Ascaridíase hepatobiliar complicada por pneumonia lipoídica / Hepatobiliary ascariasis complicated by lipoid pneumonia

OBJETIVO: Apresentar um caso de ascaridíase hepatobiliar complicado por pneumonia lipoídica e discutir as implicações anestésicas envolvidas. DESCRIÇÃO DO CASO: Menina de dois anos de idade com ascaridíase hepatobiliar complicada por pneumonia lipoídica por aspiração e desnutrição grave, advinda de família em condições sociais precárias em zona rural, com quatro irmãos. Foi tratada com sucesso por uma combinação de lavados broncopulmonares sucessivos e cirurgia. COMENTÁRIOS: Ascaridíase biliar corresponde a cerca de 10 por cento dos casos de complicações de ascaridíase. Apenas uma minoria precisa de tratamento cirúrgico. O uso de óleo mineral por via oral é um tratamento tradicional para a suboclusão intestinal pelo Ascaris lumbricoides, mas a broncoaspiração do óleo e a conseqüente pneumonia lipoídica representam um risco alto para o seu uso. Anestesia geral para laparotomia exploradora em pré-escolar desnutrido com pneumonia lipóide e ascaridíase biliar é uma situação pouco contemplada na literatura médica, o que exigiu um planejamento terapêutico específico.

OBJECTIVE: To present a case of hepatobiliary ascariasis complicated by exogenous lipoid aspirative pneumonia and the anesthetic implications involved. CASE DESCRIPTION: We present a case of hepatobiliary ascariasis complicated by exogenous lipoid aspirative pneumonia and severe undernourishment in a two-year-old female from a five-children poor family from the Brazilian rural area. She was successfully treated by the association of repeated bronchopulmonary lavage and surgery. COMMENTS: Biliary ascariasis corresponds roughly to 10 percent of complicated ascariasis cases. Only a minority requires surgery. Mineral oil is a traditional treatment for intestinal Ascaris lumbricoides subocclusion, but oil aspiration and lipoid pneumonia remain a highly morbid risk of this practice. General anesthesia and laparotomy in an undernourished small child with lipoid pneumonia and biliary ascariasis were rarely addressed in the medical literature. Therefore, the therapeutic planning of this case was difficult.

[Acute abdomen due to massive intestinal ascaridiasis: a case report]. / Un caso di addome acuto da infestazione massiva da ascaridi.

Ascaridiasis is a geohelminthiasis with a worldwide distribution, especially occurring in countries with hot-humid climates. The infection occurs most frequently in children between three and nine years of age. We report a case of ascaridiasis regarding a ten-year-old girl born in Bangladesh who arrived in Italy about one year before. During laparotomy for suspected acute appendicitis, a large number of ascaridia nematodes were seen in the small intestine.

Consequences of concurrent Ascaridia galli and Escherichia coli infections in chickens.

Three experiments were carried out to examine the consequences of concurrent infections with Ascaridia galli and Escherichia coli in chickens raised for table egg production. Characteristic pathological lesions including airsacculitis, peritonitis and/or polyserositis were seen in all groups infected with E. coli. Furthermore, a trend for increased mortality rates was observed in groups infected with both organisms which, however, could not be confirmed statistically. The mean worm burden was significantly lower in combined infection groups compared to groups infected only with A. galli. It was also shown that combined infections of E. coli and A. galli had an added significant negative impact on weight gain.

The effect of concurrent infections with Pasteurella multocida and Ascaridia galli on free range chickens.

Pasteurella multocida and Ascaridia galli are observed with high prevalences in free range chickens in Denmark, but the impact is unknown. A study was carried out to examine the interaction between A. galli and P. multocida in chickens and the impact on production. Five groups, each with 20 18-week-old Lohmann Brown chickens were infected. Group 1 was orally infected with 1000+/-50 embryonated A. galli eggs. Group 2 received 10(4) cfu P. multocida intratracheally. Group 3 was infected with A. galli and subsequently with P. multocida. Group 4 was infected with P. multocida followed by A. galli. Group 5 was the control. The study ran for 11 weeks where clinical manifestations, weight gain and egg production were recorded. Excretion of P. multocida was determined on individual basis and blood smears were made for differential counts. At the end of the study pathological lesions and the number of adult worms, larvae and eggs in the faeces were recorded. The birds were more severely affected when infected with both pathogens compared to single infections with A. galli or P. multocida, respectively. A lower weight gain and egg production was observed with dual infections. A. galli infection followed by a secondary P. multocida infection resulted in more birds with pathological lesions and continued P. multocida excretion. In conclusion a negative interaction between A. galli and P. multocida was observed and it is postulated that free range chickens are at higher risk of being subjected to outbreaks of fowl cholera when they are infected with A. galli.

The effect of Plasmodium gallinaceum on a challenge infection with Ascaridia galli in chickens.

