Cryosurgery for axillary hyperhidrosis.

Abstract

Lassa fever: retrospective diagnosis of two patients seen in Great Britain in 1971Lassa fever was first described by Frame et all in 1970, but it was not until three outbreaks had occurred in Jos, Liberia, and Sierra Leone that the disease attracted general attention,2-4 especially as the mor- tality of these outbreaks averaged 45%.We describe two patients admitted under our care in 1971 who recovered.The diagnosis was confirmed retrospectively by serological tests. Case 1This patient, a nursing sister, had worked in Sierra Leone for nearly four years.On the morning of 10 June 1971 she became ill at Serabu Hospital with general aches and pains, fever, and rigors and treated herself for malaria without improvement.Her temperature persisted and varied between 38' and 40'C, and she had severe anorexia, nausea, and vomiting.Despite courses of chloramphenicol and ampicillin the symptoms persisted and she was transferred to Freetown, where pseudomonal septicaemia was diagnosed and she was given a course of prednisone and cloxacillin.Her condition improved and she was transferred to the Tropical Diseases Unit in Liverpool for further investigation.She arrived by air from Sierra Leone via Las Palmas, with an overnight stop at the airport hospital in London on 8 July.On admission she had been feverish for two days (38'C), had a severe right-sided iridocyclitis, and felt weak.Findings on physical examination were essentially normal, except for slight tenderness in the right hypochondrium.She was managed as a case of pyrexia of unknown origin, isolated in a side ward, and barrier-nursed.Nothing abnormal was found on investi- gation, except for hookwortm and stronglyoides, for which she was treated.Her iridocycitis subsided after a course of subconjunctival hydrocortisone, her condition continued to improve, and she was discharged on 23 July with a diagnosis of ?pseudomonal septicaemia/ ?arbovirus infection.A team from the Communicable Diseases Centre, Atlanta, visiting Sierra Leone in September 1972, tested her serum and found a complement fixation titre to Lassa fever of 1/16, indicating that her illness in June 1971 was undoubtedly Lassa fever.In 1975 the titre had fallen to 1/4. Case 2This patient, a doctor, had been working in Segbwema Hospital, SierraLeone.On 21 September 1971 he developed flu-like symptoms and despite a course of tetracycline by mouth continued to feel ill, his temperature rising to 38°-39°C over the next three days.On 24 September he left Sierra Leone on a scheduled flight "feeling grim," and on arrival in the UK next day proceeded to his home in Kirton, Lincs.On the 27th he still complained of malaise, headache, anorexia, and generalised joint pains.On examination he looked ill, was feverish, and had a sallow complexion.Results of physical