Albendazole for the treatment of human gnathostomiasis.

The efficacy of albendazole was investigated in 112 patients with symptomatic gnathostomiasis; 49 received 400 mg twice daily, 51 received 400 mg once daily, and 12 patients received placebo, all for 21 d. Subsequent follow-up was for 6 months. Cure (no further swelling) was seen in 93.9% and 94.1% of the treatment groups but in none of the placebo group. Additionally, reductions in eosinophil counts and in immunoglobulin G antibody were observed after treatment. Side effects were minimal. Albendazole may be an effective compound for the treatment of gnathostomiasis.

Cryptosporidiosis among orphanage children in Thailand: a one year prospective study.

The prevalence of cryptosporidiosis and other parasitic infections was studied among the orphanage children in Nonthaburi province, Thailand, during May 1986--April 1987. Cryptosporidium oocysts were detected in fecal specimens of 22 out of 303 diarrheal cases (7.3%) by using a modified cold Kinyoun acid-fast technique. None were found among 513 children without diarrhea. Most of the cryptosporidiosis cases were those under 3 years old. The duration of diarrhea in 20 cases varied from 1 to 25 days (mean = 6.6 days). All cases recovered uneventfully without repeated infection. No sexual preponderance was found. Most of the infections were documented during March to June when both temperature and rainfall were high. It was also noted that these children had high rates of other parasitic infections, 38.1% of the total population. Thus, cryptosporidiosis was not uncommon among children with diarrhea and could be detected almost throughout the year.

Cryptosporidiosis: report of a case with life-threatening diarrhea.

A case of life-threatening chronic diarrhea, caused by Cryptosporidium spp., was reported. The patient was a seven month old boy from an orphanage suffering from voluminous watery diarrhea, fever and vomiting three days before admission. He presented with severe dehydration and severe hypokalemia. Numerous cryptosporidial oocysts were detected in the stools without other enteropathogens. Although co-trimoxazole and gentamicin were administered in the first week of illness, the diarrheal symptom was still persistent. At the end of the third week, spontaneous remission was observed. The overall diarrheal period lasted twenty-five days. In this case, cryptosporidiosis manifested as severe chronic diarrhea in the immunocompetent and supportive management was very important because an effective drug is not available at present.

First outbreak of human trichinellosis caused by Trichinella pseudospiralis.

This is the first report of an epidemic of human infection with Trichinella pseudospiralis. An outbreak of trichinellosis affecting 59 individuals, of whom one died, occurred in southern Thailand during 1994-1995. The source of this epidemic was raw pork from a wild pig that was distributed to villagers by a local hunter. The most striking clinical features among 50 individuals who could be followed were muscular swelling, myalgia, and asthenia persisting for > 4 months. These were associated with significant elevations of creatine phosphokinase and lactate dehydrogenase levels. All patients had Trichinella-specific IgG antibodies in an enzyme-linked immunosorbent assay. Muscle biopsies, performed in six cases, showed nonencapsulated, actively migrating Trichinella larvae. Experimental infection of mice with larvae from human biopsies revealed nonencapsulated muscle larvae consistent with T. pseudospiralis. The identification of muscle larvae from a human specimen by random amplified polymorphic DNA analysis confirmed the causative agent to be T. pseudospiralis. Patients seemed to respond best to treatment with albendazole.