Native parasite affecting an introduced host in aquaculture: cardiac henneguyosis in the red seabream Pagrus major Temminck & Schlegel (Perciformes: Sparidae) caused by Henneguya aegea n. sp. (Myxosporea: Myxobolidae).

BACKGROUND: Henneguya Thélohan, 1892 (Myxobolidae) is one of the most species-rich genera of myxosporean parasites infecting fish. Although common in nature, there are few reports of these parasites causing important disease in aquaculture. In this paper, we describe a new species of Henneguya infecting Pagrus major (Temminck & Schlegel), a fish host introduced to the Mediterranean Sea from Japan in the late 1980s. RESULTS: Large plasmodia of the parasite were found in the bulbus arteriosus and in the ventricle of the infected fish. Spores were found mainly in the kidney and heart and were accompanied by melanized macrophages or vascular intimal proliferation mixed with a mild non-suppurative response, respectively. Comparisons of morphometric data for spore and polar capsule length and width, suggest a unique combination of features in the newly described species. Molecular analysis, based on 18S rDNA sequence of the parasite, followed by phylogenetic analysis, indicated that the parasite described here is a novel species of Henneguya, clustered with the marine congeneric species. CONCLUSIONS: Henneguya aegea n. sp. infects in aquaculture P. major, a host introduced as eggs to the Mediterranean from Japan. Despite the high host specificity of the myxobolid parasites, H. aegea n. sp. seems to be able to use P. major as a host and propagate successfully, causing morbidity and mortality. This could result in spillback of the new species from high density cultured non-native P. major to native fish hosts.

Hidatidosis cardíaca: tratamiento quirúrgico para recidiva de quiste hidatídico en ventrículo izquierdo / Cardiac hydatid disease: surgical treatment for recurrent hydatid cyst in the left ventricle

INTRODUCCIÓN: El quiste hidatídico cardiaco es una patología infrecuente, producida por la llegada de Equinococcus granulosus a la circulación coronaria. MATERIALES Y MÉTODO: Hombre de 52 años, con antecedente de quiste hidatídico cardiaco operado hace 27 años, insuficiencia cardiaca y enfermedad coronaria. Presentó disnea progresiva de un año de evolución. Estudio con radiografía de tórax, ecocardiografía y tomografía computada que mostró imagen compatible con hidatidosis cardiaca recidivada en el ventrículo izquierdo, arteria pulmonar e hilio pulmonar izquierdo, rodeando por completo el tronco coronario común izquierdo y parte proximal de la arteria descendente anterior. Se constató fracción de eyección de ventrículo izquierdo aproximadamente de 30%. No se encontró evidencia de enfermedad hidatídica extracardiaca. Se decidió tratamiento quirúrgico. Se abordó por esternotomía media y en circulación extracorpórea, se observaron lesiones compatibles con quiste hidatídico multiloculado de ubicación miocárdica en ventrículo izquierdo, con incontables vesículas hijas. Se realizó quistectomía más periquistectomía hidatídica sin incidentes. Presentó hemorragia postoperatoria por lo que requirió reintervención quirúrgica precoz. Evolucionó favorablemente y fue dado de alta sin complicaciones. A seis años de seguimiento se encuentra asintomático, sin evidencia tomográfica y ecocardiográfica de recidiva. DISCUSIÓN: La hidatidosis es una zoonosis endémica en Chile. La ubicación cardiaca es infrecuente, correspondiendo al 0,5 al 2% de los casos. Suele asociarse a la presencia de quistes extracardiacos. La ubicación más frecuente es la pared libre del ventrículo izquierdo a nivel intramiocárdico. El tratamiento médico suele ser insuficiente, por lo que se recomienda la resección quirúrgica.

INTRODUCTION: Cardiac hydatid cyst is a rare disease caused by Echinococcus granulosus arrival of the coronary circulation. MATERIAL AND METHOD: 52 years old man with a history of cardiac hydatid cyst operated 27 years ago, heart failure and coronary artery disease. He presented with a history of one year of progressive dyspnoea. Study with chest radiography, echocardiography and computed tomography showed an image compatible with cardiac hydatid disease recurrence in relation to the left ventricle, pulmonary artery and anterior descending artery. Ejection fraction of the left ventricle was approximately 30%. No evidence of extracardiac hydatid disease was found and surgical treatment was decided. Addressed by median sternotomy and extracorporeal circulation, a multiloculated myocardial hydatid cyst, with hundreds of daughter vesicles of different size was found. Pericystectomy of the hydatid cyst was performed without incident. The patient presented postoperative bleeding which required early reoperation. Posteriorly, was discharged without complications. DISCUSSION: Hydatid disease is an endemic zoonosis in Chile. Heart location is infrecuent and correspond to 0.5 to 2% of the cases, usually associated with the presence of extracardiac cysts. The most common location is the free wall of the left ventricle at intramyocardial level. Medical treatment is often inadequate and surgical resection is recommended.

