Non-gonococcal urethritis (NGU) due to trichomonas vaginalis in Ibadan.

Two hundred and sixty two male patients attending the Special Treatment Clinic (STC) of the University College Hospital, Ibadan between July and December 1989, were examined for Trichomonas vaginalis as a cause of non-gonococcal urethritis using both microscopic and culture methods. Thirteen of the 262 male patients were the sexual partners of trichomonas vaginalis infected women. While 47(17.9) percent of the 262 men investigated had gonococcal urethritis, 215(82.1 percent) had non-gonococcal urethritis out of whom 18(8.4 percent) had trichomonal urethritis. The age range of peak incidence among the patients investigated is 20-29 years. A significant difference (P < 0.001) between the number of male sexual contacts that were positive for trichomoniasis (38 percent) and other male patients included in this study (8.4 percent) was demonstrated. Culture of the samples from the male patients investigated gave the highest proportion (100 percent) of positive results. This indicates the superiority of culture methods over other methods of diagnosing trichomoniasis such as microscopic method routinely used in our centre.

Listeria septicaemia and meningitis in a neonate: case report.

We report the first case of neonatal septicaemia and meningitis in Trinidad due to Listeria three days after blood transfusion. It is important to be aware of the organism in foods and patients. Modern methods of isolation and identification will be of invaluable assistance in future recognition of the organism.

Rhinosporodium: case report.

This is the first reported case of rhinosporidiosis in Ibadan, Nigeria. A review of literature shows that the patient came from northern Nigeria where the first case was reported in the country. The organism is difficult to culture and the diagnosis was based on microscopy and histological examination of the polyp. We present the case of recurrent rhinosporidiosis in a 16 year old girl a year after polypectomy in Zaria, northern Nigeria.

Anogenital warts in patients attending the sexually transmitted diseases clinic in Ibadan, Nigeria.

One hundred and forty-eight cases of anogenital warts comprising 98 males and 50 females were seen at the Special Treatment Clinic, University College Hospital, Ibadan between May 1977 and 1984. The ages of the patients ranged from 11 months to 49 years. Ten cases occurred in children under 9 years. The peak incidence was in the 20-24 years age group. Local applications with podophyllin was the most frequently recommended therapy as the first line of treatment and produced a cure rate of 38.8% in those treated for three weeks. Thirty-three percent of the patients treated with podophyllin showed marked improvement before they were lost to follow up. Cryotherapy gave a cure rate of 85% but was recommended only for 20 patients. The clinical implication of these findings as well as the limitations encountered in the management of anogenital warts in a developing country are discussed.

Cryptococcal meningitis with malaria. A case report.

Cryptococcal meningitis is an uncommon infection globally, including Nigeria. This systemic fungal infection often is associated with immunodeficiency. The most common causes of meningitis in Nigeria in the 2-3 year age group are the malaria parasites and bacteria. The concomitant infections of Cryptococcal neoformans and Plasmodium falciparum are uncommon. We present here the report of a case of fatal cryptococcal meningitis with malaria infection in a 2 year old child from Nigeria (one of the malaria endemic regions of the world). This case emphasizes the importance of doing a combination of fungal and bacterial cultures as well as looking for malarial parasites in the determination of etiological agents of meningitis in any hospital in Africa. We suggest that cerebrospinal fluid from meningitis cases must be cultured using Sabouraud dextrose agar and any growth on the agar must be examined using Indian ink.

Incidence of Aeromonas species in diarrhoeic stool in University College Hospital Ibadan, Nigeria.

Between February and July 1989, stool samples from 100 diarrhoeic patients were screened for Aeromonas species. For isolation, alkaline peptone water was used for enrichment and xylose desoxycholate citrate agar as differential and selective medium. Only one sample (1%) yielded Aeromonas hydrophila having come from a 2-month old baby. No other enteric pathogens were isolated from the positive stool sample, a strong indication that A. hydrophila was responsible for the diarrhoea in the baby. Of nine antimicrobial agents used the lone A. hydrophila isolate was resistant only to ampicillin.

Single dose treatment of gonococcal urethritis with augmentin in Ibadan.

Augmentin, a new orally absorbed broadspectrum antibacterial agent comprising of amoxycillin trihydrate and potassium clavulanate, was investigated in the treatment of gonococcal urethritis in Ibadan, Nigeria, where penicillinase producing Neisseria gonorrhoeae (PPNG) constitute about 80% of the circulating strains of gonococci. Two different formulations of the agent were employed in the study. The first formulation consisting of 3.0 g amoxycillin and 125 mg clavulanic acid, achieved a cure rate of 75% (i.e. eighteen out of twenty-four patients) among PPNG infections, but 100% cure rate among nine patients with non-PPNG infections. The second formulation consisting of 3.0 g amoxycillin and 250 mg clavulanic acid, had a cure rate of 86% (i.e. fifty-seven out of sixty-six patients) among PPNG infections, and 91% (i.e. ten out of eleven patients) among non-PPNG infections. Clavulanic acid appears to potentiate and enhance the activity of amoxycillin against the beta-lactamase produced by the gonococci. Augmentin seems to be a good and acceptable agent for the treatment of gonococcal infections, in this environment and further studies on its efficacy are therefore justified, such as the simultaneous administration of probenecid.

Intraoral condylomata acuminata. A case report.

Condylomata acuminata occurred intraorally in a 6 year old Nigerian girl. Since she had no skin or genital lesions and no history of sexual contact, the virus was probably acquired from environmental sources. Non-sexual modes of transmission should, therefore, be considered, particularly when the lesions are extragenital.

Septicaemia in the tropics. A prospective epidemiological study of 146 patients with a high case fatality rate.

A prospective study showed that during the first 6 months of 1976, 146 patients out of a total of 3938 admitted to a hospital in Nigeria were suffering from septicaemia, or developed the condition while in hospital. Findings differed from those reported from developed countries in that the majority of infections were community acquired, those most frequently and severely affected were the very young, and salmonella spp. and Staphylococcus aureus were the most important pathogens. However, other gram-negative organisms, particularly klebsiella spp. and Pseudomonas aeruginosa also occurred frequently among the very young, in whom they produced a high mortality. The type of epidemiological pattern, and the bacteria responsible for the bloodstream infections reflect a differing age structure of the population in tropical countries from that in temperature developed countries, as well as the fact that bacterial infections are still one of the most important causes of illness and hospital admission among tropical communities.