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232 points BostonFern | 3 comments | | HN request time: 0.44s | source
1. bsmirnov ◴[] No.41862627[source]
If you're interested in this topic, look up Dr. Kevin Cahill and his work in tropical medicine.

Sadly, situations like these are far more common than people think. My wife studied abroad in India in 2004 and returned with persistent stomach issues. After seeing multiple doctors (gastroenterologists, infectious disease specialists, etc.) and undergoing countless tests (stool samples, endoscopy, colonoscopy), no one could figure out what was wrong. One doctor labeled it IBS (a catch-all diagnosis), and another suggested anti-depressants, citing the side effect of diarrhea to treat her constipation.

Someone recommended she see Dr. Kevin Cahill, who specialized in tropical diseases. He charged $500 in cash and did all the tests himself, including a sigmoidoscopy. Unlike typical practices, he personally examined the samples. After six months of suffering, we got a diagnosis the next day: amoebiasis. With the right medication, she began to improve within weeks.

Dr. Cahill, who passed away in 2022 (https://www.nytimes.com/2022/09/17/nyregion/kevin-m-cahill-d...), had a near-legendary reputation because of his success rate. He was one of the last U.S. doctors to conduct tests and analyze samples himself, a practice that gave him a much higher detection rate for parasitic infections.

Ten years later, we had a similar issue. My wife fell ill again, and despite numerous tests, nothing was found. We went back to Dr. Cahill. Once again, he called the next day with a diagnosis—this time whipworm and giardia. I tested positive too, despite having no symptoms. Dr. Cahill explained that these infections can easily pass between spouses but often don't affect children.

He lamented that modern medicine has drifted away from these hands-on diagnostic practices. In the latest edition of his book, he even published a study showing that major medical institutions only detected parasitic infections in about 50% of known positive samples. The main issue? Sample degradation during transit, disinterested lab technicians, and improper detection methods.

Dr. Cahill was critical of procedures like colonoscopies for detecting protozoa or small helminths. He explained that the bowel-cleansing laxatives used before the procedure wipe out traces of the parasites, leaving the doctor with an inflamed but “clean” view. It’s no surprise that issues return shortly after.

I believe that a significant number of people in developed countries may unknowingly live with parasitic infections, from whipworms to giardia to toxoplasmosis. A single instance of poor hygiene in a restaurant or undercooked food is all it takes. Ironically, poorer countries often have better detection tools due to reliance on old-school methods.

Considering AI's success in areas like breast cancer detection, it seems like there’s a huge untapped potential for AI in diagnosing parasitic infections, especially given the inconsistency and difficulty in manual detection. This is a pervasive issue that cuts across social status, and many infected individuals will never know unless they get lucky with the right doctor.

replies(2): >>41864838 #>>41866727 #
2. LorenPechtel ◴[] No.41864838[source]
Very, very interesting--I have always assumed I inherited my mother's issues. Docs have done stool tests, nothing--but as it says they are prone to false negatives. The labs aren't good with the rare stuff. I almost certainly came down with malaria but made the "mistake" of going to the doc my wife worked with. GP, but he did work with DWB and had plenty of clinical experience with malaria. Labs come back a week later--they weren't set up to do the simple swab he ordered and substituted the closest thing they had which wasn't close at all. Came back "negative" so I'm not in the CDC data. The thing is I'm pretty sure of the initial infection point--20+ years earlier. At the time, three rounds of it before I got back to the states and talked to a tropical medicine guy. No symptoms at the time so he wasn't sure what he did would get it all. Never actually lab-diagnosed by the fever pattern is obvious and it responded to chloroquine but I was in an area with some resistance and couldn't take the right drug.

Do you know anybody else who does this sort of thing?

3. matheusmoreira ◴[] No.41866727[source]
As a brazilian doctor, it's great to see people paying attention to tropical diseases. I gotta admit it's kind of surreal, intestinal worms and Giardia lamblia are an everyday thing here.