Asunto(s)
Enfermedades Pulmonares Parasitarias , Paragonimiasis , Tuberculosis Pulmonar , Humanos , Niño , Paragonimiasis/diagnóstico , Paragonimiasis/tratamiento farmacológico , Tos/etiología , Enfermedades Pulmonares Parasitarias/complicaciones , Enfermedades Pulmonares Parasitarias/diagnóstico , Enfermedades Pulmonares Parasitarias/tratamiento farmacológicoRESUMEN
Toxocara canis, a common roundworm that mainly causes toxocariasis, is a zoonotic parasite found worldwide. Humans, an accidental host, can acquire T. canis infection through accidental ingestion of T. canis-embryonated egg-contaminated food, water, and soil, and by encapsulated larvae in a paratenic host's viscera or meat. Long-term residence of T. canis larvae in a paratenic host's lungs may induce pulmonary inflammation that contributes to lung injury, airway inflammatory hyperresponsiveness, and collagen deposition in mice and clinical patients. This study intended to investigate the relationship between T. canis infection and allergic asthma in BALB/c mice inoculated with high, moderate, and low doses of T. canis eggs for a 13-week investigation. The airway hyperresponsiveness (AHR) to methacholine, collagen deposition, cytokine levels, and pathological changes in lung tissues was assessed in infected mice at weeks 1, 5, and 13 postinfection. The cell composition in bronchoalveolar lavage fluid of infected mice was assessed at weeks 5 and 13 postinfection. Compared with uninfected control mice, all groups of T. canis-infected mice exhibited significant AHR, a dose-dependent increase in eosinophilic infiltration leading to multifocal interstitial and alveolar inflammation with abundant mucus secretion, and collagen deposition in which the lesion size increased with the infective dose. Infected mice groups also showed significant expressions of eotaxin and type 2 T-helper-dominant cytokines such as interleukin (IL)-4, IL-5, and IL-13. Overall, these results suggest that T. canis larval invasion of the lungs may potentially cause pulmonary inflammatory injury and could subsequently contribute to the development of allergic manifestations such as asthma.
Asunto(s)
Asma/inmunología , Enfermedades Pulmonares Parasitarias/inmunología , Pulmón/inmunología , Hipersensibilidad Respiratoria/inmunología , Toxocara canis , Toxocariasis/inmunología , Animales , Asma/etiología , Asma/patología , Asma/fisiopatología , Líquido del Lavado Bronquioalveolar/citología , Colágeno , Citocinas/inmunología , Modelos Animales de Enfermedad , Eosinofilia/inmunología , Interleucina-13/inmunología , Interleucina-4/inmunología , Interleucina-5/inmunología , Pulmón/parasitología , Pulmón/patología , Pulmón/fisiopatología , Enfermedades Pulmonares Parasitarias/complicaciones , Enfermedades Pulmonares Parasitarias/patología , Enfermedades Pulmonares Parasitarias/fisiopatología , Ratones , Ratones Endogámicos BALB C , Moco , Hipersensibilidad Respiratoria/etiología , Hipersensibilidad Respiratoria/patología , Hipersensibilidad Respiratoria/fisiopatología , Células Th2/inmunología , Toxocariasis/complicaciones , Toxocariasis/patología , Toxocariasis/fisiopatologíaRESUMEN
Background & objectives: Pulmonary disease is the main cause of morbidity and mortality in cystic fibrosis (CF). The infection occurs with a unique spectrum of bacterial pathogens that are usually acquired in an age-dependent fashion. The objective of this study was to find out the aetiological agents in respiratory specimens from children with CF during pulmonary exacerbation and relate with demographic variables. Methods: In this observational study, airway secretions from children (n=104) with CF presenting with pulmonary exacerbations were collected and tested for bacteria, fungi, mycobacteria and viral pathogens using appropriate laboratory techniques. The frequencies of isolation of various organisms were calculated and associated with various demographic profiles. Results: Bacteria were isolated in 37 (35.5%) and viral RNA in 27 (29.3%) children. Pseudomonas was the most common bacteria grown in 31 (29.8%) followed by Burkholderia cepacia complex (Bcc) in three (2.8%) patients. Among viruses, Rhinovirus was the most common, identified in 16 (17.4%) samples followed by coronavirus in four (4.3%). Fungi and mycobacteria were isolated from 23 (22.1%) and four (3.8%) children, respectively. Aspergillus flavus was the most common fungus isolated in 13 (12.5%) children. Interpretation & conclusions: Pseudomonas was the most common organism isolated during exacerbation. Non-tuberculous mycobacteria were not isolated, whereas infection with Bcc and Mycobacterium tuberculosis was observed, which could probably have a role in CF morbidity. Polymicrobial infections were associated with severe exacerbations.
