Tropical Pathology

General Aspects.- 1 Guidelines for Autopsies in the Tropics.- A. Introduction.- B. The Roles of the Autopsy.- I. General and in AIDS.- II. Cancer Registries.- III. Perinatal Mortality.- IV. Maternal Mortality.- V. Future Clinicopathological Research.- C. The Performance and Product of the Autopsy.- I. Consent for an Autopsy.- II. Performance of Autopsies in the Tropics.- III. Clinicopathological Discordance.- IV. Mortality Statistics.- V. Autopsy Histopathology and the Costs of Autopsy.- D. Medicolegal Autopsies.- E. Safety Issues.- I. Risks of Acquiring Infection from an Autopsy.- 1. Hepatitis Viruses.- 2. Tuberculosis.- 3. HIV.- II. Glove Puncture.- F. Facilities and Practice Within Mortuaries.- G. Conclusions and Suggestions.- References.- 2 Geomedicine.- A. Introduction.- B. Early History of Geomedicine.- C. The Evolution of Geomedical Research.- I. Europe and North America.- 1. Germany.- 2. France.- 3. United Kingdom.- 4. United States.- 5. Canada.- 6. Scandinavia.- 7. Soviet Union.- II. Asia.- III. Africa.- IV. Latin America.- D. Concepts and Definitions.- E. Methods and Examples of Geomedical Research.- I. Methods.- II. Examples of Geomedical Research.- 1. Disease Mapping.- 2. Geocancerology.- 3. Disease Diffusion.- F. Future Prospects of the Geography of Health.- References.- 3 Genetic Diseases in the Tropics.- A. Introduction.- B. Genetic Variation and Disease: Ecogenetics.- I. Physical Agents.- 1. Cold Stress.- 2. Heat Adaptation.- 3. High Altitude Adaptation.- 4. Ultraviolet Light.- II. Chemical Agents.- 1. Pseudocholinesterase Variation.- 2. Acetyltransferase Variation.- 3. Paraoxonase Variation.- 4. Alcoholism and Genetics.- III. Infectious Agents.- 1. Blood Groups and Other "Normal" Traits.- 2. Mannose Binding Protein.- 3. Sixth Component of Complement Deficiency.- 4. Fungal Infections.- IV. Nutritional Factors.- 1. Persistent Hereditary Intestinal Lactase Activity.- 2. Dietary Iron Overload.- 3. Metabolic Diseases Probably Due to Dietary Change.- 4. Coronary Heart Disease and Hypertension.- C. Congenital Malformations.- I. Introduction and Definitions.- II. Incidence in the Tropics.- III. Down Syndrome in the Tropics.- D. Consanguinity and Genetic Disease.- E. The Burden of Genetic Disease in the Tropics.- I. Genetic Diseases and Public Health in the Tropics.- II. Genetic Services and Primary Health Care.- F Conclusion.- References.- Infectious Diseases.- 4 New Technology for the Diagnosis of Infectious Disease.- A. Introduction.- B. Nucleic Acid Hybridization.- I. Principles.- II. Nucleic Acid Probes.- III. Labeling and Detection of Nucleic Acid Probes.- IV. Hybridization Formats.- 1. Solid Support Hybridization.- 2. In Solution Hybridization.- 3. In Situ Hybridization.- V. Nucleic Acid Amplification.- VI. Analysis of Nucleic Acids in Archival Tissues.- VII. Applications in Infectious Disease Diagnosis and Research.- C. Immunoassays.- D. New Laboratory Instrumentation.- I. Recombinant Gene Products and Synthetic Peptides.- II. Flow Cytometry.- E. Summary.- References.- Bacterial Diseases.- 5 Intestinal Bacterial Infections.- A. Diarrhoeagenic Escherichia coli.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis and Pathology.- IV. Laboratory Confirmation.- B. Cholera.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis.- IV. Pathology.- V. Laboratory Confirmation.- C. Shigellosis.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis.- IV. Pathology.- V. Laboratory Confirmation.- D. Typhoid Fever.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis.- IV. Pathology.- V. Laboratory Confirmation.- References.- 6 Non-Intestinal Bacterial Infections.- A. Plague.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis.- IV. Pathology.- V. Laboratory Confirmation.- B. Brucellosis.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis and Pathology.- IV. Laboratory Confirmation.