Chorionic villus sampling after first trimester diagnosis of fetal cystic hygroma colli.

Diagnostic findings of four cases of cystic hygroma discovered at 11 weeks of gestation are reported. The discovery of cystic hygroma by echotomography was followed by sample taking of chorionic villi which revealed one case of monosomy X and three cases of trisomy 18. Caryotype determination in the presence of cystic hydroma is essential for diagnostic confirmation and subsequent genetic counselling.

Investigation of the presence of Salmonella in two Nigerian meat packing plants.

Two large and very well established meat processing plants supervised by the Veterinary Public Health Department were examined to assess the incidence of Salmonella within the premises and on the processed carcasses. The overall incidence was 65 out of the 252 samples or 25.9%. Salmonella was found in forty-one of 167 samples (25%) in one and twenty-four out of eighty-five samples (29%) in the other. The high incidence shows a high degree of probability of contamination of the products from both plants. The public health significance of the findings is emphasized and control problems are high-lighted.

[The importance of fluid perfusion for the outcome of the disease in malarial coma due to Plasmodium falciparum in adult Africans]. / Znachenie perfuzii zhidkosti dlia iskhoda bolezni pri maliariinoi kome, vyzvannoi Plasmodium falciparum, u vzroslykh afrikantsev.

Malaria coma induced by P.falciparum was diagnosed in 51 of 390 adult African patients who had been admitted to the therapeutical unit of the Donk Central Hospital and were receiving parenteral quinine at day 1 of the onset of coma. Examining some clinical and laboratory manifestations of malaria coma indicated that fatal outcome was significantly recorded among the patients with severe concomitant anemia and among the patients who had not or had received inadequate liquid parenterally on the first day of coma. The occurrence of acute renal failure in 4 patients with malaria coma resulted in 3 deaths. No great impact on the prognosis of malaria "hyperparasitemia", the severity of fever, the values of blood pressure was found. Whether it is advisable to use the parameters characterizing the opportuneness and scope of health care delivered to patients with severe malaria is discussed.

[Malignant tropical malaria in native Africans living in a large city]. / Zlokachestvennaia tropicheskaia maliariia u korennykh afrikantsev, zhitelei krupnogo goroda.

The clinical and laboratory features of severe Plasmodium falciparum-induced malaria were analyzed in 91 adult patients living a large African city. Within a week, 52 patients developed the disease from the manifestations of overall intoxication to the complete picture of severe malaria accompanied by coma. Fifty eight patients were found to be residents of Conakry and 54 of them left the city 2 months before the malaria attack. Eighty one patients had experienced malaria, including 38 patients had 1-2 attacks in the past year. The patients were parenterally treated with quinine in a dose of 750-850 mg of the active ingredient for 24 hours during 4.1 +/- 1.7 days at hospital. In 17 of 34 patients, parasitemia disappeared from single to 5-10 parasites and more in the field of thick drop field, in the other 17 patients it decreased from 5-10 to single parasites at recovery. Twenty four comatose patients died at days 3-8 of hospital stay, most of them had symptoms of oligoanuria. The high cost of hospitalization and specific drugs were the reasons for late referral to hospital and for the use of low daily and course doses of quinine. The necessity of reviewing the principal trends of a national malaria control programme.

[Reemergence of contagious bovine pleuropneumonia in Senegal]. / Réémergence de la péripneumonie contagieuse bovine au Sénégal.

The authors have described an epizootic infection of contagious bovine pleuropneumonia (CBPP), caused by Mycoplasma mycoides subsp. mycoides biotype Small Colony (MmmSC), that has affected Ndama bovine in Lounthy village, a locality based in Bala city in the Eastern part of Senegal, during the post-rainy season in November 2012. After the cessation of vaccination, a hotbed of suspicion of CBPP was identified on November 3rd 2012 in the village of Lounthy: out of the total of 98 cattle, 13 animals were sick and 5 of them died. These studies have been done according to clinical aspects, serological, bacteriological and molecular analysis of the samples. This reemergent disease will give new orientations for CBPP control in Senegal, where it was supposed the disease has been eradicated since 2005.

Bacteriological survey of leptospirosis in Zaria, Nigeria.

A total of 252 rodents were trapped in the environs of Ahmadu Bello University, Zaria, over a two-year period, of which 221 were brown field rats (Arvicanthus niloticus). Only these were found positive (4.5%). Titers were detected against Leptospira interrogans, serovars australis, icterohaemorrhagiae, tarassovi and hardjo. All positive sera except one reacted against a single serovar. Eight isolates were obtained from field rats: five were serovar australis, one ballum and two unidentified. Five isolates were recovered from 74 bovine kidneys examined: one was serovar pyrogenes and four unidentified. One unidentified isolate failed to react with any of the 16 screening leptospira antisera and another was tentatively considered to be serovar ballum. Two isolates, one ballum and one unidentified, were recovered from the Kubani stream waters. No leptospira was isolated from piggery sewage effluents collected at Kano and Kaduna. It is suggested that serovar ballum be included in any screening battery for leptospirosis in man and animals in Nigeria.

