Acute hemodynamic changes during treatment of louse-borne relapsing fever.
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Biomedical subjects
Publications and source records attributed to A D Bryceson.
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We report 11 patients with leishmaniasis from different endemic areas, treated in the UK with intravenous aminosidine alone or in combination with other drugs. Clinical and parasitological cures were achieved in all 7 patients from the Mediterranean zone who had visceral disease, with one relapse. Two of 4 patients with cutaneous or mucosal disease were cured; the other 2, from Iraq and Iran, did not respond. Toxic effects were high-tone deafness in 2 patients, one of whom had pre-existing renal impairment, and transient, mild elevation of serum creatinine in 3. Aminosidine is an effective, tolerable and relatively non-toxic alternative to existing antileishmanial drugs for the treatment of visceral leishmaniasis. Further studies will be needed to assess its place in cutaneous and mucosal disease.
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Five preparations of ointment containing aminosidine were used to treat lesions of 'Old World' cutaneous leishmaniasis. A preparation containing 12-15% aminosidine with 10% urea in white soft paraffin was nontoxic. 23 of 27 patients treated healed in a mean of 6.7 weeks, the ointment being applied daily for up to 12 weeks.
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Diagnosing the febrile returned traveller is a problem faced ever more frequently by the practising physician. This article aims to provide a structured approach to what may, at first, seem a complex issue.