- C. Melioidosis (Whitmore's Disease).- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis.- IV. Pathology.- V. Laboratory Confirmation.- D. Anthrax.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis.- IV. Pathology.- V. Laboratory Confirmation.- E. Scleroma (Rhinoscleroma).- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis.- IV. Pathology.- V. Laboratory Confirmation.- F. Tropical Pyomyositis.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis.- IV. Pathology.- V. Laboratory Confirmation.- G. Cutaneous Diphtheria.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis.- IV. Pathology.- V. Laboratory Confirmation.- H. Tropical Ulcer.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis.- IV. Pathology.- V. Laboratory Confirmation.- J. Buruli Ulcer (Searle's Ulcer, Bairnsdale Ulcer, Kakerifu Ulcer, Toro Ulcer).- K. Actinomycotic Mycetoma and Botryomycosis.- References.- 7 Spirochaetal and Leptospiral Diseases.- A. Introduction.- B. Spirochaetal Diseases.- I. Syphilis.- 1. Serological Tests for Syphilis.- 2. Acquired Syphilis.- 3. Congenital Syphilis.- II. Endemic Treponematoses (Non-Venereal).- 1. Yaws.- 2. Non-Venereal Endemic Syphilis.- C. Leptospiral Diseases.- I. Leptospirosis (Weil's Disease).- II. Borrelia Infections.- 1. Relapsing Fever.- 2. Lyme Disease.- D. Tropical Phagedenic Ulcer.- References.- 8 Infections Caused by Rickettsiae and Rickettsia-Like Organisms and Bartonellosis.- A. Rickettsial Infections.- I. The Typhus Group of Infections.- 1. Epidemic Typhus Fever.- 2. Endemic (Murine) Typhus Fever.- II. The Spotted Fever Group of Infections.- 1. Rocky Mountain Spotted Fever.- 2. Other Spotted Fevers.- 3. Rickettsial Pox.- III. Miscellaneous Rickettsial Infections.- 1. Scrub Typhus.- IV. Laboratory Confirmation of Rickettsial Infections.- B. Infections Caused by Rickettsia-Like Organisms.- I. Q Fever.- 1. Epidemiology.- 2. Clinical Features.- 3. Pathogenesis.- 4. Pathology.- 5. Laboratory Confirmation.- II. Trench Fever.- 1. Epidemiology.- 2. Clinical Features.- 3. Pathology.- 4. Laboratory Confirmation.- III. Other Rochalimaea-Associated Infections.- IV. Ehrlichial Infections.- 1. Epidemiology.- 2. Clinical Features.- 3. Pathology.- 4. Laboratory Confirmation.- C. Bartonellosis.- I. Epidemiology.- II. Clinical Features.- 1. Oroya Fever.- 2. Transition Phase.- 3. Verruca Peruviana.- III. Pathogenesis and Pathology.- IV. Laboratory Confirmation.- References.- 9 Mycobacterial Infections of the Skin.- A. Introduction.- B. Leprosy.- I. Introduction and Epidemiology.- II. Clinical Features.- 1. Indeterminate Leprosy.- 2. Polar Tuberculoid Leprosy.- 3. Borderline Leprosy.- 4. Polar Lepromatous Leprosy.- 5. Neuritic Leprosy.- III. Pathogenesis and Pathology.- 1. Immunology.- 2. Pathology.- IV. Reactions.- 1. Reversal Reactions.- 2. Erythema Nodosum Leprosum.- 3. Therapy of Reactions.- V. Treatment of Leprosy.- 1. Chemotherapeutic Agents.- 2. WHO's Multidrug Therapy.- 3. Determination of Efficacy of Chemotherapy.- 4. Immunotherapy and Vaccination.- VI. Leprosy and HIV Infection.- VII. Experimental and Naturally Acquired Leprosy in Animals.- VIII. Diagnosis and Differential Diagnosis.- C. Tuberculosis of the Skin.- I. Primary Tuberculosis.- 1. Primary Inoculation Tuberculosis.- 2. Generalized Miliary Tuberculosis (Tuberculosis Cutis Miliaris Disseminata).- II. Reinfection Tuberculosis.- 1. Lupus Vulgaris.- 2. Tuberculosis Verrucosa Cutis.- 3. Scrofuloderma.- 4. Tuberculosis Cutis Orificialis.- III. Tuberculids.- 1. Papulonecrotic Tuberculid.- 2. Lichen Scrofulosorum.- 3. Erythema Induratum of Bazin.- D. Mycobacterium ulcerons Infection (Buruli Ulcer).- I. Introduction and Epidemiology.- II. Clinical Features.- III. Pathogenesis and Pathology.- IV. Treatment.- V. Diagnosis and Differential Diagnosis.- E. Less Common Mycobacterial Infections.- I. Rapid-Growing Mycobacteria (M. fortuitum and M. chelonei).