We report on a five month-old infant from Cameroon, who was admitted because of febrile gastroenteritis after living in Germany for two weeks. Since the patient was somnolent, had a parasitaemia of Plasmodium falciparum of 230,000/microliter, a haemoglobin concentration of 5.3 g/dl and a thrombocytopenia, a complicated falciparum malaria was diagnosed. Treatment was started immediately with intravenous 20 mg quinine/kg bw as a loading dose, followed by 10 mg/kg bw every 12 hours, combined with intravenous clindamycin 10 mg/kg bw bd. Red blood cells were transfused once. The parasitaemia dropped to 2000 trophozoites/microliter within 48 hours. No asexual stages were detectable from the third day of treatment on. Weekly controls for the following four weeks remained negative. The mortality rate of complicated malaria is 50% in the first year of life, which can be reduced by early treatment. We present this case to draw attention to therapeutic options in infants.

Animals↗

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Imported schistosomiasis in Europe: sentinel surveillance data from TropNetEurop.

BACKGROUND: Schistosomiasis is a major parasitic disease, increasingly imported into temperate climates by immigrants from and travelers to endemic areas. METHOD: To generate valid data on imported infectious diseases to Europe and to recognize trends over time, the European Network on Imported Infectious Diseases Surveillance (TropNetEurop) was founded in 1999. Three hundred and thirty-three reports of schistosomiasis were analyzed for epidemiologic and clinical features. RESULTS: Male patients accounted for 64% of all cases. The average age of all patients was 29.5 years. The majority of patients were of European origin (53%). Europeans traveled predominantly for tourism (52%). Main reasons for travel for people from endemic areas were immigration and refuge (51%) and visits to relatives and friends (28%). The majority of infections were acquired in Africa; 92 infections were clearly attributable to Schistosoma haematobium, 130 to Schistosoma mansoni, and 4 to Schistosoma intercalatum. Praziquantel was the only treatment used. No deaths were recorded. CONCLUSION: TropNetEurop sentinel provides valuable epidemiologic and clinical data on imported schistosomiasis to Europe.

Adolescent↗

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[Parasitic infections in pregnancy and congenital protozoan infections. Part I.: Protozoan infections].

Intestinal protozoan disease diagnosed in pregnancy is mostly controlled by symptomatic treatment. Specific therapy can be delayed until after delivery. Only severe cases, i.e. continued diarrhea leading to malnutrition of either mother or fetus, require an immediate specific drug therapy, which might be harmful to the fetus due to toxic and teratogenic potentials. Vertical transmission of intestinal protozoa has not been described. Invasive protozoan infections can be lethal to the mother making immediate drug therapy mandatory, even if the potentials of fetotoxicity or teratogenicity are known. Vertical transmission occurs independent of maternal symptoms, causing clinical disease in the child either directly after birth or during the first months of life. The knowledge of endemic regions and of the maternal travel history is essential for early diagnosis and treatment of protozoan disease in pregnancy and of congenital protozoan infections.

Adult↗

PubMedDate not supplied

[Parasitic infections in pregnancy and congenital parasitoses. II. Helminth infections].

The main sequela of helminthic infections is anemia, causing increased perinatal mortality and morbidity worldwide. During pregnancy symptomatic treatment is usually sufficient to control the disease. The specific and very effective treatment with albendazole, mebendazole, ivermectin and praziquantel has embryo-, fetotoxic, mutagenic and teratogenic potential. Therefore, it should be delayed until after delivery. In some cases immediate specific therapy might be mandatory. Congenital helminthic infection in humans is a rarely described event.

Abnormalities, Drug-Induced↗