Tropical Doctor最新文献

Histoid leprosy is an uncommon variant of lepromatous leprosy. It poses a diagnostic challenge because of its distinctive clinical and histopathological features. It presents as smooth papules and nodules that rarely ulcerate. We present the case of a 22-year-old Nigerian man with a 2-year history of multiple, dome-shaped papules and nodules on the skin with necrotic centres. General examination showed right axillary lymphadenopathy, non-pitting oedema, foot ulcer, and glove and stocking sensation loss. Despite previous misdiagnoses, histopathological examination showed dermal expansion by histiocytes arranged in a storiform pattern. Slit skin smear yielded abundant bacilli. The patient was started on WHO multidrug treatment, resulting in the improvement of his lesions. This case emphasises the importance of increased awareness of this rare presentation of leprosy.

Scabies is a neglected tropical disease and has been highlighted as a target for control. Sarcoptic mange affects animals, but mange is also considered a zoonosis. We present rapid assessment data on scabies and sarcoptic mange collected from key informants via a web-based questionnaire in Ceará State (1265 data entries). A total of 181/184 (98.3%) municipalities reported the occurrence of human scabies; 149 (80.9%) current occurrence; 168 (91.3%) severe cases; and 113 (61.4%) severe cases currently. Sarcoptic mange was reported from 149/184 (80.9%) municipalities, and severe mange from 128 (69.9%), most commonly in dogs (117 municipalities), cats (79), pigs (17), cattle (15), horses (15), and goats (2). Respondents from 171 (92.9%) municipalities observed seasonality of occurrence. Scabies and sarcoptic mange are important public health issues in a northeast Brazilian state. The wide distribution of severe cases requires an integrated One Health approach effectively and sustainably to reduce the disease burden.

Dengue is a disease endemic to tropical countries such as India. In the past two years, cases of COVID-19 associated Mucormycosis have become a commonly encountered phenomenon. However, cases of dengue associated Mucormycosis have not found a significant mention in the literature yet. We, therefore, report two such cases in which Mucormycosis developed after recovery from Dengue fever and try to dig into the possible mechanism behind such an occurrence.

We present the case of a young female with fever, rash, and joint pain without any other history of connective tissue disorder, who was found on evaluation to have neutrophilic leucocytosis, elevated inflammatory markers and lymphadenopathy with hepatosplenomegaly. After extensive workup, the possibility of adult onset Still's disease was suggested by Yamaguchi criteria. She was started on naproxen, but later on developed drug-induced liver injury. She already had central serous retinopathy due to steroid use, and it was difficult to treat the adult-onset Stills disease due to the liver injury in view of contraindication to use of anti-inflammatory drugs but her illness was monocyclic and did not require further immunosuppression.

Expanded dengue syndrome is a severe form of dengue fever that can cause acute liver failure and patients with this condition have a high mortality rate. This is because it can cause a cytokine storm, Unfortunately, standard treatments are often ineffective. Therapeutic plasma exchange is a procedure that removes cytokines and improves the patient's condition. Our study involved 15 patients with expanded dengue syndrome having acute liver failure, who were not responding to standard therapies. We treated them with plasmapheresis, and 11 of the patients showed significant improvement in liver function and survived. Unfortunately, the remaining four patients died owing to other complications. Early treatment is crucial for the best possible outcome.

Female genital tuberculosis (FGTB) is asymptomatic or may present with a few symptoms among which infertility is the most common. The diagnosis of FGTB is challenging, as there is no single diagnostic test available.We researched 50 infertile patients by various special investigations and found 50% had tuberculosis, by various means. Endometrial biopsy and Hystero-laparoscopy are complementary procedures, and Cartridge Based Nucleic Acid Amplification Test is a useful new addition to the diagnostic armamentarium for endometrial and peritoneal samples.

Drainage after axillary lymph node dissection is a major cause of morbidity. We evaluated the outcomes of topical epinephrine with xylocaine + systemic tranexamic acid (EXT) after axillary lymph node dissection. The primary endpoint was the rate of seroma development. This resulted in reduced hospital stay with similar rates of seroma as drainage after axillary lymph node dissection; thereby making it possible to avoid drainage.

The Ponseti method of clubfoot treatment is ideal for low- and middle-income countries since it is minimally invasive and easily implementable through non-surgeon providers. However, variables related to the socioeconomic status of the community, patient-related factors, treatment provider-related factors, and health system-related factors may influence the outcome of this deformity. These barriers need a two-pronged approach, a top-down (involvement at the policy level) as well as a bottom-up method (involvement at an individual level). Improving the knowledge level of the caregiver as well as the provider and addressing the issues regarding financial constraints will help in eliminating various barriers to the treatment of clubfoot. Furthermore, regular audits help in identifying the efficacy of various solutions employed as well as identifying new barriers to treatment. Integration at the policy level with the involvement of governmental as well as non-governmental organisations helps to remove health system-level bottlenecks.