South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Case Reports
Congo-Crimean haemorrhagic fever in South Africa. Report of a fatal case in the Transvaal.
A 13-year-old boy, after having spent a week at a camp in a nature reserve in the western Transvaal, developed an acute illness of sudden onset characterized by chills, severe headache, muscle pains and high fever. On the 3rd day he developed a haemorrhagic state with profuse bleeding from the gastro-intestinal tract and other mucous membranes and petechial haemorrhages into the skin, from which he died on the 6th day after onset of the illness. ⋯ The provisional clinical diagnosis of Congo virus fever was confirmed in the laboratory by the isolation of the virus in newborn mice inoculated with the patient's blood. This is the first incrimination of Congo virus as the cause of a fatal case of haemorrhagic fever in South Africa, although it is known to occur in several countries in the tropical region of Africa and in south-eastern Europe and Asia.
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Tuberculosis is a major health problem in South Africa. More than 40 000 new cases are notified annually and there is good evidence that this represents only a proportion of all patients with active disease. ⋯ In the 1970s our death rate from this disease probably approximated that which pertained in the UK in the 1940s just before antituberculosis drugs came into general use. Current concepts in tuberculosis and its control are reviewed and the suggestion made that a specialized task force be set up to improve control measures in South Africa.
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Portal-systemic shunts, either spontaneous or artificial, are occasionally complicated by the development of spastic paraparesis. We report on 2 young patients who developed this complication following splenorenal shunts which were made for the treatment of oesophageal varices associated with cirrhosis of the liver and portal hypertension.