RESUMO
Chloroquine-resistant plasmodium falciparum malaria has been described in many parts of the world, including Africa as far south as south-western Africa. We report a case of chloroquine-resistant P. falciparum cerebral malaria in the RSA. It seems likely that the infection was acquired in the Louis Trichardt district of the northern Transvaal. Despite the administration of an adequate course of chloroquine, the parasitaemia failed to clear and even increased (type III resistance). Eventually clinical and laboratory-proven cure was obtained only after combined quinine and tetracycline therapy. To our knowledge this is the first case of chloroquine-resistant P. falciparum malaria acquired in the RSA.
Assuntos
Cloroquina/uso terapêutico , Malária/tratamento farmacológico , Quinina/uso terapêutico , Adolescente , Cloroquina/farmacologia , Resistência Microbiana a Medicamentos , Quimioterapia Combinada , Feminino , Humanos , Plasmodium falciparum/efeitos dos fármacos , Tetraciclina/uso terapêuticoRESUMO
The incidence of bronchiectasis should decrease because of improved immunization, but certain defects would still cause the malady. Fifteen consecutive patients with bronchiectasis were examined for ciliary defects by examining the nasal mucosae with an electron microscope and measuring the clearance of technetium-99m from the lung with a gamma camera. Three patients were found to have defects. Compound cilia, disorganization of the tubular structure, vacuolization and deficient inner dynein arms were observed. In one patient a loss of cell membranes which returned to normal after 4 months, was observed. Ciliary abnormalitites can either be anatomical or physiological and 'sick cilia' should be considered as a cause of bronchiectasis.
