Unusual causes of death in Haitians residing in Miami. High prevalence of opportunistic infections
L. B. Moskowitz, P. Kory, J. C. Chan, H. W. Haverkos, F. K. Conley and G. T. Hensley
Twenty-one (100%) Haitians and 42 (21.5%) of 192 native black Americans
autopsied in a 33-month period at Jackson Memorial Hospital, Miami, were
included in this review. All autopsied materials were examined. Among the
Haitians autopsied, infectious diseases accounted for 11 (52%) of 21
deaths. Toxoplasma encephalitis was the leading cause of death (five
cases). Other infectious causes of death included disseminated
cryptococcosis (one), disseminated cytomegalovirus diseases (one),
Pneumocystis carinii pneumonia (one), chronic active hepatitis B (two), and
bacterial pneumonia (one). Malignant neoplasms were also found to be causes
of death and these included a single cases of each of the following:
adenocarcinoma of the lung, multiple myeloma, diffuse histiocytic lymphoma,
hepatoma, and Kaposi's sarcoma. Deaths of the remaining cases were due to
hypertensive cardiovascular diseases (two), rheumatic heart disease (one),
glomerulonephritis (one), and intimal fibroplasia of coronary arteries
(one). Seven Haitian cases fulfilled the Centers for Disease Control case
definition for the acquired immune deficiency syndrome (AIDS). For
comparison, autopsies of black Americans were chosen from conditions that
would most likely predispose them to opportunistic infections. Among the
autopsies on black Americans there were no cases of opportunistic
infections or Kaposi's sarcoma that were considered to be consistent with
the AIDS.
