Tropical Doctor最新文献

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.

Vitamin B₁₂ deficiency can manifest in various forms, including skin changes in the form of hyperpigmentation. The hyperpigmentation in vitamin B₁₂ deficiency commonly presents over the hands and feet, but presenting over the face and oral cavity is very rare. Here we describe an interesting case where there was hyperpigmentation in the face and oral cavity which was mimicking Addison's disease, but the actual diagnosis was vitamin B₁₂ deficiency. This case stresses that knowing the uncommon manifestations of common disease is more important than knowing the common manifestations of uncommon disease.

An evaluation of the Veterans Affairs Medical Center score in predicting abdominal wound dehiscence and an assessment of its risk factors after abdominal surgery in adults was conducted at our tertiary care hospital over a period of 1 ½ years.

Human metapneumovirus (HMPV) is an emerging respiratory pathogen causing infections across various age groups, particularly among children, the elderly, and immuno-compromised individuals. The recent surge of cases reported in late 2024 and early 2025 across Asia, Europe, and North America highlights its re-emergence as a pathogen of global concern. Laboratory confirmation, particularly using reverse transcription-polymerase chain reaction, remains the gold standard for diagnosis, while antigen detection and serology have supplementary roles. No licensed antivirals or vaccines are currently available, and management remains largely supportive, although ribavirin and intravenous immune globulin have been trialled in select severe cases. Strengthened surveillance networks, including WHO influenza-like illness/severe acute respiratory infections monitoring and national programmes, are crucial for early detection and control. This review provides an overview of HMPV's virology, epidemiology, clinical manifestations, diagnostic methods, and management strategies, with emphasis on the recent global resurgence and the need for continued vigilance and research.