5 On the other hand, tropical endomyocardial fibrosis (EMF) which is due to hypereosinophilia is mostly check details observed during the first 6 months of microfilaraemia.6,7 However, EMF cannot be worked out in this context because eosinophilia has low incidence in chronical form of parasitic infections. Treatment of loiasis is based on the use of the microfilaricidal and macrofilaricidal drug DEC, of which sometimes repeated courses are required. Ivermectin
can be administered prior to DEC, especially when microfilaremia is high (>2/µL). Both drugs may cause fatal encephalopathy but in conditions with high microfilaremia. Conversely, microfilaremia was low in our patient even before Ivermectin treatment. We could not find an explanation to the encephalopathy that occurred in our patient. In conclusion, we described a case of atypical loiasis presenting with a chronic pleuroperitoneal effusion in a 50-year-old woman from Central Africa. Loiasis has to be kept in mind when facing patients with chronic pleuroperitoneal effusion. The authors state they have no conflicts of interest to declare. “
Infectious diarrhea is an important problem among travelers and deployed US military overseas causing substantial morbidity due to acute illness and may result in burdensome postinfectious sequelae. Methods. The nonsystemic antibiotic rifaximin was evaluated for prevention of travelers’ diarrhea (TD) Galunisertib nmr in a US Non-specific serine/threonine protein kinase military and civilian adult beneficiary population in a randomized, double-blind, placebo-controlled clinical trial. In all, 100 volunteers deployed to Incirlik Air Base, Turkey, received rifaximin 1,100 mg once daily or placebo for 2 weeks, and participants were followed daily for 2 weeks. Results. In an intention
to treat analysis (n = 95), TD (based on subjects meeting case definition or early treatment) developed in 6.3% (3 of 48) of the rifaximin group compared with 19.2% (9 of 47) in the placebo group (Fisher’s exact test p = 0.07). Rifaximin provided 67% (95% confidence interval, −13% to 91%, p = 0.07) protection against TD. Rifaximn 1,100 mg once daily was well tolerated with no observed differences in adverse events, whether solicited or unsolicited among the two treatment groups. Conclusions. Rifaximin may represent an option among military personnel on deployment for prevention of TD with supportive future studies that consider deployment length, settings, and operational situations where widespread use of chemoprophylaxis may increase force health protection without undue risk during critical deployments. Historically and in modern times, infectious diarrhea among deployed US war fighters has posed a significant health threat despite advances in field preventive measures.