Upper Gastrointestinal Bleeding Induced by Gastric Ulcer Secondary to Strongyloidiasis: A Case Report.

Strongyloidiasis, a parasitic infestation by Strongyloides stercoralis, involves the gastrointestinal tract with a spectrum from duodenitis to enterocolitis. However, gastric involvement with the manifestation of upper gastrointestinal bleeding is an extremely rare condition due to Strongyloides stercoralis. Due to irregular excretion of larvae, unclear symptoms, paucity of effective diagnostic tools and low parasitic load, makes clinicians difficult to reach the diagnosis of strongyloidiasis. Here, we present a case of upper gastrointestinal bleeding due to a large gastric ulcer whose aetiology was identified to be Strongyloides stercoralis infection of the gastric region by the diagnosis of exclusion. Keywords: gastric ulcer; gastrointestinal haemorrhage; Strongyloides stercoralis; strongyloidiasis.

Gastric ulceration caused by genetically identified Anisakis simplex sensu stricto in a harbor porpoise from the Western Pacific stock.

The genus Anisakis is a well-known group of nematodes that parasitize cetaceans as the final host and cause mucosal damage to their stomach. However, little has been done to precisely identify the nematodes recovered from the final hosts, especially in the Western Pacific, because of taxonomic confusion about the discrimination of sibling species and the difficulties of obtaining specimens from cetaceans. We describe the results of genetic identification and histopathological observations of specimens recovered from an ulcerated lesion and stomach contents in the forestomach of a female harbor porpoise accidentally caught by a set net fishery in Usujiri, southern Hokkaido, Japan. All the specimens arbitrarily collected from the lesion and stomach contents were identified as Anisakis simplex sensu stricto according to their ITS rDNA sequences. The size of the ulcer was approximately 6.3 mm in diameter and it was infected with 119 individual nematodes, mostly consisting of L3 and L4 stage larvae (95.0%). Histological sections were characterized by a locally extensive ulcer with the parasites penetrating into the muscularis externa that caused a thickening of the surrounding mucosa.

Morphology and Molecular Characterization of Parabronema smithii (Cobbold, 1882) (Nematoda: Habronematidae) from Wild Asian Elephant (Elephas maximus maximus) of Sri Lanka.

PURPOSE: The aim of the present study was to carry out a detailed study of morphological features and to determine the phylogenetic position of Parabronema smithii (Cobbold, 1882) found in wild elephants in Sri Lanka. METHODS: Adult worms were collected from stomach ulcers at postmortem examination of wild elephants in the Udawalawe National Park, Sri Lanka. The detailed morphology of P. smithii was studied using light microscopy and, for the first time, scanning electron microscopy. Fifteen morphological characteristics were investigated. The phylogenetic analysis was conducted using the second internal transcribed spacer region (ITS2), and portions of the large subunit ribosomal DNA (28S) and cytochrome c oxidase subunit 1 (cox1). Furthermore, the present study provides a comparison of morphology and morphometrics of Parabronema species that occur in different hosts. CONCLUSION: Parabronema smithii isolated from wild elephants exhibited the key morphological features. Phylogenetic analysis of selected genes revealed that P. smithii is closely associated with P. skrjabini and Habronema spp. Findings of the present study enhance our understanding of the biology and taxonomy of P. smithii in wild elephant in Sri Lanka and will contribute to future phylogeographic studies.

Gastric ulcer perforation credited to paracoccidioidomycosis. Case report with autopsy / Úlcera gástrica perfurada por paracoccidioidomicose. Relato de caso com necropsia

Paracoccidioidomycosis or South American blastomycosis is an endemic disease that occurs predominantly in rural South America, caused by a termo-dimorphic fungus named Paracoccidioides brasiliensis. Its epidemiologic importance relates to its characteristics of transmissibility, susceptibility and morbidity, in addition to its high cost due to prolonged medical monitoring. It has a polymorfims in the description, explained by absent or nonspecific initial symptoms such as night sweats, weight loss or fever, and later symptoms according to its location of involvemente. The objective of this study was to report a case of uncommon presentation of this pathology. The case repot is the autopsy of a 74-year-old, white, female patient with predominant manifestation in the gastrointestinal tract originating from paracoccidioidomycosis, and complicated by one of the gastric ulcer perforation. This is an unusual presentation, and reports of gastric perforation credited to this agent were not found in the literature...