Echinococcosis in left ventricle: a case report.

INTRODUCTION: Echinococcosis, also called hydatid disease, is a common parasitic infection of the liver. However, echinococcus lesions rarely involve the heart, especially in children. PATIENT CONCERNS: An 8-year-old child from grazing areas of northwest China was referred to our hospital for the complaint of inpersistent precordial chest pain and left upper quadrant pain for 3 years. Palpation showed hepatomegaly, abdominal palpable mass while inspection abdominal distension. Routine blood tests were within the normal ranges. DIAGNOSIS: Combining the life history in pasture area, imaging features and serology results, it was consistent with the diagnosis of cardiac echinococcosis. INTERVENTIONS: Surgery was performed to evacuate cyst liquid and remove the internal capsule of the cyst. OUTCOMES: There was no cystic lesion in heart on ultrasound and her physical condition improved significantly after the surgery. The patient died of hepatic hydatid cyst rupture due to refusing high-risk surgical treatment and other treatment. LESSONS: We presented a rare case of cystic echinococcosis involving left ventricle in a child, and surgery is an alternative and effective therapy for this lesion due to the cyst rupture or leakage that can result in anaphylaxis. The typical imaging features of the cardiac echinococcosis on cardiac magnetic resonance are presented. Patient prognosis relies on proper treatment of all lesions.

Canine and feline dirofilariosis in a highly enzootic area: first report of feline dirofilariosis in Greece.

Dirofilaria immitis (heartworm) is enzootic in many areas of the world and quite prevalent in southern European countries. Although dogs are the main host of the parasite, cats may also be infected, and the prevalence of feline dirofilariosis is associated with the respective prevalence of canine infection in any given area. The aim of the present study was to investigate the proportion of D. immitis infection among dogs and cats that were not under any kind of prophylactic treatment and were living in a heartworm enzootic area. In total, 180 stray animals (148 dogs and 32 cats) living in a shelter in Northern Greece were examined for heartworm infection by the Knott's test and serology (antigen and in cats also antibody detection), and additionally echocardiography in the infected cats. Thirty-seven (25%, CI 18.7-32.5%) of the dogs and 3 (9.4%, CI 3.2-24.2%) of cats were found to be positive, by at least one of the tests applied. In 2 of the infected cats, the parasites were also detected by echocardiography. One of the positive cats died suddenly 1 year after diagnosis and at necropsy two decomposing D. immitis were found in the right ventricle and pulmonary artery. This is the first report of confirmed feline dirofilariosis in Greece. The detected proportion of infection in cats was 38% of the respective canine infection in the examined shelter. The results of the present study underline the high risk of infection of cats living in enzootic areas and the imperative character of preventive measures in such conditions.

Incidental finding of cardiac hydatid cysts, report of two cases.

BACKGROUND: Hydatid is a parasitic infection which can affect any organ of body. In some organs like liver and lung; it can be found regularly while in other organs like heart, it is seen very rarely. Cardiac hydatid cysts comprise less than of 2% of hydatid infection cases and may be detected incidentally. CASE PRESENTATION: Authors report two cases of cardiac hydatid cysts in young adult patients living in rural areas of the country with positive animal contact. Both patients were complained from shortness of breath and cough. Contrast enhanced chest computed tomography (CT) revealed left ventricular wall hydatid cysts in addition to lung and liver hydatid cysts. CONCLUSION: Cardiac hydatid cyst is a rare finding with wide range of signs and symptoms. These may be suspected in patients coming from endemic areas. Echocardiographic follow up of patients with liver or lung hydatid cysts can be helpful.

Cardiac and Pulmonary Cystic Echinococcosis With Massive Obstruction of the Pulmonary Vessel System in a 16-Year-Old Girl.

We describe herein the management of a 16-year-old girl with cystic echinococcosis of the right ventricle and massive obstruction of the pulmonary vessel system by parasitic metastatic dissemination. After resection of the cardiac cyst, pulmonary thromboendarterectomy was performed to remove parts of the obstructive parasitic material. The treatment reduced the elevated pulmonary arterial pressure, improving the patient's overall condition.

