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Vande Walle N, Van den Enden E, Fostier K, De Coninck A, Nieboer K, Velkeniers B, Lacor P. Systemic anaplastic large cell lymphoma presenting with cutaneous manifestations in a young man: a case report. Acta Clin Belg 2012; 67:127-9. [PMID: 22712169 DOI: 10.2143/acb.67.2.2062643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Skin lesions can be a sign of internal disease. When they are associated with persisting systemic signs, the possibility of an internal malignancy should always be considered. We describe a 25-year-old man who presented with weight loss, fatigue, subpyrexia, xerostomia and skin rash of 6 months duration. Physical examination showed a dry red skin, most prominent in the face, the palms of the hands and the soles of the feet. Laboratory investigations revealed signs of inflammation and a high level of antinuclear antibodies. Retroperitoneal lymph nodes were visualized on a CT scan of the abdomen. CT-guided biopsy of an abdominal lymph node revealed the presence of an anaplastic large cell lymphoma (ALCL), ALK-positive. A biopsy of the skin showed non-specific signs of inflammation.The patient underwent 8 cycles of chemotherapy according to the CHOP protocol. A complete remission was obtained. Non-Hodgkin lymphoma can indeed be associated with skin lesions. They result from direct invasion by malignant cells or are of paraneoplastic origin, as was the case in this patient.
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Affiliation(s)
- N Vande Walle
- Department Interne Geneeskunde, Universitair Ziekenhuis Brussel, Brussel, België.
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Van den Enden E, Vlieghe E, Demeester R, Ieven G, Jansens H, Van den Hauwe L. A traveler with neurobrucellosis. Travel Med Infect Dis 2009; 7:215-8. [DOI: 10.1016/j.tmaid.2009.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Revised: 03/06/2009] [Accepted: 05/18/2009] [Indexed: 10/20/2022]
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Bottieau E, Clerinx J, Colebunders R, Van den Enden E, Wouters R, Demey H, Van Esbroeck M, Vervoort T, Van Gompel A, Van den Ende J. Selective ambulatory management of imported falciparum malaria: a 5-year prospective study. Eur J Clin Microbiol Infect Dis 2007; 26:181-8. [PMID: 17297605 DOI: 10.1007/s10096-007-0264-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The ambulatory management of imported Plasmodium falciparum malaria is controversial because criteria for safe selection of patients are imprecise. The aim of the present study was to investigate the evolution and outcome of patients diagnosed with Plasmodium falciparum malaria at a Belgian referral institute in order to assess the safety of the institute's current selective ambulatory management protocol. From 2000 to 2005, all patients diagnosed with P. falciparum infection at the Institute of Tropical Medicine and the University Hospital of Antwerp were enrolled prospectively. Ambulatory treatment was offered to nonvomiting patients if they exhibited none of the 2000 World Health Organization criteria of severity and had parasitemia below 1% at the initial assessment. The treatment of choice was quinine (plus doxycycline or clindamycin) for inpatients and atovaquone-proguanil for outpatients. P. falciparum malaria was diagnosed in 387 patients, of whom 246 (64%) were Western travelers or expatriates and 117 (30%) were already on antimalarial therapy. At diagnosis, 60 (15%) patients had severe malaria. Vital organ dysfunction was initially seen in 34 and developed later in five others. Five patients died. Of the 327 patients initially assessed as having uncomplicated malaria, 113 (35%) were admitted immediately; of these, 4 developed parasitemia >/=5% at a later stage but without any clinical consequence. None of the 214 individuals initially treated as outpatients experienced any malaria-related complications, including 10 who were admitted later. Vital organ dysfunction was observed in only 2 of the 214 patients with initial parasitemia <1% who had not taken antimalarial agents (both patients had impaired consciousness at presentation). Ambulatory treatment is safe in treatment-naive malaria patients with parasitemia <1% who do not vomit and who do not exhibit any criteria of severe malaria.
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Affiliation(s)
- E Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
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Affiliation(s)
- E Van den Enden
- Department of Internal Medicine, Institute of Tropical Medicine, Antwerp.