Paracoccidioidomicose ou blastomicose Sul Americana é uma enfermidade endêmica rural que ocorre predominantemente na América Latina, tendo como etiologia o fungo termodimórfico Paracoccidioides brasiliensis. Sua importância epidemiológica está nas características de transmissibilidade, suscetibilidade e morbidade dos casos, além de seu alto custo, devido ao acompanhamento médico prolongado. É uma doença cujos sintomas iniciais são ausentes ou inespecíficos como sudorese noturna, emagrecimento ou febre, diferente dos sintomas tardios, que acontecem conforme sua localização de acometimento, o que justifica o polimorfismo em sua descrição. O objetivo deste estudo foi relatar um caso de apresentação incomum dessa doença. Caso clínico com necrópsia de paciente do gênero feminino, 74 anos, branca, com manifestações clínicas predominantes no trato gastrintestinal provenientes de paracoccidioidomicose complicada pela perfuração de uma das úlceras gástricas. Trata-se de uma apresentação incomum e não foram encontrados relatos na literatura de perfuração de úlcera gástrica creditada a esse agente...

Gastric lesions in free-ranging black caimans (Melanosuchus niger) associated with Brevimulticaecum species.

The stomachs of 100 free-ranging black caimans (Melanosuchus niger Spix, 1825) from the Mamirauá Sustainable Development Reserve, Amazonas state, Brazil, were examined for parasitism and pathologic lesions. All animals were harvested for human consumption. Ascaridoid nematodes were found in 67 caimans and were identified as Brevimulticaecum sp. These parasites were associated with focally extensive, chronic gastric ulcers and formation of localized intramural granulomas containing nematodes. All caiman were in good nutritional condition, which suggests that effects of gastric nematodiasis on the crocodilian hosts were minimal at the time of slaughter.

Gastric perforation caused by Strongyloides stercoralis: a case report.

Strongyloidiasis is a parasitosis caused by the female nematode of the Strongyloides stercoralis. S. stercoralis causes a chronic infection that is asymptomatic in 50% of chronically infected patients, and it can also affect the stomach. Gastric involvement causes symptoms mostly mimicking gastritis. We report herein a case of gastric perforation in a 37-year-old woman, which was thought to be caused by S. stercoralis.

Survey of gastric lesions and blood pepsinogen levels in pigs in Burkina Faso.

The purpose of the study was to investigate the prevalence of gastric lesions and to provide diagnostic values for serum pepsinogen in non-infected pigs and in pigs with gastric disease. In an abattoir survey, the pepsinogen concentrations were measured in the serum from 62 non-infected pigs, 33 pigs with gastric lesions and 17 pigs infected with Hyostrongylus rubidus, using a specific radioimmunoassay (RIA). The mean (+/- SE) pepsinogen concentrations in the serum of non-infected pigs, in pigs with gastric ulcers, and in pigs with a heavy H. rubidus infection were 630.8 +/- 39.2 ng/ml, 1084.5 +/- 166.2 ng/ml and 1095.2 +/- 102.3 ng/ml, respectively (p<0.05). Because of the higher concentrations of pepsinogen in the blood of pigs with gastric ulcers or parasitic infections, it is suggested that the measurement of serum pepsinogen by RIA may be an effective biochemical approach to the diagnosis of chronic gastric disorders in pigs.

Dilated cardiomyopathy and amebic gastritis in a giant anteater (Myrmecophaga tridactyla).

