First description of a fatal equine infection with Halicephalobus gingivalis in Portugal. Relevance for public health.

Halicephalobus gingivalis is a small saprophytic rhabditid nematode, represented only by females with a typical rhabditoid oesophagus and one egg in the uterus, capable of infecting vertebrates. This opportunistic parasite present in the soil, manure and decaying humus, is thought to penetrate through previous injuries to the mouth, eyes and skin of horses and migrate to various organs. The brain is one such organ, where the females lay their eggs, leading to malacia and causing a sudden onset of neurological signs, such as anorexia, ataxia, urinary incontinence, blindness, decreased menace and tonal reflexes, tremors and aggressiveness. The disease is invariably fatal whenever brain lesions are present, and the diagnosis usually achieved only post-mortem. The present work aims to describe the first case of infection by H. gingivalis ever reported in Portugal. An 8-year old warmblood horse presented with an 8-day history of progressive blindness involving the left eye, initially with normal pupillary reflexes, advancing to bilateral blindness and increasing deterioration in clinical condition. After euthanasia, the animal was submitted for necropsy. Organ samples were collected and fixed in 10% neutral buffered formalin for routine histopathology. A large mass was found in the left kidney corresponding to fibrous tissue heavily infiltrated with inflammatory cells and numerous nematodes. In the brain, multiple, bilateral and asymmetrical foci of malacia containing several rhabditoid nematodes, larvae and zygotes, and high numbers of inflammatory cells were found. The nematodes were identified as H. gingivalis. The clinical history, necropsy and histological findings presented constitute a typical case of H. gingivalis infection in a horse, never previously described in Portugal to the authors' best knowledge. Humans can be infected by contact with contaminated manure, which makes this nematode a public health concern, especially for people living and/or working in close proximity to horses.

Polyparasitism of Rhabditis Axei and Enterobius Vermicularis in a Child from Beijing, China.

BACKGROUND: Rhabditis (Rhabditellae) axei is a common species in soil, which has been reported repeatedly in human urine and the digestive system. Humans exposed to sewage or mistakenly polluted sewage is the cause of larvae infecting the digestive tract or via the urethra. We reported a patient infected with Rhabditis axei and Enterobius Vermicularis. The migration of the nematodes caused true signs of hematuria, diarrhea, and high eosinophilia. METHODS: Stool and urine are collected to detect parasite eggs and genotype. Specimens are sent for polymerase chain reaction (PCR)-based species identification. Amplification of the 18S ribosomal RNA gene was performed by PCR as described [1]. RESULTS: Morphological features and PCR amplification of the 18S ribosomal RNA gene confirmed Rhabditis axei and Enterobius vermicularis as the pathogen of infection. CONCLUSIONS: Herein, we presented a case that confirmed Rhabditis axei and Enterobius vermicularis infection in humans can be associated with high eosinophilia.

Nematode eggs observed in cytology of cerebrospinal fluid diagnostic for intramedullary Spirocerca lupi spinal cord migration.

Spinal spirocercosis due to aberrant Spirocerca lupi nematode migration is an emerging etiology for acute myelitis in dogs in Israel, causing severe, mostly nonsymmetrical hind limb paresis or paralysis, and sometimes tetraparesis or tetraparalysis. So far, incidental identification of parasites during spinal surgery or at necropsy provides the only definite diagnosis, while antemortem diagnosis of this condition has been uncertain. Specifically, antemortem diagnosis is based on the typical clinical presentation of acute, progressive, asymmetrical hind limb paresis or paralysis, with moderate to severe eosinophilic to mixed cerebrospinal fluid (CSF) pleocytosis and increased CSF protein concentration. Exclusion of other differential diagnoses also requires using spinal cord imaging. In this novel report, we document a case of an intradural spinal spirocercosis in a dog, diagnosed antemortem, by detecting S lupi eggs in the CSF, and subsequent treatment, resulting in the resolution of the clinical signs.

Rhinella marina (Amphibia: Bufonidae) Versus Rhabdias paraensis (Nematoda: Rhabdiasidae): Expanding the View on a Natural Infection.

Amphibian and reptile lungs are frequently infected with Rhabdias parasites, and this condition ultimately leads to reduced survival, performance, and growth because of granulomatous inflammation, nodule formation, and nematodal pneumonia onset. Here we investigate the histopathological features of naturally infected Rhinella marina by the lung nematode Rhabdias paraensis. A total of 10 host animals were captured in peridomiciliar areas in the eastern Brazilian Amazon, and anatomic-histological analyses were performed on both the infected and non-infected lungs of these amphibians. Helminths were usually found within the secondary and primary septa of infected lungs whereas parasites were not detected within vessels or adhering to tissues. In addition, we observed discrete erythrocytes, diapedesis foci, few granulocytes and erythrocytes in the interseptal spaces, discrete cell infiltration, and a small number of melanomacrophages, and no granulomas or cysts were observed. New aspects related to changes in tissue and helminth-host interactions are discussed for the relationship of R. paraensis × Rhi. marina from the Amazon region.

