HEPATIC LYMPHOMA AND SPLENIC ASPERGILLOSIS MIMICKING HEPATOSPLENIC ABSCESSES FROM MELIOIDOSIS IN THAILAND.

We report here a case of hepatic lymphoma and splenic aspergillosis in an elderly patient with diabetes mellitus, exhibiting hepatosplenic abscesses mimicking melioidosis. Immunohistochemistry confirmed the diagnosis of a diffuse hepatic large B-cell lymphoma. Biopsy of the spleen revealed a clump of fungus with a slender shape and dichotomous branching, morphologically consistent with aspergillosis. Hepatosplenic abscesses are a common presentation in melioidosis, but this case reveals this assumption can lead to misdiagnosis. Histological and microbiological confirmation are required, especially in patients with hepatosplenic lesions.

A Case of Lagochilascariasis in Suriname with the Involvement of the ENT System and the Skull Base.

We describe a case of human lagochilascariasis, with skull-base involvement and a chronic and relapsing course after treatment. This rare parasitic infection is usually manifested in the head and neck area, characterized by progressive granulomatous inflammation and the formation of abscesses. Transmission to humans most likely occurs by the consumption of undercooked meat of wild rodents. On the basis of literature studies, we propose the most likely life cycle of the parasite that involves wild feline and rodent species, with humans as accidental hosts. Even in endemic areas, it is very difficult to recognize the disease at an early stage. Progression will eventually lead to involvement of the (central) nervous system, as described in our case. Treatment is often difficult and involves resection and prolonged treatment with anthelmintic drugs. Recurrences are not uncommon and at present, long-term oral administration of ivermectin seems to be the most effective treatment.

Enterobius vermicularis: Can it be a possible pathogen in Bartholin gland abscess formation?

The most frequent disorders of the Bartholin glands are cysts or abscesses. Bartholin gland abscesses occur generally as a result of polymicrobial infections or agents that cause sexually transmitted diseases. But as far as we know, no parasite has been previously reported among the infectious agents that are detected from the abscesses of the Bartholin gland. Here, we report a 45-year-old woman, in the Bartholin abscess aspirate of whom Enterobius vermicularis eggs were detected in between the inflammatory infiltrate by cytological examination.

The first genetically confirmed case of Dioctophyme renale (Nematoda: Dioctophymatida) in a patient with a subcutaneous nodule.

We describe a nematode larva in a subcutaneous nodule excised from a 44-year-old Chinese male who had been living in Japan for 15 years. Morphological features suggested that the worm was a dioctophimatid nematode. PCR amplification and sequencing of small subunit ribosomal DNA and mitochondrial cytochrome subunit c oxidase genes allowed us to identify the larva as the giant kidney worm, Dioctophyme renale (Goeze, 1972). This is the first molecularly confirmed human case of a dermal D. renale infection.

Dirofilaria repens infection in a ten-year-old boy from the Istria Peninsula: case report.

Dirofilariasis is a zoonotic infection caused by worms belonging to the genus Dirofilaria. The disease is transmitted by mosquitoes and the hosts are usually dogs. Infections in humans are rare and they usually manifest as a subcutaneous nodule or a conjunctival form. We present a 10-year-old boy with a subcutaneous nodule on his left forearm, who was admitted to the hospital. On examination, the only significant findings were high levels of eosinophils. The pediatrician suspected dirofilariasis and the boy was referred to pediatric surgery. The whole lesion was surgically removed and histopathologic examination confirmed parasitic infection by Dirofilaria repens. Although human dirofilariasis is a rare disease, the number of reported cases has recently increased worldwide. The disease mainly occurs in southern European countries, but has also been described in eastern Europe, Central Asia and Sri Lanka. Croatia is one of the endemic areas for dirofilariasis, especially in the region of the Istria Peninsula. The case presented highlights the requirement for further monitoring of endemic areas in order to establish effective preventive measures.

Bilateral parotid abscesses as the initial presentation of strongyloidiasis in the immunocompetent host.

BACKGROUND: Most suppurative parotid abscesses are unilateral and result from bacterial infection via Stensen's duct. Formation of bilateral parotid abscesses rarely occur, and cases arising in the setting of parasite infection have not been described to date. METHODS AND RESULTS: A 41-year-old man presented with bilateral parotid abscesses and underwent incision and drainage of right-sided swelling because of poor response to the aspiration drainage and intravenous antibiotic therapy. A nematode larva, morphologically consistent with Strongyloides stercoralis (S. stercoralis), was found in the cytologic examination, and bilateral abscesses regressed significantly after administration of Ivermectin. CONCLUSION: We report the first case of S. stercoralis infection presenting as bilateral parotid abscesses. This case expands the spectrum of diseases associated with S. stercoralis and suggests that clinicians, especially in the endemic regions, should consider S. stercoralis infection in the differential diagnosis of refractory parotid abscess.