Asunto(s)
Fibrosis Quística/microbiología , Infecciones por Picornaviridae/complicaciones , Infecciones por Pseudomonas/complicaciones , Aspergilosis Pulmonar/complicaciones , Adolescente , Factores de Edad , Aspergillus flavus , Betacoronavirus , Infecciones por Burkholderia/microbiología , Complejo Burkholderia cepacia/aislamiento & purificación , COVID-19 , Candida albicans , Candidiasis/complicaciones , Candidiasis/microbiología , Niño , Preescolar , Coinfección/microbiología , Infecciones por Coronavirus/virología , Progresión de la Enfermedad , Femenino , Humanos , India , Lactante , Enfermedades Pulmonares Parasitarias/complicaciones , Enfermedades Pulmonares Parasitarias/parasitología , Masculino , Mycobacterium tuberculosis/aislamiento & purificación , Pandemias , Infecciones por Picornaviridae/virología , Neumonía Viral/virología , Pseudomonas/aislamiento & purificación , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa/aislamiento & purificación , Aspergilosis Pulmonar/microbiología , Estudios Retrospectivos , Rhinovirus/aislamiento & purificación , SARS-CoV-2 , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/aislamiento & purificación , Centros de Atención Terciaria , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/microbiologíaRESUMEN
Alternatively activated macrophages are essential effector cells during type 2 immunity and tissue repair following helminth infections. We previously showed that Ym1, an alternative activation marker, can drive innate IL-1R-dependent neutrophil recruitment during infection with the lung-migrating nematode, Nippostrongylus brasiliensis, suggesting a potential role for the inflammasome in the IL-1-mediated innate response to infection. Although inflammasome proteins such as NLRP3 have important proinflammatory functions in macrophages, their role during type 2 responses and repair are less defined. We therefore infected Nlrp3 -/- mice with N. brasiliensis Unexpectedly, compared with wild-type (WT) mice, infected Nlrp3 -/- mice had increased neutrophilia and eosinophilia, correlating with enhanced worm killing but at the expense of increased tissue damage and delayed lung repair. Transcriptional profiling showed that infected Nlrp3 -/- mice exhibited elevated type 2 gene expression compared with WT mice. Notably, inflammasome activation was not evident early postinfection with N. brasiliensis, and in contrast to Nlrp3 -/- mice, antihelminth responses were unaffected in caspase-1/11-deficient or WT mice treated with the NLRP3-specific inhibitor MCC950. Together these data suggest that NLRP3 has a role in constraining lung neutrophilia, helminth killing, and type 2 immune responses in an inflammasome-independent manner.
