[Classification of findings and staging in infectiology including AIDS].
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Biomedical subjects
Publications and source records attributed to T Löscher.
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The case is presented of a 20-year-old tourist with mild falciparum malaria and bilateral preretinal and intraretinal hemorrhage, including a macular hemorrhage with reversible visual loss, which developed during his return flight from West Africa. The diagnosis was initiated by the university eye hospital originally consulted. Possible pathogenic mechanisms, ocular findings in malaria, and the increasing problems of imported malaria are summarized and reviewed.
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A female patient resident in Germany is described, who had developed dirofilariasis presenting as a hard subcutaneous nodule at the glabella. Dirofilaria repens was isolated after surgical removal of the skin lesion. She was treated with diethylcarbamazine (Hetrazan) for 4 weeks. Exposures related to infection with Dirofilaria repens are discussed.
A brother and sister (the latter having been resident in Ruanda for three years) fell ill with African trypanosomiasis (sleeping sickness) after a two-day safari in the Akagera National Park. Cardinal symptoms were fever, lymphadenopathy and the typical primary lesion (trypanosomal chancre). The diagnosis was confirmed by demonstrating trypanosomes in the peripheral blood. There was no CNS involvement in either case. Administration of suramin, 1 g weekly intravenously for six weeks, quickly brought about regression of the symptoms and the parasitaemia. According to the number of cases reported since 1970, the risk for German travellers to certain African areas of contracting trypanosomiasis is about 0.3 per 100,000. Since in Africa the incidence of the disease is increasing, in some parts considerably, one must reckon with an increasing risk for tourists.
Five cases of Kala-Azar carried in from the Mediterranean area between May 1977 and March 1979 suggest that in this age of mass tourism these diseases, considered by us as rarities until now, may become more common. In all cases considerable difficulties in diagnosis were first encountered. Serology was always indicative, the indirect fluorescence antibody test (IFAT) being found very reliable. In 4 of the 5 cases the identity of the pathogen was previously established by different methods.