Chloroquine in amoebic dysentery

Chloroquine in amoebic dysentery

540 CORRESPONDENCE REFERENCE DASGUPTA,B. (1965). Trans. R. Soc. trop. Med. Hyg., 59, 441. CHLOROQUINE IN AMOEBIC DYSENTERY SIR,--Although largely ...

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540

CORRESPONDENCE REFERENCE

DASGUPTA,B. (1965). Trans. R. Soc. trop. Med. Hyg., 59, 441.

CHLOROQUINE IN AMOEBIC DYSENTERY

SIR,--Although largely superseded by metronidazole the combination of tetracycline with a luminal amoebicide and chloroquine is still sometimes used for the treatment of amoebic dysentery. Chloroquine is included in this regimen in order to protect the liver against possible amoebic invasion until eradication of Entamoeba histolytica from the bowel is achieved. Since the value of chloroquine in preventing the development of hepatic infection has recently been questioned (KNIGHT, 1971) records of some earlier clinical trials at this Unit have been analysed. All patients had acute amoebic dysentery and were observed in hospital for 27 days after commencing treatment. Whilst in hospital amoebic liver abscess developed in 25 of 509 patients who were treated with broad-spectrum antibiotics or luminal anaoebicides, but in none of 125 subjects who were also given chloroquine. It was once quite a common experience in Durban to encounter patients who developed liver abscess whilst they were receiving treatment with broad-spectrum antibiotics or luminal amoebicides for dysentery. This virtually ceased with the addition of chloroquine to this regimen. We are, etc., S. J. POWELL, R. ELSDON-DEw, Amoebiasis Research Unit, and Department of Medicine, University of Natal, 1 June, 1971 Durban, South Africa. REFERENCE

KNIGHT, R. (1971). Trop. Dis. Bull., 68, Abst. No. 65.

A S C A R I S IN THE LACHRIMAL DUCT

SIR,--A mother brought her 3-year old son to hospital with % worm in his eye." Examination showed the front 0.5 cm. of a nematode protruding from the puncture and wriggling vigorously in the conjunctival sac. By gentle traction, a young Ascaris lumbricoides, some 10 cm. long, was drawn from the naso-lachrimal duct, a procedure which did not appear to cause any very great discomfort to the young patient, but which induced severe nausea in the Sister who was holding his head. Ascaris lumbricoides, in both its larval and adult forms, is notorious for its peregrinations through the human body, but the naso-lachrimal duct would seem to be an uncommon, though by no means unique, site for the worm. A case reported by LAIGNER-TERRASSE(1932) is referred to by DUKE-ELDER(1952). I n a personal communication, Professor J. J. C. Buckley (for whose interest and help I am very grateful) tells me that ocular infestations with Ascaris are mentioned in two text-books which he consulted, but in neither case is a reference given. I am, etc., P. J. L. ROCHE, Seychelles Hospital, Victoria, Mahe, 2 ffune, 1971 Seychelles. REFERENCES

LAIGNER-TERRASSE(1932). Nemathelminthes et Plathelminthes de l'appareil oc. humain, Paris. DUKE-ELDER, SIR S. (1952). Text-Book of Ophthalmology, Vol. 5, p. 5340. London: Henry Kimpton.