Dr Anton Breinl and the Australian Institute of Tropical Medicine. Part 1.
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We describe a case of isolated pectoralis swelling and tenderness, without systemic signs of infection, in a North American adult with diabetes mellitus and rheumatoid arthritis. The etiology was discovered to be pyomyositis, usually thought to be a disease of tropical climates. It is the first such case with group B Streptococcus as the causative organism.
Over a period of 23 months, 30 cases of cryptococcosis have been studied in Bujumbura (Burundi). Through them, epidemiological and clinical aspects have been underlined, and attempts have been made to establish links between cryptococcosis and A.I.D.S., which is significantly frequent in Central Africa. Cryptococcosis strikes young adults (40% between 30 and 35 years of age). Its high frequency in Bujumbura among patients infested by A.I.D.S., suggest some thoughts. A.I.D.S. in Central Africa, and particularly in Burundi, presents some peculiarities linked to surrounding and possibilities of diagnosis: opportunistic diseases are of different frequency in temperate or tropical climates: pneumocystosis are more frequent in U.S.A. but cryptococcosis and candidosis are more frequent in Africa because their diagnosis is easier. lack of classical risk factors in African populations is known, but other risk factors have to be taken into consideration: tuberculosis, intestinal parasitosis, chronic virus B hepatitis, protein-caloric deficiency.
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The high number of the strains of Escherichia coli (E. coli) isolated from faeces, demonstrated that this bacteria takes the first place in diarrhoea. These isolations had the same frequency all the year long. In infants, the enteropathogenic E. coli (E. P. E. C.) (28.57%) are still frequent contrary to developed countries. The E. coli with hemagglutination phenomenon (colonisation factors) but without toxin detected were also responsible (mortality 6%). The E. coli without toxin and not belonging to E. P. E. C. group were also frequent (71.42%). In adults, only the enteroinvasive E. coli (E. I. E. C.) (16.6%) and the E. coli with hemagglutination but without toxin detected (16.6%) were observed. This situation is due to bad hygienic conditions among the people and the tropical climate.
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An Eskimo who had been treated for a nasopharyngeal carcinoma was subsequently found to have a rapidly progressive form of Kaposi's sarcoma confirmed at biopsy. No objective response was obtained by irradiation treatment of isolated nodules. However, vinblastine sulfate arrested the progression of the disease. Because this neoplasm is most prevalent in tropical climates its presentation in an Eskimo is believed sufficiently unusual to warrant this report.
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