Asunto(s)
Inflamasomas/fisiología , Enfermedades Pulmonares Parasitarias/inmunología , Proteína con Dominio Pirina 3 de la Familia NLR/fisiología , Nippostrongylus/inmunología , Infecciones por Strongylida/inmunología , Animales , Caspasa 1/fisiología , Quimiotaxis de Leucocito , Eosinofilia/etiología , Eosinofilia/inmunología , Furanos/farmacología , Compuestos Heterocíclicos de 4 o más Anillos , Inmunidad Innata , Indenos , Interleucina-4/farmacología , Lectinas/biosíntesis , Lectinas/genética , Pulmón/patología , Pulmón/fisiología , Enfermedades Pulmonares Parasitarias/complicaciones , Enfermedades Pulmonares Parasitarias/patología , Enfermedades Pulmonares Parasitarias/fisiopatología , Macrófagos Alveolares/enzimología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Proteína con Dominio Pirina 3 de la Familia NLR/antagonistas & inhibidores , Proteína con Dominio Pirina 3 de la Familia NLR/deficiencia , Proteína con Dominio Pirina 3 de la Familia NLR/genética , Neutrófilos/inmunología , Regeneración , Infecciones por Strongylida/complicaciones , Infecciones por Strongylida/patología , Infecciones por Strongylida/fisiopatología , Sulfonamidas/farmacología , Sulfonas , Transcripción Genética , beta-N-Acetilhexosaminidasas/biosíntesis , beta-N-Acetilhexosaminidasas/genéticaRESUMEN
A 37-year-old woman presented to our hospital with mild abdominal pain experienced for 2 months and hepatic nodules in segments 3 and 8. Peripheral blood eosinophilia was observed, and toxocariasis was serologically diagnosed. Seventeen days after the first imaging evaluation, a new lesion was found in segment 9 of the right lung, which was contiguous through the diaphragm to the hepatic nodule in segment 8. After treatment with albendazole, the liver and lung nodules disappeared. We suspect that larvae had directly invaded the lung from the liver, through the diaphragm.
Asunto(s)
Larva Migrans Visceral/diagnóstico , Parasitosis Hepáticas/diagnóstico por imagen , Enfermedades Pulmonares Parasitarias/diagnóstico por imagen , Dolor Abdominal , Adulto , Albendazol/uso terapéutico , Antihelmínticos/uso terapéutico , Antivirales/uso terapéutico , Diafragma , Eosinofilia , Femenino , Hepatitis C/complicaciones , Hepatitis C/tratamiento farmacológico , Humanos , Larva Migrans Visceral/complicaciones , Larva Migrans Visceral/tratamiento farmacológico , Parasitosis Hepáticas/complicaciones , Parasitosis Hepáticas/tratamiento farmacológico , Enfermedades Pulmonares Parasitarias/complicaciones , Imagen por Resonancia Magnética , Toxocariasis/complicaciones , Toxocariasis/diagnóstico , Toxocariasis/tratamiento farmacológicoAsunto(s)
Enfermedades Pulmonares Parasitarias/diagnóstico , Pulmón/diagnóstico por imagen , Eosinofilia Pulmonar/diagnóstico , Animales , Cardiomiopatía Hipertrófica Familiar/complicaciones , Tos/etiología , Diagnóstico Diferencial , Electrocardiografía , Filariasis Linfática/diagnóstico , Eosinofilia/diagnóstico , Humanos , Enfermedades Pulmonares Fúngicas/diagnóstico , Enfermedades Pulmonares Parasitarias/complicaciones , Masculino , Microfilarias , Persona de Mediana Edad , Eosinofilia Pulmonar/complicaciones , Radiografía Torácica , Evaluación de SíntomasRESUMEN
Dirofilariasis is a little-known zoonosis, with dogs and cats as definitive hosts. It is caused by nematodes and transmitted by mosquito bites. We report the case of a 67-year-old man with a consumptive syndrome with two subpleural pulmonary opacities. A transthoracic lung biopsy revealed a Dirofilaria worm. Myocardial nuclear magnetic resonance (NMR) demonstrated dilated cardiomyopathy after myocarditis related to dirofilariasis. Human infection is rare and occurs accidentally. The most common radiological alteration is a mainly subpleural coin lesion. Dirofilariasis is a neglected emergent disease and knowledge about it is important for differential diagnoses from neoplastic pulmonary nodules.