- II. Swimming Pool Granuloma (M. marinum Infection).- III. M: avium-intracellulare complex (MAC) and M. scrofulaceum.- IV. M. kansasii Infection.- V. M. haemophilum Infection.- VI. M. szulgai Infection.- VII. Other Mycobacteria Causing Cutaneous Lesions.- References.- 10 Sexually Transmitted Diseases in the Tropics.- A. Introduction.- B. Gonorrhoea.- C. Non-Gonococcal Urethritis.- D. Acute Epididymo-Orchitis.- E. Acute Pelvic Inflammatory Disease.- F. Trichomoniasis.- G. Genital Candidiasis.- H. Bacterial Vaginosis.- J. Syphilis.- I. Early Syphilis.- 1. Primary Syphilis.- 2. Secondary Syphilis.- 3. Diagnosis and Treatment of Primary and Secondary Syphilis.- 4. Pathology of Early Syphilis.- 5. Latent Syphilis.- II. Tertiary Syphilis.- 1. Cutaneous, Mucosal and Bony Gummas.- 2. Cardiovascular Syphilis.- 3. Neurosyphilis.- 4. Diagnosis of Tertiary Syphilis.- 5. Pathology of Late Syphilis.- III. Syphilis in Pregnancy.- IV. Congenital Syphilis.- 1. Early Congenital Syphilis.- 2. Late Congenital Syphilis.- 3. Laboratory Diagnosis of Congenital Syphilis.- K. Genital Herpes.- L. Chancroid.- M. Lymphogranuloma Venerum.- N. Granuloma Inguinale.- O. Genital Warts.- P. Molluscum Contagiosum.- Q. Scabies.- R. Pubic Lice (Pediculosis Pubis).- References.- Viral Diseases.- 11 The Viral Haemorrhagic Fevers.- A. Mosquito Borne Viral Haemorrhagic Fevers.- I. Yellow Fever.- 1. Epidemiology.- 2. Clinical Features.- 3. Pathogenesis.- 4. Pathology.- 5. Laboratory Confirmation.- II. Dengue Haemorrhagic Fever/Dengue Shock Syndrome.- 1. Epidemiology.- 2. Clinical Features.- 3. Pathology.- 4. Laboratory Confirmation.- III. Rift Valley Fever.- 1. Epidemiology.- 2. Clinical Features.- 3. Pathology.- 4. Laboratory Confirmation.- IV. Chikungunya Haemorrhagic Fever.- 1. Epidemiology.- 2. Clinical Features.- 3. Pathology.- 4. Laboratory Confirmation.- B. Tick Borne Viral Haemorrhagic Fevers.- I. Crimean-Congo Haemorrhagic Fever.- 1. Epidemiology.- 2. Clinical Features.- 3. Pathogenesis and Pathology.- 4. Laboratory Confirmation.- II. Omsk Haemorrhagic Fever and Kyasanur Forest Disease.- 1. Epidemiology.- 2. Clinical Features.- 3. Pathology.- 4. Laboratory Confirmation.- C. The Arenaviral Haemorrhagic Fevers.- I. Epidemiology.- II. Clinical Features.- 1. Argentinian and Bolivian Haemorrhagic Fevers.- 2. Venezuelan Haemorrhagic Fever.- 3. Lassa Fever.- III. Pathogenesis.- IV. Pathology.- 1. Argentinian and Bolivian Haemorrhagic Fevers.- 2. Venezuelan Haemorrhagic Fever.- 3. Lassa Fever.- V. Laboratory Confirmation.- D. Filoviral Haemorrhagic Fevers.- I. Epidemiology.- II. Clinical Features.- III. Pathology.- 1. Marburg Virus Disease.- 2. Ebola Haemorrhagic Fever.- IV. Laboratory Confirmation.- E. Hantavirus Infections.- I. Epidemiology.- II. Clinical Features.- III. Pathology.- IV. Laboratory Confirmation.- F. Haemorrhagic Smallpox.- I. Epidemiology.- II. Clinical Features.- III. Pathogenesis and Pathology.- IV. Laboratory Confirmation.- References.- Protozoal Diseases.- 12 Intestinal Protozoa.- A. Giardia duodenalis.- I. Introduction.- II. Life Cycle and Transmission.- III. Distribution and Epidemiology.- IV. Pathogenesis and Symptomatology.- V. Pathology of Giardiasis.- VI. Diagnosis.- B. Dientamoeba fragilis.- I. Introduction.- II. Life Cycle and Transmission.- III. Distribution and Epidemiology.- IV. Pathogenesis and Symptomatology.- V. Diagnosis.- C. Entamoeba histolytica.- I. Introduction.- II. Life Cycle and Transmission.- III. Distribution and Epidemiology.- IV. Pathogenesis, Symptomatology and Pathology.- 1. Luminal Amoebiasis.- 2. Invasive Amoebiasis.- V. Diagnosis.- 1. Luminal Amoebiasis.- 2. Intestinal Invasive Amoebiasis.- 3. Extra-Intestinal Invasive Amoebiasis.- D. Limax and Leptomyxid Amoebae.- I. Introduction.- II. Life Cycle and Transmission.- III. Distribution and Epidemiology.- IV. Pathogenesis and Symptomatology.- V. Pathology of Limax and Leptomyxid Amoebiasis.