Table Of Content

Manson’s Tropical Diseases Tw e n t y - T h i r d E d i t i o n Sir Patrick Manson (1844–1922), GCMG, FRS Content Strategist: Belinda Kuhn Content Development Specialist: Poppy Garraway Content Coordinator: Trinity Hutton, Emma Cole Project Manager: Sruthi Viswam Design: Miles Hitchen Illustration Manager: Jennifer Rose Illustrator: Richard Tibbitts Marketing Manager(s) (UK/USA): Katie Alexo Manson’s Tropical Diseases Tw e n t y - T h i r d E d i t i o n Jeremy Farrar, FRCP, FMedAcSci, Gagandeep Kang, MD, PhD, DPhil, OBE FRCPath, FASc, FAAM Professor of Tropical Medicine Professor and Head University of Oxford The Wellcome Trust Research Laboratory Oxford, UK Division of Gastrointestinal Sciences Director Christian Medical College Oxford University Clinical Research Unit Vellore, India Wellcome Trust Major Overseas Programme South East Asia Infectious Disease Clinical David Lalloo, MB BS, MD, FRCP, Research Network FFTM RCPS(Glasg) Hospital for Tropical Diseases Professor of Tropical Medicine Ho Chi Minh City, Vietnam Dean of Clinical Sciences and International Public Health Peter J. Hotez, MD, PhD, Liverpool School of Tropical Medicine FAAP, FASTMH Liverpool, UK Dean, National School of Tropical Medicine Professor of Pediatrics and Nicholas J. White, OBE, MD, DSc, Molecular Virology & Microbiology FRCP, FMedSci, FRS Baylor College of Medicine Professor of Tropical Medicine Texas Children’s Hospital Endowed Chair of Faculty of Tropical Medicine Tropical Pediatrics Mahidol University President and Director Bangkok, Thailand Sabin Vaccine Institute and Texas Children’s Nuffield Department of Medicine Hospital Center for Vaccine Development University of Oxford Houston, TX, USA Oxford, UK Thomas Junghanss, MD (Internal Medicine, subspecialties Tropical Medicine and Infectious Diseases), MSc PHDC (Lon) apl Professor and Head Section Clinical Tropical Medicine Department of Infectious Diseases University Hospital Heidelberg Heidelberg, Germany SAUNDERS is an imprint of Elsevier. © 2014, Elsevier Limited. All rights reserved. First edition published 1898 Twenty-second edition published 2009 The right of Jeremy Farrar, Nicholas J. White, Peter J. Hotez, Thomas Junghanss, David Lalloo and Gagandeep Kang to be identified as authors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. ISBN: 9780702051012 Ebook ISBN: 9780702053061 International edition ISBN: 9780702051029 Front cover images (from left to right): Image 1: Typical place of transmission of T.b. rhodesiense; habitat of G. morsitans. Courtesy of Irene Küpfer (Swiss Tropical and Public Health Institute): Urambo District, Tanzania. From Chapter 45, Human African trypanosomiasis. Image 2: A villager carrying a heavy load in rural Sri Lanka. Courtesy of Mr Priyanjan De Silva. From chapter 69, Musculoskeletal Disorders. Image 3: Chest radiography of primary tuberculosis causing right middle lobe pulmonary collapse. Courtesy of Guy Thwaites. From Chapter 40, Tuberculosis. Image 4: Preparation of eflornithine. Courtesy of François Chappuis (Médecins sans Frontières Switzerland; Banda, Democratic Republic of the Congo. From Chapter 45, Human African trypanosomiasis. Image 5: Figure 40.4 Granulomatous lymphadenopathy caused by M. tuberculosis. Magnification ×400 (H&E stain) showing a Langhans’ multinucleated giant cell with its horseshoe-shaped arrangement of nuclei adjacent to some caseous necrosis. By kind permission of Mr Roger Webb, Consultant Maxillofacial Surgeon and Dr Jon Salisbury, Consultant Histopathologist, King’s College Hospital, London, United Kingdom. From Chapter 40, Tuberculosis. Image 6: Pigs scavenging for food in an African village. Courtesy of Dr. Seth O’Neal. Chapter 57 Other Cestode Infections: Intestinal