The effect of a primary infection with the haemoparasite Plasmodium gallinaceum on the establishment of a challenge infection with the nematode Ascaridia galli in chickens was studied. Four groups were infected as follows. Group 1: inoculated intravenously with 10(6) P. gallinaceum-infected erythrocytes on day 0; group 2: orally infected with 500 embryonated A. galli eggs on day 10; group 3: infected with P. gallinaceum on day 0 and A. galli on day 10; and group 3: non-infected control birds. The results of this investigation demonstrates that a primary infection with P. gallinaceum in chickens alters the course of a subsequent infection with A. galli. Thus, an antagonistic effect was seen in which the malaria infection caused a significant reduction on the establishment of the nematode in concurrently infected animals.

[Peripheral eosinophilia associated with ascaridiasis]. / Eozinofilia periferica asociata ascaridiozei.

The positive diagnosis of ascaridiasis is sometimes difficult to identify because the anamnesis is insufficient, the clinical symptoms are poor or not very specific and the paraclinical arguments can be distinguished only in some cases and at different stages of the disease. Furthermore, the coproparasitological examination can ascertain negative results on false basis. Since the specialised literature associates ascaridiasis with peripheral eosinophilia, we attempted to monitor the frequency and the grade of this haematological parameter and its variations when considering the patients sex and age, in order to evaluate its diagnostic value.

[Current epidemiological situation of bilharziasis in the Antananarivo plain]. / Situation épidémiologique actuelle des bilharzioses dans la plaine d'Antananarivo.

In 1994, prior to the Project of Development of the Plain of Antananarivo, an epidemiological survey was conducted in primary schools to assess the level of schistosomiasis. The results of stool examination by the Kato-Katz method demonstrated a prevalence of 4.3% among 6,169 randomized schoolchildren. The most infected four villages are located close the Mamba river. In 1999, after the realization of the project, another study had been done in the same Public Primary School to evaluate the evolution of schistosomiasis endemicity. 5,222 randomized pupils aged 5 to 16 years old took part in the study. The sex ratio was 1.4/1. The global prevalence was 1.8%. High prevalence are respectively notified in Antanandrano Primary school (23%) close to the Mamba river in the Northern part of the capitol and in Ambohitsoa Primary School (16.3%) located near the Mahazoarivo lac. Thus, between 1994 and 1999, a significant overall decrease in prevalence was observed (p < 10(-1)), although a few areas still have relatively high rates. Many factors may explain this improvement, including sanitary education, urbanization and a lack of conditions needed in the development of intermediate host. In addition, a high prevalence of ascaridiasis (79%) and trichocephalosis (67%) was observed. 4.3% of schoolchildren had been infected by Taenia sp. Schistosomiasis is hypoendemic in the plain of Antananarivo. The strategy against this disease must include an IEC programme, focusing in childhood exposure.

Right hepatic segmentectomy for the treatment of intrahepatic biliary stones due to ascaris lumbricoides: report of a case.

We report herein the case of a 46-year-old woman investigated for recurrent acute cholangitis. Ultrasound, endoscopic retrograde cholangiopancreatography, and computed tomography scan revealed dilatation and multiple images suggestive of intrahepatic biliary stones in the ducts that drained segments V and VI of the liver. Endoscopic treatment was attempted unsuccessfully, and based on the severity of the last crisis of cholangitis a laparotomy was performed. A right hepatic lobectomy including segments V and VI was carried out without any complications, resulting in complete relief of symptoms. Pathological examination of the liver demonstrated the presence of worm nests in the liver parenchyma with chronic granulomatous lesions.

Achados radiologicos nas complicacoes da ascaridiase: relato de casos e revisao da literatura / Radiological approach of clinical complications in ascariasis: case report and revision

Os autores estudaram tres casos de ascaridiase na infancia que apresentaram aspectos radiologicos, ultra-sonograficos e intra-operatorios caracteristicos...

Pre- and post-therapy blood lymphocyte levels in IgE-negative urticaria, associated with several parasitic or fungal diseases.

115 patients with non-immune (IgE-negative) urticaria, related to parasitic (lambliasis, oxyuriasis, ascaridiasis) or fungal (candidiasis) associations were investigated-both before and one month after specific and antihistaminic therapy-concerning different percentage levels of blood lymphocyte sets and subsets, by means of flow cytometry. Before therapy, three kinds of immune deficiency patients were obtained, one in lambliasis and oxyuriasis, the second in ascaridiasis, and the third in candidiasis, respectively. Clinical, biological and immunological recovering after therapy exhibited some differences related to the presumed non-allergic etiology, i.e. better in lambliasis and oxyuriasis and worse in ascaridiasis and candidiasis.

Prurido cutâneo e urticária relacionados com infecçäo por áscaris / Cutaneous pruritus and urticaria related to ascaris infection

É apresentado um caso de paciente com queixas de prurido generalizado pelo corpo e urticária sem causa definida. Após eliminaçäo espontânea de um áscaris, o paciente foi medicado com mebendazol, havendo desaparecimento da sintomatologia. Discute-se a natureza alérgica do fenômeno, alertando-se para a possibilidade de ascaridíase em pacientes com prurido sem causa definida