Medical and scientific journals withdraw or retract articles on a regular basis, usually because of errors discovered or questions raised about the research described. A few days ago, however, a highly unusual “correction” appeared in the prestigious British Medical Journal announcing the withdrawal of a case study titled “Cutaneous larva migrans with pulmonary involvement.” 
 
 The article, which was not retracted, contained no errors. The BMJ simply said in the undated note that “with no admission of liability, BMJ has removed this article voluntarily at the request of the patient concerned.” 
 
 Here’s what happened. 
 
 While sunbathing on a beach in Martinique, a British woman suddenly felt a burning sensation on her backside. The next day, she woke up to find a nasty rash of “red pinprick marks” on her bottom. 
 
 Soon her husband broke out with the same rash in the same unfortunate place. 
 
 While they received treatment in Martinique in the form of steroid cream, antibiotics and antifungal medication, the irritation did not subside. The voyage home, 10 days on a cruise ship, must have been uncomfortable. 
 
 Nor was the rash gone when they got home. 
 
 So they went for treatment at Addenbrooke’s Hospital in Cambridge, England. Doctors there found their backsides “infested by worms,” as the Cambridge News reported. The couple found relief from a combination of medications. 
 
 The doctors thought their case so interesting they wrote it up for the British Medical Journal. The journal did not use the name of the patients. But as journals often do in case studies, it accompanied the text with photos — in this case, of their backsides, from different angles, in full color. 
 
 The couple gave their permission and were warned that journal articles were often read by journalists as well as medical professionals, the BMJ said in an email to The Washington Post. But the couple apparently had not anticipated the potential for tabloid interest. 
 
 By mid-January, their buttocks were spread across Britain and, indeed the world, with headlines such as “Til Rash Do Us Part” in The Sun and “Caribbean getaway leaves a nasty souvenir” in the Daily Mail. 
 
 These were not your typical titillating tabloid photos. They were shots from various distances of behinds bearing inflamed red blotches. 
 
 Many tabloid readers found them gross. 
 
 “A description would have done,” commented one reader of Britain’s Daily Mail, adding that “we didnt need to see the evidence.” 
 
 “Does the DM pixelator have a day off today?!?,” wrote another. 
 
 “Thanks — that’s put me right off my cheese & ham toastie,” wrote a third. 
 
 Like the journal article, the stories did not include the names of the patients or say where they lived or when they visited Martinique. 
 
 But there was enough information — the age of the woman, the island, the cruise, the hospital — that the couple apparently felt that acquaintances conceivably could have made the connection. 
 
 One of the patients — the journal didn’t say which one — got in touch with BMJ and “explained that they were concerned about being identified by close friends and/or colleagues, as a result of the subsequent media coverage,” the publication said in a statement emailed to The Post. 
 
 “Prior to publication of the article, written consent from the patient was obtained,” said the statement. “By signing the consent form, the patient indicated their understanding that complete anonymity could not be guaranteed and it was also made clear in the consent form that BMJ publications are viewed by many non-doctors, including journalists.” 
 
 “The patient’s concerns did not amount to a legal threat,” it added. “… Nevertheless, the journal took the editorial decision to remove the article, because of the distress the patient had suffered. 
 
 ” … To be clear, the removal of the article does not amount to a retraction and the journal stands by its factual content.” 
 
 A spokesman for the hospital, part of Cambridge University Hospitals, also issued a statement: “The case study was shared with the BMJ with the aim of medical advancement, to aid other clinicians, and potentially help the treatment of future patients with similar conditions. Because the article was being picked up in nonmedical publications, a request was made for it to be removed.” 
 
 In fairness to the tabloids, there was some news and public service value to the stories useful to people planning on visits to tropical or subtropical beaches. 
 
 The diagnosis, as described by Livescience, quoting the no-longer-accessible case study, was “cutaneous larva migrans,” otherwise known as a hookworm infection. 
 
 According to the Centers for Disease Control and Prevention, people pick up this nasty parasite from the feces of dogs and cats. If those dogs and cats leave their waste on a beach, sunbathers can contract the infection. 
 
 In the case of the British couple, the infection found its way into their lungs, causing coughing, and in the woman, shortness of breath and pain. 
 
 The advice from the CDC for those visiting such beaches: “wear shoes and use protecting mats or other coverings to prevent direct skin contact with sand or soil.” 
 
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 Flawed drug tests used to remove scores of Canadian children from their parents, report finds ||||| A husband and wife returned home from a Caribbean cruise with identical souvenirs from their vacation: parasitic infections that caused itchy, red rashes on the couple's backsides, according to a report of their case. 
 
