Tropical Doctor最新文献

Hepatitis A is usually a self-limiting infection in children, commonly presenting with jaundice. However, rare extra-hepatic manifestations may complicate the course, including cardiac and pancreatic involvement. We report two paediatric cases of hepatitis A virus (HAV) infection with such atypical presentations. A 6-year-old boy presented with lethargy, vomiting, and bradycardia; an electrocardiogram revealed complete heart block progressing to Mobitz type I block, with bilateral pleural effusion. Also, a 10-year-old boy presented with acute abdominal pain and was found to have elevated pancreatic enzymes and imaging findings consistent with pancreatitis. Both improved with conservative management. These cases highlight the importance of recognising unusual systemic complications of HAV. They also reinforce the urgent need to integrate hepatitis A vaccination into the national immunisation schedule in India.

Amoebic liver abscess (ALA) remains a major health burden in tropical regions. Our observational study evaluated the association between serum lipid profiles and disease severity in 118 patients with ALA. Patients were classified into uncomplicated and complicated ALA groups. Serum high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in ALA patients compared to controls and further reduced in complicated cases. HDL-C emerged as an independent predictor of complicated ALA and demonstrated better predictive value than conventional inflammatory markers such as total leucocyte count and C-reactive protein. Lower HDL-C levels were also linked to an increased need for percutaneous catheter drainage and longer hospital stay. Post-treatment assessments showed significant improvement in HDL-C levels. These findings suggest that HDL-C is a valuable, low-cost biomarker for assessing ALA severity and guiding clinical decisions, especially in resource-limited settings.

Filariasis is an endemic infection caused by nematodes Wuchereria bancrofti and Brugya malayi, highly prevalent in Bihar, Kerala and Tamil Nadu. The disease mainly affects the lymphatics, both channels and nodes. Breast filariasis is rather uncommon, and might mimic a neoplastic breast lump.

Herpes simplex virus (HSV) infection of the gastro-intestinal tract is rare, except for the oesophagus, found in immunosuppressed individuals. HSV colitis may also occur, especially in patients with inflammatory bowel disease receiving systemic steroids and antimetabolites. Involvement of the small intestine by HSV is extremely rare. We present a case of dual ileal infection (HSV-1 and Tubercular ileitis) in a 30-year-old immunocompromised individual.

We present a case series describing the management and genetic findings in five neonates with meconium ileus, presenting within 48 h of birth. Whole-exome sequencing identified cystic fibrosis transmembrane conductance regulator mutations in three neonates, confirming cystic fibrosis, with one heterozygous variant of unknown significance. Two ultimately required surgical intervention after failed conservative management. One died of septic shock.

Granulomatous liver disease presents a significant diagnostic challenge, as it encompasses a broad spectrum of aetiology. Diagnosing the underlying cause can be particularly difficult when classic clinical clues are absent.

The majority of hookworm infestations are asymptomatic; however, an increased parasite burden can lead to symptoms ranging from abdominal pain to iron deficiency anaemia. Rarely, hookworm can lead to complications such as upper gastrointestinal bleeding or malnutrition.

Melioidosis, caused by Burkholderia pseudomallei, is an under-diagnosed tropical infection that often mimics tuberculosis and other chest diseases. We report the case of a 42-year old diabetic female who presented with fever and pneumonia and who developed septic arthritis. Blood, joint fluid, and abscess cultures grew B. pseudomallei. Initial treatment was with meropenem but owing to a suboptimal response, the patient was changed to a combination therapy with ceftazidime which led to clinical and biochemical improvement. She was then discharged with a three month course of co-trimoxazole for eradication. This case illustrates the multifocal nature of melioidosis and the diagnostic challenges even in endemic areas, emphasizing the need for high clinical suspicion as well as the need for prompt and aggressive antimicrobial therapy for optimal outcome.