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Wynants H, Van Gompel A, Morales I, Vervoort T, Ponomarenko N, Surmont I, Bourgeois P, Van den Enden E, Van Marck E, Van den Ende J. The hypereosinophilic syndrome after residence in a tropical country: report of 4 cases. Acta Clin Belg 2000; 55:334-40. [PMID: 11484424 DOI: 10.1080/17843286.2000.11754320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Severe eosinophilia may be complicated by acute or chronic visceral damage. The underlying origin of the hypereosinophilia may be infectious, allergic, toxic, malignant or systemic (the secondary or reactive hypereosinophilic syndrome), but in a number of cases no cause can be found (the idiopathic hypereosinophilic syndrome). We describe 4 cases with hypereosinophilia and secondary visceral damage after residence in a tropical region. In three cases a helminthic infection was the obvious cause, the brain and the heart were the target organs. After treatment of the infection both the hypereosinophilia and the neurological and cardiac lesions disappeared. The fourth patient died of multi-organ disease. No definite trigger of the hypereosinophilia could be found. We discuss clinical findings, necessary investigations and therapeutic strategies.
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Affiliation(s)
- H Wynants
- Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium
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Pelgrom J, Bastian I, Van den Enden E, Portaels F, Colebunders R. Cutaneous ulcer caused by Mycobacterium avium and recurrent genital herpes after highly active antiretroviral therapy. Arch Dermatol 2000; 136:129. [PMID: 10632226 DOI: 10.1001/archderm.136.1.129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Guimard Y, Bwaka MA, Colebunders R, Calain P, Massamba M, De Roo A, Mupapa KD, Kibadi K, Kuvula KJ, Ndaberey DE, Katwiki KR, Mapanda BB, Nkuku OB, Fleerackers Y, Van den Enden E, Kipasa MA. Organization of patient care during the Ebola hemorrhagic fever epidemic in Kikwit, Democratic Republic of the Congo, 1995. J Infect Dis 1999; 179 Suppl 1:S268-73. [PMID: 9988194 DOI: 10.1086/514315] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
In contrast with procedures in previous Ebola outbreaks, patient care during the 1995 outbreak in Kikwit, Democratic Republic of the Congo, was centralized for a large number of patients. On 4 May, before the diagnosis of Ebola hemorrhagic fever (EHF) was confirmed by the Centers for Disease Control and Prevention, an isolation ward was created at Kikwit General Hospital. On 11 May, an international scientific and technical committee established as a priority the improvement of hygienic conditions in the hospital and the protection of health care workers and family members; to this end, protective equipment was distributed and barrier-nursing techniques were implemented. For patients living far from Kikwit, home care was organized. Initially, hospitalized patients were given only oral treatments; however, toward the end of the epidemic, infusions and better nutritional support were given, and 8 patients received blood from convalescent EHF patients. Only 1 of the transfusion patients died (12.5%). It is expected that with improved medical care, the case fatality rate of EHF could be reduced.
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Affiliation(s)
- Y Guimard
- Institute of Tropical Medicine, Antwerp, Belgium
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Bwaka MA, Bonnet MJ, Calain P, Colebunders R, De Roo A, Guimard Y, Katwiki KR, Kibadi K, Kipasa MA, Kuvula KJ, Mapanda BB, Massamba M, Mupapa KD, Muyembe-Tamfum JJ, Ndaberey E, Peters CJ, Rollin PE, Van den Enden E, Van den Enden E. Ebola hemorrhagic fever in Kikwit, Democratic Republic of the Congo: clinical observations in 103 patients. J Infect Dis 1999; 179 Suppl 1:S1-7. [PMID: 9988155 DOI: 10.1086/514308] [Citation(s) in RCA: 328] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
During the 1995 outbreak of Ebola hemorrhagic fever in the Democratic Republic of the Congo, a series of 103 cases (one-third of the total number of cases) had clinical symptoms and signs accurately recorded by medical workers, mainly in the setting of the urban hospital in Kikwit. Clinical diagnosis was confirmed retrospectively in cases for which serum samples were available (n = 63, 61% of the cases). The disease began unspecifically with fever, asthenia, diarrhea, headaches, myalgia, arthralgia, vomiting, and abdominal pain. Early inconsistent signs and symptoms included conjunctival injection, sore throat, and rash. Overall, bleeding signs were observed in <45% of the cases. Typically, terminally ill patients presented with obtundation, anuria, shock, tachypnea, and normothermia. Late manifestations, most frequently arthralgia and ocular diseases, occurred in convalescent patients. This series is the most extensive number of cases of Ebola hemorrhagic fever observed during an outbreak.