Cestodes, Cysticercosis, Other Larval Cestode Infections Image 7: Typical place of transmission of T.b. gambiense where human–fly contact is high; habitat of G. palpalis. Courtesy of Christian Burri (Swiss Tropical and Public Health Institute): Kikongotanga, Democratic Republic of the Congo. From Chapter 45, Human African trypanosomiasis. Image 8: Diffuse cutaneous leishmaniasis caused by L. aethiopica. Patient from Ethiopia; disease duration: three years. Courtesy of C. Yansouni. From Chapter 47 Leishmaniasis Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 PREFACE TO THE FIRST EDITION A manual on the diseases of warm climates, of handy size, and other systematic writers in the same field. The author avails yet giving adequate information, has long been a want; for the himself of this opportunity to acknowledge the valuable assis- exigencies of travel and tropical life are, as a rule, incompatible tance he has received, in revising the text, from Dr. L. Westerna with big volumes and large libraries. This is the reason for the Sambon and Mr David Rees, MRCP LRCP lately Senior House present work. Surgeon, Seamen’s Hospital, Albert Docks, London. While it is hoped that the book may prove of practical He would also acknowledge his great obligation to Mr service, it makes no pretension to being anything more than an Richard Muir, Pathological Laboratory, Edinburgh University, introduction to the important department of medicine of for his care and skill in preparing the illustrations. which it treats; in no sense is it put forward as a complete trea- tise, or as being in this respect comparable to the more elaborate Patrick Manson works by Davidson, Schebe, Rho, Laveran, Corre, Roux, and April 1898 ix PREFACE TO THE TWENTY-THIRD EDITION In 1898 Sir Patrick Manson (1844–1922), often dubbed the conditions and the challenges of old and new diseases in a father of tropical medicine, wrote “A Manual of the Diseases of changing world. Manson’s textbook has always been slightly Warm Climates”. This preface introduces the 23rd edition. Few unusual (some would say eccentric), perhaps a reflection on its textbooks have survived as long as this reference. Manson would originator, and his pioneering colleagues. This edition has been have been fascinated by its evolution, as modern medicine has thoroughly revised and reformatted but not at the expense of transformed all our lives (although sadly he would still recog- its character. We hope you will find it refreshing, interesting nize many of the treatments recommended for parasitic dis- and useful. eases). Although much has changed, the improvements in living standards that have greatly lengthened life expectancy have been Jeremy Farrar less in the tropics than in temperate countries, and infectious Peter J. Hotez diseases and nutritional deficiencies continue to exert a sub- Thomas Junghanss stantial toll in these regions. Today, tropical diseases remain Gagandeep Kang leading causes of death and disability in developing countries David Lalloo and there is still an important place for a textbook about these Nicholas J. White xi CONTRIBUTORS Steven Abrams, MD Guy Baily, MD FRCP Professor of Pediatrics Consultant Physician Baylor College of Medicine Infection and Immunity Specialty Group Attending Physician, Section of Neonatology The Royal London Hospital Texas Children’s Hospital Barts Health NHS Trust Houston, TX, USA London, UK Adekunle M. Adesina, MD, PhD, Till Bärnighausen, MD, ScD, MSc FCAP, FMCPath Associate Professor Professor of Pathology, Immunology and Pediatrics- Department of Global Health and Population Hematology/Oncology Harvard School of Public Health Medical Director Boston, MA, USA Neuropathology and Molecular Neuropathology Senior Epidemiologist Texas Children’s