 After sunbathing on a sandy beach in Martinique one afternoon, the wife said she felt a burning sensation on her rear end. By the next day, this irritation had blossomed into an extremely itchy rash with "red pinprick marks," according to the report, which was published Jan. 13 in the journal BMJ Case Reports. 
 
 The woman's husband also developed a rash on his backside after spending time with his wife on the beach. So, the British couple sought help from the medical staff on the cruise ship, who prescribed antibiotics and anti-fungal medications, as well as a steroid cream to relieve the rash and quell the itchiness, the report said. [8 Awful Parasite Infections That Will Make Your Skin Crawl] 
 
 But these treatments didn't help, so when the couple returned home from the cruise, they went to the hospital. By this point, it had been 10 days since they'd sat on the Martinique beach. 
 
 When doctors at Addenbrooke's Hospital in Cambridge, England, examined the 52-year-old woman, they saw a wavy, red rash on her bottom. Her husband had a similar-looking rash on his backside, and doctors diagnosed both of them with "cutaneous larva migrans," according to the case report. 
 
 This is a skin condition caused by a hookworm infection. The most common culprit for the infection in the Caribbean is the hookworm Ancylostoma braziliense, according to the case report. 
 
 People can pick up the parasite after encountering hookworm larvae; these can be excreted in the feces of an infected animal, typically a dog or cat, onto sandy beaches or moist soil, the report said. 
 
 A high percentage of dogs and cats are infected with hookworm, especially strays, said Dr. Peter Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, who was not involved in the couple's case. When these animals defecate on the beach, hookworm larvae can easily migrate through the sand, he said. 
 
 But Caribbean beaches aren't the only places you can find hookworms; some beaches along the Gulf Coast of the U. S. and the Atlantic seaboard may also be teaming with the parasites, Hotez told Live Science. [10 Ways the Beach Can Kill You] 
 
 For a person to become infected with hookworm, there has to be direct contact between the skin and the larvae of the worm, Hotez said. That means that walking barefoot on contaminated beach may cause the infection. Hotez said he speculates that this couple may have sat bare-bottomed on the sand, or the sand may have gotten into their bathing suits. 
 
 Once a hookworm larva penetrates a person's skin, it can burrow around, leaving a trail-like rash of inflamed skin known as a "creeping eruption," Hotez said. Sometimes, the rash can have a winding appearance, as was the case for this couple, or sometimes it can look like lines on the skin, he noted. (The species of hookworm that is thought to have infected the couple can't reproduce in humans; as a result, when the worms infect humans, they typically burrow around in the skin until they die, Live Science previously reported.) 
 
 Doctors prescribed anti-parasitic medication to the husband and wife, according to the report. But five days later, the woman went to the emergency room because she was experiencing shortness of breath, a dry cough and chest pain. Her husband also developed a dry cough. 
 
 A small percentage of people with cutaneous larva migrans may get symptoms in their lungs, Hotez said. When this occurs, it means the larvae got into the bloodstream and were carried to the lungs, he said. 
 
 A chest X-ray can show if the larvae have infiltrated the lungs, Hotez said. And indeed, there was evidence of this in both the man and the woman, according to the case report. 
 
 Lung-related symptoms tend to happen when there is significant exposure to hookworm larvae, Hotez noted; in other words, a person would have to be infected with a large number of larvae. 
 
 The couple was given a second dose of anti-parasitic medication, and the treatment quickly helped clear up their skin as well as their lungs, according to the case report. 
 
 Originally published on Live Science. ||||| A Tennessee teen's summer trip to Florida turned nightmarish after he contracted hookworms from playing in the sand at the beach, according to news reports. 
 
 The 17-year-old Michael Dumas visited south Florida in June for a church trip, and during a beach-outing, his friends buried him in sand, according to news station Local Memphis. 
 
 Soon after, the teen started feeling itchy, and he later developed blisters, scrapes and rashes on his lower body, Local Memphis reported. The wounds are "incredibly horrible and they're so graphic," his mother, Kelli Dumas, told the station. "One of them is 3 inches by 3 inches. It's a crater in his foot," she said. [Beachgoers Beware? 5 Pathogens That Lurk in Sand] 
 
 Michael Dumas' foot on July 25. Dumas contracted hookworms from sand at a Florida beach, according to his mother Kelli Dumas. Credit: Kelli Mulhollen Dumas 
 
 The teen was diagnosed with hookworms, which are parasites that can infect both people and animals. Some species of hookworm that typically infect cats and dogs can be transmitted to people through contaminated sand or soil, according to the Centers for Disease Control and Prevention (CDC). 
 
