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The Philippines' Department of Health believes that up to 90% of children in the country could be prone to poor physical and mental development because the problem of intestinal worms has gone largely unchecked. A nationwide study conducted over 10 years by the Department of Education, Culture, and Sports found a prevalence of 50-90% in children aged 2-14 years. Up to 30% of the population of 22 million children may have 1 or more of the 3 most common types of soil transmitted helminths: roundworm, hookworm, and whipworm. Infection with such worms through ingestion, skin penetration, or both, often affects children's performance in school because it can stunt growth, decrease physical activity, and cause poor physical and mental development. The most common symptoms of worm infestation are pain, enlargement of the abdomen, loss of appetite and weight, vomiting, insomnia, and irregular respiration. Worms thrive in tropical climates and are endemic to many developing countries. Infestation, however, is easily dealt with; 1 dose of albendazole given once per year for 3 years is enough to eradicate worms in a child. A pilot project launched last year in 2 villages in Aurora province in northern Luzon has thus far yielded encouraging results.
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PMID:Intestinal worms impair child health in the Philippines. 991 19

Severe or complicated malaria is defined by infestation by Plasmodium falciparum into all red blood cells, especially those in the brain, causing coma and repeated convulsions; severe anemia (6 g/dl hemoglobin, 20% hematocrit); renal insufficiency (265 mcmol/l creatinine, 400 ml/day diuresis); pulmonary edema; hypoglycemia (2.2 ml/l or 0.4 g/l); shock; diffuse hemorrhaging; massive hemoglobinuria; and blood acidosis. Other possible symptoms of severe malaria are clouded thinking, changes in behavior, and inability to focus. It is most common in people with no immunity to malaria (children aged 4 and travelers in endemic zones). Pregnancy, splenectomy, corticotherapy, or poorly maintained immunity status favor severe anemia in adults. Sources of chloroquine-resistant P. falciparum have existed since 1960. Resistance has since expanded from Southeast Asia and South America to Africa, posing treatment problems. Malaria usually begins with fever (40 or more degrees Celsius), headaches, muscular pain, digestive troubles (e.g., diarrhea, nausea, or vomiting), and abdominal pain. In suspected cases of malaria, a blood sample or a thick blood smear as well as treatment (even in the absence of parasitological proof) needs to be done as soon as possible. Intravenous quinine diluted in a 5-10% glucose solution should be delivered at a rate of 24 mg/kg/day. In the case of severe jaundice, the dose should be cut in half beginning 8 hours after treatment began. If intravenous delivery is impossible, intramuscular delivery should be done. Corticosteroids, anticoagulants, and aspirin are contraindicated. In 2-4 days, oral administration (chloroquine, halofantrine, or mefloquine) is warranted. 20% of malaria-related deaths among patients who receive treatment are due to complications of the central nervous system. Protection against mosquito bites prevents malaria. Chemoprophylaxis in endemic zones should be limited to short trips to malaria zones or to pregnant women.
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PMID:[Severe malaria]. 1229 Jan 83

We describe the case of a 28-year-old man from Greece with Opistorchis felineus infestation. The patient presented with intense abdominal pain, bilious emesis and eosinophilia. He probably acquired the infection overseas, since he was a commercial airline pilot who used to fly to endemic areas and to consume raw or undercooked fish. He was successfully treated with praziquantel administered in divided doses over a single day. Opisthorchiasis is common to eastern Europe and areas of the former Soviet Union, but extremely rare in Greece. Medical personnel should be cognizant of this parasitic infection, since world travel can spread it to areas of the world unaccustomed to it.
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PMID:A case of Opisthorchis felineus infestation in a pilot from Greece. 1473 89

There is increasing evidence of permanent sequalae from acute organophosphate poisoning. We report on accidental diazinon overexposure with acute organophosphate poisoning through cutaneous absorption and inhalation followed by persistent neurological effects. In addition, we observed skeletal and endocrine effects likely attributable to the diazinon poisoning. A family of seven was exposed to diazinon in June 1999 over a two-day period. The pesticide company mistakenly used diazinon to heavily spray the inside of the home instead of permethrin. The applicator applied the pesticide over the entire surface of the floor, carpeting, furniture, and clothing in closets to eradicate an infestation of fleas. Acute symptoms in the family members included headaches, nausea, skin irritation, runny nose, and vomiting. The family was first evaluated at 3 months and then 3 years after the acute poisoning. There were persisting neurological symptoms of memory loss, decreased concentration, irritability, and personality changes of varying degrees in all family members. Objective neurological findings of impaired balance, reaction time, color vision, slotted pegboards and trials making were present in the three older children who could be tested. Neuropsychological evaluation revealed evidence of organic brain dysfunction in all seven family members. Bone growth difficulties are present in four of five children. One child has delayed menarche.
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PMID:Health effects of diazinon on a family. 1546 49

Bruns' syndrome is characterized by sudden and strong headache, accompanied by vomiting, acuphenos and vertigo, triggered by abrupt movement of the head and can produce deep coma and death. This can be due to neurocysticercosis by cyst in the fourth ventricle, which contains the larval stage of Taenia solium. In the last years, new cases of this parasitosis are being seen in Spain because of the immigration from endemic areas, but the clinical forms of this infestation are not varied. We present a 44 year old man Ecuadorian who has clinical symptoms consistent with Bruns' syndrome secondary to cyst in the fourth ventricle that progressed badly despite undergoing surgery with ventriculoperitoneal shunt and treatment with albendazol. Finally, he was operated with the excision of the lesion by means of suboccipital craniectomy. We conclude that this syndrome must rule out a cystic or non-cystic, intraventricular lesion and that the appropriate manipulation of the cysticerotic ventricular cysts carries a more favourable prognosis.
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PMID:[Bruns' syndrome: description of a case of neurocysticercosis with pathological study]. 1572 76