An outbreak of bovine meningoencephalomyelitis with identification of Halicephalobus gingivalis.

Halicephalobus gingivalis is an opportunistic parasite which is known to cause fatal meningoencephalomyelitis primarily in equines but sporadically also in humans. In April 2014, laboratory examination of the head of a young dairy calf, euthanized due to severe central nervous system symptoms, revealed the presence of granulomatous to necrotizing encephalitis and myriads of nematodes in the brain lesion. Morphologically the parasites were identified as H. gingivalis. The diagnosis was confirmed by molecular analysis of the large subunit (LSU) rRNA and the small subunit (SSU) rRNA genes, revealing genetic variations of 0.5-4.4% and 0.7-8.6%, respectively, between the H. gingivalis isolated from the Danish calf and published isolates, collected worldwide from free-living and parasitic stages of the nematode. Clinical symptoms and histological changes indicated infection with H. gingivalis from another three calves in the herd. This is the first scientific publication of H. gingivalis induced meningoencephalomyelitis in ruminants. As ante mortem diagnosis is a major challenge, the infection may easily remain undiagnosed in cattle.

First report of fatal systemic Halicephalobus gingivalis infection in two Lipizzaner horses from Romania: clinical, pathological, and molecular characterization.

Halicephalobus gingivalis (H. gingivalis) causes a rare and fatal infection in horses and humans. Despite the zoonotic potential and severity of the disease, the epidemiology and pathogenesis of halicephalobiasis are still poorly understood. Several European cases of equine halicephalobiasis have been documented; however, in South-Eastern European countries, including Romania, equine neurohelminthiasis caused by H. gingivalis has not been previously described. Two Lipizzaner horses with a clinical history of progressive neurological signs were referred to the Pathology Department of the Cluj-Napoca (Romania) for necropsy. Both horses died with severe neurological signs. Gross examination and cytological, histological, and molecular analyses were performed. The stallions came from two different breeding farms. No history of traveling outside Romania was recorded. At necropsy, granulomatous and necrotizing lesions were observed in the kidneys, lymph nodes, brain, retroperitoneal adipose tissue, and lungs, indicating a systemic infection. Parasitological and histopathological analyses evidenced larval and adult forms of rhabditiform nematodes consistent with Halicephalobus species. Parasites were observed in both lymph and blood vessels of different organs and were also identified in urine samples. A subunit of the large-subunit ribosomal RNA gene (LSU rDNA) of H. gingivalis (673 bp) was amplified from lesions in both horses.To the authors' knowledge, this is the first report of equine systemic H. gingivalis infection in Romania and in South-Eastern Europe. Our findings provide new insights into the geographic distribution of specific genetic lineages of H. gingivalis, while also raising public health awareness, as the parasite is zoonotic.

Sicarius uncinipenis and Deletrocephalus cesarpintoi in captive greater rheas of Minas Gerais State, Brazil / Sicarius uncinipenis e Deletrocephalus cesarpintoi em emas de cativeiro no Estado de Minas Gerais, Brazil

The present study details the pathological and parasitological findings of parasitic ventriculitis and nematode infections in the large intestines of two female Rhea americana americana birds. The birds were housed in captivity, and both exhibited poor body condition and lethargy. The rheas were sent to the Veterinary Hospital of the Veterinary School, Universidade Federal de Minas Gerais (UFMG) and, despite medical care, the clinical condition of the birds did not improve. The birds died two days after admission, and were submitted to necropsy. Gross, histopathology and parasitological analysis resulted in the identification of Sicarius uncinipenis, which is associated with parasitic ventriculitis, while Deletrocephalus cesarpintoi was identified in the large intestine of both rheas. The apparent clinical indications, including loss of appetite and death, combined with the discovery of numerous parasites and other pathology changes, supported the conclusion that the death of the birds was caused by the parasitic infection. Further investigations of these infections in free-living and captive rheas are required, such that accurate data on the incidence and pathogenicity of these parasites can be obtained.