- VI. Diagnosis.- E. Blastocystis hominis.- I. Introduction.- II. Life Cycle and Transmission.- III. Distribution and Epidemiology.- IV. Pathogenesis and Symptomatology.- V. Pathology of Blastocystosis.- VI. Diagnosis.- F. Balantidium coli.- I. Introduction.- II. Life Cycle and Transmission.- III. Distribution and Epidemiology.- IV. Pathogenesis and Symptomatology.- V. Pathology of Balantidiasis.- VI. Diagnosis.- G. Isospora belli.- I. Introduction.- II. Life Cycle and Transmission.- III. Distribution and Epidemiology.- IV. Pathogenesis and Symptomatology.- V. Pathology of Isosporiasis.- VI. Diagnosis.- 1. Stool Examination.- 2. Biopsy.- H. Sarcocystis Species.- I. Introduction.- II. Life Cycle and Transmission.- III. Distribution and Epidemiology.- IV. Pathogenesis and Symptomatology.- V. Pathology of Sarcosporidiosis.- 1. Intestinal Sarcosporidiosis.- 2. Extra-Intestinal Sarcosporidiosis.- VI. Diagnosis.- J. Cryptosporidium Species.- I. Introduction.- II. Life Cycle and Transmission.- III. Distribution and Epidemiology.- IV. Pathogenesis and Symptomatology.- V. Pathology of Cryptosporidiosis.- VI. Diagnosis.- K. Microsporidiosis.- I. Introduction.- II. Life Cycle and Transmission.- III. Distribution and Epidemiology.- IV. Pathogenesis and Symptomatology.- V. Pathology of Microsporidiosis.- 1. Intestinal Microsporidiosis.- 2. Extra-Intestinal Microsporidiosis.- VI. Diagnosis of Microsporidiosis.- 1. Intestinal Microsporidiosis.- 2. Extra-Intestinal Microsporidiosis.- L Toxoplasma gondii.- I. Introduction.- II. Distribution and Epidemiology.- III. Pathogenesis and Symptomatology.- IV. Pathology of Toxoplasmosis.- V. Diagnosis.- References.- 13 Malaria.- A. Epidemiology.- B. The Parasites.- C. Life Cycle.- D. Transmission.- E. Susceptibility and Manifestation of Disease.- F. Pathogenesis and Clinicopathologic Features.- I. Fever.- II. Anemia.- III. Liver Damage.- IV. Alterations to the Spleen.- V. Gastrointestinal Damage.- VI. Renal Damage.- VII. Thrombocytopenia and Clotting Defects.- VIII. Pulmonary Damage.- IX. Cerebral Injury.- G. Gross and Microscopic Pathology of Fatal Falciparum Malaria.- I. Brain.- II. Kidney.- III. Liver.- IV. Spleen.- V. Bone Marrow.- VI. Lymph Nodes.- VII. Heart.- VIII. Lungs.- IX. Gastrointestinal Tract.- X. Placenta.- H. Diagnosis.- J. Prophylaxis and Treatment.- I. Introduction.- II. Individual Medications.- 1. The 4-Aminoquinoline Drugs.- 2. The 8-Aminoquinoline Drugs.- 3. Cinchona Alkaloids.- 4. Dihydrofolate Reductase Inhibitors.- 5. Sulfonamides.- 6. Tetracyclines.- 7. 4-Quinolinemethanols and Other New Drugs.- III. Additional Drugs Used in the Treatment of Malaria.- IV. Other Forms of Therapy.- K. Pathologic Complications of Malarial Therapy.- L. Vaccine Development.- References.- 14 Leishmaniasis.- A. Introduction.- B. Parasite Morphology and Life Cycle.- C. Cutaneous and Mucocutaneous Leishmaniasis.- I. Epidemiology.- II. Clinical Manifestations.- 1. New World Cutaneous Leishmaniasis.- III. Pathogenesis.- IV. Pathology.- V. Immunology.- VI. Laboratory Diagnosis.- VII. Differential Diagnosis.- D. Visceral Leishmaniasis.- I. Epidemiology.- II. Clinical Manifestations.- III. Pathogenesis and Pathology.- IV. Immunology.- V. Diagnosis.- VI. Differential Diagnosis.- References.- 15 Trypanosomiasis.- A. Introduction.- B. American Trypanosomiasis (Chagas' Disease) (A. L. BITTENCOURT).- I. Introduction.- II. Parasite Morphology and Life Cycle.- III. Epidemiology.- IV. Clinical Features.- 1. Acute Disease.- 2. Chronic Interdeterminate Disease.- 3. Chronic Cardiac Disease.- 4. Chronic Digestive Disease.- 5. Chronic Nervous Disease.- 6. Congenital Disease.- V. Immunology.- VI. Pathogenesis.- 1. Acute Disease.- 2. Chronic Disease.- VII. Pathology.- 1. Acute Disease.- 2. Chronic Interdeterminate Disease.- 3. Chronic Cardiac Disease.- 4. Chronic Digestive Disease.- 5. Chronic Nervous Disease.