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PubMedDate not supplied

[Migrant erythema as clinical presentation of cutaneous larva migrans in Mexico City].

Cutaneous larva migrans (CLM) is a ubiquitous self-limited skin eruption, most frequently caused by the larvae of dog and cat hookworms. Although CLM is most frequent in tropical climates, the infection is becoming more common in urban areas. CLM has been frequently misdiagnosed and/or treated inappropriately, and mimics rheumatic, infectious, vascular, or dermatologic diseases. We here in report the clinical presentation and management of 18 cases of CLM.

Adolescent↗
PubMed1999

Evaluation of fever in the returned traveler.

The differential diagnosis of a febrile illness in the returned traveler is extensive. The most commonly encountered tropical infections are malaria, dysentery, hepatitis, and dengue fever; a substantial number of febrile illnesses are never diagnosed. Malaria is by far the most important infection to consider in the returned traveler who presents with fever. As international travel continues to increase in popularity, the ongoing need for clinicians to broaden their knowledge of travel-related diseases is evident. The ability to recognize and manage tropical diseases in travelers is essential because the morbidity and mortality of these infections are often preventable with prompt therapy. When expertise in this area is lacking, febrile returned travelers should be referred to a tropical disease unit or an infectious disease consultant for urgent assessment.

Diagnosis, Differential↗
PubMed1999

A case series of falciparum malaria-induced acute renal failure.

Falciparum malaria is a disease of tropical climates which affects 270 million people annually and has an overall mortality of 1%. While the incidence of acute renal failure in malaria is less than 1%, mortality is reported to be as high as 45% in those with renal failure. We report the clinical course and outcome in 5 patients with falciparum malaria-induced acute renal failure treated at the Singapore General Hospital between June and July 1997. All 5 males, with mean age of 35.2 +/- 13.1 years, were admitted with history of fever and reported travel to a known malarious zone. Mean laboratory parameters upon admission included serum creatinine 725 +/- 515 mumol/L and serum urea 47 +/- 31 mmol/L. Three patients with hypotension on admission were started on haemodiafiltration, of whom 2 were subsequently converted to haemodialysis as their haemodynamics improved. Two remaining patients were started on intermittent bicarbonate haemodialysis. The overall mortality in our series was 20%, with 1 patient having died of complications of adult respiratory distress syndrome, disseminated intravascular coagulation and multiorgan failure. The remaining 4 survived and recovered their renal function. The single patient mortality occurred in the patient with admission serum creatinine of 1632 mumol/L, a value significantly higher than that of the 4 patients who survived (mean serum creatinine, 499 +/- 106 mumol/L, P < 0.002). These results suggest that falciparum malaria associated with acute renal failure is associated with a high morbidity, but early presentation and intervention with appropriate antimalarial and renal replacement therapy is associated with improved survival and recovery of renal function.

Acute Kidney Injury↗
PubMed2000

[Pharmaceutical development concerning diseases predominating in tropical regions: the concept of indigent drugs].

When the WHO certified the eradication of smallpox in 1981, there was a general impression that the fight against infectious diseases which began with Jenner and Pasteur was entering a phase of achievement: poliomyelitis, dracunculasis, leprosy, Chagas' disease and neonatal tetanus were also responding to eradication campaigns. However, in 1995, infectious diseases are still an important cause of mortality and morbidity and the rising incidence of emerging or re-emerging diseases remains a matter of great concern. Although this situation can be explained, at least partly, by the deterioration of health care systems and diverse socio-economic and ecological disorders, important changes occurring in the drug industry since 1980 have also played a role due to changes in pharmaco-epidemiology and new policies of drug development. Among the 1061 new drugs developed from 1975 to 1994, less than 2.7% concern tropical diseases. Since praziquantel, novel drugs have issued from veterinary medicine (ivermectin), military research (halofantrine, mefloquine) or fortuitous analysis of pharmacopoeia (artesunate). The cost of investments and the lack of market potential and market security in developing countries have dampened interest in developing drugs for tropical diseases. Observing the combined effect of deficient pharmaceutical development, drug wear due to chemoresistance (chloroquine, sulfadoxine-pyrimethamine, aminopenicillins), the cost barrier (second generation molecules) and the potential abandon of major drugs (eflornithine, melarsoprol) has led us to establish a classification of these "indigent" drugs (in opposition to "orphan" drugs) into five classes: true indigent drugs (eflornithine), indigent drugs by indication (pentamidine), indigent drugs by function (ceftriaxone), indigent drugs by formulation (melarsoprol) and indigent drugs by default (suramin). This analysis can serve as a basis for a search for solutions (regulatory, administrative and financial incentives) favoring a reactivation of drug development for diseases predominating in intertropical regions.