Enterobius vermicularis infection with tuboovarian abscess and peritonitis occurring during pregnancy.

BACKGROUND: Extraintestinal Enterobius vermicularis infections are rare but may occasionally affect the female genital tract. Although mostly asymptomatic or causing minor clinical problems, they may lead to severe infectious complications. METHODS: Case report and review of the pertinent English language literature. RESULTS: A 31-year-old, 30-week-pregnant female was admitted with a clinical suspicion of appendicitis. At surgery, the appendix appeared normal, but generalized peritonitis of unclear origin was present. Eggs of Enterobius vermicularis were found upon microbiological and pathological examination. Because of persisting infectious disease, the patient underwent an elective caesarean section, and at that time the diagnosis of a right tuboovarian abscess was made, and salpingo-oophorectomy was performed. The pathology report confirmed the diagnosis of an E. vermicularis salpingo-oophoritis. CONCLUSION: This case was extraordinary because of a combination of tuboovarian abscess and generalized peritonitis with E. vermicularis infection occurring during late pregnancy. Ectopic enterobiasis should be considered in the differential diagnosis of pelvic infections of gynecological origin.

Comparison of two genetically related Entamoeba histolytica cell lines derived from the same isolate with different pathogenic properties.

Entamoeba histolytica is known for its extraordinary capacity to destroy human tissues, leading to invasive diseases such as ulcerative colitis or extra-intestinal abscesses. In order to identify the virulence factors of this parasite phenotypes and proteomes of two recently identified genetically related cell lines (A and B), derived from the laboratory E. histolytica isolate HM-1:IMSS, were compared. Both cell lines are indistinguishable on the basis of highly polymorphic tandem repeat DNA sequences. However, cell line A is incapable to induce liver abscesses in experimentally infected rodents, whereas cell line B provokes considerable abscesses. Phenotypic analyses revealed increased hemolytic activity, lower growth rate, smaller cell size, reduced cysteine peptidase activity and lower resistance to nitric oxide stress for cell line A. In contrast, no differences between the two cell lines were found for cytopathic activity, erythrophagocytosis, digestion of erythrocytes or resistance to complement, hydrogen peroxide and superoxide radical anions. Proteomic comparison by 2-D DIGE followed by MS, identified a total of 21 proteins with higher abundance in cell line A and ten proteins with higher abundance in cell line B. Remarkably, three differentially up-regulated antioxidants were exclusively found in the pathogenic cell line B. Notably, only for two differentially regulated proteins, namely a Fe-hydrogenase and a C2 domain protein, a similar type was found at the level of transcription. Summarized, a defined set of different proteins could be identified between cell lines A and B. These molecules may have an important role in amoeba pathogenicity.

[Mansonella perstans isolated on aspiration puncture of a salivary gland]. / Mansonella perstans aislada en una punción-aspiración de glándula salival.

Chronic parasitosis due to nematode worms (filariae) in tissue are very common in tropical ecosystems; their larvae (microfilariae) have been isolated in lymph vessels, skin, and blood. The case reported here is of a Nigerian patient suffering severe renal failure and admitted owing to the presence of a right submandibular gland abscess. In the FNAP, the presence of a Mansonella perstans microfilaria was identified. Post-surgery examination of pathology samples from the gland reported an acute inflammatory infiltrate including abundant eosinophils and microfilariae. There are some reports in the literature of haematic or lymphatic microfilariae, especially in epithelial or glandular tissues, and, as in this case, in inflammatory or malignant conditions. Both ivermectin and mebendazol are used for treatment; the scant pathogenicity of the genus Mansonella should, however, lead to an individualized decision.

[Visceral leishmaniasis--surgical aspects]. / Leishmanioza viscerala--aspecte chirurgicale.

Visceral Leishmaniasis is a multi-organic parasitic disease caused by an intracellular protozoon named Leishmania Donovani; the mean signs are: weight loss, cough, fever, hepatosplenomegaly, adenopathy and cutaneous lesions; death without treatment is the rule. The main treatment is a conservative one. Surgical treatment is necessary for complications, especially for those intra-abdominally. We wish to present a young female patient who underwent two subsequent interventions due to an unclear diagnosis. We emphasize the difficulties in achieving a certain diagnostic, because of the rarity of disease in Romania; there are also revealed surgical aspects, which are important because of very few available data in the literature.

