Polyneuritis und Myositis bei Trypanosoma-gambiense-Infektion
| Autor: | W. Schachenmayr, W. Dorndorf, M. S. Damian, I. Singer, B. Leinweber, H. Burkardt |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Myocarditis Prednisolone Trypanosoma brucei gambiense Hepatosplenomegaly Melarsoprol Suramin Gastroenterology Diagnosis Differential Electrocardiography Polyneuropathies Cerebrospinal fluid Internal medicine medicine Animals Humans Mean corpuscular volume Myositis medicine.diagnostic_test biology Electromyography business.industry General Medicine Middle Aged medicine.disease Rash Trypanosomiasis African Immunoglobulin M Splenomegaly biology.protein Drug Therapy Combination medicine.symptom business Hepatomegaly medicine.drug |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 119:1690-1693 |
| ISSN: | 1439-4413 0012-0472 |
| DOI: | 10.1055/s-2008-1058888 |
| Popis: | During a four-week trip to Nigeria a 54-year-old German developed a fever of 39 degrees C. Later on he had lymphadenopathy, pretibial oedema, dyspnoea and weight loss. After 16 weeks a wreath-like pale pink skin rash, increased pulse rate with pulse deficit and hepatosplenomegaly were noted. Abnormal laboratory findings were an increased blood sedimentation rate (95 mm), raised immunoglobulin M (483 mg/dl), haemoglobin of 12.0 g/dl, mean corpuscular volume of 76 fl and Borrelia IgM antibody titre of 1:512. The electrocardiogram was suggestive of myocarditis: the cardiac symptoms were controlled with digoxin and verapamil. The patient's general condition deteriorated while he was receiving antibiotic treatment with tetracycline and penicillin. Cerebrospinal fluid (CSF) showed an increased cell count (39/microliters) and albumin (0.98 g/dl). There was a mild, predominantly proximal, tetraplegia which--on the basis of electromyographic and biopsy findings--was thought to be due to polyneuritis and myositis. At this stage blood smear and CSF examination revealed Trypanosoma. He thereupon received suramin (1.0 g) and prednisolone (120 mg down to 40 mg) daily, to which melarsoprol was added after 6 days (0.5 ml up to 5.0 ml daily for 36 days). Almost all symptoms then regressed within 6 weeks. |
| Databáze: | OpenAIRE |
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