Animals↗
PubMed1999

An Advisory Committee Statement (ACS). Committee to Advise on Tropical Medicine and Travel (CATMAT). Statement on meningococcal vaccination for travellers.

The Committee to Advise on Tropical Medicine and Travel (CATMAT) provides Health Canada with ongoing and timely medical, scientific, and public-health advice relating to tropical infectious disease and health risks associated with international travel. Health Canada acknowledges that the advice and recommendations set out in this statement are based upon the best current available scientific knowledge and medical practices, and is disseminating this document for information purposes to both travellers and the medical community caring for travellers. Persons administering or using drugs, vaccines, or other products should also be aware of the contents of the product monograph(s) or other similarly approved standards or instructions for use. Recommendations for use and other information set out herein may differ from that set out in the product monograph(s) or other similarly approved standards or instructions for use by the licensed manufacturer(s). Manufacturers have sought approval and provided evidence as to the safety and efficacy of their products only when used in accordance with the product monographs or other similarly approved standards or instructions for use.

Adolescent↗
PubMed2000

[Mycobacterium ulcerans infection].

Mycobacterium ulcerans infection, or Buruli ulcer, is the third most common mycobacterial disease of the immunocompetent host in the tropical areas. M. ulcerans reservoir is aquatic. Infection occurs in children and young adults. The lesion begins with an indolent subcutaneous nodule, principally located on the limbs, that progressively changes into a deep indolent extensive ulcer. M. ulcerans produces a lipidic necrotic and immunosuppressive toxin, named mycolactone, that causes the clinical lesions. In endemic areas, clinical diagnosis is confirmed by microscopic examination. Spontaneous healing occurs after several months or years, causing retractile scars. Surgical excision and grafting is the treatment of choice. Antibiotic therapy is of limited value.

Adult↗
PubMedDate not supplied

House dust mites in the city of Lima, Peru.

Since mites are the most common house dust allergens, knowledge about the species most prevalent in a region is important for diagnostic and specific immunotherapy purposes. In order to establish the prevalence of house dust mites in different city districts, 100 house dust samples were collected from different parts of Lima. Lima is a city of tropical climate located along the coast of the Pacific Ocean. The relative air humidity is 80-90% and the various districts studied are located at altitudes ranging from 37-355 meters. The mite Blomia tropicalis was the organism most frequently detected, being present in 59% of the house dust samples. Dermatophagoides pteronyssinus occupied second place (15.9%), followed by Chortoglyphus arcuatus and Tyrophagus putrescentiae. These four mites, taken together, represented more than 90% of the mites detected. No specimen of the species Dermatophagoides farinae was detected. We conclude that B. tropicalis and D. pteronyssinus are the most common house dust mites in Lima. Considering the high prevalence of B. tropicalis in Lima and the fact that its cross-reactivity with antigens of the mites of the family Pyroglyphidae is minimal, we conclude that sensitization to this mite should be investigated separately in allergic patients living in Lima.

Animals↗
PubMed1975

Tropical ulcers.

We review 230 cases of tropical ulcers, includied reports of 7 cases with squamous cell carcinoma. We think the etiology may be a combination of the hot, humid environment, trauma, local infection, and malnutrition. Agressive treatment of these ulcers is advocated, to heal the wounds and to prevent malignant transformation.

Adult↗
PubMed2001

[Infectious myopathies].

Infectious myopathies are rare acquired affections which have, generally, a good prognostic. Many types of viral infections can cause transient inflammatory myopathies. HIV myopathy may be present early in the HIV infection, but more often it is a complication of fully developed AIDS. Influenza virus myositis tend to be more severe in adults than in children. Group B coxsackie virus has been isolated from striated muscle of patients with epidemic myalgia. Parasitic infections of muscle include trichinosis, toxoplasmosis, and cysticercosis. Trichinosis is the most frequent parasitic myositis. The ocular, lingual or pharyngeal weakness and/or hypereosinophilia suggest the diagnosis. Pyomyositis, is a located zone of suppuration of muscle due to staphylococcus in 90% of the cases. It is a common occurrence in tropical climates, but has been recognized increasingly in temperate climates.

