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Tropical Medicine

A Clinical Text, 8th Edition, Revised and Expanded

Kevin M. Cahill M.D.

Publication Year: 2011

The history of tropical medicine is as dramatic as the story of mankind—with its own myths and legends, with tales of epidemics destroying whole civilizations; and, still today, with silent stealth, these diseases claim more lives than all the current wars combined. Having had the privilege of working throughout Africa, Asia, and Latin America, as well as in the great medical centers of Europe and the United States, the author presents the essential details for understanding pathogenesis, clinical manifestations, therapy, and prevention of the major tropical diseases. The text, now in its eighth edition, has been used for a half-century by medical students, practicing physicians, and public health workers around the world. This fascinating book should also be of interest to a broad, nonmedical readership interested in world affairs. All royalties from the sale of this book go to the training of humanitarian workers.

Published by: Fordham University Press

Title Page, Copyright

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pp. ix-xiv

This book has its origins in a lecture given in 1961 at Bellevue Hospital in New York City. Since I was fortunate to have had a medical elective for a period in Calcutta, India, I was asked to discuss a patient with a tropical disease. My talk included a history of the disease, the usual— and unusual—clinical signs and symptoms, as well as the diagnostic...

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pp. 1-3

Knowledge of clinical tropical medicine is essential for every modern physician. The diseases of warm climates are no longer restricted by geographic boundaries because the scope and speed of air travel and flows of ideas and people have destroyed the barriers of time and space, and the massive increase in international migration in the past half...

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pp. 4-25

In the vast underdeveloped areas of the tropics—where the majority of the world’s population struggle to exist, and which, in this jet age, have become the playgrounds of tourists, the arenas of diplomatic conflicts, and the reservoirs for expanding business cartels—malaria rules. No other disease so decimates the childhood population, so enfeebles and...

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The Trypanosomatidae

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pp. 26-56

Tens of thousands of arable African acres lie fallow today because of trypanosomiasis. In tropical areas where food shortage and malnutrition causes so much infant mortality and adult morbidity, such waste of land is disastrous. For the visitor from a temperate climate, the persistence of sleeping-sickness zones may curtail travel plans and even...

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pp. 57-68

Entamoeba histolytica is a protozoal parasite of man and a wide range of nonhuman primates. The organism was first described in St. Petersburg by Losch in 1875; in 1903, it was distinguished by Schaudinn from the more common, nonpathogenic organism Entamoeba coli. Human infection has been reported in all countries but is much...

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Bacterial and Rickettsial Diseases

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pp. 69-84

Typhoid occurs worldwide but is much more prevalent in the tropics and subtropics. Typhoid and malaria are the two most common causes of fever in persons recently returned from a visit abroad. More than 90% of patients with typhoid in developed countries are infections...

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pp. 85-90

As the twenty-first century begins, tuberculosis (TB) remains a global scourge. In fact, the incidence and severity of tuberculosis, especially in the tropics, is rising. The United Nations estimates that more than 9 million people are infected with TB, with an <10% prevalence of HIV in new adult cases. In Africa, south of the Sahara, tuberculosis...

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pp. 91-95

Rabies is a zoonosis, a disease primarily of wild and domestic animals that is occasionally transmitted to human beings. Another name for it is ‘‘hydrophobia’’: fear of water. The person is thirsty but an attempt to drink brings violent painful muscular contractions, accompanied by extreme fear. The danger of contracting this disease from an infected...

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pp. 96-104

Leprosy has been known since antiquity. The Egyptians noted it among their slaves 1,300 years before Christ. Confucius mentions it, as do the early Vedic physicians of India. The disease is recorded in the Old Testament, and a famous parable in the New Testament describes a well-organized system of community isolation against...

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Treponemal and Fungal Infections

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pp. 105-114

It is thought that treponemal infections evolved in the primeval, moist jungles of Africa, altered in highlands and arid desert communities, and finally halted in an arrested state in the Americas. Between the florid sores of yaws and the limited depigmentation of pinta lie a variety of lesions with a multitude of local names, including...

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Diarrheal Diseases

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pp. 115-129

Cholera has existed in the Ganges Delta since time immemorial, but in the nineteenth century, six great pandemics spread as far and rapidly as man was then able to travel. A seventh pandemic due to the El Tor biotype began in Indonesia in 1961, spreading throughout southern Asia and into Africa, killing tens of thousands. In Bangladesh and...

