FATAL ARTERITIS DUE TO PYTHIUM-INSIDIOSUM INFECTION IN PATIENTS WITH THALASSEMIA

Six thalassaemic patients had a distinct clinical syndrome characteriz ed by progressive ischemia of the lower extremities, with ascending ar teritis and thrombosis of the main arteries of the lower limbs. With p eriodic acid Schiff and Gomori's methenamine silver staining a large n umber of hyphae were revealed in the arterial wall and the outer part of the thrombus. Pythium insidiosum was isolated from 3 patients. The clinical course of the disease was progressive gangrene of the extremi ties and the patients invariably died when the infectious process reac hed the bifurcation of the aorta. There is no effective antimicrobial agent for the syndrome and radical amputation was the only method to e nsure survival of the patients. P. insidiosum infection should be cons idered in thalassaemic patients with leg ulcers or arterial occlusion of the lower limbs.