- 6. Reactivation of Chagasic Infection.- 7. Congenital Disease.- VIII. Diagnosis.- C. African Trypanosomiasis (T. G. ASHWORTH).- I. Introduction.- II. Epidemiology.- 1. Parasite Morphology and Life Cycle.- 2. Distribution and Frequency.- 3. Vector.- 4. Host-Parasite Relationship.- III. Clinical Features.- 1. Introduction.- 2. Stage I Disease.- 3. Stage II Disease.- 4. Congenital Transmission.- 5. Coexistent Disease and Complications of Treatment.- IV. Pathology and Pathogenesis.- 1. Introduction.- 2. Pathology and Pathogenesis of Stage I Disease.- 3. Pathology of Stage II Disease.- 4. Pathogenesis of Stage II Disease.- V. Laboratory Diagnosis.- References.- Mycotic Diseases.- 16 Tropical Mycotic Diseases.- A. Introduction.- B. Mycetomas.- I. Introduction.- II. Epidemiology and Aetiological Agents.- III. Clinical Aspects.- IV. Pathology.- 1. Black Grains of Eumycotic Mycetomas.- 2. Pale Grains of Eumycotic Mycetomas.- 3. Grains of Actinomycotic Mycetomas.- V. Immunology.- VI. Diagnosis.- VII. Differential Diagnosis.- C. Sporotrichosis.- I. Introduction.- II. Epidemiology.- III. Clinical Aspects.- IV. Pathology.- V. Immunology.- VI. Diagnosis.- VII. Differential Diagnosis.- B. Chromoblastomycosis.- I. Introduction.- II. Epidemiology.- III. Clinical Aspects.- IV. Pathology.- V. Immunology.- VI. Diagnosis.- VII. Differential Diagnosis.- E. Rhinosporidiosis.- I. Introduction.- II. Epidemiology.- III. Clinical Aspects.- IV. Pathology.- V. Immunology.- VI. Diagnosis.- VII. Differential Diagnosis.- F. Lobomycosis.- I. Introduction.- II. Epidemiology.- III. Clinical Aspects.- IV. Pathology.- V. Immunology.- VI. Diagnosis.- VII. Differential Diagnosis.- G. Entomophthoromycosis.- I. Introduction.- II. Epidemiology.- III. Clinical Aspects.- 1. Subcutaneous Form.- 2. Mucocutaneous Form.- 3. Primary Visceral Form.- IV. Pathology.- V. Immunology.- VI. Diagnosis.- VII. Differential Diagnosis.- H. Paracoccidioidomycosis.- I. Introduction.- II. Epidemiology.- III. Clinical Aspects.- IV. Pathology.- 1. Gross Aspects.- 2. Microscopic Aspects.- V. Immunology.- VI. Diagnosis.- VII. Differential Diagnosis.- J. African Histoplasmosis.- I. Introduction.- II. Epidemiology.- III. Clinical Aspects.- IV. Pathology.- V. Immunology.- VI. Diagnosis.- VII. Differential Diagnosis.- K. Cryptococcosis.- I. Introduction.- II. Epidemiology.- III. Clinical Aspects.- IV. Pathology.- 1. Gross Aspects.- 2. Microscopic Aspects.- V. Immunology.- VI. Diagnosis.- VII. Differential Diagnosis.- References.- Metazoal Diseases.- 17 Helminthology.- A. Introduction to Helminths.- I. Acoelemate.- II. Pseudocoelemate.- III. Coelemate.- IV. Classifying the Worm.- B. Helminths Pathogenic to Humans.- I. Phylum: Platyhelminthes.- Class: Trematoda.- 1. Schistosomiasis.- 2. Troglotrematidae.- 3. Opisthorchiidae.- 4. Dicrocoeliidae.- 5. Fasciolidae.- 6. Echinostomatidae.- 7. Heterophyidae.- 8. Paramphistomatidae.- 9. Rare Trematode Infections of Humans.- 10. General Comments on Therapy for Trematodes.- Class: Cestoidea.- 1. Pseudophyllidea.- 2. Cyclophyllidea; Family: Taeniidae.- 3. Cyclophyllidea; Family: Hymenolepididae.- 4. Cyclophyllidea; Family: Dipylidiidae.- 5. Cyclophyllidea; Family: Davaineidae.- 6. Other Cyclophyllidean Infections of Humans.- II. Pseudocoelomates: The Nematodes.- Subclass: Adenophorea.- 1. Trichuris.- 2. Capillaria.- 3. Trichinella.- 4. Dioctophyma and Eustrongylides.- Subclass: Secernentea.- 1. Halicephalobus (syn. Micronema).- 2. Stronggyloides.- 3. Ancylostoma and Necator Species.- 4. Mammomonogamus.- 5. Trichostrongylus.- 6. Angiostrongylus and Metastrongylus.- 7. Ascaris.- 8. Visceral Larva Migrans.- 9. Anisakis, Contracaecum, Phocanema (Pseudoterranova), Terranova, Porrocaecum, and Hysterothylacium.- 10. Enterobius.- 11. Cutaneous Larva Migrans.- 12. Spirocerca, Thelazia.- 13. Filarial Nematodes.- 14. Dracunculus.- III. Pseudocoelomates: Acanthocephala.