ABSTRACT
Crohn's disease is rare in South African black people and primary sclerosing cholangitis (PSC) is also rare in black patients with IBD, from South Africa. The presence of HLA-B27 is generally associated with seronegative spondylo-arthropathies and correlates with the occurrence of ankylosing spondylitis, recurrent mouth ulcers and uveitis, in patients with IBD. We describe two women with the combination of Crohn's disease, PSC and HLA-B27 from our cohort of the last 5 years of three black patients with Crohn's disease. Crohn's disease, PSC and HLA-B27 respectively, occur rarely in black South Africans and their concurrent presence in two black women suggests a pathogenetic link of HLA-B27 between Crohn's disease and PSC in this population. Female gender might be an additional determinant in this setting.
Subject(s)
Cholagogues and Choleretics/administration & dosage , Cholangitis, Sclerosing , Crohn Disease , Genetic Predisposition to Disease/ethnology , HLA-B27 Antigen/genetics , Immunosuppressive Agents/administration & dosage , Adult , Alkaline Phosphatase/blood , Azathioprine/administration & dosage , Back Pain/etiology , Black People , Cholangiopancreatography, Magnetic Resonance/methods , Cholangitis, Sclerosing/complications , Cholangitis, Sclerosing/diagnosis , Cholangitis, Sclerosing/drug therapy , Cholangitis, Sclerosing/ethnology , Cholangitis, Sclerosing/genetics , Cholangitis, Sclerosing/physiopathology , Colonoscopy/methods , Crohn Disease/complications , Crohn Disease/diagnosis , Crohn Disease/drug therapy , Crohn Disease/ethnology , Crohn Disease/genetics , Crohn Disease/physiopathology , Diarrhea/etiology , Female , Humans , Mercaptopurine/administration & dosage , Methotrexate/administration & dosage , Severity of Illness Index , South Africa/epidemiology , Treatment Outcome , Ursodeoxycholic Acid/administration & dosage , gamma-Glutamyltransferase/bloodABSTRACT
Chromobacterium violaceum sepsis is extremely rare and usually fatal. A very few cases of C. violaceum infection have been reported from Africa, but never from South Africa. As far as could be ascertained, this infection has never been reported in a patient with leukaemia. We describe what we believe to be the first such case of C. violaceum sepsis, in a 16-year-old female patient with acute biphenotypic leukaemia, which developed during the neutropenic phase after intensive chemotherapy. The infection was due to a non-pigmented strain of C. violaceum and was associated with a co-infection with Candida parapsilosis; both were successfully treated using broad-spectrum antibiotics, antifungals and removal of a Hickman line.