Diphyllobothriasis Associated with Eating Raw Pacific Salmon

This tapeworm disease is changing from one of rural populations to one of urban populations worldwide

ACUTE HEPATITIS A IN A JAPANESE TRAVELER AFTER OCCURRENCE OF DENGUE FEVER DURING STAY IN INDIA

We report a case of acute hepatitis A that developed following an occurrence of dengue fever during a stay in India. The patient was a 52-year-old Japanese man who visited Delhi, India, from September 29 to October 20, 2010. During that stay, he developed a high fever and rash, with thrombocytopenia and slight liver dysfunction (platelet count 7.0×10＾4/μl, AST 94 IU/ml, ALT 63 IU/ml), then was diagnosed with dengue fever on October 14. Soon after returning to Japan, the patient was well, with anti-HA IgM, hepatitis B surface antigen, and anti-hepatitis C all negative, though liver dysfunction transiently worsened. The DENV genome-sequence was not amplified, while IgM and IgG antibodies were detected. In mid-December 2010, one month after returning from India, he noted fatigue and appetite loss. When the patient came to us on January 12, 2011, jaundice was apparent. A laboratory examination revealed highly elevated aminotransferase levels (AST 4002 IU/ml ALT 4715 IU/ml) and positivity for anti-HA IgM, and we made a diagnosis of acute hepatitis A. The clinical course of acute hepatitis A showed smooth improvement without adverse symptoms. By the end of March 2012, the total bilirubin and aminotrasferase levels were completely normalized. We recommend that non-immune individuals be pre-immunized with HA-vaccine and be fully aware of potential health risks at their intended destinations before traveling to endemic countries

Aortic Dissection in a Patient with Human Immunodeficiency Virus Infection That was Diagnosed at Autopsy : A Case Report.

A 43-year-old homosexual man was referred to our hospital for chest pain and loss of consciousness. He was hypertensive, and had an uncontrolled viral load. Serum creatinine revealed acute renal failure, and he died 3 days later. On autopsy, aortic dissection (TypeB) was found. No obvious inflammatory change, granulation, bacterial or fungal infection, or medionecrosis were seen at the dissection site. To our knowledge, this was the first case with HIV in whom aortic dissection was diagnosed at autopsy. Aortic dissection is a potential differential diagnosis even in young patients presenting with hypertension and chest pain