Malaria (Plasmodium falciparum) - a difficult diagnostic and therapeutic problem

The authors deal with the problem of malaria induced by Plasmodium falciparum and imported to Poland by people returning from tropics. They stress significance of the variable clinical pattern involved and of chloroquine resistance. Basing on their own observations of a definitely diagnosed malaria (22 out 35 cases observed and suspected of malaria) the authors discuss diagnostic and therapeutic difficulties encountered in 7 patients with Plasmodium falciparum-induced malaria. Two representative cases of malaria (Plasmodium falciparum) have been discussed in detail. One of the cases with malaria imported from tropics, presented severe course and an atypical clinical pattern (with involvement of central nervous system) which made appropriate diagnosis difficult and delayed application of specific causal treatment. The other unusual case involved a nurse who contracted Plasmodium through a small skin wound with which patient's blood came into contact when the nurse was drawing blood for testing. Course of the disease was grave, with deep anaemia and central nervous system and kidney involvement. In both cases the disease had favourable outcome due to complex anti-malarial therapy and multispecific medical intervention

Clinical criteria and evaluation of lymphonodular toxoplasmosis

We aimed at analysis of the clinical pattern and the course of lymphonodular toxoplasmosis taking into account the intensity and duration of the illness. Ninety seven patients (69 adults and 28 children) with lymphonodular toxoplasmosis were examined. Toxoplasmosis was diagnosed by indirect immunofluorescence; the titres of antibodies of IgG and IgM classes were also estimated. Depending on the duration of the illness, three periods: early, regression of symptoms and protraction of symptoms were defined; depending on the intensity of signs and symptoms of toxoplasmosis three courses of the disease: acute, subacute and chronic were defined. The analysis showed that clinical picture of lymphonodular toxoplasmosis was characterized by swelling of various peripheral lymph nodes as well as by general clinical symptoms (88 ,7% of cases) the intensity and duration of which, to a large extent, determined course of the illness. No correlation between clinical course and duration (early and regression period) of lymphonodular toxoplasmosis and titres IFA-IgG and IFA-IgM (before therapy) was found. Pathomorphology of lymph nodes in patients with toxoplasmic lymphadenopathy is a valuable complementary examination which renders it possible to determine the period of the disease

Clinical appraisal of patients and detection of serum antibodies by ELISA and CIA tests in late periods of

Results of our studies using ELISA and competitive inhibition assay (CIA) tests fully confirmed the previously experienced trichinellosis and reflected persistent stimulation of antibody production due to the antigen release from Trichinella larvae, which had survived longer and undergone gradual destruction in the muscles. The studies proved that the tests complement each other, yielding concordant results in 86.7 % of cases. Due to its higher specificity, the CIA test can help in interpreting pathological signs/symptoms and in evaluating humoral response activity at late and distant in time periods following the invasion

Clinical appraisal of patients and detection of serum antibodies by ELISA and CIA tests in late periods of Trichinella sp. invasion

Results of our studies using ELISA and competitive inhibition assay (CIA) tests fully confirmed the previously experienced trichinellosis and reflected persistent stimulation of antibody production due to the antigen release from Trichinella larvae, which had survived longer and undergone gradual destruction in the muscles. The studies proved that the tests complement each other, yielding concordant results in 86.7 % of cases. Due to its higher specificity, the CIA test can help in interpreting pathological signs/symptoms and in evaluating humoral response activity at late and distant in time periods following the invasion