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Affiliation(s)
- M A Bwaka
- Hôpital Général de Référence de Kikwit, Diocèse de Kikwit, and 5ème Région Militaire, Democratic Republic of the Congo
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Van den Enden E, Stevens A, Van Gompel A. Treatment of cutaneous larva migrans. N Engl J Med 1998; 339:1246-7. [PMID: 9786758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Van den Ende J, Coppens G, Verstraeten T, Van Haegenborgh T, Depraetere K, Van Gompel A, Van den Enden E, Clerinx J, Colebunders R, Peetermans WE, Schroyens W. Recurrence of blackwater fever: triggering of relapses by different antimalarials. Trop Med Int Health 1998; 3:632-9. [PMID: 9735933 DOI: 10.1046/j.1365-3156.1998.00287.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Five cases of blackwater fever (BWF) are described, all of whom had a history of recent quinine therapy. In two cases a second haemolytic crisis was induced by halofantrine, in one case also a third. Increasing frequency of this syndrome with its dramatic clinical presentation is to be expected as imported P. falciparum infection, parasite resistance to chloroquine and the use of quinine and other related antimalarials become more frequent.
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Van den Ende J, Blot K, Kestens L, Van Gompel A, Van den Enden E. Kabisa: an interactive computer-assisted training program for tropical diseases. Med Educ 1997; 31:202-209. [PMID: 9231140 DOI: 10.1111/j.1365-2923.1997.tb02568.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
In Europe, tropical pathology is usually taught in special short courses, intended for those planning to practise in developing countries. The theoretical knowledge to be assimilated during this short period is considerable, and turning such newly acquired knowledge into competence is difficult. Kabisa is a computer-based training program for tropical diseases. Instead of concentrating on strictly tropical diseases, students are trained in recognizing diseases in patients presenting randomly in an imaginary reference hospital in a developing country. Databases are compiled by experts from experiences in various parts of Africa, Asia and tropical America. Seven languages and three levels of competence can be chosen by the student. Updating of all databases is possible by teachers who want to describe a particular setting. A 'consistency checker' verifies the internal consistency of a new configuration. The logical engine is based upon both a 'cluster' and a Bayesian logic, with built-in corrections for related disease characteristics. This correction allows calculated probabilities to stay closer to real probabilities, and avoids the 'probability overshoot' that is inherent to 'idiot Bayes' calculations. The program provides training in diagnostic skills in an imaginary second-line setting in a tropical country. It puts tropical and cosmopolitan diseases in perspective and combines applied clinical epidemiology and pattern recognition within varying sets of presenting symptoms. Students are guided in searching for the most relevant disease characteristics, in ranking disease probability, and in deciding when to stop investigating.
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Affiliation(s)
- J Van den Ende
- Institute of Tropical Medicine, Clinical Department, Antwerp, Belgium
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Van den Ende J, Schroyens W, Van den Enden E. Clinical problem-solving: hypereosinophilic syndrome. N Engl J Med 1996; 334:539-40. [PMID: 8559222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Abstract
A 32-year-old Italian man developed fever and general malaise 3 weeks after arrival in Zaïre. Malaria was diagnosed by a thick blood film, but consequent treatment with quinine was unsuccessful. After repatriation, the diagnosis of early stage sleeping sickness was established. Treatment with eflornithine (Ornidyl) resulted in complete recovery.
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Affiliation(s)
- D Buyse
- Instituut voor Tropische Geneeskunde, Antwerpen
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Wynants H, Van den Ende J, Randria J, Van Gompel A, Van den Enden E, Brands C, Coremans P, Michielsen P, Verbist L, Colebunders R. Diagnosis of amoebic infection of the liver: report of 36 cases. Ann Soc Belg Med Trop 1995; 75:297-303. [PMID: 8669977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The classical clinical picture of amoebic infection of the liver consists of fever, right upper quadrant pain and hepatomegaly. In recent years, the widespread availability of ultrasound and serology made an early diagnosis possible, which could result in less prominent clinical pictures. Thirty six cases of liver amoebiasis diagnosed in Antwerp between 1985 and 1992, were reviewed. Three patients acquired their infection in Belgium. For the other patients, the average delay between arrival in Belgium and the first symptoms was 5.64 months. The classical triad of clinical signs (fever, right upper quadrant pain and hepatomegaly), was observed in only 13.9% of the patients, whereas it was much more frequent in earlier studies (68-75%). The right lobe was the most frequently affected (94%). The colour of the liquid, obtained by puncture, was brown in 61% of patients in whom it was reported. Amoebic cysts were found in the stools of only one patient. Amoebic serology was initially negative in only one patient, but became positive on second testing. Chest X-rays were abnormal in 34% of the patients. All patients who develop unexplained fever during the year after a stay in tropical countries should undergo an abdominal ultrasound examination and serological testing for Entamoeba histolytica.