- 1. Macracanthorhynchus.- 2. Moniliformis.- 3. Acanthocephalus, Corynosoma, and Bolbosoma.- IV. Phylum: Annelida.- V. Phylum: Arthropoda.- C. Helminths Categorized by Organ System Involvement.- D. Artifacts, Arthropods and Nonpathogenic Worms Commonly Mistaken for Parasites.- E. Polyparasitism and Final Comments.- References.- Non-Infectious Diseases.- 18 Malnutrition and Intestinal Malabsorption.- A. Protein Energy Malnutrition.- I. General Aspects.- II. Overnutrition in the Tropics.- III. Undernutrition (Nutritional Growth Retardation).- IV. Marasmus.- V. Kwashiorkor.- 1. Oedema.- 2. Skin Changes.- 3. Mucous Membranes.- 4. Hair Changes.- 5. Muscle Wasting.- 6. Mental and Neurological Changes.- 7. Renal Function.- VI. Marasmic Kwashiorkor.- VII. Pathology of Protein Energy Malnutrition.- 1. Water and Electrolyte Balance.- 2. Skeletal Muscle Atrophy.- 3. Heart.- 4. Liver.- 5. Pancreas.- 6. Endocrine System.- 7. Gastrointestinal Tract.- 8. Haemopoietic System.- 9. Lymphoreticular System.- VIII. Interaction of Protein Energy Malnutrition with Infection.- IX. Long-Term Sequelae of Protein Energy Malnutrition.- B. Vitamin and Mineral Malnutrition.- I. Vitamins.- 1. Vitamin A.- 2. Vitamin E.- 3. Vitamin K.- 4. Thiamine (Vitamin B1.- 5. Riboflavin (Vitamin B2).- 6. Niacin (Nicotinic Acid Vitamin B5).- 7. Pyridoxine (Vitamin B6).- 8. Pantothenic Acid.- 9. Cobalamin Compounds (Vitamin B12).- 10. Folic Acid.- 11. Ascorbic Acid (Vitamin C).- 12. Vitamin D, Calcium and Phosphorus.- II. Minerals and Trace Elements.- 1. Iron Deficiency Anaemia.- 2. Zinc Deficiency.- 3. Selenium, Copper and Manganese.- C. Nutritional Siderosis.- D. Tropical Sprue.- E. Chronic Pancreatic Disease in the Tropics.- References.- Special Pathology of Organ Systems.- 19 Cardiovascular Diseases in the Tropics.- A. Introduction.- B. Idiopathic Cardiomyopathy.- I. Dilated Cardiomyopathy.- 1. Aetiology.- 2. Macroscopic Pathology.- 3. Microscopic Pathology.- 4. Ultrastructure.- II. Variants of Dilated Cardiomyopathy.- 1. Keshan Disease.- 2. Duchenne Muscular Dystrophy.- 3. Becker Muscular Dystrophy.- 4. Familial Cardiomyopathy.- 5. Right Ventricular Cardiomyopathy.- 6. Non-Compaction of Ventricular Myocardium.- III. Hypertrophic Cardiomyopathy.- 1. Macroscopic Pathology.- 2. Microscopic Pathology.- IV. Restrictive/Obliterative Cardiomyopathy.- 1. Aetiology.- 2. Primary Endocardial Fibroelastosis.- 3. Amyloidosis.- 4. Cardiac Siderosis.- 5. Sarcoidosis.- 6. Endomyocardial Fibrosis: Obliterative Cardiomyopathy.- V. Löffler's Endocarditis.- B. Inflammatory Diseases of Myocardium.- I. Myocarditis.- 1. Non-Specific Myocarditis.- 2. Granulomatous Myocarditis.- 3. Tuberculosis.- 4. Typhoid Fever.- II. Protozoal and Parasitic Diseases.- 1. Toxoplasmosis.- 2. Sarcocystis.- 3. Amoebiasis.- 4. Trypanosomiasis.- III. Helminthic Parasites.- 1. Tapeworms (Cestodes).- C. Systemic Hypertension.- D. Rheumatic Heart Disease.- E. Idiopathic Cardiac Aneurysms.- F. Coronary Atherosclerosis.- G. Epidemic Dropsy.- H. Congenital Heart Disease.- J. Kaposi's Sarcoma.- K. Heat Injury and Role of Heat Shock Proteins.- I. Heat Injury.- II. Heat Shock Proteins.- L. Pericardial Diseases.- I. Purulent (Suppurative) Pericarditis.- II. Tuberculous Pericarditis.- M. Vascular Diseases.- I. Idiopathic (Takayasu's) Aortitis.- II. Tuberculous Arteritis and Aneurysms.- III. Peripheral Mucoid Arteriopathy.- IV. Ainhum.- V. Cerebrovascular Disease.- VI. Thromboangiitis Obliterans (Buerger's Syndrome).- References.- 20 Blood Diseases in the Tropics.- A. Introduction.- B. Normal Values and References Ranges.- I. Haemoglobin (Hb).- II. White Blood Cell Count (WBC).- III. Platelet Counts.- C. Anaemia - General Features.- I. Introduction.- II. Basic Mechanisms.- III. Clinical Features.- D. The Nutritional Anaemias.- I. Introduction.- 1. Iron Metabolism.- 2. Iron Deficiency and Iron Deficiency Anaemia.- 3. Iron Overload.