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Pediatr Infect Dis J ; 12(2): 136-9, Feb. 1993.
Artigo em Inglês | MedCarib | ID: med-8221


A randomized placebo-controlled prospective trial was conducted to evaluate the efficacy of erythromycin therapy in 69 patients affected with Bacillus Calmette-Guerin lymphadenitis. When patients who developed subsequent regional abscesses were excluded, erythromycin caused significantly earlier resolution of lymphadenitis (5.1 months vs. 5.7 months for placebo; p < 0.001) compared with placebo. There was no significant difference in the proportion of patients who developed subsequent regional abscesses between the 2 groups (47 percent for erythromycin, 60 percent for placebo, p = 0.14). When the entire group of 69 patients was evaluated for "duration to heal" (regardless of subsequent abscess formation), erythromycin therapy (4.1 +/- 1.5 sd months) did not differ significantly from the placebo group (3.5 +/- 1.3 months, p = not significant). Patients who develop subsequent abscess (n = 36) along with those with B. Calmette-Guerin regional abcesses at presentation (n = 27) were further studied to compare oral erythromycin therapy with that of single dose 50-mg intranodal isoniazid instillation. Local isoniazid therapy caused significantly earlier resolution of the abscesses (3.9 months) compared with erthromycin therapy (5.2 months; p < 0.001). (AU)

Feminino , Humanos , Masculino , Abscesso/tratamento farmacológico , Vacina BCG/efeitos adversos , Eritromicina/uso terapêutico , Isoniazida/uso terapêutico , Linfadenite/tratamento farmacológico , Abscesso/etiologia , Administração Oral , Eritromicina/administração & dosagem , Lactente , Instilação de Medicamentos , Isoniazida/administração & dosagem , Linfadenite/etiologia , Mycobacterium bovis/isolamento & purificação , Estudos Prospectivos
Pediatr Infect Dis J ; 9(12): 890-3, Dec. 1990.
Artigo em Inglês | MedCarib | ID: med-8673


An outbreak of axillary lymphadenitis and abscesses after Bacillus Calmette-Guerlin (BCG) vaccination (Pasteur Paris, Batch N5122) occurred in 139 Jamaican children between January and July, 1988. The overall rate of this complication was 0.95 percent. The attack rate was 1.92 percent among the 0- to 6 week age group and 0.6 percent in the 7- to 52-week age group. Of 139 patients there were 77 males and 62 females and the mean age at presentation was 4 months. The mean size of the BCG scar, duration of healing and Mantoux reaction size differed significantly in patients compared with those of control infants (P less than 0.01). Mycobacterium bovis was isolated from 11 patients. Immunologically index patients and controls differed significantly only with respect to T lymphocyte subpopulation percentages and concanavalin A stimulation indices. Evaluation of the BCG vaccine did not reveal either increased potency or microbial contamination. We conclude that increased susceptibility to the Pasteur strain of BCG might have contributed to the increased incidence of complications in these Jamaican children and hence caution should be exercised in switching one vaccine for another as is often done in the developing countries. (AU)

Humanos , Lactente , Masculino , Feminino , Abscesso/epidemiologia , Vacina BCG/efeitos adversos , Surtos de Doenças , Linfadenite/etiologia , Abscesso/epidemiologia , Fatores Etários , Axila/anormalidades , Estudos de Casos e Controles , Bactérias Gram-Negativas/isolamento & purificação , Jamaica/epidemiologia , Linfadenite/epidemiologia , Mycobacterium bovis/isolamento & purificação , Staphylococcus aureus/isolamento & purificação
West Indian med. j ; 39(Suppl. 1): 48, Apr. 1990.
Artigo em Inglês | MedCarib | ID: med-5267


The most common adverse effect of BCG vaccination is regional lymphadenitis, but the treatment of this complication is controversial. A group of 69 patients, with BCG adenitis following vaccination were randomly assigned to receive either "no therapy" or oral erythromycin for one month. Systemic erythromycin therapy caused earlier resolution of the lymph node but failed to prevent progression to abscess formation. Patients who developed subsequent abscesses (36) and another group who had abscess at the time of presentation (27) showed more rapid resolution when treated with single instillation of isoniazid (50mg) into the abscess cavity, compared to oral erythromycin therapy (AU)

Humanos , Criança , Adulto , Vacina BCG , Linfadenite/complicações , Linfonodos/anormalidades , Abscesso
Cancer ; 61(7): 1477-82, Apr. 1988.
Artigo em Inglês | MedCarib | ID: med-12084


As part of epidemiologic studies of human T-lymphotropic virus (HTLV)-I-associated malignancies in Jamaica, the authors evaluated 26 patients with non-Hodgkin's lymphoma for the presence of integrated HTLV-I provirus in their malignant cells. Fifteen of 26 patients had integrated provirus. All 15 also were HTLV-I antibody positive. Eleven patients did not have integrated provirus, and all 11 were antibody negative. All of the antibody-positive cases had onset of their disease in adulthood (age range, 21-57 years) as opposed to the broad age range of negative cases (4-66 years). Clinical features which were more common in provirus positive than negative patients included leukemic phase, skin involvement, and hypercalcemia, which are all features frequently seen in HTLV-I-associated adult T-cell leukemia/lymphoma (ATLL). The presence of skin involvement, circulating malignant cells, abnormal liver function tests, or the presence of two or more of these four features were statistically significantly different between virus-positive and virus-negative cases. Although the survival of positive cases (6 months) was shorter than that of negative cases (9 months), this was not statistically significant. The only significant determinant of survival was hypercalcemia, with those who developed hypercalcemia at some point in their disease course, independent of their HTLV-I status, surviving a mean of 5 months as compared to a mean of 17.5 months in those who never became hypercalcemic. The six HTLV-I-positive lymphomas that underwent cell typing were all primarily OKT4 positive, whereas two HTLV-I antibody-negative cases that were typed were B-cell lymphomas. (AU)

