1/9. African trypanosomiasis in two travelers from the united states.African trypanosomiasis is a rare but well-documented cause of fever in united states travelers returning from areas where it is endemic. We report two recently diagnosed cases that involved tourists who went on safari in tanzania. review of these and 29 other published cases indicates that disease in returning united states travelers is nearly always of the East African form, a fulminant illness for which prompt diagnosis is necessary. In the united states, timely and appropriate therapy for this disease has resulted in favorable outcomes for most patients. Chemoprophylaxis for East African trypanosomiasis is not recommended, but travelers visiting areas of endemicity should practice appropriate preventive measures to prevent tsetse fly bites.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
2/9. Cerebrospinal trypanosomiasis masquerading as pulmonary infectious disease in a 1-year-old boy.A 1-year-old boy with cerebrospinal trypanosomiasis presented with severe respiratory symptoms, hepatosplenomegaly and no neurological signs of trypanosomiasis. Agitation and high fever on the 2nd day in hospital prompted a lumbar puncture and trypanosomes were recovered from the cerebrospinal fluid.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
3/9. East African sleeping sickness in Chennai.A traveler to East africa developed fever, an eschar on his forearm and thrombocytopenia shortly after returning home to Chennai, india. trypanosoma brucei rhodesiense infection was diagnosed on examination of his peripheral smear. He made a full recovery after receiving a course of suramin.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
4/9. Sleeping sickness in brothers in london.Brothers 9 and 14 years of age presented in london with fever and skin lesions after a safari in East africa. malaria films were negative, but trypanosomes were seen in blood films and chancre fluid. Sleeping sickness should be considered in children returning from East africa.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
5/9. African sleeping sickness in the united states. Successful treatment with eflornithine.The traditional treatment of African sleeping sickness (trypanosomiasis) with central nervous system involvement is an organic arsenical compound, melarsoprol, which is associated with severe and even life-threatening side effects. A polyamine biosynthesis inhibitor, eflornithine (chemical name, DL-alpha-difluoromethylornithine, supplied as monohydrochloride monohydrate), was used to treat a 3 1/2-year-old child with newly diagnosed severe trypanosomiasis that had been acquired more than two years previously in Zaire or the congo. Treatment consisted of 300 to 400 mg/kg/d of eflornithine by continuous intravenous infusion for 25 days followed by 300 mg/kg/d of eflornithine by mouth divided in four equal doses daily for 17 days. The child's recovery was dramatic, with eradication of blood and cerebrospinal fluid parasites in the first week. cerebrospinal fluid pleocytosis resolved completely. Her generalized adenopathy and fever gradually resolved. Severe ataxia, inability to walk or to change posture on her own, marked language regression, and lethargy all improved during and after her therapy. The drug was well tolerated; the only noted adverse effect was transient thrombocytopenia during the fourth week of therapy. eflornithine was a safe and effective agent for treatment of trypanosomiasis with central nervous system involvement in this child.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
6/9. African sleeping sickness presenting in an American emergency department.A 27-year-old American man who had returned recently from East africa presented with African sleeping sickness, probably of the Rhodesian (East African) type. High fever, malaise, and watery diarrhea were his predominant symptoms. No trypanosomal chancre was noted. Treatment for malaria in africa had not been effective. In the emergency department, diagnosis was established by demonstrating trypanosomes on blood smear. Treatment with an IV course of suramin was successful.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
7/9. Some transfusion-induced parasitic infections in zambia.The risk of acquiring a transfusion-induced infection in zambia was studied for the first time. blood slide examination of donors, despite the insensitivity of the method, established malaria as the most serious hazard. The species involved was plasmodium falciparum, the cause of cerebral malaria, and which could be rapidly fatal in a non-immune host visiting an endemic area. Microfilariae of dipetalonema perstans and wuchereria bancrofti were also found in donor populations. While no disease may be induced, allergic reactions due to the breakdown products of dead microfilariae may manifest themselves. Several cases of transfusion-induced malaria, a case of relapsing fever and a case of rhodesian trypanosomiasis are reported. toxoplasmosis and kalatazar, which may also be transfusion-induced, are both known to occur in the country but no cases were observed. It is emphasized that prophylactic measures should be mandatory in areas where no regular, screened, donor panel is available. The awareness and ackowledgement of the risk of transfusion-induced infections may be the best safeguard against the serious consequences in developing countries.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
8/9. African trypanosomiasis in an American hunter in East africa.An American citizen acquired African trypanosomiasis while on a hunting safari in sudan, East africa. His travel history and rapid onset of symptoms, including fever, chills, headache, lethargy, and weight loss, were suggestive of trypanosoma brucei rhodesiense infection, and trypanosomes were demonstrated in routine blood smears and buffy-coat preparations. Despite the presence of headaches, nuchal rigidity, and CSF pleocytosis, he was treated for non-CNS African trypanosomiasis, based on a normal CSF IgM level. This case report, along with a review of previously reported cases of imported African trypanosomiasis, illustrates the importance of clinical consideration of this rare, but often misdiagnosed, tropical illness in febrile patients returning from africa.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
9/9. The hemorrhagic fevers of Southern africa with special reference to studies in the South African Institute for Medical research.In this review of studies on the hemorrhagic fevers of Southern africa carried out in the South African Institute for Medical research, attention has been called to occurrence of meningococcal septicemia in recruits to the mining industry and South African Army, to cases of staphylococcal and streptococcal septicemia with hemorrhagic manifestations, and to the occurrence of plague which, in its septicemic form, may cause a hemorrhagic state. "Onyalai," a bleeding disease in tropical africa, often fatal, was related to profound thrombocytopenia possibly following administration of toxic witch doctor medicine. Spirochetal diseases, and rickettsial diseases in their severe forms, are often manifested with hemorrhagic complications. Of enterovirus infections, Coxsackie B viruses occasionally caused severe hepatitis associated with bleeding, especially in newborn babies. Cases of hemorrhagic fever presenting in February-March, 1975 are described. The first outbreak was due to marburg virus disease and the second, which included seven fatal cases, was caused by rift valley fever virus. In recent cases of hemorrhagic fever a variety of infective organisms have been incriminated including bacterial infections, rickettsial diseases, and virus diseases, including Herpesvirus hominis; in one patient, the hemorrhagic state was related to rubella. A boy who died in a hemorrhagic state was found to have congo fever; another patient who died of severe bleeding from the lungs was infected with leptospira canicola, and two patients who developed a hemorrhagic state after a safari trip in Northern botswana were infected with Trypanosoma rhodesiense. An illness manifested by high fever and melena developed in a young man after a visit to zimbabwe; the patient was found to have both malaria and marburg virus disease.- - - - - - - - - - ranking = 10keywords = fever (Clic here for more details about this article) |