Pentamidine Health Dictionary

There are two major forms of the disease: Trypanosoma brucei gambiense is con?ned to west and central Africa, and T.b. rhodesiense to central, east, and south-east Africa. The infection is caused by the bite of tsetse ?y (Glossina spp.). Clinically, a trypanosomal CHANCRE may develop at the site of the tsetse-?y bite. After introduction into the bloodstream, the parasite develops in blood and lymphatic glands. After the blood stage, it enters the central nervous system, causing characteristic neurological sequelae (see below). Infection may be followed by a generalised macular papular reaction. In

T.b. gambiense infection, enlarged glands in the neck (Winterbottom’s sign) may be striking. Onset of disease is accompanied by fever, progressive ANAEMIA, and enlarged glands; these signs and symptoms are followed by increasing lethargy, slowing of mentality, and physical weakness, and give way to headache and an increasing tendency to sleep. These symptoms are caused by proliferation of parasites in the patient’s cerebral blood vessels; this is accompanied by in?ammatory changes and disorganisation of nervous tissue. Patients become emaciated and develop bed sores. Death ?nally takes place either as a result of gross emaciation or of an intercurrent infection.

Diagnosis is by detection of trypanosomes in a blood specimen or, alternatively, a sample of cerebrospinal ?uid. Serological tests are of great value in diagnosis.

Treatment is with suramine or pentamidine; when cerebral involvement has ensued, melarsoprol – which penetrates the blood-brain barrier – is of value. In T.b. gambiense infection, e?ornithine has recently given encouraging results; however, this form of CHEMOTHERAPY is not e?ective in a T.b. rhodesiense infection. From the point of view of prevention, control of the tsetse-?y population is crucial; even so, only a very small percentage of these vectors is infected with Trypanosoma spp.... sleeping sickness

PNEUMONIA caused by a species of the genus of PROTOZOA, a parasitic micro-organism. Pneumocystis carinii causes an opportunistic infection in the lung which is dangerous to people whose immune system is impaired (see IMMUNITY), thus reducing their resistance to infections. People with AIDS/HIV or LEUKAEMIA have impaired immune systems and P. carinii is a major cause of death in the former. Fever, dry cough and breathlessness are among the symptoms; treatment is with high doses of antibiotic drugs such as CO-TRIMOXAZOLE or PENTAMIDINE.... pneumocystis pneumonia

(visceral leishmaniasis, Dumdum fever) n. a tropical disease caused by the parasitic protozoan *Leishmania donovani. The parasite, which is transmitted to humans by *sandflies, invades the cells of the lymphatic system, spleen, and bone marrow. Symptoms include enlargement and subsequent lesions of the liver and spleen; anaemia; a low *leucocyte count; weight loss; and irregular fevers. The disease occurs in Asia, South America, the Mediterranean area, and Africa. Drugs containing antimony, with supplementary pentamidine, are used in the treatment of this potentially fatal disease.... kala-azar

n. a genus of protozoans. The species P. jiroveci (formerly carinii) causes pneumonia in immunosuppressed patients, usually following intensive chemotherapy. Pneumocystis jiroveci (carinii) pneumonia (PCP) is fatal in 10–30% of cases if untreated, but it can be overcome with high doses of *co-trimoxazole or *pentamidine.... pneumocystis