Cutaneous myiasis due to dernatibia hominis: a report of six cases

We report six cases of Dermatobia hominis myiasis imported into the U.K. from Belize. With increasing international travel, myiasis may be encountered more frequently in countries in which the parasites are not indigenous. The life-cycle of D. hominis is described, and scanning electron micrographs show the detailed appearance of the larva (SUMMARY)

A clinico-pathological study of cutaneous leishmaniasis in British troops from Belize

Thirty-four cases of cutaneous leishmaniasis contracted by British soldiers in Belize were studied. Pre- and post-treatment biopsies were taken from all patients. The range of histological appearances is described and the value of histological examination (including Giemsa staining and immunohistochemistry), cytological preparations and microbiological culture in diagnosis and clinical management assessed. Histology and culture were found to be complementary techniques in reaching a positive diagnosis, whilst cytological preparations were of no additional value. Histological examination of post-treatment biopsies merely confirmed the clinical impression of healing or non-healing whilst culture identified viable organisms in apparently healed lesions, which were subsequently re-treated (AU)

Cutaneous leishmaniasis in British troops from Belize

The medical records of 306 British soldiers in whom a clinical diagnosis of cutaneous leishmaniasis had been made following a tour of duty in Belize were analysed. Parasitological confirmation of the diagnosis was established in 187 cases; leishmania were cultured in 117 cases and leishman-Donovan bodies were identified in 78 cases and Leishmania mexicana mexicana in a further 29 cases. Leishmania braziliensis was indentified in 78 cases and Leishmania mexicana mexicana in a further 29 cases. Seventy-one per cent of patients had a single lesion which, in most cases, occurred on the exposed extremities. The mean diameter of the ulcers was 14.4 mm. Treatment with sodium stobogluconate was effective. Two regimens were used, consisting of either 600-800 mg daily given initially for 10 days, or 600 mg b.d. given initially for 14 days. Of those allocated to the lower dose regimen 48.5 percent were cured after the initial 10-day course, and ultimately the ulcers of 93 percent of patients healed following more prolonged treatment at this dose. Of those allocated to the higher dose regiment 63.9 percent were cured after the initial 14-day course and ultimately the ulcers of all patients healed after more prolonged treatement at this dose. A transient leucopenia and a rise in liver enzymes were noted during treatment, and these changes were dose-dependent. No cases of mucocutaneous leishmaniasis were encountered (AU)

Emergency room: profile of patients flow

The case notes of 1274 patients registered in the Emergency Room are reviewed. The vast majority 933 (73 percent) were treated and discharged and only 151 (12 percent) needed admission to the ward. A mean 182 patients were seen each day. Nearly 50 percent of the patients were children. For a population of 150,000 thew number of persons who attend the emergency room, is very high. The situation would benefit from increased emergency space and staff, increased training for staff and public health education with emphasis on prevention. (AU)