Hydatid disease is a parasitic infestation caused by a tapeworm of the genus Echinococcus, and it is common in Mediterranean regions. Cystic lesions cause symptoms via compressing adjacent organs or may be totally silent. Morbidity is usually secondary to free rupture of the echinococcal cyst with or without anaphylaxis, infection of the cyst or dysfunction of affected organs. The cyst of Echinococcus granulosus is commonly located in the liver and frequently causes no symptoms. Anaphylactic reactions as a result of cyst perforation generally occur during interventions such as needle aspiration or open surgery; however, the spillage of cyst fluid with intravascular spread resulting from trauma may also trigger anaphylaxis, and rare case reports of this kind are present in the literature. We report the case of a 17-year-old man who was admitted to the public hospital with a sudden onset of nausea, vomiting and fainting. After a short period of intervention in the emergency department he died. As the cause of his sudden death was unknown, a forensic autopsy was carried out by the Forensic Council of Turkey. The autopsy revealed a macroscopically non-ruptured hydatid cyst in the liver and laryngeal oedema. In histopathological examination, two scolices in the pulmonary artery and inflammatory infiltration mainly composed of mast cells in the larynx were detected. Sudden death in this case was attributed to anaphylactic shock caused by intravascular spread of the cyst contents.
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PMID:Non-ruptured hydatid cyst can lead to death by spread of cyst content into bloodstream: an autopsy case. 1587 31

Reports of intestinal trematode infections are not common from Bihar, India. However, we herewith report one case of fasciolopsiasis from North Bihar, India. A 14 years old girl presented with diarrhea, vomiting, generalized pain abdomen and loss of weight. Routine stool examination and upper gastrointestinal endoscopy revealed fasciolopsis buski in large numbers. Her rural life style and food habit (ingestion of raw vegetables- caltrops and water chest nuts) supported the cause of infestation. Despite treatment with praziquantel, the patient died after two days. Mild infestations of Fasciolopsis buski may pass on unnoticed. However, heavy infestations may cause considerable prostration, illness and even death in younger age groups. Awareness regarding this parasitic infestation (endemic in some regions), especially in the rural set up is still a much needed entity.
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PMID:Intestinal trematode infection in North Bihar. 1716 98

A 10-year-old boy was admitted with a 4-month history of ataxic gait, headache, vomiting and diplopia. The headaches had worsened in month 4 and were associated with vomiting during head movement. Cranial computed tomography (CT) and magnetic resonance imaging (MRI) scans revealed a hydatid cyst located in the posterior fossa. The patient underwent suboccipital craniotomy and a cerebellar hydatid cyst (approximately 5 cm in diameter) was removed using Dowling's technique. The diagnosis was confirmed during surgery and by histological examination of a tissue sample from the cyst. The patient was treated with the antihelmintic agent albendazole in combination with antibiotics. The post-operative course was uneventful and the patient was discharged after 1 week. In conclusion, when a cystic lesion is detected on CT or MRI scans, hydatid disease should be taken into consideration in countries where hydatid infestation is endemic.
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PMID:Giant hydatid cyst in the posterior fossa of a child: a case report. 1823 Feb 79

Tick-borne Relapsing Fever (TBRF) is a vector-borne disease of humans which causes serious illness, primarily for children under five years old and pregnant women. Understanding people's knowledge, attitude and practices on the disease is important in designing appropriate interventions. This study was conducted to explore community knowledge, attitudes and practices regarding TBRF transmission and control to provide baseline data for the planned scaling up of intervention in Dodoma rural District in central Tanzania. A total of 198 heads of households were interviewed using a semi-structured questionnaire. Of these, 94.5% were aware of TBRF. Fever of unknown origin (69.5%), body pain (8.5%), headache (8.5%), chills (4.5%) and vomiting (3.5%) were the most commonly mentioned symptoms. The domestic tick-infestation and tick-bites was known to 82.8%. High domestic tick infestation reported to occur during dry season (85.4%). The majority believed that the disease spreads through tick-bites (85.9%). Regular plastering of house floors and walls was the most common method used by the community to control domestic tick infestation (96.5 %). Majority (84.3%) of the respondents preferred public healthcare facilities for treatment. Only a small proportion (15.7%) preferred using traditional medicines. Poor knowledge of the study subjects about the disease and its control underscores the need for health educational campaigns if any control and/or elimination programme is to succeed.
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PMID:Community knowledge, attitudes and practices related to tick-borne relapsing fever in dodoma rural district, central Tanzania. 1902 37

Infestation with Ascaris lumbricoides in children has a varied manifestation, but encephalopathy is a very rare presentation. This report describes a case of ascariasis-associated encephalopathy in a child. An 18-month-old boy was admitted with altered sensorium. He had a history of vomiting and was passing Ascaris worms in the vomitus. The cerebrospinal fluid analysis did not reveal any abnormality. The patient was treated with an antihelminthic drug and he recovered completely. Worm encephalopathy should be considered as a differential diagnosis for unexplained encephalopathy in tropical areas.
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PMID:Ascariasis-associated worm encephalopathy in a young child. 1929 1


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