Humanos , Deltaretrovirus/isolamento & purificação , Linfoma não Hodgkin/epidemiologia , Provírus/isolamento & purificação , Anticorpos Antivirais/análise , DNA Viral/análise , Doença de Hodgkin/epidemiologia , Doença de Hodgkin/imunologia , Doença de Hodgkin/microbiologia , Doença de Hodgkin/mortalidade , Hipercalcemia/mortalidade , Deltaretrovirus/imunologia , Jamaica , Leucemia Linfoide/epidemiologia , Leucemia Linfoide/imunologia , Leucemia Linfoide/microbiologia , Leucemia Linfoide/mortalidade , Leucemia Mieloide Aguda/epidemiologia , Leucemia Mieloide Aguda/imunologia , Leucemia Mieloide Aguda/microbiologia , Leucemia Mieloide Aguda/mortalidade , Linfadenite/epidemiologia , Linfadenite/imunologia , Linfadenite/microbiologia , Linfadenite/mortalidade , Linfoma não Hodgkin/imunologia , Linfoma não Hodgkin/microbiologia , Linfoma não Hodgkin/mortalidade , Provírus/imunologia
West Indian med. j ; 35(1): 12-7, Mar. 1986.
Artigo em Inglês | MedCarib | ID: med-11624


An epidemic of BCG auxillary lymphadenitis affected at least 37 children, primarily infants, in Saint Lucia in late 1982 and early 1983. Eleven infants had spontaneous rupture or required incision and drainage of supportive lymph nodes. Cases developed auxillary lymphadenitis from 1-22 weeks after immuniazation with Connaught BCG vacine, first introduced into the country in September, 1982. No single factor could be reliably implicated as the sole cause of the epidemic. More potent BCG vaccines, such as the Connaught product, give better protection but more reactions than weaker BCG vaccines and may reduce patient compliance with the Expanded Programme on Immunization in general. Those in BCG programmes should be alert to adverse reactions and scrupulous in storing, reconstituting, and administering the correct dose of BCG vaccine intradermally. Keeping good vaccination records and vials of each lot of vaccine used can help to determine whether epidemics of adverse reactions are occuring and what their cause might be. (AU)

Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Vacina BCG/efeitos adversos , Surtos de Doenças/epidemiologia , Linfadenite/epidemiologia , Axila , Linfadenite/etiologia , Risco , Fatores de Tempo , Santa Lúcia
West Indian med. j ; 32(3): 177-80, Sept. 1983.
Artigo em Inglês | MedCarib | ID: med-11420


Two cases of the acquired immune deficiency syndrome are reported from Trinidad. Both patients were male homosexuals who had opportunistic infections. One had disseminated infection with cryptococcus neoformans and the other with toxoplasma gondii. This is the first report of the syndrome from the Commonwealth Caribbean (AU)

Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Imunodeficiência Adquirida/complicações , Criptococose/etiologia , Toxoplasmose/etiologia , Homossexualidade , Linfadenite/etiologia , Trinidad e Tobago
West Indian med. j ; 26(4): 204-10, Dec. 1977.
Artigo em Inglês | MedCarib | ID: med-11192


Four cases of sinus histiocytosis fulfilling the clinico-pathological requirements laid down by Rosai and Dorfman are reported. This benign disease is characterized by massive lymphadenopathy especially in the cervical region and pathologically by enlargement of lymph node sinuses by phagocytic histiocytes. The disease is self-limiting, regressing over a variable period of time from months to years. These four cases and the six reported by Rosai and Dorfman are, to our knowledge, the total number of cases reported in the West Indies to date (AU)

Adolescente , Adulto , Pré-Escolar , Feminino , Humanos , Masculino , Histiócitos/patologia , Linfadenite/patologia , Doenças Linfáticas/patologia , Diagnóstico Diferencial , Linfadenite/diagnóstico , Doenças Linfáticas/diagnóstico , Jamaica
Doc Med Geogr Trop ; 4(4): 361-5, 1952. ilus
Artigo em Inglês | MedCarib | ID: med-2141


The possible causes of an acute filaria attack are discussed, and case histories are given. Acute lymphadenitis is one of the clinical manifestations of the infection with W. bancrofti. In one case an acute attack occurred during treatment with hetrazan, which histopathologically must have been the result of the death of a macrofilaria. An acute filaria attack is described, which must have been due to dissemination of microfilariae; the outlet from the lymphatic gland had evidently been obstructed. However, the cause of lymphadenopathy (acute lymphadenitis) has not been explained, not even by the so-called allergic reaction

Relatos de Casos , Resumo em Inglês , Humanos , Filariose Linfática/etiologia , Wuchereria bancrofti , Suriname , Linfadenite , Microfilárias