Ribavirin has not been evaluated yet in controlled clinical trials.Use of ribavirin during pregnancy is generally not recommended, as some studies indicate the possibility of teratogenic effects. If aseptic meningitis, encephalitis, or meningoencephalitis develops in consequence to LCMV, hospitalization and supportive treatment may be required. In some circumstances, anti-inflammatory drugs may also be considered. In general, mortality is less than one percent. Prognosis
Lymphocytic choriomeningitis is not a commonly reported infection in humans, though most infections are mild and are often never diagnosed. Serological surveys suggest that approximately 1–5% of the population in the U.S. and Europe has antibodies to LCMV. The prevalence varies with the living conditions and exposure to mice, and it has been higher in the past due to lower standards of living. The island of Vir in Croatia is one of the biggest described endemic places of origin of LCMV in the world, with IFA testing having found LCMV antibodies in 36% of the population. Individuals with the highest risk of infection are laboratory personnel who handle rodents or infected cells. Temperature and time of year is also a critical factor that contributes to the number of LCMV infections, particularly during fall and winter when mice tend to move indoors. Approximately 10–20% of the cases in immunocompetent individuals are thought to progress to neurological disease, mainly as aseptic meningitis. The overall case fatality rate is less than 1% and people with complications, including meningitis, almost always recover completely. Rare cases of meningoencephalitis have also been reported.
A vesicointestinal fistula (or intestinovesical fistula) is a form of fistula between the bladder and the bowel. Types
A fistula involving the bladder can have one of many specific names, describing the specific location of its outlet:

Bladder and intestine: "vesicoenteric", "enterovesical", or "vesicointestinal"
Bladder and colon: "vesicocolic" or "colovesical"
Bladder and rectum: "vesicorectal" or "rectovesical"

Symptoms and signs
If fecal matter passes through the fistula into the bladder, the existence of the fistula may be revealed by pneumaturia, fecaluria, or recurrent urinary tract infection. Migration of urine through the fistula into the bowel may cause rectal passage of urine. Causes
Many causes exist including:
diverticulitis : most common ~ 60%
colorectal cancer (CRC) : ~ 20%
Crohns disease : ~ 10%
radiotherapy
appendicitis
trauma

Diagnosis
Various modalities of diagnosis are available:
Cystoscopy
Colonoscopy
Poppy seed test
Transabdominal ultrasonography
Abdominopelvic CT
MRI
Barium enema
Bourne test
CystogramA definite algorithm of tests is followed for making the diagnosis. See also
Gouverneur’s syndrome

References


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