I also started becoming sensitive to the weather patterns, especially low pressure systems. I jokingly call myself the “human barometer” because I seem to predict rain better than the weatherman! During periods of damp or cold weather, my muscles and joints heavily protest, and in turn, the pain increases substantially. I found that I have a low tolerance for any kind of exercise, it makes me feel worse rather than making me feel energetic and refreshed. I have also developed difficulty with my short term memory and concentration (i.e.-”fibro-fog”), which has affected all aspects of my life, especially work.

Today, it remains difficult for me to deal with the pain and fatigue that I experience every day with fibromyalgia. My doctor has changed my pain reliever from Mobic to tramadol, which is a bit stronger, so my pain is at a tolerable level most of the time. But I definitely have my share of bad days. On a positive note, I have learned a few things from my experience with fibromyalgia. I’ve learned not push myself to do more than I can handle, but I’m still learning that it’s okay to ask for help. I have also learned to prioritize what is actually important and to just take things one day at a time. Having fibromyalgia has made me realize it is so important not to take anything for granted. After my diagnosis, my rheumatologist had pointed out to me that fibromyalgia is not a deadly or destructive disease, which is very fortunate. However, living with chronic pain and fatigue is still a difficult challenge, no matter what the cause or prognosis. Yes, fibromyalgia is REAL.

Related posts:

1. Fibromyalgia – Chronic Pain and Fatigue
2. Tension Headache – The Toll We Pay for a Stressful Living

This is a guest post by Ashley Warner. Ashley is a graduate student working toward her Masters in Conservation Biology. She currently resides in Washington state and is a part-time content creator for Online Biology Degree.

Danger level: High

What is it?

Chagas disease (also called “American trypanosomiasis”) is an infection that eventually causes potentially fatal heart and digestive problems in 20-40 percent of infected humans.

Who gets it?

The parasite responsible for the disease, Trypanosoma cruzi (T. cruzi), exists mostly in central and south America and in Mexico, although a small number of infections documented in the southern United States indicate that the disease has spread into the north. Similarly, recent population movements have led to cases as far afield as Europe. Anyone living in one of these regions, particularly in a rural area, could potentially become infected.

What causes it?

T. cruzi lives in wild mammals such as opossums, armadillos, rats and raccoons and may inhabit domestic animals as well. The disease is transmitted to humans by triatomines (also called reduviid bugs), insects that feed on the blood of vertebrate animals. Often biting the faces of human victims, triatomines are commonly called “kissing bugs.”

A kissing bug. Photo by Fernando Otálora Luna

These insects defecate while feeding, and if one is carrying T. cruzi from a previous meal, the parasites will be in the feces. When human victims scratch at the bite, the infected feces enter the blood through the bite wound itself. The parasites can also pass through other places, such as the eye.

T. cruzi can also be transmitted by consumption of contaminated food (including breast milk), through transfusion of infected blood or transplantation of infected organs, and from an infected mother to her unborn child.

How does it feel?

Chagas disease proceeds in two phases.

The initial, acute phase, lasts for weeks or months. It usually brings about mild symptoms, if any, beyond swelling at the site of infection. The most recognizable symptom of acute infection, called Romaña’s sign, is swelling around the eye where the parasites reside.

A child with a Romana’s sign.

After several weeks, the infection proceeds to the chronic phase. In most cases, the parasites’ presence will cause no symptoms. This is known as indeterminate chronic Chagas disease. However, when symptoms do develop, they severely affect the heart and digestive system.

Cardiomyopathy (damage to the heart muscle) can lead to sudden death, while megacolon and megaesophagus (dilation and enlargement of the intestines and throat) cause difficulty swallowing, loss of weight and malnutrition and other life-threatening complications. In some cases chronic Chagas disease also affects the nervous system, impairing reflexes and sense perception.

How is it discovered?

Because it often presents no distinct symptoms (or no symptoms at all), Chagas disease can be difficult to detect. Diagnosis depend on detecting T. cruzi in the blood or the presence of antibodies specific to the parasite (antibodies are molecules the body produces to fight an infection).

How is it treated?

Acute cases respond well to antiparasitic drugs, and are often completely curable. In general, the younger the patient and the sooner treatment is received, the better the odds that the parasites can be eliminated.