An approximately 11-mo-old female giant anteater (Myrmecophaga tridactyla) exhibited anorexia, lethargy, hypothermia, depression, and minimal response to external stimuli. Radiography and ultrasonography revealed an enlarged heart, with free gas and fluid in the abdomen. Abdominocentesis produced a clear brown fluid with an acute to subacute septic suppurative exudate. Cardiac ultrasonography revealed a dilated, thin-walled left ventricle with a comparatively low fractional shortening. Despite intensive supportive care, the anteater died. Postmortem findings included gastric ulceration with perforation near the pylorus. Entameba spp. and Acanthamoeba spp. were both identified in large numbers at the site of the gastric ulceration and perforation.

Inter-relationship between Gasterophilus larvae and the horse's gastric and duodenal wall with special reference to penetration.

The degree of penetration into the stomach and duodenum of the horse by bot fly larvae, Gasterophilus intestinalis (De Geer) and G. nasalis (Linnaeus) (Diptera : Gasterophilidae) was evaluated. Evidence of larval perforation of the stomach or duodenum was not found on gross inspection. Palpation of the intact stomach and duodenum was not effective in establishing the existence of Gasterophilus larvae within the organs. Findings suggest that larvae of both species produce an ulcer of similar depth within the gastrointestinal wall. The ulcer depth produced by larvae did not correlate with the normal, unaffected thickness of the particular stomach or duodenum. Tissue proliferation beneath ulcers of the stomach and duodenum was not correlated with the depth of the ulcer. Proliferation of the tissue beneath the ulcers of the stomach generally exceeded that found under duodenal ulcers. Gastric wall beneath the G. intestinalis ulcer frequently attained a thickness equal to or greater than the normal stomach wall. Histopathological examinations below the ulcer revealed intense fibrosis. Duodenal thickness below the G. nasalis ulcer was typically less than normal and resulted in an attenuated wall. Histopathological analysis of the affected duodenum revealed severe loss of submucosal glands in a sharply demarcated area below and surrounding the lesion. Fibrosis of the underlying lamina propria mucosae and tunica submucosa was appreciable but failed to restore the original thickness of the duodenal wall. Host tissue response and moderation of the parasite' s behavior reduce the chances of direct perforation of the gastrointestinal tissue.

[A fatal case of trichinelliasis with intensive invasion and acute massive hemorrhage from a stomach ulcer]. / Letal'nyi sluchai trikhinelleza s intensivnoi invaziei i ostrym massivnym krovotecheniem iz iazvy zheludka.

The paper deals with a fatal case of trichinosis in a 61-year-old male due to acute massive gastric hemorrhage from the old silent gastric ulcer developed at week 8 after the onset of infection (or at week 3 after the appearance of the first clinical signs). At autopsy, the method of ingestion of cross-striated muscular samples revealed high Trichinella spiralis infection rates: from 135 larvae per g of muscles of the tongue to 512 larvae in the diaphragm. Infection had occurred due to long-term (1-month) ingestion of the pork obtained from a subsidiary farm of Moscow Province. A role of alcohol used by the patient for the infection period (about 30 days) and some other factors which could contribute to intensive infection and death are discussed.

Strongyloides stercoralis associated with a bleeding gastric ulcer.

Infection with the helminthic parasite, Strongyloides stercoralis, is usually acquired by skin invasion (or occasionally via ingestion of larvae). After transformation to the adult form, the parasite preferentially localises in the small intestine, especially in the duodenal and jejunal part. A remarkable feature of Strongyloides is its property of endogenous reinfection. In the case of an immunocompromised host a massive infection, called hyperinfections Strongyloides, may occur. Numerous gastrointestinal complications of strongyloides infections, sometimes with a lethal outcome, have been reported. The intestinal manifestations are usually limited to the small bowel, and rarely involve the stomach. We report a patient with complicated strongyloides infection of the stomach.