Malaria: A Review of 33 Cases

We aimed to evaluate epidemiological and clinical features of the patients with malaria followed in our clinic, and to review current status of malaria in Turkey. Epidemiological, clinical, diagnostic, therapeutic and prognostic features of 33 patients with malaria (4 female, 29 male, mean age: 28 ± 11 years, range: 15-60) followed in our clinic between 1981 and 2000 were retrospectively evaluated. Malaria data of our country for 1926-2000 were obtained from Ministry of Health. Diagnosis was established by thin blood smears obtained in the febrile period in all cases. Plasmodium vivax was detected in 26 patients (25 local and 1 foreign origin), and P. falciparum in 7 (2 local and 5 foreign origin). Sixty-one percent of the patients had the prodromal symptoms of the disease and various antibiotics have been used. All cases demonstrated the typical pattern of fever with chills. Fever (100%), splenomegaly (91%), hepatomegaly (55%), anemia (70%), leukopenia (48%), thrombocytopenia (48%), a rise in sedimentation rate (100%), and abnormalities in hepatic enzymes (30%) were determined in the patients. Chloroquine + primaquine were given to all patients with P. vivax, chloroquin (for 3) or mefloquin (for 3) alone were given to the patients with P. falciparum. One patient with P. falciparum died soon after admission, all the remaining recovered. Data from Ministry of Health revealed that the most common (~100%) species in our country is P. vivax. Although an eradication program against malaria initiated in 1926 achieved success, it still remains as an important health problem. Every febrile patient with a history of travel to the regions where malaria is endemic (tropical regions for the world, Southeast Anatolia and Çukurova for Turkey) should raise the suspicion of malaria. Every country should fight against malaria and a global cooperation is essentially important

A Case of Chronic Diarrhea Due to Isospora belli

We present a case of 56 years old male patient with HIV infection and chronic renal failure from Cameroon. He had been having diarrhea without blood or mucus for four months. The patient who has been in Chad and Zaire for eight years was hospitalized to the Infectious Diseases Division of Medical Faculty of Cerrahpafla on October 1997. On the examination of his feces on two subsequent days in the third week of his admittance to the service, immature oocytes of Isospora were detected. The diarrhea of the patient was cured on the second day of TMP/SMX therapy which was planned for one month. From our country 6 cases of isosporiasis have been reported until today. The case that we present was a traveller from Africa who came to visit our country. He had come to our clinic because of his increasing complaints. We have wanted to draw attention to the isosporiasis cases in HIV infected patients with diarrhea in a season of increased touristic activity