Treatment of invasive pulmonary aspergillosis in severely neutropenic children with malignant disorders using liposomal amphotericin B (AmBisome), granulocyte colony-stimulating factor, and surgery: report of five cases.

Five children with malignancies developed invasive pulmonary aspergillosis during chemotherapy-induced neutropenia. All patients were treated with liposomal amphotericin B and human recombinant granulocyte colony-stimulating factor. Two patients did not recover from bone marrow aplasia and died from organ-infiltrating fungal invasion. Two patients who recovered from bone marrow aplasia survived after surgery of the pulmonary lesions. The fifth patient had a complete resolution of invasive pulmonary aspergillosis after neutrophil recovery without surgical intervention. We conclude that not only the antifungal treatment but also the recovery of granulocytes are important in localizing invasive forms of Aspergillus infections in patients with profound immunosuppression.

On the drinking water situation on the Cape Verde Islands (Island of Santiago).

On the Cape Verde Islands drinking water investigations were made. The drinking water was tested in chemical and bacteriological respects as well as on amebas and rotaviruses. The isolated germs were investigated on their reaction against several antibiotics and chemotherapeutics by means of the agar diffusion test. The changing of drinking water quality from water-supply-places to the households was investigated as well. According to the fact, that only 10.6% of 207 public water supplies investigated show drinking water quality after ONORM, and that nearly 30% and 80.2% of them contained E. coli and coliforme germs respectively, the urgency of extensive sanitations of water supplies on the Cape Verde Islands is evident.

Investigation of human stool samples from the Cape Verde Islands (district Santa Cruz/Santiago).

Based on the rate of occurrence of diseases associated with diarrhoea, stool samples were also investigated; parasitologically, using the MiFC-enrichment method for intestinal parasites; serologically, using ELISA for rotavirus and bacteriologically for Shigella and Salmonella on the Cape Verde Islands. 90% of the samples came from children aged between 6 and 14 years. Entamoeba histolytica, the causal agent of amoebic dysentery was demonstrated in 17.4%, Lamblia intestinalis in 28.7% and rotavirus in 14.5%.

Additional human Q-fever studies on the Cape Verde Islands--2nd report.

The MAR-test results including titer levels of 1:4 and higher revealed 92% positive reactions in the district of Santa Cruz/Santiago and 77% positive reactions in 6 villages of Santo Antao. The submitted examinations prove the agent Coxiella burnetti's existence responsible for different clinical pictures observed on the Cape Verde Islands.

Serological investigations in Q-fever and listeriosis of wild-living small mammals on the Cape Verde Islands.

Serological investigations of small mammals had been made on the Island Santiago (Cape Verde Islands), to clear up how far synantropic, small mammals are reservoir hosts for pathogens, such as Coxiella burnetti and Listeria monocytogenes. 367 small mammals representing two species (Rattus rattus and Mus musculus) were trapped. Q-fever antibodies were detected in 155 of 350 examined rats and mice (44.29%). 18.89% of all tested sera showed positive results to Listeria-antigen, serovar 4bH, 5.48% to 4b0 and 9.75% to 01.

On the drinking water situation on the Cape Verde Islands (Islands of Santiago).

On the Cape Verde Islands drinking water investigations were made. The drinking water was tested in chemical and bacteriological respects as well as on amoebas and rotaviruses. The isolated germs were investigated on their reaction against several antibiotics and chemotherapeutics by means of the agar diffusion test. The changing of drinking water quality from water supply places to households was investigated as well. The results make evident the urgency of extensive sanitations of water supply places on the Cape Verde Islands.

Serological investigations for antibodies against Treponema pallidum on the Cape Verde Islands (Santiago and Santo Antao)--2. report.

On the Cape Verde Islands, Santiago and Santo Antao 581 human blood samples were collected. The VDRL and TPHA tests were employed in the serological examinations of samples for antibodies against Treponema pallidum. Positive reactions were shown in 2 of the 191 sera from the Santiago Island and in 12 of the 390 sera from the Santo Antao Island in both the VDRL and the TPHA tests. Including the alone TPHA-positives of 5 and 8 sera respectively, results in a 3.7% of positive sera for Santiago and a 5.1% for Santo Antao. By not taking into account children under 13 years of age, the positivity rises to 4.2% and 7.6% respectively. Giving a total contamination rate of 6.3% for Treponema pallidum.

Further serological investigations in humans and domestic animals on the Cape Verde Islands (Q-fever, brucellosis, listeriosis, shigellosis, campylobacteriosis, yersiniosis, toxoplasmosis and chlamydia of PLT-group).

439 sera of domestic animals and various number (150-500) of human sera of the Cape Verde Islands were examined for antibodies against Coxiella burnetti, Brucella abortus, B.melitensis, Listeria monocytogenes, Shigella dysenteriae, S.flexneri, S. boydii, S.sonnei, Campylobacter jejuni, C.fetus ssp. intestinalis, Yersinia enterocolitica, Toxoplasma gondii and Chlamydia of the PLT-group. It could be shown, that on the Cape Verde Islands there is to be counted with numerous zoonoses due to various microorganisms in man as well as in domestic animals. Q-Fever examination showed exceedingly high positivity of human sera (81.6%) and those of domestic animals (84.7%). One of the main reasons for the wide distribution of infectious diseases, especially diarrhoeal diseases such as Shigellosis, Yersiniosis and Campylobacter infections as well as Salmonellosis and Amebiasis on the Islands is the bad hygienic situation, an improvement of which as well as an intensification of research work, health education and a better medical care would be essential for the control of communicable diseases on the Cape Verde Islands.

Resistance to antibiotics in humans and animals on the Cape Verde Islands.

From the Cape Verde Islands no studies are known about an efficient treatment with antibiotics and chemotherapeutics. Because of this human samples and samples of domestic animals were collected, the different bacterias were isolated and the antibiograms were analyzed by agar-diffusions-test. The human samples consisted of wound-, eye-, anal-, vaginal- and throat-smears, the animal samples consisted of jaw-, anal- and wound-smears. the aim of these investigations was to make efficient treatment with antibiotics and chemotherapeutics possible. The best efficacy had Cefotaxim, Gentamicin and Trimethoprim + Sulfonamid. Very poor were Penicillin G, Aminopenicillin and Cephalexin.