[Disseminated strongyloidiasis]. / Anguillulose disséminée.

ENDEMIC ZONES: Strongyloidiasis is an intestinal parasitosis which is frequently found in tropical and subtropical regions. RISK: The "autoinfection" cycle during this helminthiasis explains why the infection can be perpetuated without further exposure to exogenous, infective larvae. Hyperinfection may occur by dissemination of Strongyloides stercoralis in immuno-compromised patients, particularly those under corticotherapy. DISSEMINATATED STRONGYLOIDIASIS: Disseminated strongyloidiasis is characterized by severe gastrointestinal and respiratory tract involvement, meningitis, skin rash, or Gram-negative bacteremia. Since disseminated stronglyoidiasis is fatal in 80% of cases it is imperative to diagnose and treat this condition before long-term corticotherapy. Ivermectin is currently recommended because it is effective and well tolerated.

[A 2500 year-old patient. Nosological study of a statue of the Nok culture, Nigeria]. / Un malade vieux de 2500 ans.... Etude nosologique d'une statue de la culture Nok, Nigéria.

The authors describe a terra cotta statue of the Nok culture (Nigeria) dating from between 450 and 50 B. C. Amongst thousands of the same origin, this statue is the only one representing a pathological state of cirrhosis, aetiology of which may be viral, parasitological or iatrogenic. Although no precise diagnosis can be made, this statue pays tribute to the power of observation of the artist who conceived it.

[Apropos of 1 case of hepatogastric fascioliasis in Cape Verde]. / A propos d'un cas de fasciolose hépato-gastrique en provenance du Cap-Vert.

The authors report a case of Fascioliasis sp. distomiasis with a double hepatic and gastric location primitively associated with a gastric cancer metastazed to the liver. The parasitic origin of the lesions suspected from the histological specimen of the gastric biopsy (the presence of eggs) was confirmed by serology with the presence of the arc 2 specific to immunoelectrophoretic analysis, while the parasitological examination of the stools was always negative. The patient grew well after a day's cure of triclabendazole (375 mg x 2). Although the ectopic locations of Fascioliasis are classic, they are usually in the abdominal wall, less frequently in the gastric or colic wall. The fact that the contamination originated on the Cape Verde is indiscutable, since the patient had never left the island. It is the 5th case described in medical literature, thus confirming the presence of Fasciola hepatica (or gigantica) on the islands of the Cape Verde, whose population is of both Portuguese and African origin and has kept the eating habits of the former colonial power (Portugal is a zone of high endemicity for human fascioliasis). It would be interesting to look for Limnaea and contaminated bovine on the Cape Verde islands.

[Parasitic diseases and fecal hazards: diseases due to helminths]. / Maladies parasitaires et péril fécal: les maladies dues aux helminthes.

Ascaris, trichocephalus, hookworm, necator and anguillula--all of which are human parasites--are closely linked to fecal peril and especially prevalent among populations in developing countries, where fecal hygiene is insufficient or lacking. Epidemiological surveys seeking to evaluate the frequency of the various intestinal helminths are usually intermittent, few in number, and especially difficult to compare because of the different coprological techniques used. However this may be, the respective prevalence of these worms depends on geographical, climatic, economic, and human conditions. Their effect on health is not negligible, especially on children's health and in particular when malnutrition also occurs. To fight effectively against these verminoses, education and economic development must be promoted, but the present situation of the economy in most developing countries is postponing indefinitely the fight against fecal peril especially as its control is not seen as a priority.

[Apropos of 5 new cases of onchocerciasis edema]. / A propos de cinq nouveaux cas d'oedème onchocerquien.

We report 5 cases of onchocerciasis presenting as limb's swelling collected in the tropical disease unit of a parisian hospital between 1982 and 1993. They are 5 men which have lived between 3 weeks and 4 years in forested areas of Cameroon in four cases and Côte d'Ivoire in one case. The incubation period varied from 5 months to 2 years. The limb oedema was always located to one arm. It was associated with a blood eosinophilia above 2000/mm3 in 4 of 5 patients. The skin detection of microfilaria of Onchocerca volvulus was positive in every case. The serodiagnostic tests were negative for indirect immunoflurescent assay and immunoelectrophoresis with exception of one patient. These patients were cured with ivermectine and/or diethylcarbamazine. In addition, 26 other cases described in the literature are discussed.

[A case of dirofilariasis of the scrotum of probable origin in Languedoc]. / Un cas de dirofilariose du scrotum en provenance probable du Languedoc.

Adult Dirofilaria (Nochtiella) repens in scrotal cavity is a rare localisation (likewise in others localisations). This report deals with a case occurred in Languedoc (about 50 cases of subcutaneous dirofilariasis were described in France). The localisation in scrotal cavity occurred probably after migration of adult female in subcutaneous tissue.

[Mycetoma of the neck and the nape of the neck due to Madurella mycetomatis. Apropos of a case in Mauritania]. / Mycétome du cou et de la nuque à Madurella mycetomatis. A propos d'un cas mauritanien.

