Prevalence of Helicobacter pylori Infection in Patients with Squamous Cell Carcinoma of the Oesophagus. A Descriptive Case Series Study.

INTRODUCTION: Helicobacter pylori is an important causative factor in gastric carcinogenesis; its role in extra-gastric gastrointestinal malignancies such as oesophageal cancer is controversial. H. pylori is thought to cause extensive gastric atrophy associated with squamous cell carcinoma of the oesophagus. We conducted a study to determine the prevalence of H. pylori infection in patients with squamous cell carcinoma of the oesophagus. METHOD: We collected biopsies from the antrum and corpus of 59 patients with confirmed squamous cell carcinoma of the oesophagus, two from each area. These were then examined by an experienced histopathologist using methylene blue staining for the presence of H. pylori. RESULTS: H. pylori was found in 30 (51 %) of the patients, a prevalence similar to that of the general population in South Africa. Five patients were found to have associated intestinal metaplasia, and all but two had chronic inflammation. CONCLUSION: The prevalence of H. pylori in our patients with squamous cell carcinoma of the oesophagus is 51 %, similar to that previously reported in the general population.

The efficacy and tolerance of a three-day course of azithromycin in the treatment of community-acquired pneumonia.

The clinical efficacy and tolerance of a three-day course of azithromycin was evaluated in patients with community-acquired pneumonia in an open, non-comparative pilot study. Sixty-six patients with clinical and radiological findings of pneumonia were treated with a total dose of 1.5 g azithromycin (500 mg once-daily for three days). Of these 66 patients, 40 were evaluable clinically and microbiologically. Of the remaining 26 patients, 22 had no organisms isolated at baseline, and could only be evaluated clinically; two patients were lost to follow-up; and two patients were protocol violators. Of the 40 patients in whom aetiological agents were identified, 39 (98%) had a satisfactory clinical response (34 cured, five improved), including all eight patients diagnosed as having Legionella pneumophila pneumonia on the basis of serology. One patient with recurrent Haemophilus influenzae infection on day 8 was considered a failure. Total severity score for overall signs and symptoms was reduced significantly from a baseline level by day 2 (P = 0.0001). Bacteriological eradication was achieved in 32 of 33 (97%) isolates including 27 of 27 Streptococcus pneumoniae, the most frequently isolated pathogen. All six patients with pneumococcal bacteraemia were cured clinically by day 14, and blood cultures were negative for four of these patients within 48 h. Treatment-related side effects were reported in 4 of 66 (6%) patients, but were all mild. Laboratory abnormalities were observed in 5 of 62 (8%) patients: elevated liver enzymes (2), elevated creatine levels (1), haematological test abnormalities (2), including one patient with severe eosinophilia.(ABSTRACT TRUNCATED AT 250 WORDS)

Linear IgA dermatosis and Hodgkin's lymphoma--report of a case in an African and review of the literature.

Linear IgA dermatosis and Hodgkin's lymphoma were diagnosed at the same time in a 47-year-old Black South African man. Skin changes of linear IgA dermatosis responded to a combined treatment with dapsone and MOPP regimen. Prior administration of dapsone alone did not result in improvement of the skin condition. Four documented cases of linear IgA dermatosis and lymphoma outside the gastrointestinal tract, three of them of Hodgkin's type, have been reported in the literature. Review of the literature suggests that different forms of lymphoma seem to be associated with linear IgA dermatosis and dermatitis herpetiformis. The present patient represents the first immunologically verified case of linear IgA dermatosis in an adult Black African.