Asunto(s)
Dirofilariasis/complicaciones , Enfermedades Pulmonares Parasitarias/complicaciones , Miocarditis/etiología , Anciano , Dirofilariasis/diagnóstico , Humanos , Enfermedades Pulmonares Parasitarias/diagnóstico , Masculino , Miocarditis/diagnósticoRESUMEN
A 43-year-old woman was referred to our hospital with peripheral blood hypereosinophilia and abnormal chest X-ray findings. Her pleural effusion revealed hypereosinophilia and a low glucose level. She was diagnosed with pulmonary paragonimiasis based on an elevated antibody level of Paragonimiasis westermani. Although she had no medical history of allergic disorders, a pulmonary function test revealed bronchodilator reversibility. After praziquantel therapy, her symptoms, hypereosinophilia in peripheral blood, and pleural effusion were improved. A repeated pulmonary function test after praziquantel therapy showed a negative bronchodilator response. Pulmonary paragonimiasis may induce bronchodilator reversibility during the acute phase of infection.
Asunto(s)
Bronquios/fisiopatología , Enfermedades Pulmonares Parasitarias/complicaciones , Enfermedades Pulmonares Parasitarias/fisiopatología , Paragonimiasis/complicaciones , Paragonimiasis/fisiopatología , Pruebas de Función Respiratoria/métodos , Enfermedad Aguda , Adulto , Antihelmínticos/uso terapéutico , Broncodilatadores/administración & dosificación , Eosinofilia/diagnóstico por imagen , Eosinofilia/etiología , Femenino , Humanos , Enfermedades Pulmonares Parasitarias/diagnóstico , Enfermedades Pulmonares Parasitarias/tratamiento farmacológico , Paragonimiasis/diagnóstico , Paragonimiasis/tratamiento farmacológico , Derrame Pleural/diagnóstico por imagen , Derrame Pleural/etiología , Praziquantel/uso terapéutico , Radiografía TorácicaRESUMEN
Abstract Dirofilariasis is a little-known zoonosis, with dogs and cats as definitive hosts. It is caused by nematodes and transmitted by mosquito bites. We report the case of a 67-year-old man with a consumptive syndrome with two subpleural pulmonary opacities. A transthoracic lung biopsy revealed a Dirofilaria worm. Myocardial nuclear magnetic resonance (NMR) demonstrated dilated cardiomyopathy after myocarditis related to dirofilariasis. Human infection is rare and occurs accidentally. The most common radiological alteration is a mainly subpleural coin lesion. Dirofilariasis is a neglected emergent disease and knowledge about it is important for differential diagnoses from neoplastic pulmonary nodules.
Asunto(s)
Humanos , Masculino , Anciano , Dirofilariasis/complicaciones , Enfermedades Pulmonares Parasitarias/complicaciones , Miocarditis/etiología , Dirofilariasis/diagnóstico , Enfermedades Pulmonares Parasitarias/diagnóstico , Miocarditis/diagnósticoRESUMEN
Protozoic infections are prevalent worldwide, particularly in immunosuppressed patients. We reported the case of a patient from the city of Viña del Mar, Chile, a carrier of acute myeloid leukemia in whom an infection by Lophomonas sp. was confirmed by bronchoalveolar lavage. She was treated with antibiotics but died of complications of the underlying disease. There is little literature available on this microorganism. We conclude that Lophomonas sp. should be considered as a diagnostic possibility if protozoa are found in bronchoalveolar lavage of immunosuppressed patients.
Las infecciones por protozoos son prevalentes a nivel mundial, en particular en pacientes inmunosuprimidos. Comunicamos el caso de una paciente procedente de la ciudad de Viña del Mar, Chile, portadora de leucemia mieloide aguda en quiense confirmó una infección por Lophomonas sp. en lavado bronquioalveolar. Se manejó con antibióticos, pero falleció decomplicaciones de su enfermedad de base. Existe poca literatura disponible respecto a este microorganismo. Concluimos que debe considerarse a Lophomonas sp. como posibilidad diagnóstica si se encuentran protozoos en lavados bronquioalveolares de pacientes inmunosuprimidos.