 This happens when infected animals defecate in sand or soil and pass hookworm eggs in their stool. People can then become infected if they walk barefoot or lie down on the infested sand or soil, the CDC says. 
 
 The hookworm larvae can burrow into the skin and then crawl around in the top layers of skin. However, because humans aren't the normal hosts for these hookworms, the parasites usually don't live more than six weeks in people, the CDC says. 
 
 These hookworms are typically found in tropical or subtropical regions. In January, a Canadian couple reported that they contracted hookworms in their feet while walking barefoot on a Caribbean beach. 
 
 Michael Dumas was treated with more than $1,300 worth of medications and is still recovering, according to news reports. 
 
 "He is in pain and this is AWFUL," Kelli Dumas posted to Facebook. "Please, please pray for him to heal," she said. 
 
 Original article on Live Science. ||||| Sharks will tear open your flesh. Jellyfish will double you over in pain. And now, another villain has joined the list of threats at the beach. 
 
 Beware of hookworms lurking in the sand. 
 
 A teenager from Memphis was attacked by hookworms after his friends buried him in the sand at Pompano Beach, his mother says. 
 
 Kelli Dumas, a Memphis dentist, said she’s confident her son Michael got the worms on the beach because he always wore shoes and walked on concrete during the rest of his time in Florida. 
 
 At least four others with him contracted the intestinal parasite, but Michael has the worst case by far, she said. 
 
 Dumas shared graphic pictures of her son’s swelling and reddened feet and detailed the cost of his treatment, including a steroid medicine that cost more than $1,300 for six pills. “He is in pain and this is awful,” Dumas wrote on Facebook. “Never be buried in sand or allow your children to be either.” 
 
 Photo courtesy of Kelli Dumas Foot of Michael Dumas Foot of Michael Dumas (Photo courtesy of Kelli Dumas) 
 
 Rare as it seems, hookworms are plausible at the beach, said Glenn Morris, who directs the University of Florida’s Emerging Pathogens Institute. 
 
 “Basically, you would have to get contamination of the sand from fecal material,” Morris said. “It can happen.” 
 
 Beaches could be a risk because they are crowded with people and animals, Morris said. Sanitation on the beaches is vital, he said. Wash your hands and wear shoes if you want to reduce the likelihood of infection. 
 
 In 2010, the Miami-Dade Health Department linked an outbreak of hookworm to stray cats living at the beach. At least six cases were confirmed, with a dozen more suspected. 
 
 Hookworms used to be fairly common in the U.S., but improvements in living conditions have greatly reduced the number of infections, according to the Centers for Disease Control and Prevention. 
 
 They are transmitted through the feces of an infected person. Infections typically spread when people walk barefoot on a contaminated site, such as soil or a field, according to the CDC. 
 
 Some patients with hookworms experience abdominal pain, especially those infected for the first time, the CDC said. Symptoms in severe cases include diarrhea, loss of appetite and weight loss. The most serious problem from hookworm infection is blood loss that leads to anemia. The infection is treatable with medicine. 
 
 Kelli Dumas Michael Dumas Michael Dumas (Kelli Dumas) 
 
 Pompano Beach spokeswoman Sandra King said the city hasn’t been notified of the hookworm incident or any hookworm outbreak. “We haven’t heard from anyone, not any resident, not the health department,” she said. The Florida Department of Health is investigating, spokeswoman Candy Sims said. 
 
 Michael Dumas was in South Florida from June 16 to 23 as part of a mission trip sponsored by his church, the Church of Christ at White Station in Memphis. The teens painted picnic tables, packed boxes of food and attended Vacation Bible School. 
 
 “These kids were not on vacation. They worked,” Kelli Dumas said. 
 
 On Thursday, more than a month after Michael went to the beach, Dumas said her son has not yet recovered. “He is not doing well,” she said. “There are open gaping wounds on his feet and his inner and outer calves. He can’t go to football practice. He can’t wear shoes.” ||||| Woman admitted to intensive care after infection from pet dog 
 
 An elderly woman was admitted to intensive care due to organ failure following a rare, yet potentially life-threatening infection believed to be transmitted by her household pet, an Italian greyhound. 
 
 Writing in the online journal BMJ Case Reports, doctors who treated the 70-year-old patient explain that she developed acute kidney failure after a few days of being admitted to hospital. 
 
