[Hepatic amebiasis in the Kilimanjaro region. Serodiagnosis on micro-specimens of dried blood and attempts at treatment with tinidazole (fasigyn)].
Amoebic dysentery appears to be rare in the northeast of Tanzania. Hepatic amoebiasis, on the other hand, is apparently widespread since at least 200 cases are seen every year at the Kilimanjaro Christian Medical Centre. This incidence of cases enabled us to carry out trials on the spot with a new imidazole derivative, Tinidazole. Formerly the difficult diagnosis based on clinical symptoms had to be buttressed by radiological evidence and possibly by the result of puncture. Indirect fluorescent antibody tests for the diagnosis of amoebiasis were performed elsewhere on all the patients, using for this purpose microspecimens of dried blood. In 12 cases out of 34 an agglutination test with sensitized latex particles was performed on the spot. This latter test has the practical advantage of being easy to employ. It cannot, however, be considered as a screening test since it is subject to downward and upward errors. The indirect fluorescent antibody test has been found to be constantly and highly positive, certain antibody titres attaining 1/6400. This fully confirms the value of the method even under special working conditions. Seventeen of our 34 patients (2 women and 15 men ranging in age from 20 to 75 years) were treated with 2 g of Tinidazole per day in a single dose for 2 to 3 consecutive days. Puncture to evacuate pus was also performed where abscesses had collected. Tolerance on the whole was good without a single sign of cardiovascular or urinary toxicity. However, paraesthesia of the hands was observed in one case, transitory thrombocytopenia in one other patient, and increased alkaline phosphatases. Minor disorders were also observed in our series of patients: mild vertigo (7 cases), headache (6 cases), and dry mouth (2 cases). After 8 months the therapeutic results were as follows: 12 complete cures out of 17, 2 improvements with final cure probable, 3 partial failures necessitating supplementary treatment with Metronidazole (2.4 g per day for 2 days). These preliminary trials appear to the encouraging and the study is being continued with series compared with cases treated with Emetine or Metronidazole.
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D004640:Emetine / Q000627:therapeutic use; D005260:Female; D005455:Fluorescent Antibody Technique; D006225:Hand; D006801:Humans; D008101:Liver Abscess, Amebic / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009593:Nitroimidazoles / Q000627:therapeutic use*; D010292:Paresthesia / Q000139:chemically induced; D011677:Punctures; D012698:Serologic Tests; D013636:Tanzania; D013921:Thrombocytopenia / Q000139:chemically induced; D014011:Tinidazole / Q000009:adverse effects / Q000627:therapeutic use*
D009593:Nitroimidazoles; D014011:Tinidazole; D008795:Metronidazole; D000469:Alkaline Phosphatase; D004640:Emetine
Amibiase hépatique dans la région du Kilimanjaro. Séro-diagnostics sur micro-prélévements de sang séché et essais de traitement par le tinidazole (fasigyn)