O presente estudo relata os achados patológicos e parasitológicos de ventriculite parasitária e da infecção por nematódeo no intestino grosso em duas fêmeas Rhea americana americana. As aves eram mantidas em cativeiro e ambas apresentaram condição corporal ruim e inapetência. As emas foram encaminhadas para o Hospital Veterinário da Escola de Veterinária da UFMG e, apesar dos cuidados médicos, não houve melhora na condição clínica. As aves morreram dois dias após a internação e foram encaminhadas para a necropsia. Ao exame macroscópico, histopatológico e parasitológico, Sicarius uncinipenis foi identificado e associado com ventriculite parasitária, enquanto Deletrocephalus cesarpintoi foi identificado no intestino grosso. Possivelmente, o quadro de inapetência e morte foi causado pela infecção parasitária, pois os parasitos eram numerosos. Mais investigações dessa infecção são necessárias em emas de vida livre e cativeiro, para a obtenção de informações mais precisas da incidência e patogenicidade desses parasitos.

Fatal parasitic meningoencephalomyelitis caused by Halicephalobus deletrix : a case report and review of the literature.

Infection with the saprophagous nematode Halicephalobus species is uncommon but has been reported in horses worldwide. Only 3 human cases have been previously described, all of which have been fatal. We report a fourth fatal case, which occurred in a 39-year-old woman who presented with meningeal signs, altered mental status, and a prodromal pruritic rash. Diagnostic evaluation included an open brain biopsy, which was diagnosed as granulomatous vasculitis. The patient subsequently died after a course of steroids and cyclophosphamide. At autopsy, a robust perivascular mixed inflammatory infiltration of the brain parenchyma, meninges, and ventricular system was present with larval forms and mature nematodes morphologically consistent with Halicephalobus deletrix . Although extremely rare, this organism needs to be considered in the differential diagnosis of human helminthic infection of the central nervous system.

Rhabdias kongmongthaensis sp. n. (Nematoda: Rhabdiasidae) from Polypedates leucomystax (Amphibia: Anura: Rhacophoridae) in Thailand.

Rhabdias kongmongthaensis sp. n. is described based on specimens found in the lungs of the tree frog Polypedates leucomystax (Gravenhorst) (Amphibia: Rhacophoridae) from Kanchanaburi Province, western Thailand. The new species is similar to two North-American species, Rhabdias ranae and R. americanus, by presence of two lateral pseudolabia, each with two inner submedian protuberances. R. kongmongthaensis differs from both species by relative length and shape of the tail, and by its distribution and host specificity. Presence of lateral pseudolabia distinguishes the new species from the geographically closest Rhabdias species as well as from those parasitizing other rhacophorid frogs.

Radiculomeningomyelitis due to Halicephalobus gingivalis in a horse.

An adult horse was euthanatized following a clinical diagnosis of cauda equina neuritis. Significant gross postmortem and histopathologic findings were limited to the sacral spinal cord and cauda equina. The sacral spinal cord, meninges, and spinal nerve roots were expanded and partially effaced by sclerosing granulomatous inflammation with necrosis. The lesion contained numerous nematode larvae and fewer adults with a rhabditiform esophagus having a corpus, isthmus, and valved bulb. Female nematodes were amphidelphic and didelphic with reflexed ovaries. These morphologic features confirm Halicephalobus gingivalis as a novel cause of clinical signs in this case of cauda equina neuritis.

Halicephalobus gingivalis (Nematoda) infection in a Grevy's zebra (Equus grevyi).

A 6-yr-old female Grevy's zebra (Equus grevyi) with a disseminated rhabditiform nematode infection is described. Antemortem clinical signs were limited to blindness and abnormal behavior believed to be caused by a recurrent nematode-induced uveitis. Histologic examination of the kidneys, heart, eyes, uterus, and lymph nodes revealed granulomas containing multiple sections of rhabditiform nematodes. Most of the recovered nematodes were larval stages with only a few adult females noted. The adults measured 243-297 microm x 11-16 microm (x = 269 x 14 microm). The distinctive rhabditiform esophagi had corpus:isthmus:bulb proportions of 19:11:5. On the basis of adult morphology, the nematode was identified as Halicephalobus gingivalis. This is the first report of this parasite in a zebra and indicates that this parasitic granulomatous disease should be considered in zebras with neurologic disease.

Disseminated Halicephalobus deletrix infection in a horse.

A 13-year-old Quarter Horse gelding was referred for evaluation of a draining tract and fracture of the right hemimandible of 4 weeks' duration. Two days prior to admission, the horse had developed pigmenturia. Radiography of the mandible revealed a fracture of the vertical ramus of the right hemimandible, loss of the right lower second premolar, and osteomyelitis involving an extensive portion of the hemimandible. Ultrasonography of the left kidney revealed loss of normal renal architecture. Histologic examination of tissue obtained from the right hemimandible revealed granulomatous osteomyelitis and multiple metazoan parasites identified as Halicephalobus deletrix. The horse was treated with antimicrobial and deworming agents, and the mandible was surgically debrided. The horse became atactic 8 days after surgery and was euthanatized. Necropsy identified parasitic migration in the right hemimandible, kidneys, and CNS.