Human oesophagostomiasis: a histomorphometric study of 13 new cases in northern Ghana.

Oesophagostomiasis is an infrequently described and recognised parasitic infection in humans, caused by Oesophagostomum bifurcum. Although the disease is most often found in the northern part of Togo and the neighbouring part of Ghana, sporadic cases have been described in other parts of Africa and in Asia and South America: Uganda, Ivory Coast, Sudan, Kenya, Ethiopia, Indonesia, Malaysia and Brazil. Infection probably occurs by way of the ingestion of L3 larvae. These larvae penetrate the intestinal wall, especially that of the colon. Some of these larvae develop into young adult worms and return to the bowel lumen. Other larvae, however, develop into immature worms, which fail to settle in the lumen, forming abscesses in the bowel wall and causing pathology. In the literature 105 human cases have been described, many originating in the northern regions of Ghana and Togo. The present study was performed to evaluate 13 new cases originating in the northern part of Ghana (7 female and 6 male patients, aged between 2 and 60 years). Histopathologically, the patients could be divided into two groups: the first group showed multinodular disease, while patients in the second group presented with a single, nodular mass. In the first group, abscesses were seen throughout the colonic wall. The mean size of the cavities was 4.3+/-0.7 mm. There was no relation between the size and the localisation in the colonic wall. Abscesses were significantly larger in male patients than in female patients. There was no correlation with age. In the second group, histopathological examination showed a cyst of variable wall thickness with very limited inflammation. These cysts represented older lesions, often encapsulated in the mesentery. In conclusion, in this study we present 13 new cases of human oesophagostomiasis. The abscess formation was found to be organ specific, independent of age, and gender-related, producing a more intense tissue reaction in male patients.

[The association between human toxocariasis and pyogenic abscesses]. / A associação entre a toxocaríase humana e os abscessos piogênicos.

The association between hepatic abscesses and schistosomiasis mansoni was confirmed by clinical and experimental studies. Other parasites may cause systemic immunologic changes and local structural alterations in the affected organs that can facilitate the seeding of these areas by bacteria. Tropical pyomyositis, pyogenic liver and renal abscesses are frequent diseases in tropical areas. The visceral larva migrans syndrome is caused by the presence, in the human body, of larvae of worms that have other animals as their definitive host, most commonly being caused by Toxocara canis. The larvae migrate to various body organs leading to many inflammatory reactions in the form of granuloma and tissue necrosis. In this review we discuss the possible host-parasite-bacteria interactions that would favour the formation of abscesses in the organs involved by the larva of T. canis and present preliminary results of a clinical and experimental study undertaken during the last four years to define the role of this parasite in the pathogenesis of the abscesses.

[Infective stomatitis of the palate]. / Localización palatina de las estomatitis infecciosas.

Having on base a wide and selective review of the literature, it has seemed to us interesting to detail the infective pathology on this location or sometimes occurring. This region is, as well will see, the seat of a rich pathology. We pretend on the other hand to reassess the importance of the meticulous examination of the oral cavity in "systemic problems". We describe the palatal infections divided in four groups: bacterial, viral, fungal and parasitory, according to the causal agent. We review the palatine manifestations of other fewer current syndromes as well.

Fine needle aspiration diagnosis of a subcutaneous abscess from Enterobius vermicularis infestation. A case report.

BACKGROUND: Extraintestinal infestation by Enterobius vermicularis is uncommon. It has been reported to occur in the peritoneal cavity, ovary, fallopian tube, endometrium, lung, liver and urinary tract. CASE REPORT: Fine needle aspiration diagnosis was made in a case of enterobiasis presenting with a subcutaneous abscess in the natal cleft. Eggs, as well as fragments of cuticle of the adult worm, were found; the morphology of both was best visualized in Papanicolaou-stained smears. Polarizing microscopy highlighted the equally spaced parallel grooves of the cuticle. CONCLUSION: Fine needle aspiration cytology of subcutaneous abscesses due to enterobiasis can be diagnostic when eggs, or eggs with cuticle, are identified in a suppurative or granulomatous inflammation.

Furuncular cuterebrid myiasis.

Myiasis is the infestation of skin bythe larvae of flies. In North America cases are caused by the botfly (Cuterebra) and occur most commonly in children. The usual presentation is a subcutaneous abscess, and for this reason these patients may be referred to surgeons. Knowledge of this entity can avoid delays in diagnosis, unnecessary incision and drainage procedures, and unnecessary courses of antibiotics.