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Viral Infections of the Tropics

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pp. 130-150

Several viral infections are important causes of severe disease in the tropics. Some of these viruses, such as those causing yellow fever, dengue, and Japanese B encephalitis, are now largely confined to the tropics. Others, such as the viruses of measles, hepatitis B, and the retroviruses, although occurring worldwide, pose special problems in...

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Intestinal Nematode Infections

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pp. 151-164

Human intestinal infection with helminths is widespread in the tropics. According to a 2005 report by the World Health Organization (WHO), approximately one billion humans have ascariasis, and there are approximately 700 million cases of trichuriasis and hookworm infections worldwide. Most infections are light or moderate and do little...

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Intestinal Cestode Infections

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pp. 165-167

These worms, although varying in size from 10 mm to 20 meters, have certain characteristics in common. They are flattened and ribbonshaped. A minute head (scolex) attaches firmly to the intestinal mucosa by means of suckers, hooklets, or suctorial grooves. A short neck leads to a body made up of 100 to 4,000 segments...

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Intestinal Trematode Infections

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pp. 168-169

Food-borne trematode infections affect more than 40 million people worldwide, with a high prevalence in southeast Asia and the Far East. The intestinal trematodes (flukes) are flat, leaf-shaped hermaphroditic worms equipped with a ventral sucker by which they attach to the human intestinal mucosa. If eggs, passed in the feces, reach fresh...

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Larval Helminth Infections

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pp. 170-183

Human disease may be caused by infection with the larval stage of intestinal helminthic parasites of animals. In the case of Trichinella spiralis, both adults and larvae are present, but in cysticercosis and hydatid disease, only the larval forms develop in human tissues. It need hardly be noted that only in exceptional circumstances does man...

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pp. 184-202

Filarial worms are long thread-like nematodes that parasitize the tissues of humans and animals. In the tropics, they include some of the most important parasites of humans. Except for Dracunculus medinensis, the life cycles are very similar. The adult worms live in the body for 15 years or longer during which time, the female produces enormous...

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pp. 203-220

In many parts of South America and the Caribbean, as well as throughout Africa, the Middle East, and the Orient, schistosomal infections are a clinical and an economic curse. It is estimated that more than 200 million people worldwide are infected: Most live in poor communities without access to safe drinking water and adequate sanitation...

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pp. 221-226

Individual malnutrition periodically culminates in devastating famines throughout the tropics. More people have starved to death in the past century than at any other time in history, and modern society has been numbed by the television images of skeletal refugees. Life is precarious in the developing world, and if the rains fail or fall too much, if locusts...

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Hereditary Anemias

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pp. 227-239

Anemia remains one of the most important medical problems of the tropics and subtropics. When relatively mild, it reduces the physical well being and work capacity of whole populations; when severe, it is an important cause of death. Common diseases already considered include malnutrition, with deficient intake of iron often compounded...

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pp. 240-263

Burkitt’s lymphoma is found primarily in the bones of the jaw and in the ovaries of young girls. Undifferentiated lymphoblasts surround scattered large clear histiocytes, giving a ‘‘starry sky’’ appearance under low-power microscopy. The tumors are commonly multiple, symmetrical, and extremely fast growing, with a cell doubling time of only...

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Advising Tropical Travelers

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pp. 264-277

Many physicians in the developed world will deal with tropical medicine only when asked to help prepare a tourist for a tropical journey. Travel, whether for business or pleasure, has increased tremendously in recent years due to availability, relative ease and low cost. International travel increased from 20 million persons in...

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pp. 278-285

I conclude this Jubilee Edition with some personal reflections on my own professional journey in tropical medicine. When the initial chapters of this book were serialized in The New York State Journal of Medicine, I was a young physician who had been introduced to tropical infections on a fellowship in Calcutta, India. I was fascinated by...


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pp. 287-288


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pp. 289-302

The Center for International Humanitarian Cooperation and The Institute for International Humanitarian Affairs

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pp. 303-304

About the Author

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pp. 305

E-ISBN-13: 9780823249558
Print-ISBN-13: 9780823240616

Page Count: 290
Illustrations: 42
Publication Year: 2011