Cutaneous leishmaniasis in Al-Ahsa Oasis in Saudi Arabia and in Sudan: a comparative study

This is a comparative study of cutaneous leishmaniasis [CL] in the Eastern Province of the Kingdom of Saudi Arabia and Sudan. The disease in both countries is caused by Leishmania major of different syndromes and the vector is Phlebotomus papatasi. The animal reservoir host in Saudi Arabia is Psammomys obesus and the Nile rat in Sudan. The clinical manifestations are similar, but some forms encountered in Sudan were not seen in Saudi Arabia. The pathology, immunology, diagnosis and treatment of CL are discussed

Gastrointestinal Basidiobolomycosis mimicking colon cancer in a Sudanese patient

Basidiobolomycosis is a rare disease caused by the fungus Basidiobolus ranarum. The incidence Rate of Gastrointestinal Basidiobolomycosis is approximately 1 in 45,333,334 or 0.00% in every 5 people in USA], member of the class Zygomycetes found worldwide [1].Basidiobolomycosis is usually a subcutaneous infection but rarely gastrointestinal1. This fungus is found mainly in the soil and on decaying vegetations2. It has been isolated from the banks of tropical rivers in West Africa, and has also been found in association with some insects2. The fungus is known to be present in the gastrointestinal tracts of reptiles, amphibians, and some bat species3. Definitive diagnosis requires culture and serological testing may be helpful. The fungal morphology and the Splendore-Hoeppli phenomenon are characteristic histological features. Basidiobolomycosis is treated with surgical resection and itracanzole 200mg BD for three months or Amphotericin B 5mg /kg iv/24 hrs4

Addison's disease due to Histoplasma duboisii infection of the adrenal glands

Histoplasmosis is a fungal infection caused by Histoplasma capsulatum. In the normal individual, both disseminated histoplasmosis and symptomatic adrenal histoplasmosis are rare. Herein, we describe the case of a 50-year-old gentleman residing in western Sudan who presented with a 7-month history of generalized body weakness, easy fatigue, and frequent attacks of vomiting and diarrhea. Physical examination and laboratory investigations confirmed the diagnosis of Addison's disease due to Histoplasma capsulatum var duboisii infection of the adrenal glands. He was treated with intravenous hydrocortisone, followed by oral prednisolone and itraconazole

Peutz -jegher's syndrome: three case reports

Peutz-Jegher syndrome [PIS] is an autosomal dominant disease characterized by hamartomatous intestinal polyps associated with muco-cutaneous melanocytic macules. STK11 /LBK1 is proved to be the responsible gene for inheritanatcel[1] Patients with PIS have 15 fold increase risk of developing malignancy[2], which could be gastrointestinal as oesophageal, gastric, pancreatic and colonic or non intestinal cancer such as lung, breast, ovary and testicular cancer. Here we reported three patients presented to the Gastroenterology Department at Ibn Sina Hospital Sudan over the last ten years

large giant cell tumor of the sacrum. Advantage of an abdomino-sacral approach

We report a case of giant cell tumor of the sacrum, presenting with sacral pain, swelling, and change of bowel habits. Rectal examination revealed a huge retrorectal mass fixed to the sacrum but not to the wall of the rectum. Abdominal ultrasonography, computed tomography CT scan, and magnetic resonance imaging MRI showed a huge pelvic mass invading the sacrum. Exploration via posterior sacral approach was not successful due to both, extensive bleeding and difficult accessibility. Re-exploration was carried out 2 days later with the patient in lithotomy position. Using abdomino-sacral approach the mass together with part of the sacrum and the whole coccyx were excised. Histopathology reported giant cell tumor of the sacrum with no evidence of mitosis. The patient was symptomless 12 months after surgery and on follow up

Visceral leishmaniasis in the Sudan: clinical and hematological features

The clinical and hematological feature and response to therapy in 17 Sudanese patients with visceral leishmaniasis are described. The clinical features in our cases were similar to those described from Ethiopia and East Africa. Fever, hepatosplenomegaly, leucopenia, lymphopenia, and thrombocytopenia were common findings. An unusual feature is the relatively high frequency of hepatic dysfunction. One patients died of cerebral hemorrhage and another of gastrointestinal bleeding. Hemorrhagic manifestations were attributed to immune complex vasculitis and thrombocytopenia. The response to sodium stibogluconate was good

Lymphocyte phenotypes and HLA-DR expression in the lesions of cutaneous leishmaniasis and their draining lymph nodes

T-lymphocyte phenotypes and human leukocyte antigen-DR expression [HLA-DR] expression in skin lesions and draining lymph nodes of zoonotic leishmaniasis caused by Leishmania major were studied. T lymphocytes were the dominant cells in the lymphocytic preponderance type of lesion. They were lowest when the parasitized macrophage was the dominant cell or when the reaction consisted of an equal admixture of lymphocytes, macrophages and plasma cells. Both inducer/helper and suppressor/ cytotoxic T cells were present in varying proportions. The latter were thought to be suppressor rather than cytotoxic cells. Their late appearance in the host reaction was believed to play a major role in halting the inflammatory response. Low levels of cells expressing the suppressor/cytotoxic phenotype and the continued presence of antigen in macrophages was associated with persistence of the lesions even when parasites were largely eliminated after specific antileishmanial therapy. Such lesions healed after local or systemic steroid therapy. The majority of cells in the dermal infiltrate were HLA-DR positive. Keratinocytes also expressed HLA-DR