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PubMed1995

Prevalence, geographical distribution and clinical manifestations of onchocerciasis on the Island of Bioko (Equatorial Guinea).

A survey for the prevalence, geographical distribution and clinical manifestations of onchocerciasis was conducted on the Island of Bioko (formerly Fernando Póo), Equatorial Guinea, between 1987-89. The whole population (1799 inhabitants) of thirteen villages distributed around the island was surveyed. Identification data, physical examination and Snellen "E" test for visual acuity were performed. Skin snips were taken from both iliac crests and right scapula and calf. Differential diagnosis between Onchocerca volvulus and Mansonella streptocerca was carried out in both fresh and Giemsa stained preparations. The overall prevalence (+ skin snips) and mean microfilarial density were 75.2% (range 51.9% to 87.1%) and 32.2 mf/snip respectively. Skin snips showed a higher microfilarial density from iliac crests. The following clinical manifestations were found: 560 (31.2%) with nodules; 518 (28.8%) with dermatitis, pigmentation changes and cutaneous atrophy; 753 (41.9%) with lymphoadenopathy and lymphoedema. Blindness due to different causes was registered in 13 cases (0.8%). The results showed that onchocerciasis is hyperendemic and widespread over the island. It is estimated that almost the whole population (62,000) is at risk of infection.

Adolescent↗

PubMedDate not supplied

Penicillin--intermediate-resistant pneumococcal spondylodiscitis.

Pneumococcal osteomyelitis probably was more common in the pre-antibiotic era, but currently is rare. Sickle-cell disease and possibly, bone trauma and advanced age are predisposing factors for pneumococcal osteomyelitis. Bone infection usually occurs as a result of hematogenous spread from an infective focus, which often cannot be identified. In patients without evidence of other focci of infection, pneumococcal spondylodiscitis probably is caused by "primary" pneumococcal bacteriemia, originating in the oropharynx, especially if the patient has alterations that disrupt the oropharyngeal mucose. Whereas early in the antibiotic era, all Streptococcus pneumoniae strains were susceptible to penicillin, resistance to this antibiotic is on the rise, and in many parts of the world, it has emerged as a major problem. We report the case of a young patient with penicillin-resistant pneumococcal vertebral and intervertebral disk disease who had no evidence of pneumococcal infection elsewhere, and we discuss the possible mechanism of infection. We also review briefly the resistance to penicillin of S. pneumoniae and the treatment of choice.

Adolescent↗