Paradoxical response during chemotherapy of tuberculous cervical lymphadenitis: a report of four cases

Enlargement of tuberculous cervical lymph nodes during chemotherapy is referred to as a paradoxical response, and it causes anxiety during treatment. Although the exact mechanism is still obscure, studies suggest it may be due to alteration in nodal tissue due to an immunological response. We present four cases of paradoxical response during antituberculous chemotherapy

Praziquantel, oxamniquine, and metrifonate in the treatment of schistosomiasis in Riyadh

This study sought to compare the effectiveness and side effects of praziquantel versus oxamniquine in treating 200 patients with schistosoma mansoni infection and praziquantel versus metrifonate in treating 100 patients with S. haematobium infection. Praziquantel and oxamniquine were given in single doses of 40 mg/kg body weight and 25 mg/kg, respectively. Metrifonate was given doses of 10 mg/kg, and repeated three times at fortnight intervals. In s. mansoni infections, the cure rate was 96% for parziquantel and 91% for oxamniquine. In s. haematobium infections, the cure rate was 98% for praziquantel and 90% for metrifonate. Side effects were generally minor and temporary and were noted in 44% of patients treated with praziquantel, in 60% of patients treated with metrifonate, and in 70% of the patients treated with oxamniquine. The most common side effects were dizziness and abdominal pain. It is concluded that the drugs are effective against the species of Schistosoma present in our area. Praziquantel appears to be the drug of choice for S. haematobium. Praziquantel and low-dose oxaminquine [25 mg/kg] were comparable in their effect on S. mansoni

Fever of unknown origin: experience in Riyadh, Saudi Arabia

Fever of unknown origin constitutes a continual challenge to clinicians all over the world. The pattern of etiological factors varies from one geographic area to another. Over a 4-year period, 62 patients were diagnosed as having this syndrome in the University Hospitals, Riyadh, kingdom of Saudi Arabia. Of these, infection and neoplasms accounted for 71% of the cases. Tuberculosis, brucellosis, and lymphoma were the most common diagnoses. Infection by Schistosoma mansion and Salmonella typhi caused prolonged obscure fever in one patient. Our approach to diagnosis is discussed and compared with the experience in the literature. The application of noninvasive diagnostic methods such as ultrasonography, radioisotope scanning and improved microbiological techniques should further reduce the incidence of fever of unknown origin in the Kingdom. However of its epidemiological pattern in this area will assist practicing physicians in the judicious use of available diagnostic facilities