Management of severe strongyloidiasis attended at reference centers in Spain.

INTRODUCTION: Strongyloides stercoralis is a globally distributed nematode that causes diverse clinical symptoms in humans. Spain, once considered an endemic country, has experienced a recent increase in imported cases. The introduction of serology helps diagnosis and is currently replacing microbiological techniques in some settings, but its sensitivity is variable and can be low in immunocompromised patients. Diagnosis can only be confirmed by identification of larvae. Often, this "gold standard" can only be achieved in severe cases, such as disseminated S.stercoralis infection, or S.stercoralis hyperinfection syndrome, where parasite load is high. In addition, these clinical presentations are not well-defined. Our aim is to describe severe cases of S.stercoralis, their epidemiological profile, and their clinical details. METHODS: An observational retrospective study of disseminated S.stercoralis infection, or hyperinfection syndrome. Inclusion criteria: aged over 18, with a diagnosis of disseminated S.stercoralis infection, or hyperinfection syndrome, confirmed by visualization of larvae. Patients were identified through revision of clinical records for the period 2000-2015, in collaboration with eight reference centers throughout Spain. RESULTS: From the period 2000-2015, eighteen cases were identified, 66.7% of which were male, with a median age of 40 (range 21-70). Most of them were foreigners (94.4%), mainly from Latin America (82.3%) or Western Africa (17.6%). Only one autochthonous case was identified, from 2006. Immunosuppressive conditions were present in fourteen (77%) patients, mainly due steroids use and to retroviral coinfections (four HIV, two HTLV). Transplant preceded the clinical presentation in four of them. Other comorbidities were coinfection with HBV, Trypanosoma cruzi, Mycobacterium leprae or Aspergillus spp. All presented with digestive disorders, with 55.6% also presenting malaise. 44.4% of cases had fever, 27.8% skin complaints, and 16.7% respiratory or neurological disorders. One patient presented anemia, and one other nephrotic syndrome. Diagnosis was confirmed by identification of larvae in fresh stool samples (n = 16; 88.9%), concentration techniques (n = 6; 33.3%), larval culture (n = 5; 29.4%), or digestive biopsies (n = 8; 44%). S.stercoralis forms were identified during necropsy in one case. In addition, ten (55%) had a positive serology. All the cases were treated with ivermectin, six (33%) also received albendazole and one case received thiabendazole followed by ivermectin. All needed inpatient management, involving a mean hospitalization stay of 25 days (range 1-164). Two cases received intensive care and eventually died. CONCLUSIONS: Only eighteen cases of disseminated S.stercoralis infection/hyperinfection syndrome were identified from the 15-year period, most of which were considered to have been imported cases. Among those, immunosuppression was frequent, and mortality due to S.stercoralis was lower than previously described.

Performance of Debaryomyces hansenii as a Diet for Rotifers for Feeding Zebrafish Larvae.

The zebrafish larval stage is a critical moment due to high mortality rates associated with inadequate supplies of nutritional requirements. Larval feeding has important challenges associated with such factors as small mouth gape (≈100 µm), the low activity of digestive enzymes, and the intake of live food. A common zebrafish live food at the onset of exogenous feeding is rotifers, mainly Brachionus plicatilis. These rotifers should be fed with other microorganisms such as microalgae or yeast, mostly from the Saccharomyces genus. In the laboratory, the culture of microalgae is more expensive than the culture of yeast. The aim of this study was to evaluate the performance of Debaryomyces hansenii as a diet for rotifers in comparison to a microalgae-based diet (Rotigrow®). To achieve this aim, we assessed the rotifer total protein content, the rotifers fatty acid profile, zebrafish larval growth performance, the expression of key growth, and endocrine appetite regulation genes. The total protein and fatty acids content were similar in both rotifer cultures, averaging 35% of dry matter (DM) and 18% of DM, respectively. Interestingly, the fatty acids profile showed differences between the two rotifer cultures: omega-3 fatty acids were only observed in the Microalgae/rotifer, whereas, omega-6 fatty acids presented similar levels in both rotifer cultures. No differences were observed in the larval body length distribution or mortalities between the rotifer cultures. However, gh, igf-1, and cck gene expression showed significantly higher upregulation in zebrafish fed the Microalgae/rotifer diet compared with those fed the Debaryomyces/rotifer diet. In conclusion, D. hansenii could be an alternative diet for rotifer used as a live food in zebrafish larvae at the onset of exogenous feeding. The gene responses observed in this work open up the opportunity to study the effect of omega-3 supply on growth regulation in zebrafish.

[Biology of Agistemus brasiliensis Matioli, Ueckermann & Oliveira (Acari: Stigmaeidae) and its predation potential on Brevipalpus phoenicis (Geijskes) (Acari: Tenuipalpidae)]. / Biologia de Agistemus brasiliensis Matioli, Ueckermann & Oliveira (Acari: Stigmaeidae) e sua potencialidade de predação sobre Brevipalpus phoenicis (Geijskes) (Acari: Tenuipalpidae).

The present work aimed to study the biology of Agistemus brasiliensis Matioli, Ueckermann & Oliveira at the following temperatures, namely 15, 20, 25, 30 and 35 degrees C, fed with Brevipalpus phoenicis (Geijskes) and Typha pollen, in laboratory conditions. Life tables were calculated to evaluate the biological parameters. The optimal development of A. brasiliensis took place at 29 degrees C. The values of T (time of generation - days), R0 and r m at 30 degrees C were, 13.95, 16.25 and 0.20, respectively. The prey consumption of A. brasiliensis was studied at the densities of 5, 10, 20, 40 and 60 leprosis mite females per cage (3 cm in diameter) on citrus fruits at 29 degrees C. The maximum prey, namely 7.6 B. phoenicis females per day, were consumed at a density of 20 leprosis mites. At densities of above 40 leprosis mites per cage, A. brasiliensis oviposits 4.7 eggs per day, in comparison to 2.5 eggs per day at 20 mites per cage.