 Paramedics discovered her slumped in a chair, with decreased consciousness, after she had slurred speech and became unresponsive while on the telephone to a relative. 
 
 Upon admission to hospital, her symptoms temporarily improved, but on the fourth day, she developed confusion, headache, diarrhoea, and rigors, along with high fever. She was transferred to intensive care for kidney failure. 
 
 Blood cultures revealed Capnocytophaga canimorsus, a rare yet significant cause of sepsis. It is a bacterium frequently isolated in the oral cavities of cats and dogs. 
 
 After two weeks of intensive care and antibiotic treatment, the patient made a full recovery. 
 
 Only 13 cases of sepsis related to C. canimorsus have been reported in the UK since 1990. Mortality rates of 26%, with 60% of cases reporting a dog bite and 24% reporting other dog contact, have been documented. 
 
 "This is an interesting case", the doctors explain, "because neither scratch nor bite was established, although close petting including licks was reported." 
 
 Diseases which can be transmitted to humans from animals are frequently missed diagnoses, explain the doctors, and they summarise important infections transmitted by cats and dogs (see table 1). 
 
 Pinworms found in teenage girl's appendix **video available** 
 
 A teenage girl admitted to hospital with suspected appendicitis was found to have pinworms in her appendix (see video footage), according to an article published in the online journal BMJ Case Reports. 
 
 The 15-year-old patient was admitted to the paediatric department in the UK following abdominal pain with nausea, but without vomiting. Her pain was located on the right hand side of her hip, a common sign of appendicitis. 
 
 Even though blood tests, a urine sample and abdominal ultrasound were inconclusive, surgeons decided to operate because appendicitis is a common and potentially life threatening condition. 
 
 After removal of the pinworms during surgery, the girl along with her family, were treated with medications to kill any of remaining parasites and eggs. Her pain disappeared and she made a full recovery. 
 
 After surgery, microscopic examination confirmed the presence of pinworms and absence of appendicitis. 
 
 Parasitic worms are one of the most common infections worldwide. Estimates suggest that up to 50% of British children may have a related infection. 
 
 Concerns over traditional Indian herbal remedy 
 
 A 26-year-old student developed lead poisoning from taking Indian Ayurvedic herbal medicine, write doctors in the online journal BMJ Case Reports. 
 
 During a trip to India, he took the herbal medications to treat his low back pain. On returning to the USA, he began to use them regularly, but developed pain in the upper central region of his abdomen, weight loss, dark stools, nausea and vomiting. 
 
 A blood test showed he was suffering from anaemia and a high level of lead in his blood. 
 
 No other source of lead exposure was evident, so doctors advised him to discontinue use of his four different types of Ayurvedic medications. He was given morphine and medications for nausea and vomiting. 
 
 Treatment to remove excess iron, known as chelation therapy, was initiated, and within months the patient's symptoms resolved. 
 
 "This case follows similar reports in the USA of acute lead toxicity from Ayurvedic medications produced in India," writes Dr Judith Green-McKenzie, University of Pennsylvania Perelman School of Medicine. 
 
 "Concern regarding the use of Ayurvedic herbal medicines originates from their easy availability, increasingly international use and global reach, lack of focused scientific research and the possibility of abuse in an unregulated industry," she concludes. 
 
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– After suffering painful red rashes on their backsides, a husband and wife were left red in the face—so much so that a case study of their ordeal has now been pulled from the prestigious British Medical Journal. As BMJ tells the Washington Post, the British pair whose bottoms became infested with hookworm larvae on a beach in Martinique initially agreed to the Jan. 13 publication of their case, as well as photos of "red pinprick marks" on their backsides. Though their names were never mentioned, the pair "indicated their understanding that complete anonymity could not be guaranteed" and were warned journalists might pick up the story, BMJ says. But when that happened—with headlines like "His and Her Hookworm: Same Rash Strikes Couple on the Rear"—the pair had a change of heart. With the spread of photos and case details—including the woman's age, the couple's Caribbean destination, the cruise line on which they traveled, and the Cambridge hospital they visited—one of the pair asked that the article be withdrawn over concerns "about being identified by close friends and/or colleagues," BMJ says. In what the Post calls a "highly unusual 'correction,'" the journal then announced it was pulling the article despite standing by its content. As the Independent reports, the article was meant to helpful in combating a lack of familiarity in the medical community with hookworm infections. According to the CDC, such infections can be passed through contact with soil or sand contaminated with feces. As the BMJ study explained, the British couple were infected when they sat on a sandy, and apparently unsanitary, beach.