Hospital Africa Centre for Health and Population Studies Baylor College of Medicine University of KwaZulu-Natal Houston, TX, USA Mtubatuba, South Africa Dwomoa Adu, MD, FRCP Buddha Basnyat, MD, MSc, FACP, Consultant Physician and Nephrologist FRCP(Edinburgh) Department of Medicine and Therapeutics Director, Oxford University Clinical Research Unit University of Ghana Medical School Medical Director, Nepal International Clinic and Himalayan Accra, Ghana Rescue Association Kathmandu, Nepal Sitara S. R. Ajjampur, MB BS, MD, PhD Associate Professor of Microbiology Andrew Bastawrous, BSc (Hons), MB ChB, Department of Gastrointestinal Sciences FHEA, MRCOphth Christian Medical College Ophthalmologist & Clinical Research Fellow in International Vellore, India Eye Health International Centre for Eye Health, Clinical Research Voahangy Andrianaivoarimanana, PhD Department, Faculty of Infectious & Tropical Diseases Researcher in Plague Immunology London School of Hygiene & Tropical Medicine Plague Unit London, UK & Nakuru, Kenya Institut Pasteur de Madagascar, Ambatofotsikely, Imelda Bates, MB BS, MA, MD, FRCP, FRCPath Antananarivo, Madagascar Professor of Tropical Haematology Department of International Public Health Angelakis Emmanouil, MD, PHD Liverpool School of Tropical Medicine Faculte de Medecine Liverpool, UK Unite de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE) Daniel G. Bausch, MD, MPH&TM Marseille, France Associate Professor Department of Tropical Medicine Jeffrey K. Aronson, MA, DPhil, MB ChB, FRCP, Tulane School of Public Health and Tropical Medicine FBPharmacolS, FFPM(Hon) Clinical Associate Professor Reader in Clinical Pharmacology Department of Medicine Department of Primary Care Health Sciences Section of Adult Infectious Diseases University of Oxford Tulane Medical Center Oxford, UK New Orleans, LA, USA Inoshi Atukorala, MB BS, MD, MRCP(UK) Nicholas A. V. Beare, MA, MB ChB, Lecturer in Clinical Medicine and Consultant Rheumatologist FRCOphth, MD Department of Clinical Medicine Consultant Ophthalmologist University of Colombo St Paul’s Eye Unit Colombo, Sri Lanka Royal Liverpool University Hospital Honorary Senior Lecturer Department of Eye and Vision Science University of Liverpool Liverpool, UK xiii xiv Contributors Raman Bedi, BDS, MSc, DDS, FDSRCS(Ed), Lucille Hellen Blumberg, MB BCH, MMED, ID FDSRCS(Eng), FDSRCS (Glas), FGDP, FFPH (SA), FFTM (RCP, Glasgow), DTMH, DOH, DCH Professor Professor and deputy director Head, International Centre for Child Oral Health National Institute for Communicable Diseases Director, Global Child Dental Health Taskforce National Health Laboratory Service King’s College London Johannesburg Gauteng, South Africa London, UK Marleen Boelaert, MD, PhD Nick J. Beeching, MA, BM BCh, FRCP(L), Professor FRACP, FFTM RCPSGlasg, DCH, DTM&H, Department of Public Health Hon FCCP(SL) Institute of Tropical Medicine Senior Lecturer (Clinical) in Infectious Diseases Antwerp, Belgium Liverpool School of Tropical Medicine Clinical Director Francis J. Bowden, MB BS, FRACP, Tropical and Infectious Disease Unit MD, FACSHM Royal Liverpool University Hospital Professor of Medicine Liverpool, UK Academic Unit of Internal Medicine Australian National University Medical School Nicholas J. Bennett, MA(Cantab), Canberra, Australia MBBChir, PhD Assistant Professor in Pediatrics Bernard J. Brabin, MB ChB, MSc, PhD, FRCPCH Division of Pediatric Infectious Diseases and Immunology Emeritus Professor of Tropical Paediatrics Connecticut Children’s Medical Center Clinical Sciences Division Hartford, CT, USA Liverpool School of Tropical Medicine Liverpool, UK Anita Berlin, MB BS, MA, FRCGP Emeritus Professor of International Child Health Senior Lecturer & Sub Dean Global Child Health Group