| A case of ovale malaria in a child from Delhi is reported. Urban malaria ecotypes caused by P. ovale has never been seen before. Characteristic morphological features of the parasite in stained blood film confirmed its identification. ( info) |
12/292. doxycycline-induced esophageal ulceration in the U.S. Military service. U.S. military forces are frequently deployed with little warning to regions of the world where chloroquine-resistant malaria is endemic. doxycycline is often used for malaria chemoprophylaxis in these environments. The use of doxycycline can be complicated by esophageal injury. Two cases of esophageal ulceration will be discussed, followed by a review of the literature. doxycycline causes esophageal injury through a combination of drug-specific factors, the circumstances of drug administration, and individual patient conditions. patients with dysphagia attributable to esophageal ulceration are managed by intravenous fluid support and control of gastric acid reflux until their symptoms resolve over 5 to 7 days. The risk of esophageal injury can be minimized by use of fresh capsules, drug administration in the upright position well before lying down to sleep, and drinking at least 100 ml of water after swallowing the medication. ( info) |
13/292. Drug-induced acute malaria. The case of an elderly woman with asymptomatic P. malariae infection that acutely reactivated after 45 y of latency following treatment with chlorambucil and methylprednisolone is reported. Only 1 similar case with methotrexate-induced acute malaria has been reported in the English literature thus far. ( info) |
14/292. Observations on malaria in Indonesian timor. malaria parasitemias were found in 35% of 520 individuals from a village in Timor, indonesia. plasmodium falciparum accounted for 80% of infections. The existence of P. ovale in Timor is reported for the first time. The WHO Standard Field Test for drug resistance did not reveal significant resistance of P. falciparum or P. vivax to chloroquine. ( info) |
15/292. Application of the indirect fluorescent antibody method in a study of malaria endemicity in Mato Grosso, brazil. Four surveys of malaria endemicity were conducted in the Cuiaba Sector of Mato Grosso State, brazil, at 6-month intervals during the period April 1970 to September 1971; during April 1970 a survey was also conducted in the Campo Grande Sector. Over 4,000 dual specimens--blood films for parasite diagnosis and filter paper blood spots for determination of fluorescent antibody (IFA) response--were collected from the general population, including school populations whenever possible. Parasitologic examinations yielded positivity rates ranging from 0.8 to 2.3%. In the Cuiaba Sector, sero-positives (larger than or equal to 1:20) ranged from 9.3 to 13.6%; in the survey in the Campo Grande Sector only 4.3% of the specimens were positive. There was an expected increase in IFA response with age in both the proportion of positives and mean maximum titers. In the Cuiaba surveys 75 to 91% of the maximum positive responses were to the plasmodium falciparum antigen, while in Campo Grande only 46% of the maximum titers were for P. falciparum. The wide differences in malaria endemicity observed within the Cuiaba Secctor were attributed to differences in climate, geography, and degree of development of the several regions. A study of surveillance reports from 1966 through the survey dates revealed that the high rates of infection seen often resulted from detection activities in the larger cities and probably represented cases imported from endemic areas to the north and west. In order to interpret accurately the endemicity of malaria in an area and, thus, determine the necessity for introduction or continuation of control measures, thorough epidemiologic studies are necessary. The addition of a serologic method to normal surveillance can increase the accuracy of interpretation. ( info) |
| A female patient with plasmodium falciparum malaria apparently resistant to chloroquine is descirbed. She had recently returned from mozambique, which may prove to be a new endemic are with resistant strains. The infection was successfully treated with quinine. ( info) |
17/292. Fatal falciparum malaria among narcotic injectors. Eleven narcotic injectors from a prison in Saigon were hospitalized with falciparum malaria. coma and intense parasitemia were common and eight patients died soon after admission. Two of three autopsied cases also had purulent pulmonary infections. No non-addicted prisoners were hospitalized for malaria. Nine more unsuspected falciparum infections were found among 29 other addicts in the prison. The clustering of malaria infections among narcotic injectors who had not been in malarious areas indicates that the malaria was transmitted by the common use of needles and syringes. Cerebral malaria in an addict may be misdiagnosed as drug intoxication. malaria surveillance is recommended for the increasing addict population in the cities of Southeast asia. ( info) |
| malaria has long been among the most common diseases in the southeast Anatolia region of turkey. In 1992, 18676 cases were diagnosed in turkey, and Diyarbakir city had the highest incidence (4168 cases), followed by SanliUrfa city (3578 cases). malaria was especially common during 1994 and 1995, with 84345 and 82094 cases being diagnosed in these years, respectively. Spontaneous rupture of malarial spleen is rare. We saw two cases during 1998, which are reported herein. Both patients were male, and were receiving chloroquine treatment for an acute attack of malaria. One of the patients had developed abdominal pain and palpitations, followed by fainting. The other patient had abdominal pain and fever. Explorative laparotomy revealed an enlarged spleen in both patients. splenectomy was performed in both patients. We have identified 15 episodes of spontaneous rupture of the spleen in the English language literature published since 1961. Because of increased travel to endemic areas and resistance to antimalarial drugs, malaria is a major medical problem that is becoming increasingly important to surgeons worldwide. malaria is a particularly important problem in the southeast Anatolia region of turkey. Prophylactic precautions should be taken by tourists who travel to this region, especially during the summer. ( info) |
19/292. The potential utility of the Semi-Nested Multiplex PCR technique for the diagnosis and investigation of congenital malaria. We report three cases of congenital malaria involving two malarial immune mothers living in spain. Diagnostic PCR and Genotyping PCR for merozoite surface proteins 1 and 2 were essential to show that mothers and new-borns had different Plasmodium population parasites at the moment of the delivery, and that the infection was acquired earlier in gestation by transplacental transmission. In the first case the Plasmodium species founded in both, mother and child were different. malaria in the twins showed a mixed infection (P. falciparum plus P. malariae) while the mother presented a P. falciparum infection. These facts were confirmed studying the polymorphisms for MSP1 and MSP2. blood samples of the newborns were analyzed an half hour after delivery excluding the possibility of re-infection by mosquito bite and indicating a vertical transmission during pregnancy. ( info) |
20/292. Coadministration of mefloquine and chloroqine: use of a pharmacokinetic-based approach to reduce toxicity. A child with malaria from a chloroquine-resistant area received an accidental overdose of chloroquine administered by a parent. Application of pharmacokinetics permitted definitive treatment with mefloquine in a safe and effective manner. ( info) |