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Affiliation(s)
- H Wynants
- Instituut voor Tropische Geneeskunde, Antwerpen, Belgium
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Van den Enden E, Praet M, Joos R, Van Gompel A, Gigasse P. Eosinophilic myositis resulting from sarcocystosis. J Trop Med Hyg 1995; 98:273-6. [PMID: 7636925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Muscle sarcocystosis is a parasitic infection acquired by ingestion of sporocysts of Sarcocystis species. A case is described where symptoms of fever, chronic myositis and eosinophilia were present. Diagnosis was made via muscle biopsy. Improvement and cure coincided with treatment with cotrimoxazole. A limited review of human muscle sarcocystosis and an outline of the gaps in the knowledge of this infection is presented.
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Van den Abbeele K, Van den Enden E, Van den Ende J. Combined chloroquine and primaquine resistant Plasmodium vivax malaria in a patient returning from India. Ann Soc Belg Med Trop 1995; 75:73-4. [PMID: 7794065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Van Gompel A, Van den Ende J, Van den Enden E. The predictive value of a serologic test for the detection of Babesia microti antibody. J Infect Dis 1995; 171:504-6. [PMID: 7844402 DOI: 10.1093/infdis/171.2.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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Van den Ende J, Van Gompel A, Van den Enden E, Colebunders R. Development of hyperreactive malarious splenomegaly in an 8 year-old Caucasian boy, 18 months after residence in Africa. Ann Soc Belg Med Trop 1994; 74:69-73. [PMID: 8024351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Hyperreactive malarial splenomegaly (the former tropical splenomegaly syndrome) refers to a combination of splenomegaly, high antimalarial antibodies and high serum IgM content, a condition resulting from an aberrant immunological response to malaria. It has rarely been described in expatriates. We report the case of an 8 year-old Dutch boy who developed this syndrome 18 months after returning from Zaire. Treatment with mefloquine resulted in gradual improvement of all laboratory abnormalities. The spleen did not decrease in size, but became normal for age as height increased.
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Affiliation(s)
- J Van den Ende
- Clinical Department, Institute of Tropical Medicine, Antwerper, Belgium
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Van den Ende J, Moorkens G, Van Gompel A, Demey H, Lins R, Maldague P, Pelfrène E, Van den Enden E, Taelman H, Van der Stuyft P. Twelve patients with severe malaria treated with partial exchange transfusion. Comparison between mathematically predicted and observed effect on parasitaemia. Trop Geogr Med 1994; 46:340-345. [PMID: 7892699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Imported malaria is increasing in Western countries, which results in considerable morbidity and mortality, the latter mainly due to delayed diagnosis and treatment. Partial exchange transfusion has been proposed as a therapy for very severe falciparum malaria, but the utility of this procedure has not been proven. We report on 12 patients with severe Plasmodium falciparum malaria, treated with exchange transfusion in 5 Belgian hospitals between 1987 and 1991. The mean parasitaemia before exchange was 17.2% (range 6-35%). An average of 3.1 l was exchanged within 3 to 7 hours. Ten of the 12 patients survived. One patient recovered initially, but died as a consequence of a cascade of complications of dialysis. Three patients developed the adult respiratory distress syndrome (ARDS), two had less serious pulmonary involvement, and five had temporary renal failure; none of the survivors had sequelae. A formula is proposed to calculate the expected reduction in parasitized erythrocytes by exchange transfusion in function of the initial parasitaemia, the initial haemoglobin level and the volume of blood exchanged. Comparison between the mathematically predicted and the observed decline in parasitaemia shows on average a 25% excess of observed over predicted efficacy per unit of blood exchanged. After introducing this correction the formula enables the clinician to estimate roughly the volume of blood that has to be exchanged in order to bring the initial parasitaemia down to a desired level.
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Colebunders R, Van Damme L, Van den Abbeele K, Fleerackers Y, Van den Enden E, Dockx P. Atypical varicella zoster infection in persons with HIV infection. Acta Clin Belg 1994; 49:104-7. [PMID: 8067171 DOI: 10.1080/17843286.1994.11718373] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Four patients with HIV infection and severe immunodeficiency are described who developed atypical varicella zoster lesions. Three of the patients presented with chronic varicella zoster lesions. In two of them such lesions were hyperkeratotic. All three patients had been treated initially with subtherapeutic doses of acyclovir. In one of the patients the lesions were clinically resistant to high dose acyclovir treatment and disappeared only when renal insufficiency developed during foscarnet-famcyclovir treatment. One patient developed a disseminated varicella zoster infection.