- 4. Iron and Infection.- II. Megaloblastic Anaemia.- 1. Folate Metabolism.- 2. Folate Deficiency.- 3. Cobalamin (Vitamin B12) Deficiency.- III. Anaemia of Protein Deficiency.- E. Anaemia of Chronic Disease.- F. Haemolytic Anaemias.- I. Hereditary Abnormalities of the Red Cell Membrane.- 1. Hereditary Elliptocytosis.- 2. Hereditary Spherocytosis.- II. Hereditary Abnormalities of Hb Synthesis.- 1. The Haemoglobinopathies.- III. The Enzymopathies.- 1. G6PD Deficiency.- 2. Pyruvate Kinase (PK) Deficiency.- IV. Acquired Haemolytic Anaemia.- G. Haematological Manifestations of Malaria and Other Parasitic Infections.- I. Malaria.- 1. Anaemia.- 2. White Cell Changes.- 3. Changes in Platelets and Other Haemostatic Parameters.- 4. Interaction of Malaria with the Hereditary Erythrocytopathies.- II. Other Parasites.- H. Hypersplenism and Pancytopenia.- J. Bleeding Disorders.- K. Blood Transfusion in the Tropics.- References.- 21 Cirrhosis and Other Liver Diseases.- A. Viral Hepatitis and Hepatic Cirrhosis.- I. Viral Hepatitis.- II. Hepatic Cirrhosis.- 1. Post-Viral Cirrhosis.- 2. Indian Childhood Cirrhosis.- B. Idiopathic Portal Hypertension.- C. Hepatic Venous Outflow Obstruction.- I. Chronic Hepatic Venous Outflow Obstruction.- II. Veno-Occlusive Disease.- D. Primary Liver Carcinoma.- I. Hepatocellular Carcinoma.- II. Cholangiocarcinoma.- E Primary Recurrent Pyogenic (Oriental) Cholangitis.- References.- 22 Renal Diseases in the Tropics.- A. Introduction.- B. Protozoal Infections.- I. Malarial Nephropathy.- 1. Clinical Symptoms.- 2. Pathology in Transient Glomerulonephritis.- 3. Pathology in Acute Renal Failure.- 4. Quartan Malaria (P. malariae) Infection.- II. Visceral Leishmaniasis.- III. American Trypanosomiasis (Chagas' Disease).- IV. Amoebiasis.- C. Helminthic Diseases.- I. Filarial Nematode Infections - Bancroftian and Brugian Filariasis, Loiasis, Onchocerciasis.- II. Nematode Infection - Dioctophymiasis.- 1. Trichinosis.- 2. Dioctophymiasis.- 3. Strongyloidiasis.- 4. Opisthorchiasis.- III. Trematode Infections - Schistosomiasis.- IV. Cestode Infections.- D. Viral Infections.- I. Hantavirus - Haemorrhagic Fever with Renal Syndrome.- II. Arenaviridae Virus.- III. Togaviridae Viruses.- 1. Chikungunya Fever.- 2. Dengue Haemorrhagic Fever.- IV. Viral Hepatitis.- V. AIDS Virus (HIV).- E. Spirochaetal Infections.- I. Leptospirosis.- II. Borrelia Recurrentis - Relapsing Fever.- F. Bacterial Infections: Enteric.- I. Salmonellosis.- II. Typhoid Fever.- III. Shigellosis.- IV. Cholera.- G. Mycobacterial Infections: Leprosy.- H. Venomous Snake Bites.- J. Metabolic Derangements in the Tropics.- I. Acute Rhabdomyolysis and Myoglobinuria.- II. Heat Stroke.- III. Fluid and Electrolyte Depletion.- K. Blood Dyscrasias.- I. Sickle Cell Disease.- II. Thalassaemias.- III. G6PD Deficiency and Haemolysis.- L. Renal Diseases of Epidemiological Importance.- I. Poststreptococcal Glomerulonephritis.- II. IgA Nephropathy.- III. IgM Nephropathy.- IV. Tropical Nephropathy.- V. Haemolytic Uraemic Syndrome in Infections.- References.- Neoplasias.- 23 Cancer in the Tropics.- A. Epidemiology, Risk Factors and Prevention (A. R. P. WALKER).- I. Introduction.- II. Description of Populations.- 1. Comments on Rates.- 2. Time Trends of Cancers.- 3. Comment.- III. Cancer Prevention and Avoidance.- 1. Risk Factor Control.- 2. Other Avoidance Measures: Screening.- 3. Survival from Cancer.- IV. Epidemiological Outlook.- V. Summary and Conclusions.- B. Pathology (C. ISAACSON).- I. Carcinoma of the Breast.- II. Carcinoma of the Digestive System.- 1. Tongue.- 2. Salivary Gland.- 3. Oesophagus.- 4. Stomach.- 5. Pancreas.- 6. Large Bowel.- III. Malignant Disease in Childhood in the Tropics.- IV. Malignant Lymphomas.- V. Neoplasias of the Skin.- VI. Carcinoma of the Female Genital Tract.- 1. Corpus Uteri.- 2. Chorionepithelioma.- 3. Ovary.- VII. Carcinoma of the Respiratory System.