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Fluoroquinolones are active against Plasmodium falciparum in vitro. In a prospective, randomized, comparative trial, norftoxacin, 400 mg twice a day for 3 days, was compared with a standard course of chloroquine in semiimmune adults with symptomatic falciparum malaria in northwestem Zambia, where chloroquine resistance is uncommon. Patients were followed for 28 days. The trial was terminated after 38 patients were studied because chloroquine was markedly more effective, curing all 18 patients (100%) compared with only 8 (40%) of 20 who received norftoxacin (P < .001). Of the 12 norftoxacin failures, 6 had clearing of trophozoites but recurrence during the study period (RI), 4 had incomplete clearance of trophozoites with later recurrence (RII), and 2 had no improvement (RIII). The mean parasite clearance time was significantly shorter with chloroquine (30.4 vs. 52.7 h; P = .02). The mean defervescence time was also shorter with chloroquine (16.9 vs. 24.5 h; not significant). In contrast to its inferior efficacy, norftoxacin caused fewer adverse effects than did chloroquine (33% vs. 0; P < .001). [ABSTRACT FROM PUBLISHER]

Several recent reports have described an association between human immunodeficiency virus (HIV) infection and porphyria cutanea tarda (PCT). We describe two HIV-infected patients who developed PCT and review 29 other reported cases of coexistent PCT and infection due to HIV. Recognized porphyrinogenic factors were identified in our patients and in 27 of the 29 cases described in the literature. Even in the two cases that lacked obvious precipitant factors for PCT, the possibility of hepatitis C was not excluded. This fact suggests that the cooccurrence of PCT and infection due to HIV may reflect the coexistence of risk factors for the two diseases rather than a causal association. Despite concern that exposure to sulfonamides might exacerbate porphyria, one of our patients and three patients described in the literature were safely treated with sulfonamides. [ABSTRACT FROM PUBLISHER]

Three cases of plague, all with pneumonic involvement, occurred in a small village in northwestern Zambia. Initial recognition of the diagnosis was delayed, but the outbreak was terminated by rapid intervention with insecticides and with the use of chemoprophylaxis for individuals with high-risk exposures to case-patients. [ABSTRACT FROM PUBLISHER]