Asunto(s)
Enfermedades Pulmonares Parasitarias , Parabasalidea , Infecciones por Protozoos , Anciano , Resultado Fatal , Femenino , Humanos , Leucemia Mieloide Aguda/complicaciones , Enfermedades Pulmonares Parasitarias/complicaciones , Enfermedades Pulmonares Parasitarias/diagnóstico , Enfermedades Pulmonares Parasitarias/tratamiento farmacológico , Infecciones por Protozoos/complicaciones , Infecciones por Protozoos/diagnóstico , Infecciones por Protozoos/tratamiento farmacológicoRESUMEN
RESUMEN Las infecciones por protozoos son prevalentes a nivel mundial, en particular en pacientes inmunosuprimidos. Comunicamos el caso de una paciente procedente de la ciudad de Viña del Mar, Chile, portadora de leucemia mieloide aguda en quiense confirmó una infección por Lophomonas sp. en lavado bronquioalveolar. Se manejó con antibióticos, pero falleció decomplicaciones de su enfermedad de base. Existe poca literatura disponible respecto a este microorganismo. Concluimos que debe considerarse a Lophomonas sp. como posibilidad diagnóstica si se encuentran protozoos en lavados bronquioalveolares de pacientes inmunosuprimidos.
ABSTRACT Protozoic infections are prevalent worldwide, particularly in immunosuppressed patients. We reported the case of a patient from the city of Viña del Mar, Chile, a carrier of acute myeloid leukemia in whom an infection by Lophomonas sp. was confirmed by bronchoalveolar lavage. She was treated with antibiotics but died of complications of the underlying disease. There is little literature available on this microorganism. We conclude that Lophomonas sp. should be considered as a diagnostic possibility if protozoa are found in bronchoalveolar lavage of immunosuppressed patients.
Asunto(s)
Anciano , Femenino , Humanos , Infecciones por Protozoos , Parabasalidea , Enfermedades Pulmonares Parasitarias , Infecciones por Protozoos/complicaciones , Infecciones por Protozoos/diagnóstico , Infecciones por Protozoos/tratamiento farmacológico , Leucemia Mieloide Aguda/complicaciones , Resultado Fatal , Enfermedades Pulmonares Parasitarias/complicaciones , Enfermedades Pulmonares Parasitarias/diagnóstico , Enfermedades Pulmonares Parasitarias/tratamiento farmacológicoRESUMEN
OBJECTIVE: To describe acute respiratory distress syndrome (ARDS) and septic shock in a cat with disseminated toxoplasmosis. CASE SUMMARY: A 2-year-old neutered male domestic shorthair cat was presented for acute respiratory distress. At the time of presentation it had been receiving cyclosporine for treatment of eosinophilic dermatitis. Thoracic radiographs revealed severe mixed nodular interstitial and alveolar patterns. An endotracheal wash was performed, which confirmed a diagnosis of pulmonary toxoplasmosis. Despite initial treatment with oxygen supplementation and intravenous clindamycin, the cat developed refractory hypoxemia and hypotension requiring mechanical ventilation and vasopressor support within 24 hours of hospital admission. Cardiac arrest occurred 56 hours after admission. Necropsy was performed and histopathology revealed protozoal organisms disseminated throughout the heart, lungs, liver, and brain. NEW OR UNIQUE INFORMATION PROVIDED: The clinical and necropsy findings presented here are consistent with ARDS secondary to disseminated toxoplasmosis in a cat. This is the first detailed report of ARDS in a cat. Toxoplasma titer testing and antimicrobial prophylaxis should be considered in cats prior to immunosuppressive treatment with cyclosporine.