RESUMEN
In a retrospective study, we registered 210 patients hospitalized in Strasbourg for malaria from 1984 to 1995. The diagnosis was always confirmed by presence of the parasite on blood smears. We analysed the epidemiological, clinical, biological and therapeutic data. The number of cases rose each year, with a maximum in 1995. The majority of cases occurred in January and from August to October, these periods corresponding with the return of travelers. In most cases, infection took place in Africa. In this region, Plasmodium falciparum is the most frequent species of the parasite. The mean age of the patients was 33 years. The clinical manifestations were polymorphic: fever, chills, sweating, and headache were very frequent. We noted 15 serious infections (with the WHO's definition) and two cases of cerebral malaria. All cases had a favorable outcome. Five cases occurred in pregnant women; two of them had a severe form of malaria. Among the biological abnormalities, we found thrombopenia, haemolysis, hypocholesterolaemia and hypertriglyceridaemia. The significance of disturbance of the lipid metabolism is not known. Hypocholesterolaemia is very frequent, and hypertriglyceridaemia seems to be associated with severe malaria. Most malaria attacks occurred in patients without adequate chemoprophylaxis. This confirms the importance of prophylactic information given to patients by their physicians. Resistance develops against each new medication that is available; among these quinine remains the drug of choice to cure severe malaria.
Asunto(s)
Malaria Falciparum/epidemiología , Adulto , África , Antimaláricos/uso terapéutico , Electrocardiografía , Femenino , Francia , Humanos , Malaria Falciparum/complicaciones , Malaria Falciparum/fisiopatología , Malaria Falciparum/terapia , Masculino , Embarazo , Complicaciones Parasitarias del Embarazo/epidemiología , Estudios Retrospectivos , Estaciones del Año , ViajeRESUMEN
The tick-borne encephalitis virus, a major arbovirus, is endemic in Central and Eastern Europe. Since the first case of tick-borne encephalitis observed in Alsace in 1968, there have been approximately 30 cases reported in eastern France. The tick Ixodes persulcatus (and the western subtype I. ricinus) is both the main reservoir and vector of the disease. Early clinical signs of infection are followed by a second phase complicated with meningoencephalitis. The geographical distribution of the different viral subtypes would explain the variable severity of tick-borne encephalitis. Outcome may be fatal or leave major neurological sequellae. Currently, only symptomatic treatment is available, underlining the importance of prevention with anti-tick-borne virus vaccine for populations at risk living in endemic areas.
Asunto(s)
Encefalitis Transmitida por Garrapatas/epidemiología , Encefalitis Transmitida por Garrapatas/complicaciones , Encefalitis Transmitida por Garrapatas/terapia , Europa (Continente)/epidemiología , Europa Oriental/epidemiología , HumanosRESUMEN
A 45-year-old man with severe gout was admitted to the hospital because of Staphylococcus aureus septicemia. He had also a biclonal dysglobulinemia, without signs of myeloma. An asymptomatic lytic lesion of the left pedicle of L5 was discovered on radiographs. Histologic examination of the biopsied lesion showed typical tophaceous gout.
Asunto(s)
Gota/complicaciones , Vértebras Lumbares , Enfermedades de la Columna Vertebral/complicaciones , Gota/diagnóstico por imagen , Gota/microbiología , Humanos , Vértebras Lumbares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Radiografía , Enfermedades de la Columna Vertebral/diagnóstico por imagen , Enfermedades de la Columna Vertebral/microbiología , Staphylococcus aureus/aislamiento & purificaciónRESUMEN
In the present case report a 50-year-old woman is presented with a Strongyloides stercoralis infection after a one-month stay in Sri Lanka. She showed a severe involvement of the central nervous system without a correlation of an immunosuppression. Strongyloides stercoralis is regarded as the cause of the cerebral involvement. Other possible causes are also discussed.