ABSTRACT
In Tanzania sleeping sickness presents a serious threat to human health with a country-wide average of 400 cases reported annually. Both wild and domestic animals have been found to play a significant role in the epidemiology of sleeping sickness. Serengeti National Park in northern Tanzania, has experienced a number of sleeping sickness epidemics since 1922. The epidemics were associated with abundant game animals in the areas and Glossina swynnertoni was incriminated as the main vector. However since 2001 there has been no case of sleeping sickness reported from the park. This case report highlights on the possibility of resurgence and challenges in the diagnosis and management of sleeping sickness in Serengeti. A 38 years old Tanzanian man working in the Serengeti National Park who had experienced various tsetse bites was presented with a febrile condition and history of unsuccessful case management at different health facilities. Blood and cerebrospinal fluid (CSF) samples were examined for the presence oftrypanosomes using wet film, Field's stain and concentration techniques. Typanosoma brucei rhodesiense were detected in both the blood and CSF samples. The patient was treated successfully with melarsoprol. The results of this case study highlight the possibility of resurgence of sleeping sickness in the park hence calls for the need to create more awareness among the community and clinicians. There is need for early reporting to health facility and strengthening the diagnostic capacity of healthcare facilities in and around national parks endemic for sleeping sickness.
Subject(s)
Melarsoprol/therapeutic use , Trypanocidal Agents/therapeutic use , Trypanosoma brucei rhodesiense/isolation & purification , Trypanosomiasis, African/diagnosis , Trypanosomiasis, African/drug therapy , Adult , Animals , Diagnosis, Differential , Humans , Male , Tanzania/epidemiology , Trypanosomiasis, African/epidemiology , Trypanosomiasis, African/parasitologyABSTRACT
La enfermedad de Castleman está considerada como un cuadro linfadenopático reactivo con dos formas clínicas: una localizada, frecuente en pacientes inmunocompetentes, y otra multicéntrica, más característica en los enfermos inmunodeprimidos. Se presentan dos casos de enfermedad de Castleman multicéntrica en pacientes VIH positivos con sarcoma de Kaposi. Ambos pacientes muestran adenopatías múltiples, hepatomegalia y síntomas B al diagnóstico. Uno de ellos presenta respuesta favorable al tratamiento quimioterápico y el otro fallece. Se realiza una revisión del concepto de enfermedad de Castleman multicéntrica, así como su relación patogénica con el virus herpes humano-8
Castleman disease is considered a reactive lymphadenopathic picture with two clinical forms: one localized, frequent in immunocompetent patients and another multicenter one that is more characteristic in immunodepressed patients. Two cases of Castleman disease multicenter in HIV positive patients with Kaposi's sarcoma are presented. Both patients have multiple adenopathies, hepatomegaly and symptoms B on diagnosis. One of them had a favorable response to chemotherapy treatment and another died. A review of the concept of multicenter Castleman disease and its pathogenic relationship to human herpes virus 8 (HHV-8) is done
Subject(s)
Adult , Middle Aged , Humans , Acquired Immunodeficiency Syndrome/complications , Castleman Disease/complications , Herpesvirus 8, Human , Sarcoma, Kaposi/complicationsABSTRACT
Castleman disease is considered a reactive lymphadenopathic picture with two clinical forms: one localized, frequent in immunocompetent patients and another multicenter one that is more characteristic in immunodepressed patients. Two cases of Castleman disease multicenter in HIV positive patients with Kaposi's sarcoma are presented. Both patients have multiple adenopathies, hepatomegaly and symptoms B on diagnosis. One of them had a favorable response to chemotherapy treatment and another died. A review of the concept of multicenter Castleman disease and its pathogenic relationship to human herpes virus 8 (HHV-8) is done.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Castleman Disease/complications , Herpesvirus 8, Human , Sarcoma, Kaposi/complications , Adult , Humans , Male , Middle AgedABSTRACT
Today, ultrasound phacoemulsification is the most used method of cataract surgery. Because the side effects (injury of corneal endothelium and other nearly tissues), was tried to find alternative energy forms. Erbium laser was proven to be the most effective method among all of these.
Subject(s)
Laser Therapy/methods , Phacoemulsification/methods , Aged , Female , Humans , Male , Middle Aged , Phacoemulsification/adverse effects , Retrospective StudiesABSTRACT
High-altitude retinopathy is a very rare ocular disease in our country, which can occur isolately or as a part of high-altitude illness. This paper presents the case of a patient with high-altitude illness and the diagnosis and treatment problems of this case.
