Nederlands tijdschrift voor geneeskunde
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Of the four most dangerous protozoal infections acquired in (sub)tropical regions, falciparum malaria, amoebic abscess of the liver, visceral leishmaniasis (kala azar) and African trypanosomiasis (sleeping sickness) only the fourth was up to now unreported in the Dutch medical literature. Two case histories are presented: a Cameroonian woman, resident in the Netherlands for two years, suffering from West African type sleeping sickness, and a Dutch tourist who acquired East African trypanosomiasis while travelling through Zimbabwe. Although the parasites are morphologically identical, clinical and epidemiological characteristics are distinctly different. ⋯ The East African variety runs an acute course in Europeans leading to death within days due to myocarditis. It is therefore mandatory for the diagnosis to be made as soon as possible in order to initiate specific therapy. Both patients recovered after specific therapy.
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Ned Tijdschr Geneeskd · Oct 1995
[Surgical treatment of life-threatening mediastinitis following esophageal perforation or leakage after esophagus surgery].
Evaluation of the surgical treatment of life-threatening mediastinitis following oesophageal perforation or leakage after resection for oesophageal cancer. ⋯ Aggressive surgical treatment of life-threatening mediastinitis and sepsis as described here can save severely ill patients. Because of the high postoperative morbidity level only patients with perforations of the oesophagus and early stages of oesophageal cancer should be operated.