Surgical treatment of left ventricular echinococcosis through the HeartPort technique.

Echinococcal lesions rarely involve the heart; nonetheless, echinococcal cysts of the left ventricular myocardium often demand surgical treatment due to the risk of rupture and anaphylaxis. Herein, an echinococcal cyst of the anteroapical left ventricular wall was managed through small left anterior thoracotomy; repair was achieved under cardioplegic arrest (endoaortic balloon occlusion) with an uneventful course. We discuss the usefulness of such a less invasive approach for the depicted lesion (minimized manipulation of the heart and reduced surgical aggressiveness) and for other lesions involving the apical/lateral LV region.

Effect of heartworm disease and heartworm-associated respiratory disease (HARD) on the right ventricle of cats.

BACKGROUND: Dirofilaria immitis infection occurs in dogs and cats, both of which species are clinically affected by mature adult infections. Cats are uniquely affected by immature-adult infections with an inflammatory pulmonary disease called Heartworm-Associated Respiratory Disease (HARD). D. immitis infection causes pulmonary parenchymal and vascular pathology in the dog and cat. Dogs develop pulmonary hypertension and cor pulmonale, whereas the development of pulmonary hypertension is rare in the cat. D. immitis infection in the dog causes alteration of the right ventricular (RV) extracellular matrix, including a decrease in myocardial collagen. In this study, the RV myocardial changes of cats infected with adult and immature-adult D. immitis were assessed. METHODS: The cardiopulmonary systems of six groups of SPF cats (n = 9-10 per group) were examined 8 or 18 months after infection with L3 D. immitis. Two groups were untreated and allowed to develop adult HW; two groups were treated with ivermectin starting 3 months post infection, thus allowing HARD but no mature adult heartworms; and two groups were treated with selamectin beginning 1 month post infection, preventing development of L5 or adult heartworms. A group of specific pathogen free (SPF) normal cats was utilized as a negative control (n = 12). Lung pathologic lesions were objectively assessed, and both RV and left ventricular (LV) weights were obtained to calculate an RV/LV ratio. Intramural RV myocardial collagen content was quantitatively assessed. RESULTS: RV/LV weight ratios were not different between groups. Negative control cats had significantly greater RV collagen content than all other affected groups (P = 0.032). Analysis of the RV/LV ratios and collagen content revealed no significant relationship (r = 0.03, P = 0.723, respectively). Collagen content had a modest, but significant, negative correlation, however, with both pulmonary vascular pathology (r = -0.25, P = 0.032) as well as the total pulmonary parenchymal and vascular pathology (r = -0.26, P = 0.025). CONCLUSIONS: Cats infected with mature and immature D. immitis did not develop RV hypertrophy but did demonstrate loss of RV myocardial collagen content. The collagen loss was present at 8 and 18 months after infection in all infected cats. This loss of RV myocardial collagen was correlated with the severity of pulmonary parenchymal and vascular pathology.

Unusual Location of Hydatid Cysts: Report of Two Cases in the Heart and Hip Joint of Romanian Patients.

Hydatid cyst is usually located in the liver and lungs, rare cases showing localization in other organs or tissues. In the unusual location, echinococcosis is an excluding diagnosis that is established only after microscopic evaluation. Our first case occurred in a 67-year-old female previously diagnosed with pulmonary tuberculosis and hospitalized with persistent pain in the hip joint. The clinical diagnosis was tuberculosis of the joint, but the presence of the specific acellular membrane indicated a hydatid cyst of the synovial membrane, without bone involvement. Fewer than 25 cases of joint hydatidosis have been reported in literature to date. In the second case, the intramural hydatid cyst was incidentally discovered at autopsy, in the left heart ventricle of a 52-year-old male hospitalized for a fatal brain hemorrhage, as a result of rupture of an anterior communicating artery aneurysm. The conclusion of our paper is that echinococcosis should be taken into account for the differential diagnosis of cystic lesions, independently from their location.

An epidemiological study of A. cantonensis in Jamaica subsequent to an outbreak of human cases of eosinophilic meningitis in 2000.

