Tropical Doctor最新文献

Chromobacterium violaceum is a Gram-negative bacterium, which is an environmental pathogen causing fatal opportunistic infection in tropical and subtropical areas. This facultative anaerobe produces small colonies with dark violet metallic pigmentation due to the pigment 'Violacein', hence the organism derives its name. We report an uncomplicated urinary tract infection by this rare but fatal pathogen in a young immunocompetent female, who fortunately recovered completely with oral antibiotic therapy.

Heat stroke is a life-threatening heat-related condition. It is characterised by a core body temperature >40°C with central nervous system abnormalities or organ dysfunction. In our study of 32 adult patients, multiorgan dysfunction was present in 84%. Vasopressors, intensive care, and mechanical ventilation were required in 44%. Mortality was 6.2%. Aggressive pre-hospital cooling treatment may significantly decrease mortality; thus, preventive strategies need to be developed urgently to implement such cooling facilities in public places.

Our Multidrug-resistant tuberculosis poses a significant global health challenge, particularly in low- and middle-income countries where access to diagnostic and treatment services is limited. Our multi-centre retrospective cohort study attempts to evaluate treatment outcomes and predictors of death or failure among 546 multi-drug-resistant tuberculosis patients, treated at eight specialised units between January 2017 and August 2018, with follow-up until June 2020. Overall, 69% achieved successful outcomes and 22.2% died. Significant predictors of death included older age, weight <40 kg, prior vitamin D use, and delayed sputum conversion. Despite outcomes nearing World Health Organisation targets, older patients and those with prior second-line drug exposure require closer monitoring.

Installing reliable, affordable electricity in a Malawian hospital, through overhauling its solar and overall electrical system in response to extremely poor grid electricity, has resulted in reduced bills and reduced damage to electrical equipment, and saved money for patient care. In 2024, we reported results of this upgraded system after a year of operation from July 2022 to July 2023. In January 2024, we installed 17 more 100Ah lithium-ion batteries, and results from February 2024 to February 2025 showed significant savings. We make recommendations for other hospitals.

Dengue is a mosquito-borne viral disease with four serotypes, manifesting as an acute febrile illness with potentially severe complications. While its temporal trends are well studied, the cyclical nature of its incidence and mortality remains underexplored. This ecological study analysed dengue incidence (1990-2021) and mortality (1980-2021) using global burden of disease data. Time series analysis, employing fast Fourier transform and harmonic regression, identified significant cyclical patterns. Dengue incidence and mortality exhibit marked cyclical behaviour, with regional periodicity ranging from ∼17 to 30 years. These patterns suggest that long-term environmental and socio-epidemiological factors drive predictable waves of transmission and severity. This finding underlines the need for tailored surveillance and intervention strategies to mitigate dengue outbreaks and fatalities.

Tetanus is a rapidly progressive, life-threatening illness with the clinical hallmark of muscle spasms associated with respiratory and neurological sequelae, especially in the unimmunised population. Non-neonatal tetanus continues to be a rare diagnosis. We hereby report six cases admitted to our intensive care unit, highlighting the varied clinical features, management strategies and outcomes. Early initiation of ventilatory support, aggressive spasm control, consideration of early tracheostomy and prevention of nosocomial infections are vital for positive outcomes. Additionally, consistent supportive care by doctors and nursing staff is crucial in managing severe paediatric tetanus.

Crohn's disease is a chronic granulomatous inflammatory condition affecting any part of the gastrointestinal tract. Extra-intestinal manifestations affecting the mouth may also occur, with a prevalence varying between 0.5% and 37%. However, vulval involvement is rare with approximately130 reported cases in the literature so far. An extensive literature search has shown isolated lip and vulval involvement as extra-intestinal manifestations of Crohn's disease, with only one reported case of combined vulval and lip involvement.

Tropical fevers can occur year-round but are rare in neonates. These infections, caused by bacteria and viruses, include Dengue, Malaria, Typhoid, Yellow Fever, Zika, Chikungunya, Leptospirosis, Scrub Typhus and Influenza. This case series presents five neonatal tropical infections admitted to our NICU: two congenital Chikungunya, two neonatal Chikungunya and one co-infection of Dengue and Zika. The diagnosis was confirmed via polymerase chain reaction serology. In two cases, both mother and newborn tested positive; in three, only the newborn was positive. Neonatal tropical infections are rare and often mimic sepsis with symptoms such as skin manifestations, seizures and encephalopathy, making diagnosis challenging.