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We report for the first time four cases of ophthalmomyiasis due to the larvae of Oestrus ovis in Kuwait, before and after Operations Desert Shield and Desert Storm. The larvae were easily removed under local anaesthetic. The symptom complex of acute foreign body sensation, irritation, redness, lacrimation and photophobia resolved rapidly. Ophthalmic antibiotic and corticosteroid drops were also instilled and recovery was uneventful. The ophthalmomyiasis may not always be associated with contact with sheep-rearing per se. Medical personnel should therefore be aware that in cases of what might appear initially as acute, non-specific catarrhal conjunctivitis, patients with the persistent symptom complex should be re-examined to exclude ophthalmomyiasis due to the larvae of O. ovis in endemic areas.

During a 9-month hospital-based survey, the intestinal parasite Blastocystis hominis was detected in high numbers (five or more organisms per oil immersion field) in faecal specimens from 39 (2%) of 1960 children under 13 years old. Abdominal pain or discomfort with or without diarrhoea was present in 32 children categorized as acute (14), subacute (7) or chronic (11) cases with respective mean ages of 6.4, 7.3 and 8.7 years. They included three with other enteropathogens (Giardia lamblia, Cryptosporidium sp. or Hymenolepis nana). The remaining seven children had no gastrointestinal symptoms. The 14 acute cases (symptoms duration 1-11 days) were characterized by cramp-like abdominal pain, watery diarrhoea and vomiting. The seven subacute (3-4 weeks) and 11 chronic (3-12 months) cases presented with abdominal discomfort and/or loose non-watery stools. Four complained of flatus and eosinophilia was noted in six. All symptoms resolved with eradication of B. hominis or reduction to low numbers after metronidazole chemotherapy (28 cases) or with no treatment (four cases). This study would appear to support the role of the parasite as an enteropathogen in some children. A case control study is clearly needed to clarify the status of B. hominis as a pathogen.

During a 3-month pilot study, we identified ten children with cryptosporidiosis; they all presented with diarrhoea, most also with fever, vomiting and dehydration. For diagnosis, the formalin-acetate concentrate of the stool, and direct smears were stained for oocysts in safranin-methylene blue (S-MB). The negative staining of oocysts in trichrome-stained specimens was indicative and was confirmed by destaining and restaining in S-MB. Constraints contributing to the absence of reports from the Arabian Gulf were the lack of awareness of Cryptosporidium sp. as a cause of diarrhoea in children, inappropriate laboratory diagnostic techniques and, possibly, the initial referral of patients to polyclinics where mild cases may go undetected. Contaminated drinking water and close contact with domestic animals are possible modes of transmission of Cryptosporidium sp. but further studies are recommended to confirm this.