[Neurologic cryptococcosis: meningitis of the immunosuppressed patient].
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Biomedical subjects
Publications and source records attributed to E Chaker.
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The authors report a retrospective study of 50 cases of infantile visceral Leishmaniasis (April 1994-April 1995), and 53 cases of sporadic cutaneous Leishmaniasis of north-Tunisia (August 1990-July 1994), diagnosed in parasitology laboratory of Rabta hospital. They insist on the recrudescence and the extension of the distribution geographical area of these two clinical forms of human leishmaniasis observed in Tunisia.
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Circulation antigen and sera antibodies were measured in 122 sera obtained from 87 patients with proved hydatic echinococcosis: the sera were obtained before and after surgical treatment. Circulating antigen was detected by E. L. I. S. A., and was present in 21% of the sera. Antibodies were present by conterimmunoelectrophoresis in 56%, by haemagglutination in 72%, E. L. I. S. A. IgG in 87%, E. L. I. S. A. IgM in 54%, E. L. I. S. A. IgA in 53%, E. L. I. S. A. IgE in 25% of the sera. No evident correlations between these results and the localisation could be found, nor with anatomical integrity of the cyst, or the surgical treatment date. Only the presence of IgE or circulating antigen could suggest the high level passage of hydatic proteins, bringing to mind a fissuration of the cyst wall.
The authors remind the formation of operculated eggs. Atypical eggs of Clonorchis sinensis, Fasciola hepatica and Diphyllobothrium latum are described: no operculum for the two first species and existence of non-described buttons for the two last species. These anomalies could be explained by the way of formation of these eggs.
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The authors give the differential characters of dysenteric amoebae and cells observed in the feaces of patients affected by recto-colitis. In this purpose, they recall the usefullness of cultures for both the presence and the possibility of determination of the Amoebae. In short, they deplore the misappreciation of these advantages.
A bibliographic survey is made of the cases of fasciolasis in Maghreb, and it can be concluded that: The notion of "epidemy", or better, of simultaneous cases, brought to the diagnosis evocation, to explorations by I.D.R. and to early treatment, before the excretion of eggs. Due to drug-efficiency, the coprological proof of the disease was generally missing in the old "epidemies" of the Maghreb. Isolated cases, in contrast, where the fasciolasic etiology was not evocated, could follow natural evolution and the proof by egg or adult discovery was possible in more than half the cases. Progress in immunology of fasciolasis made possible the diagnosis of less than 10 nw cases in Tunisia and Marocco. The authors report 2 new cases from the Constantine region (Algeria). The repartition of the ascertained cases and the possible ones is shown on a map.
At the occasion of the discovery of an amoebiasis focus in a psychiatric hospital (36,2 % of the patients were Entamoeba histolytica carriers), the authors insist on the importance of systematical and continued coprological controls. They observe that the two means of fight used together, the environment and the mass treatment, have strongly limited the propagation of parasitosis. By this way they note efficiency of the association of the medicinal polyvalent and contact amoebicides.
The values of eggs mensuration and results of coproculture have been compared for the identification of species of ancylostomia infestations. Results are confirming the necessity of coproculture for this diagnosis when the size of eggs is not inferior to 61 mu or superior to 72 mu. One case of morphological anomaly of some strongyloïd larvae of Necator americanus has been related.
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A coprological investigation has been carried out on 268 refugees from the South Eastern Asiatic region. They were separated in two groups, one having received no treatment and the other having received a systematic treatment by diphetarsone, 1.-tetramisole and thiabendazole. In the first group, the infestation rate by protozoa (E. histolytica: 3,68 p. 100, G. lamblia: 9,2 p. 100, T. intestinalis: 9,81 p. 100) was lower than by helminths (A. lumbricoides: 17,44 p. 100, Ancylostomidae: 44,17 p. 100 and S. stercoralis: 25,58 p. 100) which were more frequently found. After a systematic treatment, effects on intestinal protozoa remained nearly inexistent. Indeed, the same percentages were found in the second group, whereas antihelmintic drugs were more active particularly on A. lumbricoides (4,94 p. 100) and S. stercolaris (5,49 p. 100). The compiled data have shown a high percentage of ancylostomidae infection which lead the authors to propose the systematic application of the described nematocide therapy.