Fungous mycetoma of the nape of the neck due to Madurella mycetomatis is an unusual localisation (four cases in mondial literature) and severe affection. This reports deals with a case occurred after traumatism. Despite five months of itraconazole and chirurgical treatment, the therapeutic escape was evident.

[Symptoms and development of Schistosoma haematobium infestation seen in a metropolis]. / Symptômes et évolution de l'infestation à Schistosoma haematobium vue en métropole.

Urogenital schistosomiasis is often diagnosed in France where, contrary to its severity, its initial presentation (mainly haematuria) has not changed. The frequency of major renal abnormalities seems to have diminished since 1965, but above all cystoscopy and intravenous urography have been superseded by ultrasonography, a totally harmless and painless method which provides the same information as that obtained with the previous two methods, except as regards the ureters. In particular, cystoscopy is now indicated only when tumours of the bladder are suspected at ultrasonography. Cutaneous schistosomiasis, with its characteristic features, deserves to be known and recognized.

[A probable case of Lyme Disease contracted in Mozambique]. / Un cas probable de borreliose de Lyme contractée au Mozambique.

This report deals with the first probably autochthonous case of Lyme disease occurred in Mozambique. The authors review the epidemiology of Lyme disease in Tropical Africa.

[Epidemiology and prevention of distomatosis in France]. / Epidémiologie et prévention des distomatoses en France.

Only the large liver fluke Fasciola hepatica is frequently encountered in France. The small fluke is exceptional, owing to its mode of transmission. Opithorchiasis is observed among refugees from South-East Asia. The prevention of all types of distomatosis rests on food control.

[Human bilharziasis in the Near-East Mediterranean countries. Historical aspects and current distribution]. / Les bilharzioses humaines dans le monde méditerranéen, au proche-orient. Historique et répartitions actuelles.

The countries surrounding the mediterranean share geographical ethnic, historical and pathological features. Bilharziasis infectious found in these countries include S. haematobium infection in North Africa, Egypt and Near East and S. mansoni infection in Egypt and Arabian peninsula. The origin of two bilharziasis is probably West and East Africa, Egypt.

Two outbreaks of trichinosis caused by horsemeat in France in 1985.

Two outbreaks of trichinosis occurred in France in August and October of 1985 and 1,073 cases in all were identified. In the first outbreak, two localities were involved: the town of Melun and the 14th district of Paris. To determine the origin of the contamination, three case-control studies were carried out: among patients' families, among the populations of these two areas, and among the inmates in the prison of Melun. In the second outbreak, cases again occurred in Paris but in a different district (the 12th), in the city's suburbs, and in other towns scattered throughout France. Although no parasites were found in any of the meat examined in either outbreak, results of the study indicate that infection was due to horsemeat consumption and led to the incrimination of two carcasses, one imported from a slaughterhouse in the United States and the other from West Germany. These findings led the French Ministry of Agriculture to order the inspection for trichinosis of all meat from horses slaughtered both in France and in countries exporting horsemeat to France.

[Malaria in the Mediterranean world. The historical and present-day distribution]. / Le paludisme dans le monde méditerrannéen. Historique et répartition actuelle.

The three Plasmodium species have existed in the mediterranean basin since the prehistoric era and the arrival of man. They were still widely prevalent until the beginning of the fifties. In Europe, since that time, most of malaria cases are either imported or post transfusional, except in Greece and especially in Turkey, where P. vivax has caused epidemics since 1973. In other parts of the mediterranean basin, P. falciparum is very rare and the predominant species are P. vivax and to a lesser extent P. malariae.

[Where has Kérandel's key disappeared to?]. / Mais ou est donc passée la "clé" de Kérandel?

At the primary stage of African trypanosomiasis appears a form of hyperesthesia known as Kerandel's sign or the sign of the key. This sign was described by Heckenroth and Ouzilleau in 1907.

[The onchocercal nodule]. / Le nodule onchocerquien.

The morphology of adults worms (male and female) is characteristic particularly the content of the uterus in the female worm and the fact that the organs do not fill the body cavity.

[Value of cytapheresis in the treatment of loaiasis with high blood microfilaria levels. Results in 7 cases]. / Intérêt de la cytaphérèse dans le traitement des loases à fortes microfilarémies. Résultats à propos de sept cas.

Seven patients infected with the filarial worm Loa loa received a treatment by cytapheresis in an attempt to lower the microfilaraemia. Microfilarial levels of between 6,000 and 38,500 ml, before extraction, were reduced, according to the case, by between 47 and 97% (mean 76%). The diethylcarbamazine chemotherapy which followed in 6 of 7 patients showed no sign of any of the serious side-effects which often occur in these type of cases. Due to its practicality and the fact that it is well tolerated, both clinically and biologically, cytapheresis would seem to represent the best method for initially treating loaiasis with high microfilaremia.