[Visceral leishmaniasis with gastrointestinal involvement in a 30-year-old HIV infected patient]. / Viszerale Leishmaniose mit gastrointestinalem Befall bei einer 30-jährigen HIV-infizierten Patientin.

We report the case of a 30-years old HIV-infected woman who suffered from recurrent fever up to 41 degrees C, loss of appetite, loss of 8 kg body weight and swelling of the cervical and inguinal lymph nodes. The diagnostic work-up revealed infection with leishmania in gastric and duodenal biopsies. The parasites were also found in the inguinal lymph nodes and in the bone marrow of the patient. According to patient's history the infection was acquired on a holiday in southern spain. The patient was treated with pentavalent antimony in combination with interferon gamma. Visceral leishmaniosis in immuno-suppressed patients is discussed and therapeutic approaches are described.

[Parenteral rehydration treatment of acute diarrhea]. / Parenterale Rehydratationsbehandlung bei akuter Diarrhoe.

Parenteral rehydration is mandatory if dehydration is severe, vomiting and anorexia prevails, peristalsis is abolished or consciousness disturbed. It has the aim to prevent a circulatory collapse, to fill up the deficit and maintain the requirement until oral feeding is restarted. The principles of parenteral rehydration did not change during the last 20 years. Initially a rapid infusion of isotonic Ringer's lactate solution is mandatory, which usually is followed by half isotonic Ringer's glucose solution. Hypertonic dehydration should be rehydrated very carefully and slowly. During 1976-1986 212 infants and children with severe dehydration were parenterally rehydrated in the Children's Hospital of Medical School Hannover. Dehydration was isotonic in 65.7%, hypertonic in 20.7%, and hypotonic in 13.6%. The parenteral rehydration lasted from 1 to 7 days and was longer necessary in the hypertonic and hypotonic than isotonic states. 4 infants with hypertonic dehydration showed cerebral complications, and 2 of them died. All other patients recovered quickly without acute sequelae.