Subject(s)
Altitude Sickness/complications , Hydroxyethylrutoside/analogs & derivatives , Retinal Diseases/drug therapy , Retinal Diseases/etiology , Adult , Anti-Inflammatory Agents/therapeutic use , Diagnosis, Differential , Humans , Hydroxyethylrutoside/therapeutic use , Male , Prognosis , Retinal Diseases/diagnosis , Retinal Diseases/physiopathology , Risk Factors , Severity of Illness Index , Treatment Outcome , Vasoconstrictor Agents/therapeutic use , Vitamins/therapeutic useABSTRACT
BACKGROUND: Immunoproliferative small intestine disease (IPSID) encompasses a primary intestinal lymphoma of underpriviliged populations of North Africa, Middle East, etc. This epidemiological feature strongly implicates environmental and host (genetic) factors in its pathogenesis. IPSID can be distinguished on clinicopathological grounds from "Western-type" intestinal lymphomas. "IPSID-like" lymphomas had been sporadically identified, i.e., patients with original clinico-analytical data of IPSID (chronic diarrhoea, malabsortion, clubbing of fingers, diffuse intestinal involvement, etc.) without its conventional histopathologic (lymphoplasmocytic or plasmocytic infiltration) and immunological (alpha-heavy-chain paraprotein) background. PURPOSE: The aim of this study has been: 1) to identify, in a series of small intestine lymphomas, a group of patients with a long-lasting history of chronic diarrhoea and a clinico-biologic pattern of "IPSID-like" lymphoma; 2) to analyze its clinicopathological profile; 3) to search for differences with the pattern of the remaining cases ("Western-type" lymphomas) and 4) To suggest a possible epidemiological significance. PATIENTS AND METHODS: Patients considered were 12 Spanish caucasians with primary intestinal lymphoma and a long-lasting history of chronic diarrhoea vs 31 cases of "Western-type" intestinal lymphomas admitted in our Hospital over a 33-year period. Statistical significance of differences in clinico-biological features (symptoms/signs, analytical data, patterns of involvement, histopathology, immunophenotype and tumor staging) between these two groups was evaluated using X2 test. RESULTS: The results of this retrospective study allow us to delineate a relatively homogeneous "IPSID-like" group (12 cases) among 43 cases of primary small intestine lymphoma diagnosed between 1960 and 1993. The clinico-pathological behavior of these patients was significantly different from that exhibited by the 31 cases of so-called "Western-type" lymphomas. CONCLUSIONS: It is suggested that they may represent a group of patients suffering an evanescent "IPSID-equivalent" disorder (last case diagnosed in 1975), that probably has evolved in similar but not identical epidemiological circumstances to those present in the "Third World" countries of our Mediterranean area.
Subject(s)
Immunoproliferative Small Intestinal Disease/epidemiology , Intestinal Neoplasms/epidemiology , Lymphoma, Non-Hodgkin/epidemiology , Adolescent , Adult , Aged , Child, Preschool , Chronic Disease , Developing Countries , Diagnosis, Differential , Diarrhea/etiology , Disease Susceptibility/ethnology , Environment , Female , HLA Antigens/analysis , Humans , Immunoproliferative Small Intestinal Disease/complications , Immunoproliferative Small Intestinal Disease/diagnosis , Intestinal Neoplasms/complications , Intestinal Neoplasms/diagnosis , Lymphoma, B-Cell, Marginal Zone/classification , Lymphoma, B-Cell, Marginal Zone/diagnosis , Lymphoma, B-Cell, Marginal Zone/epidemiology , Lymphoma, Non-Hodgkin/classification , Lymphoma, Non-Hodgkin/diagnosis , Male , Mediterranean Region/epidemiology , Middle Aged , Retrospective Studies , Socioeconomic Factors , Spain/epidemiology , White PeopleABSTRACT
We report the case history of a female patient suffering of a T lymphoblastic lymphoma with an atypical presentation and evolution, consisting of pleuropericardiac effusion without mediastinic masses that coexists with a plasma cell dyscrasia that fulfils the criteria for stationary multiple myeloma. The possible pathogenic relationship between both processes is discussed, emphasizing the functional evolutive dissociation between the cellular constituents of both neoplasias, immature T lymphoblasts and plasma cells, respectively; this constitutes the first reported case in literature.
