The review of imported visceral leishmaniosis in the Czech Republic.

BACKGROUND: From the late 1950s through 2000, a total of 8 cases of imported visceral leishmaniosis (VL) were registered in the Czech republic. OBJECTIVES: The authors were made to point to the issue of imported VL by the fact 3 cases of this disease (imported from East Africa, Croatia, and southern Italy) were reported in 1999, plus another one (again imported from Croatia) in 2000. METHODS: The case reports of 4 cases of imported VL are presented. They are cases 5-8 ever reported in the Czech Republic. RESULTS: The infection manifested itself by fever, marked splenomegaly, leukopenia, thrombocytopenia, and rapid weight loss. The diagnosis was confirmed by the microscopic finding of amastigotes in punctate obtained from bone marrow, liver, spleen and, also, by serology. All the patients were successfully treated with amphotericin B. CONCLUSION: Infection by VL should be considered when establishing the diagnosis not only in patient returning from endemic regions and show hepatosplenomegaly, fever, leukopenia, and thrombocytopenia. Given the long incubation time, VL may be encountered also in foreigners who had lived in the above regions. Besides, the diagnosis of VL should also be considered in immunocompromised individuals. (Ref. 27.).

[Clinical picture and treatment of alveococcosis]. / Klinický obraz a lécení alveokokózy.

A brief account of the clinical picture and treatment of alveococcosis which is the most serious parasitic disease in Central Europe is presented. Early diagnosis, surgical intervention and long-term chemotherapy considerably improved the prognosis of the disease recently.

[Cysticercosis in the Czech Republic]. / Cysticerkóza v Ceské republice.

The authors report 10 cases of cysticercosis registered by the National Reference Laboratory for tissue helminthiasis. Six Czech citizens and four foreigners contracted the disease. Four of 6 Czech citizens were contaminated abroad. Six patients suffered from nervous manifestations of cysticercosis, 2 from muscular or subcutaneous cysticercosis and 2 patients had an asymptomatic course of the infection. The prerequisite of successful treatment with new anthelmintics is early diagnostics.

Trachoma, an imported disease.

The authors review the incidence of trachoma in the Czech Republic during the last 20 years. Trachoma has become almost exclusively an imported disease. In 1989-1990 the authors treated 34 foreign nationals with imported trachoma at the Infectious Diseases Clinic in Prague. Even after many years' stay in the Czech Republic foreigners may develop exacerbations of the trachomatous process.

[Acute hemorrhagic viral conjunctivitis]. / Akutní hemorrhagická virová konjunktivitida.

Two cases of acute hemorrhagic conjunctivitis are described, in which the enterovirus Coxsackie 24 was found by serological examination to be the etiological agent. The virus was important from Nigeria. The patients suffered by the acute hemorrhagic keratoconjuntivitis with transient iritic irritation without the systemic symptoms. Since now this disease with serological verification was not diagnosed in our country. The question of the viral hemorrhagic conjunctivitis and their treatment is discussed. The necessity of virological investigation in inflammations of the anterior segment is stressed.

[Cryptosporidium species in persons with HIV infection]. / Cryptosporidium sp. u osob infikovaných virem HIV.

Oocysts of Cryptosporidium sp. were detected in the faeces of 65 subjects with the HIV virus, using the concentrating flotation method in a sugar solution and differential staining with methyl violet. In positive cases (a total of 16 subjects) continuous as well as intermittent excretion of oocysts in faeces was recorded, the longest excretion period being up to 15 months. The presented findings of oocysts confirm that Cryptosporidium sp. is a common intestinal pathogenic organism in the investigated group of subjects, and with regard to its pathogenity and opportunistic character they must be subjected to regular parasitological examinations.

[Larval stages of the filaria Mansonella (Dipetalonema) perstans in a student from Africa]. / Nález larválních stadií filárie Mansonella (Dipetalonema) perstans u studenta z Afriky.

Microfilariae were found in blood samples of a 32 year-old-student from Guinea-Bissau (Africa). Based on parasite morphology as well as some other features the microfilariae were identified as Mansonella perstans. The course of infection was asymptomatic (except for slight urticarial skin lesions). The microfilariae disappeared from peripheral blood after mebendazole treatment (200 mg daily for 1 month).

Serological diagnostics of imported malaria in Czechoslovakia.

Two serologic techniques for malaria detection were compared in this study; the indirect fluorescent antibody (IFA) test used in 214 persons (38 Czechoslovak citizens returning from visits to tropical countries and 176 foreign visitors arriving to Czechoslovakia from areas endemic for malaria) and the indirect hemagglutination (IHA) test employed in 125 persons (29 Czechoslovak citizens and 96 foreigners). Comparisons revealed poor correlation between the IFA test and IHA test data. Of the two tests the IFA test appeared to be distinctly more reliable, more sensitive and more specific, the IHA test turned out to yield both false positive and false negative results. The antigen from Plasmodium gallinaceum gave lower IFA titres than P. falciparum antigen, but reacted with antibodies to all species of human plasmodia, and gave reliable test results. Positive serologic responses were appreciably more frequent in foreigners (46.0%) than Czechoslovak citizens (23.7%). The maximum percent positivity for malarial antibody was among individuals from tropical countries of Africa (74.6%), seropositivity in people from malaria endemic areas in Asia and Latin America was far less frequent (28.4% and 44.4%, respectively).

A case of human cryptosporidiosis in Czechoslovakia.

A case of human cryptosporidiosis, the first one reported in Czechoslovakia, is described. The disease was diagnosed by the presence of Cryptosporidium oocysts in the feces. The methods used independently to identify oocysts were the fecal flotation technique employing a saturated solution of sucrose and the microscopic examination of stained fecal smears. The patient was a 4-year-old boy with watery diarrhea of 5 days' duration who was kept on a diet and treated with a suspension of Endiaron N Spofa. Excretion positivity for Cryptosporidium oocysts in the feces was detectable at 3 and 5 days after appearance of first clinical manifestations. Bacteriological examination was repeatedly negative. This finding leaves little doubt as to existence of human cryptosporidiosis in Czechoslovakia, but what remains obscure is its overall contribution to the etiology of diarrheal diseases encountered in the population.