Spurious hydrogen sulfide production by Providencia and Escherichia coli species.

Hydrogen sulfide production was noted in two Escherichia coli strands and one Provaidenica alcalifaciens (Proteus inconstans A) strain isolated from clinical stool specimens durin the summer of 1979. An investigation into this phenomenon revealed the predence of Eubacterium lentum, an anaerobe, growing in synergism with the Enterobacteriaceae and producing H2s. The implications of this association are discssed with reference to clinical microbiology laboratory practice.

Community acquired pneumonia in adults: a study comparing clinical features and outcome in Africa (Republic of Guinea) and Europe (France).

BACKGROUND: Community acquired pneumonia is the most common cause of death from infectious disease both in western and developing countries. A study was carried out in Conakry, Republic of Guinea and Tours, France in order to compare signs, symptoms, severity of illness, risk factors, and clinical outcome of community acquired pneumonia in adult patients admitted to hospital. METHODS: The study was performed in the cities of Conakry and Tours over the same one year period. Patients with nosocomial pneumonia, tuberculosis, and those who were HIV positive were excluded. Data were recorded on the same forms in both centres. A severity score was calculated according to American Thoracic Society criteria. Follow up was evaluated at days 2, 7 and 15. RESULTS: A total of 333 patients (218 from Conakry, 115 from Tours) were included in the study with a diagnosis of community acquired pneumonia, with or without lung abscess or pleural effusion. Mean age was higher and pre-existing illness rate, dehydration, agitation, and stupor were more frequent in patients in Tours. Respiration rates of > 30 breaths/min and the incidence of crackles were identical in the two centres. Fever above 39 degrees C, initial shock, chest pain, and herpes were significantly more frequent in Conakry. Initial chest radiographic abnormalities were similar in the two groups, ranging from unilateral pleuropulmonary involvement (89% and 83% in Conakry and Tours, respectively) to diffuse patchy parenchymal disease. Parapneumonic effusion was present in 17% and 16% of the patients of Conakry and Tours, respectively. Pneumonia was considered to be severe in 33% and 42% of the patients, respectively. In Conakry first line antibiotic therapy was penicillin alone (2 million units a day) for 197 patients (90%) and second line antibiotic therapy was prescribed for 25 patients (12%). In Tours first line therapy consisted of a single antibiotic (amoxicillin, third generation cephalosporins) for 65 patients (57%) and second line antibiotic therapy was prescribed for 55 patients (48%). The clinical outcome was similar in Conakry and Tours: 88% and 85% of patients, respectively, were afebrile or clinically cured at day 15. The mortality rate was similar (6% and 8%, respectively). CONCLUSIONS: The problems encountered in the management of community acquired pneumonia are quite different in western and developing countries. This study shows that low doses of penicillin can cure 90% of African patients with pneumonia as effectively as more aggregative treatments in European patients who are both older and have greater comorbidity. Although pneumococci with reduced penicillin sensitivity occur in western countries, this does not seem to be the case in black Africa. For these reasons, low doses of penicillin or amoxicillin remain good first line treatment.

Recognition of Yersinia enterocolitica multiple strain infection in twin infants using PCR-based DNA fingerprinting.

AIMS: Yersinia enterocolitica causes several syndromes in humans. The most common presentation is enterocolitis in children, presenting as fever and diarrhoea. A Y. enterocolitica multiple strain infection in twin infants was investigated. METHODS AND RESULTS: One isolate was recovered from one patient and two morphologically-different isolates were recovered from the other infant. Biochemically, all isolates were identified as Y. enterocolitica group. The genomic DNA from each strain was purified and DNA fingerprinting was performed. The banding patterns observed for Y. enterocolitica isolates 2 and 3, from patients 1 and 2, respectively, were identical when comparing the presence or absence of major bands. However, Y. enterocolitica isolate 1, from patient 1, showed a distinctive banding pattern from isolates 2 and 3. CONCLUSION: The findings indicate that one infant was colonized by more than one strain of Y. enterocolitica, demonstrating that multiple strains can colonize and invade a patient. SIGNIFICANCE AND IMPACT OF THE STUDY: Recognition of multiple strain infections can be important in diagnosis, treatment and prognosis of Y. enterocolitica infections, as well as in disease epidemiology. The technique described here offers a straightforward method for strain comparison.