Faculty of Population Health and Medical School Academic Medical Centre University College London University of Amsterdam, Netherlands London, UK Freddie Bray, BSc, MSc, PhD Ahmed I. Bhigjee, MB ChB, FRCP, MMed, Deputy Section Head FCP, PhD, FCN Section of Cancer Information Professor International Agency for Research on Cancer Department of Neurology Lyon, France The Nelson R Mandela School of Medicine Rodney A. Bray, BA, PhD, CBiol, MBS FLS University of KwaZulu-Natal Durban, South Africa Scientific Associate Department of Life Sciences Zulfiqar A. Bhutta, MB BS, PhD Natural History Museum Richard Harding Chair in Global Child & Policy London, UK Co-Director Simon J. Brooker, DPhil SickKids Center in Global Child Health Toronto, Canada Professor of Epidemiology Professor and Founding Director Faculty of Infectious and Tropical Diseases Center of Excellence in Women and Child Health London School of Hygiene and Tropical Medicine The Aga Khan University London, UK Karachi, Pakistan Matthijs C. Brouwer, MD, PhD David E. Bloom, PhD, MA Neurologist Clarence James Gamble Professor of Economics and Department of Neurology Demography Academic Medical Center Department of Global Health and Population University of Amsterdam Harvard School of Public Health Amsterdam, The Netherlands Boston, MA, USA Reto Brun, PhD Titulary Professor of Biology Department of Medical Parasitology and Infection Biology Swiss Tropical and Public Health Institute University of Basel Basel, Switzerland Contributors xv Enrico Brunetti, MD Peter L. Chiodini, BSc, MB BS, PhD, MRCS, Assistant Professor of Infectious Diseases FRCP, FRCPath, FFTM RCPS(Glasg) University of Pavia Staff Physician Consultant Parasitologist Division of Infectious and Tropical Diseases Hospital for Tropical Diseases, San Matteo Hospital Foundation Honorary Professor Pavia, Italy London School of Hygiene and Tropical Medicine, London, UK Susan Bull BSc, LLB, MA, PhD Senior Researcher in Ethics John D. Clemens, MD The Ethox Centre Executive Director Nuffield Department of Population Health ICDDR-B University of Oxford Dhaka, Bangladesh Oxford, UK Gordon C. Cook, MD, DSc, FRCP(Lond), Donald A. P. Bundy, PhD FRCP(Edin), FRACP, FLS Lead Health and Education Specialist Visiting Professor Human Development Network Department of Medical Microbiology and Centre for The World Bank Infectious Diseases Washington, DC, USA Royal Free and University College London Medical School London, UK Christian Burri, PhD, MPharm President Professor of Pharmacy and Clinical Pharmacology The Royal Society of Tropical Medicine and Hygiene Head, Department of Medicines Research (1993–1995) Swiss Tropical and Public Health Institute Formerly Professor of Medicine Department of Pharmaceutical Sciences The Universities of Zambia, Riyadh (Saudi Arabia) and Papua University of Basel New Guinea Basel, Switzerland Consultant Physician University College Hospitals Trust Amaya Bustinduy, MD, MPH Hospital for Tropical Diseases, London Paediatric Infectious Diseases Specialist St Luke’s Hospital for the Clergy Department of Parasitology Senior Lecturer Liverpool School of Tropical Medicine London School of Hygiene and Tropical Medicine Liverpool, UK London, UK President Thashi Chang, MB BS MD, MRCP(UK), The Fellowship of Postgraduate Medicine DPhil(Oxon), FRCP(Lon) London, UK 2000–2007 Consultant Neurologist and Senior Lecturer President Department of Clinical Medicine History of Medicine Section University of Colombo Royal Society of Medicine, UK Colombo, Sri Lanka Mark F. Cotton, FCPaed (SA), MMed, PhD, François Chappuis, MD, MCTM, PhD DCH (SA), DTM&H Associate Professor Professor of Paediatrics and Child Health Division of Tropical and Humanitarian Medicine Head, Division of Paediatric Infectious