- 1. Nasal Sinuses.- 2. Larynx.- 3. Bronchus.- VIII. Carcinoma of the Urinary System.- 1. Kidney.- 2. Bladder.- 3. Prostate.- 4. Testis.- 5. Penis.- IX. Tumours of the Central Nervous System.- X. Tumours of the Endocrine System.- XI. Tumours of the Jaw.- C. Molecular Biology of Particular Cancers (A.C. PATERSON).- I. Breast.- II. Oral Cavity.- III. Nasopharynx.- IV. Oesophagus.- V. Stomach.- VI. Exocrine Pancreas.- VII. Colorectum.- VIII. Uterine Cervix.- IX. Burkitt's Lymphoma.- X. Conclusion.- References.- 24 Kaposi's Sarcoma.- A. Introduction.- B. Classification, Epidemiology and Geographical Pathology.- C. Clinical Course and Disease Manifestations.- D. Fundamental Histopathology and Histological Process.- E. Additional Histological Findings.- F. Immunohistochemistry.- G. Ultrastructural Findings.- H. Flow Cytometry and Cell Ploidy.- J. Histogenesis.- K. Diagnostic Pathology.- L. Aetiology, Pathogenesis and Disease Entity.- References.- Environmental Diseases.- 25 Environmental Diseases in the Tropics.- A. Pathologic Conditions Caused by Arthropods.- I. Porocephalosis.- 1. Synonyms.- 2. Introduction and Definition.- 3. Clinical Characteristics.- 4. Pathology.- 5. Distribution.- II. Tungiasis.- 1. Synonyms.- 2. Definition, Aetiology and Clinical Characteristics.- 3. Pathology.- 4. Distribution.- III. Myiasis.- 1. Synonyms.- 2. Aetioplogy and General Description.- IV. Scabies.- B. Tropical Splenomegaly Syndrome.- I. Definition.- II. Clinical Characteristics.- III. Pathology and Pathogenesis.- IV. Aetiology.- V. Epidemiology.- VI. Additional Comments.- C. Myospherulosis.- I. Synonyms.- II. Definition, Clinical Characteristics and Pathology.- III. Distribution and Aetiology.- D. Mycotoxicosis.- I. Definition.- II. History, Epidemiology and Clinical Characteristics.- III. Pathology and Carcinogenicity.- IV. Role of Mycotoxin in Tropical Medicine.- E. Heat Disorders.- I. Heat Stroke.- 1. Synonyms.- 2. Definition and Aetiology.- 3. Clinical Characteristics and Epidemiology.- 4. Pathology.- 5. Diagnosis.- II. Heat Exhaustion.- 1. Synonyms.- 2. Definition and Aetiology.- 3. Clinical Characteristics.- 4. Differential Diagnosis.- III. Heat Cramps.- 1. Synonyms.- 2. Definition and Aetiology.- 3. Clinical Characteristics and Pathogenesis.- IV. Sunburn.- V. Miliaria Rubra.- 1. Synonyms.- 2. Definition and Aetiology.- 3. Clinical Characteristics and Pathology.- VI. Anhydrotic Asthenia.- 1. Synonyms.- 2. Definition and Aetiology.- 3. Clinical Characteristics.- F. Human Ecology and Disease Manifestations.- References.- Addendum.- 26 Diseases of Uncertain Aetiology.- A. Familial Mediterranean Fever and Related Conditions.- I. Synonyms.- II. Introduction and Definition.- III. Clinical Characteristics.- IV. Pathology.- V. Aetiology.- VI. Distribution.- VIL Additional Comments.- B. Tumoural Calcinosis.- I. Synonyms.- II. Definition.- III. Clinical Characteristics.- IV. Pathology.- V. Aetiology and Pathogenesis.- VI. Distribution.- VII. Additional Comments.- C. Idiopathic Elephantiasis.- I. Synonyms.- II. Definition.- III. Clinical Characteristics.- IV. Pathology.- V. Aetiology.- VI. Distribution.- D. Ainhum.- I. Synonyms.- II. Definition and Clinical Characteristics.- III. Pathology.- IV. Aetiology.- V. Distribution.- VI. Additional Comments.- E. Tropical Ulcer.- I. Synonyms.- II. Definition.- III. Clinical Characteristics.- IV. Pathology.- V. Aetiology.- VI. Diagnosis.- VII. Distribution.- VIII. Additional Comments.- F. Tropical Eosinophilia.- I. Synonyms.- II. Definition.- III. Clinical Characteristics.- IV. Pathology.- V. Aetiology.- VI. Diagnosis.- VII. Distribution.- G. Desert Sore.- I. Synonyms.- II. Definition and Clinical Characteristics.- III. Aetiology.- IV. Diagnosis.- V. Distribution.- H. Toxaemia of Pregnancy.- I. Synonyms, Definition and Clinical Characteristics.- II. Pathology.- III. Aetiology and Distribution.- References.