The infection status of angiostrongylosis in Jamaica was assessed in wild rats and molluscs in the 5 years following the major outbreak of eosinophilic meningitis (EM) in 2000. Parasitological analyses of 297 Rattus rattus and 140 Rattus norvegicus, and 777 terrestrial molluscs from all 14 Parishes on the island revealed Angiostrongylus cantonensis in 32·0% of the rats and in 12·5% of the molluscs. Multivariate analyses confirmed that A. cantonensis occurred significantly more frequently in R. rattus (Odds Ratio [OR] = 1·76), while mean infection intensity in R. rattus was also significantly higher (16·8) than R. norvegicus (11·3) (Mann-Whitney U-test: P = 0·01). Third-stage larvae of A. cantonensis were detected in 29% of 86 Pleurodonte spp.; in 20% of five Poteria spp.; in 18·7% of 369 Thelidomus asper; in 11% of 18 Sagda spp.; and in 6% of 24 veronicellid slugs. Most rodent infections occurred in Northeastern Jamaica (OR = 11·66), a region where infected molluscs were also abundant. Given the prevalence of A. cantonensis infection in rats has significantly increased since the 2000 outbreak, and that a survey of human infections revealed at least ten autochthonous cases in the last 15 years, angiostrongylosis persists as an important zoonosis in Jamaica.

Cystic Echinococcosis: One Entity, Two Unusual Locations.

We report two cases of cystic echinococcosis at unexpected locations. Patients were a 64-year-old man and 35-year-old woman. A cystic mass was incidentally found between the prostate and seminal vesicles in the male patient, using ultrasonography during a check-up for ischemic coronary disease. The female patient was admitted to the hospital with symptoms of cardiopulmonary disease, but her detailed radiological examination showed a cystic lesion in the interventricular septum of the heart. Both patients were operated, and examinations of the histologic sections revealed cyst walls consistent with echinococcal infection. Attention should be focused on this entity even in endemic areas, and pathologists should be aware of the histologic characteristics of this lesion, to avoid misdiagnosis as a nonspecific cyst.

Altered Cardiomyocyte Function and Trypanosoma cruzi Persistence in Chagas Disease.

Chagas disease, caused by the triatominae Trypanosoma cruzi, is one of the leading causes of heart malfunctioning in Latin America. The cardiac phenotype is observed in 20-30% of infected people 10-40 years after their primary infection. The cardiac complications during Chagas disease range from cardiac arrhythmias to heart failure, with important involvement of the right ventricle. Interestingly, no studies have evaluated the electrical properties of right ventricle myocytes during Chagas disease and correlated them to parasite persistence. Taking advantage of a murine model of Chagas disease, we studied the histological and electrical properties of right ventricle in acute (30 days postinfection [dpi]) and chronic phases (90 dpi) of infected mice with the Colombian strain of T. cruzi and their correlation to parasite persistence. We observed an increase in collagen deposition and inflammatory infiltrate at both 30 and 90 dpi. Furthermore, using reverse transcriptase polymerase chain reaction, we detected parasites at 90 dpi in right and left ventricles. In addition, we observed action potential prolongation and reduced transient outward K(+) current and L-type Ca(2+) current at 30 and 90 dpi. Taking together, our results demonstrate that T. cruzi infection leads to important modifications in electrical properties associated with inflammatory infiltrate and parasite persistence in mice right ventricle, suggesting a causal role between inflammation, parasite persistence, and altered cardiomyocyte function in Chagas disease. Thus, arrhythmias observed in Chagas disease may be partially related to altered electrical function in right ventricle.

Two New Genera of Fish Blood Flukes (Digenea: Aporocotylidae) from Catfishes in the Peruvian Amazon.

Cladocaecum tomasscholzi n. gen., n. sp. infects the heart (lumen of ventricle) of driftwood catfish, Ageneiosus inermis Linnaeus, 1766 (Siluriformes: Auchenipteridae) from the Nanay River (Amazon River Basin, near Iquitos, Peru). It differs from all other aporocotylid genera by having a highly branched intestine comprising a central cecum that terminates immediately anterior to the ovary and that has numerous laterally directed diverticula. Kritsky platyrhynchi ( Guidelli, Isaac, and Pavanelli, 2002 ) n. gen., n. comb. (= Plehniella p.) is redescribed based on paratypes plus new specimens collected from the body cavity of the type host (porthole shovelnose catfish, Hemisorubim platyrhynchos Valenciennes, 1840) (Pimelodidae) from the nearby Itaya River. Kritsky differs from Sanguinicola Plehn, 1905 , Plehniella Szidat, 1951 , Nomasanguinicola Truong and Bullard, 2013 , and Cladocaecum by the combination of having a spinous anterior sucker, an intestine comprising 6 asymmetrical ceca, a lanceolate body, a straight vas deferens, an ovary with finger-like lateral projections, a small and spheroid oötype, numerous, minute, spheroid uterine eggs, and separate genital pores. An updated list of hosts, tissues infected, and geographic localities for the catfish blood flukes (9 spp.; 5 genera) is provided. This is the first report of a fish blood fluke infecting a member of Auchenipteridae and first proposal of a new genus of blood fluke (Schistosomatoidea) from South America in 64 yr. It brings the total number of Amazonian fish blood flukes to a mere 4 species.