Diseases Geneva University Hospitals and Medecins sans Frontières Faculty of Medicine and Health Sciences Operational Center Tygerberg Children’s Hospital Geneva, Switzerland Stellenbosch University Tygerberg, South Africa Wirongrong Chierakul, MD, Thai Board of Int Med, PhD John B. S. Coulter, MD, FRCP(I), FRCPCH Lecturer Honorary Clinical Lecturer Department of Clinical Tropical Medicine Liverpool School of Tropical Medicine Mahidol-Oxford Tropical Medicine Research Unit Liverpool, UK Faculty of Tropical Medicine Mahidol University Bangkok, Thailand xvi Contributors Nigel A. Cunliffe, BSc (Hons), MB ChB, PhD, Arjen Dondorp, MD, PhD MRCP, FRCPath, DTM&H Infectious Diseases and Intensive Care Physician Professor Professor of Tropical Medicine University of Oxford Department of Clinical Infection, Microbiology & Visiting Professor of Clinical Tropical Medicine Immunology Deputy Director, Mahidol-Oxford Tropical Medicine Institute of Infection and Global Health Research Unit University of Liverpool Faculty of Tropical Medicine Liverpool, UK Mahidol University Bangkok, Thailand Bart J. Currie, MB BS, FRACP, FAFPHM, DTM&H H. Rogier van Doorn, MD, PhD Professor in Medicine and Head of Infectious Diseases Clinical Virologist Department of Infectious Diseases Centre for Tropical Medicine Royal Darwin Hospital and Menzies School of Health Oxford University Clinical Research Unit Research Ho Chi Minh City, Vietnam Darwin, Northern Territory, Australia Martin W. Dünser, MD, PD, DESA, EDIC Marian J. Currie, PhD Head Intensivist Academic Unit of Internal Medicine Department of Anesthesiology, Perioperative Medicine and Australian National University Medical School General Intensive Care Canberra, Australia Salzburg General Hospital and Paracelsus Private Medical University David A. B. Dance, MB ChB, MSc, FRCPath Salzburg, Austria Clinical Research Microbiologist Lao Oxford Mahosot Hospital Wellcome Trust Research Unit Edward M. Eitzen, Jr., MD, MPH Microbiology Laboratory, Mahosot Hospital Adjunct Associate Professor Vientiane, Lao Department of Military and Emergency Medicine Centre for Tropical Medicine Uniformed Services University of the Health Sciences University of Oxford Bethesda, MD Honorary Consultant Microbiologist Senior Partner Public Health England and Oxford University Hospitals NHS Biodefense and Public Health Programs Trust Martin, Blanck and Associates, Oxford, UK Alexandria, VA, USA Nicholas P. J. Day, MA, BM BCh, DM, FRCP, Delia A. Enria, MD, MPH FMedSci Instituto Nacional de Enfermedades Virales Humanas Professor of Tropical Medicine Pergamino; Argentina University of Oxford Jeremy Farrar, FRCP, FMedAcSci, DPhil, OBE Oxford, UK Director, Mahidol-Oxford Tropical Medicine Research Professor of Tropical Medicine Unit University of Oxford Faculty of Tropical Medicine Oxford, UK Director Mahidol University Bangkok, Thailand Oxford University Clinical Research Unit Wellcome Trust Major Overseas Programme Kevin DeCock, MD South East Asia Infectious Disease Clinical Research Network Director Hospital for Tropical Diseases Center for Global Health Ho Chi Minh City, Vietnam Centers for Disease Control and Prevention Christina Faust, MS, MSc Atlanta, GA, USA PhD Candidate Jacqueline Deen, MD, MSc Ecology and Evolutionary Biology Researcher Princeton University Global Health Division Princeton, NJ, USA Menzies School of Health Research Nicholas A. Feasey, BSc, MSc, MB BS, MRCP, Casuarina, Northern Territory, Australia FRCPath, DTM&H Sarah R Doffman, MB ChB, FRCP Clinical Research Fellow Consultant in Respiratory and General (Internal) Medicine Department of Gastroenterology Brighton and Sussex University Hospitals NHS Trust Institute of Translational Medicine Brighton, UK University of Liverpool Liverpool, UK