SAND fly fever
Abstract
CASE 1: A few days after returning from a holiday in Italy a 50-year-old man developed acute gastrointestinal symptoms, followed by headache, fever and joint pains. After transitory remission he had a relapse with fever, headache and meningitis 2 weeks later. Cerebrospinal fluid contained gram-negative diplococci, but no bacteria grew on culture. Under the suspected diagnosis of meningitis he was treated with penicillin. Ten days later he suddenly developed deafness in his right ear. The various signs and symptoms gradually disappeared and the patient was discharged after 24 days in hospital. Retrospectively serological tests indicated sandfly fever (SF) virus infection with serotype Toscana. This is thought to be the first reported case of deafness associated with this disease. CASE 2: One week after returning from a holiday in Tunisia a 34-year-old man fell ill with fever, headache, rigor, nausea, joint pains and a maculopapular rash for which he was treated as an outpatient. The symptoms improved after 7 days, except for the headache which persisted another 5 days. Serology demonstrated an acute infection by SF virus, serotype Sicilian.
CONCLUSION:
Sandfly fever should be included in the differential diagnosis of headache, fever and signs of meningitis in persons who have recently been to mediterranean countries.
IgE concentrations measured by PRIST in serum of healthy adults and in patients with respiratory allergy. A diagnostic approach.
Abstract
In order to establish reference values for total serum IgE in an adult non-atopic population, 175 individuals, 17-85 years of age, were investigated. The usefulness of a sensitive method (PRIST) for serum IgE determinations in discriminating atopy from non-atopic conditions in allergological routine diagnosis was elucidated by investigating 445 patients with symptoms of asthma, rhinitis, urticaria and eczema. Comparisons were made with case histories, in vivo tests and circulating IgE antibodies. The geometric mean for serum IgE in the reference material was 13.2 kU/l with a 2 SD range of 1.53 to 114 kU/l. No significant difference between age groups or sexes was observed. In patients classified as non-atopic and pronounced atopic, the geometric mean values for IgE were 40, 123 and 458 kU/l respectively. The IgE level correlated with number of allergens positive in RAST and with skin test results. It is concluded that IgE determinations are of great help in discriminating atopic conditions from other diseases with similar symptoms. A serum IgE value above 100 kU/l in a patient is strong evidence for the presence of an atopic disease while a value below 20 kU/l indicates that the symptoms are due to intrinsic or infectious disease.
[Neurological symptoms after an infection by the sandfly fever virus].
[Article in German]
Abstract
CASE 1: A few days after returning from a holiday in Italy a 50-year-old man developed acute gastrointestinal symptoms, followed by headache, fever and joint pains. After transitory remission he had a relapse with fever, headache and meningitis 2 weeks later. Cerebrospinal fluid contained gram-negative diplococci, but no bacteria grew on culture. Under the suspected diagnosis of meningitis he was treated with penicillin. Ten days later he suddenly developed deafness in his right ear. The various signs and symptoms gradually disappeared and the patient was discharged after 24 days in hospital. Retrospectively serological tests indicated sandfly fever (SF) virus infection with serotype Toscana. This is thought to be the first reported case of deafness associated with this disease. CASE 2: One week after returning from a holiday in Tunisia a 34-year-old man fell ill with fever, headache, rigor, nausea, joint pains and a maculopapular rash for which he was treated as an outpatient. The symptoms improved after 7 days, except for the headache which persisted another 5 days. Serology demonstrated an acute infection by SF virus, serotype Sicilian.
CONCLUSION:
Sandfly fever should be included in the differential diagnosis of headache, fever and signs of meningitis in persons who have recently been to mediterranean countries.
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