First evidence of the European wildcat (Felis silvestris silvestris) as definitive host of Angiostrongylus chabaudi.

Angiostrongylus chabaudi (Strongylida, Angiostrongylidae) is a parasitic nematode described for the first time last century from the pulmonary arteries of six European wildcats (Felis silvestris silvestris) in central Italy. Since then, this parasite remained practically unknown until recently, when immature A. chabaudi have been reported from one wildcat in Germany and two domestic cats (Felis silvestris catus) in Italy. The present report describes the first record of A. chabaudi in Greece and, most importantly, the first known case of patent infection by A. chabaudi. The necropsy of a road-killed F. s. silvestris found near the lake Kerkini, in the municipality of Serres (Macedonia, Greece), revealed the presence of nematodes of both sexes in the right ventricle and the pulmonary artery of the heart. All parasites were mature adults and numerous eggs were present in the uteruses of females. The morphological characteristics of the parasites were consistent with those of A. chabaudi. Moreover, Angiostrongylus-like first stage larvae (L1) were present in the faeces of the animal that was negative for any other cardio-pulmonary parasite. Genetic examination of adult parasites and L1 confirmed the morphological identification as A. chabaudi. Histopathological examination of the lungs showed severe, multifocal to coalescing, chronic, interstitial granulomatous pneumonia due to the presence of adult parasites, larvae and eggs. These findings demonstrate for the first unequivocal time that this nematode reproduces in the European wildcat which should be ultimately considered a definitive host of A. chabaudi. Finally, the L1 of A. chabaudi are described here for the first time, opening new prospects for further studies on this neglected parasite.

Right ventricular hydatid cyst ruptured to pericardium.

Cardiac hydatidosis is rare presentation of body hydatidosis. Incidence of cardiac involvements range from 5% to 5% of patients with hydatid disease. Most common site of hydatid cyst in heart is interventricular septum and left ventricular free wall. Right ventricular free wall involvement by cyst that ruptured to pericardial cavity is very rare presentation of hydatid cyst. Cardiac involvement may have serious consequences such as rupture to blood steam or pericardial cavity. Both the disease and its surgical treatment carry a high complication rate, including rupture leading to cardiac tamponade, anaphylaxis and also death. In the present report, a 43-year-old man with constrictive pericarditis secondary to a pericardial hydatid cyst is described.

The brighter (and evolutionarily older) face of the metabolic syndrome: evidence from Trypanosoma cruzi infection in CD-1 mice.

BACKGROUND: Infection with Trypanosoma cruzi, the protozoan parasite that causes Chagas disease, results in chronic infection that leads to cardiomyopathy with increased mortality and morbidity in endemic regions. In a companion study, our group found that a high-fat diet (HFD) protected mice from T. cruzi-induced myocardial damage and significantly reduced post-infection mortality during acute T. cruzi infection. METHODS: In the present study metabolic syndrome was induced prior to T. cruzi infection by feeding a high fat diet. Also, mice were treated with anti-diabetic drug metformin. RESULTS: In the present study, the lethality of T. cruzi (Brazil strain) infection in CD-1 mice was reduced from 55% to 20% by an 8-week pre-feeding of an HFD to induce obesity and metabolic syndrome. The addition of metformin reduced mortality to 3%. CONCLUSIONS: It is an interesting observation that both the high fat diet and the metformin, which are known to differentially attenuate host metabolism, effectively modified mortality in T. cruzi-infected mice. In humans, the metabolic syndrome, as presently construed, produces immune activation and metabolic alterations that promote complications of obesity and diseases of later life, such as myocardial infarction, stroke, diabetes, Alzheimer's disease and cancer. Using an evolutionary approach, we hypothesized that for millions of years, the channeling of host resources into immune defences starting early in life ameliorated the effects of infectious diseases, especially chronic infections, such as tuberculosis and Chagas disease. In economically developed countries in recent times, with control of the common devastating infections, epidemic obesity and lengthening of lifespan, the dwindling benefits of the immune activation in the first half of life have been overshadowed by the explosion of the syndrome's negative effects in later life.