Bacterial Infections↗
PubMed2001

Retrospective study of Aeromonas infection in a Malaysian urban area: a 10-year experience.

AIMS: To describe the patterns of isolation of Aeromonas spp. and the resulting spectrum of infection, intestinal and extra-intestinal,from infants and children in an urban area in a hot and humid country from SoutheastAsia. MATERIALS AND METHODS: Retrospective review of all bacterial culture records from children below 16 years of age, from the Department of Medical Microbiology, University of Malaya Medical Centre, Kuala Lumpur, from January 1988 to December 1997. Review of all stool samples and rectal swabs obtained from children during the same period were carried out to ascertain the isolation rate of Aeromonas sp. from stools and rectal swabs. The case records of those with a positive Aeromonas culture were retrieved and reviewed. RESULTS: During the study period, 84 culture samples were positive of Aeromonas spp. (stools 48, rectal swabs 36). During the same period, 1,352 stool samples were positive for at least one enteropathogen. Aeromonas spp. constituted 0.62% of all stool samples. Of the 61 cases reviewed,four patterns of colonization were observed: (a) 17 cases of mostly asymptomatic nursery newborns with a positive rectal swab; (b) 9 children with no diarrhoea; (c) 23 cases, of who seven were immunocompromised, had acute, brief watery diarrhoea without severe dehydration or disturbances of serum electrolytes. No chronic diarrhoea or bacteraemia was noted. (d) 12 cases had a mixed infection with a second enteropathogen isolated from stool samples. Three had chronic diarrhoea No extra-intestinal infection attributed to Aeromonas spp. was identified in this study. CONCLUSION: Aeromonas was a rare cause of gastroenteritis in urban Malaysian children. It was isolated almost exclusively from gastro-intestinal tract, caused mostly by mild gastroenteritis with no serious complications. Asymptomatic stool carriage among newborns admitted to special care nursery and older children with no diarrhoea were observed.

Academic Medical Centers↗
PubMed2001

UV disinfection for reuse applications in North America.

In an effort to conserve and protect limited water resources, the States of Florida and California have actively promoted wastewater reclamation and have implemented comprehensive regulations covering a range of reuse applications. Florida has a semi-tropical climate with heavy summer rains that are lost due to run off and evaporation. Much of California is arid and suffers periodic droughts, low annual rainfall and depleted ground water supplies. The high population density combined with heavy irrigation demands has depleted ground water supplies resulting in salt-water intrusion. During the past decade, Florida reuse sites have increased dramatically from 118 to 444 plants representing a total flow capacity of 826 MGD. California presently has over 250 plants producing 1 BGD with a projected increase of 160 sites over the next 20 years. To prevent the transmission of waterborne diseases, disinfection of reclaimed water is controlled by stringent regulations. Many states regulate wastewater treatment processes, nutrient removal, final effluent quality and disinfection criteria based upon the specific reuse application. As a rule, the resulting effluents have low turbidity and suspended solids. For such effluents, UV technology can economically achieve the most stringent disinfection targets that are required by the States of California and Florida for restricted and unrestricted reuse. This paper compares UV disinfection for wastewater reuse sites in California and Florida and discusses the effect of effluent quality on UV disinfection.

California↗
PubMed2000

[Mycotoxins in spices].

Since antiquity, spices have been used for flavoring foods and beverages and for medication. They play an important role in the national economy of several of the producing, exporting and importing countries. Tropical climatic conditions under which spices are grown offer a favorable environment for the fungal and mycotoxin contamination. This review summarized information from 44 reports on the occurrence of mycotoxins (aflatoxins, ochratoxins zearalenone, fumonisins, trichothecenes) and their levels in different spices. Aflatoxins which are highly carcinogenic compounds, produced by A. flavus and A. parasiticus, are the leading toxins present in red peppers (paprika, chilli, cayenne) nutmeg, mustard, ginger, black and white peppers, coriander. Ochratoxins have been reported also as a natural contaminants in many spices. Although the levels of mycotoxins are generally low when compared with other food products, the testing of spices (imported and domestic) by regulatory agencies seems to be in need of expansion.

Aflatoxins↗