However, in its chronic phase, Chagas disease becomes more and more incurable. In determinate chronic cases (where symptoms do appear), currently available antiparasitic treatments are not effective.

What happens after treatment?

If the disease is effectively treated with antiparasitic drugs, the parasite infection has been completely cured and the patient should suffer no further ill effects. Damage to the body in chronic cases may be irreversible even if a the parasites have been eliminated.

The bottom line — How do I avoid it?

Although research to develop one is underway, there is no vaccine for Chagas disease. The surest way to avoid infection is to avoid travel in regions where the disease is common. If you do spend any time in areas known to harbor T. cruzi and the kissing bugs that transmit it, avoid sleeping outdoors or in rural areas where the insects may inhabit buildings. Sleeping under a mosquito net is also advisable.

Related posts:

1. Leprosy – The Biblical Disease is Still With Us (As Seen On House MD)
2. Malaria – A Deadly Infection Passed On By Mosquitoes (As Seen on House MD)
3. Syphilis – The 4 Stage Disease That Will Make You Want To Wear A Condom

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)

On episode 8 of season 2, named “The Mistake”, a woman named Kayla suffers from a severe stomach pain while watching her daughters perform a school show. Later it’s found she also has uveitis (inflammation in the eye) and genital ulcers. A diagnosis is made of Behçet’s disease (the rest of the episode deals with the legal implications of a mistake Chase has made in her treatment).

Danger level: High

What is it?

Behçet’s disease is a rare disease in which inflammation of blood vessels leads to a group of symptoms, which can eventually also lead to death.

Who gets it?

As mentioned above, Behçet’s disease is quite rare. In North America and Europe it happens to about 1 out of 15,000 to 500,000 people. In other parts of the world it’s less rare. Turkey, for example, is where it’s most common – it happens to 420 people out of every 100,000. It’s also more common in Japan, Korea, China, Iran, and Saudi Arabia.

It’s more common in people of Middle Eastern and Japanese origin.

The disease tends to occur in people aged 20-40 years.

What causes it?

Behçet’s is caused by an inflammation in our blood vessels throughout the body. No one knows the exact cause, but it’s believed that the body attacks its own blood vessels. Our immune system, responsible for fighting infections, fights instead the cells of the blood vessels. This also happens in other types of diseases, making them belong to a group of diseases called autoimmune diseases (we covered some of them in the past here, including Hashimoto’s thyroiditis, Graves disease, vitiligo, and others).

Blood vessels. In Behçet’s disease, the body attacks them. Photo by Freya Mowat

How does it feel?

The most common thing in Behçet’s are mouth sores. They are painful and recurring. They can appear on the tongue, on the gums, or on the mouth’s lining.

The sores may also appear on the genital organs – the penis, scrotum, or vulva, where they tend to be painful. They may also appear in the vagina, where they are painless.

Since blood vessels throughout the body are damaged in the disease, a multitude of organs are affected. The eyes, for example, in which there is inflammation causing eye pain, redness, sensitivity to light and hazy vision. The skin can be involved as well, showing blisters or a very rapid reaction to a slight injury. The joints can become painful. Blood clots can form throughout the body, and may lead to a stroke. kidney or lung damage.

Even the digestive tract isn’t spared, possibly causing stomach cramps and diarrhea. One last organ that can be affected is the brain, causing headaches, confusion, and other things such as memory loss.

Athlete Sanya Richards describes her own experience with Behçet’s in this video:

How is it discovered?

There aren’t any lab tests that can confirm you have Behçet’s. The doctor determines a person has the disease based on their symptoms and their physical examination, and after ruling out other diseases.

How is it treated?

There is no cure for Behçet’s disease. Drugs such as steroids (and other drugs that suppress our immune system) are used to help deal with the inflammation and the symptoms.

What happens after treatment?

The disease tends to come and go. It may also result in death, but for many patients the severity of the disease usually abates with time.

Since the cause of Behçet’s disease isn’t known yet, no measures are known that can prevent the disease.

Related posts:

1. Wegener’s Granulomatosis–A Rare Inflammation in Blood Vessels that Can Lead to Death (As Seen on House MD)
2. Peripheral Arterial Disease – A Narrowing of Blood Vessels that Will Shorten Your Life
3. Familial Mediterranean fever – Fever and Inflammation Inside The Body