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Affiliation(s)
- R Colebunders
- Instituut voor Tropische Geneeskunde, Antwerpen, Belgie
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Vandenbruaene M, Colebunders R, Goeman J, Alary M, Farber CM, Kestens L, van Ham G, Van den Ende J, Van Gompel A, Van den Enden E. Evaluation of two staging systems for HIV infection for use in developing countries. AIDS 1993; 7:1613-5. [PMID: 7904453 DOI: 10.1097/00002030-199312000-00011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To evaluate the clinical axis of the World Health Organization (WHO) clinical staging system and the modified WHO staging system proposed by Montaner et al. using the lymphocyte strata > 1500, 1500-1000 and < 1000 cells x 10(6)/l. DESIGN Cross-sectional study. PATIENTS Four hundred and fifteen consecutive patients with HIV infection attending three HIV reference centres in Belgium. METHODS Absolute CD4 lymphocyte counts were compared between stages within the two staging systems. RESULTS Median CD4 lymphocyte counts decreased with increasing stage of disease in both staging systems. Differences in median CD4 lymphocyte counts between stages of each staging system were statistically significant (Kruskal-Wallis one-way analysis of variance, P < 0.001). The WHO clinical stage 1 and the modified WHO stage I had positive predictive values of 56 and 58%, respectively, for identifying patients with CD4 lymphocyte levels > 500 cells x 10(6)/l. The WHO clinical stage 4 and the modified WHO stage IV had positive predictive values of 79 and 80%, respectively, for identifying patients with CD4 lymphocyte levels < 200 cells x 10(6)/l. CONCLUSIONS The WHO clinical staging system or a modified version of this system using lymphocytes stratification may be a good alternative in developing countries to the CD4 lymphocyte count-based HIV staging system used in the developed world. Cohort studies in developing countries are needed to assess their prognostic value.
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Affiliation(s)
- A Van Gompel
- Outpatients Department, Institute of Tropical Medicine, Antwerp, Belgium
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Colebunders R, De Serrano P, Van Gompel A, Wynants H, Blot K, Van den Enden E, Van den Ende J. Imported relapsing fever in European tourists. Scand J Infect Dis 1993; 25:533-6. [PMID: 8248757 DOI: 10.3109/00365549309008539] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Two 'imported' cases of relapsing fever after a trip through Senegal are described. Two women developed a tick-borne relapsing fever after having slept outdoors on a terrace in Zinguichor, Senegal. The first patient was rapidly cured after a course of doxycycline. The second patient initially received erythromycin, but despite this treatment she developed neurological symptoms and Borrelia persisted in the thick-smear examination. After treatment with doxycycline she developed a Jarish-Herxheimer reaction. Treatment with doxycycline was continued and finally all symptoms disappeared within 36 hours after starting this treatment. A diagnosis of relapsing fever should be considered in all patients returning from the tropics with recurrent fever, especially if no malaria parasites are found.
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Van den Enden E, Van Gompel A, Van der Stuyft P, Vervoort T, Van den Ende J. Treatment failure of a single high dose of ivermectin for Mansonella perstans filariasis. Trans R Soc Trop Med Hyg 1993; 87:90. [PMID: 8465410 DOI: 10.1016/0035-9203(93)90438-v] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Infections with Mansonella perstans are common in certain parts of Africa and South America. There is no standard treatment at present. We evaluated the effect of a single high dose of ivermectin (600 micrograms/kg) on microfilaraemia in 7 consecutive patients. No decrease in microfilarial counts could be demonstrated after a follow-up period of 7-56 d.
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Van den Enden E, Van Gompel A, Vervoort T, Van der Stuyft P, Van den Ende J. Mansonella perstans filariasis: failure of albendazole treatment. Ann Soc Belg Med Trop 1992; 72:215-8. [PMID: 1476470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Infections with Mansonella perstans are common in certain parts of Africa and South America. There is no standard treatment at present. We evaluated the effect of albendazole on microfilaremia in ten consecutive patients. No decrease in microfilarial counts could be demonstrated after a median follow-up period of 45 days. Albendazole was not shown to be useful for treatment of Mansonella perstans filariasis.
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Van den Ende J, Van den Enden E, Van Gompel A, Wery M. When is fever malaria? Lancet 1992; 339:690; author reply 690-1. [PMID: 1347394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
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Verhelst JA, Van den Enden E, Mathys R. Rapidly evolving azathioprine induced pancytopenia. J Rheumatol 1987; 14:862. [PMID: 3668999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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