Surgery in tropical diseases

This chapter explores surgery on tropical diseases. Although the principles of surgical care are the same in the tropics as in developed countries, there are important differences as resources are limited in the tropics. First, there are major transport problems. Second, treatment is often complicated by underlying disease such as anaemia and malnutrition. Third, there are differences in cultural attitudes to disease. Ultimately, surgery on tropical diseases requires flexibility in both clinical management and surgical techniques. Doctors, irrespective of where they work, should be knowledgeable about common tropical diseases and be aware of the possibility of seeing an imported disease in a patient, with the concomitant risks to the patient and the community.

A Case of Cutaneous Leishmaniasis Treated with Hyperbaric Oxygen Therapy

Cutaneous leishmaniasis in Poland is an imported disease mainly occurring in tourists who travelled to tropical countries. Cutaneous symptoms occur as late as between ten and twenty days following the return from the tropics. Lesions connected with cutaneous leishmaniasis were most commonly diagnosed by Polish doctors as furuncle, ecthyma or ulceration and ineffectively treated for several weeks with antibiotics. The paper presents the case of leishmaniasis in a 30-year-old male with an ulceration of the left shank, ineffectively treated with antibiotics over a period of four months. The ulceration was healed completely only after leishmaniasis was diagnosed and following the application of a treatment based on antimony derivatives, followed by hyperbaric oxygenation performed in a hyperbaric chamber.