Ocular linguatuliasis in Ecuador: case report and morphometric study of the larva of Linguatula serrata.

Linguatula serrata is a pentastomid, a cosmopolitan parasite belonging to the Phylum Pentastomida. Humans may act as an intermediate or accidental definitive host of this parasite, manifesting the nasopharyngeal or visceral form, with the latter having been described more frequently. The occurrence of ocular linguatuliasis is extremely rare, but it has been reported in the United States and Israel. The objective of the present paper was to report the first case of ocular linguatuliasis in Ecuador and to extend the morphologic study of L. serrata by morphometric analysis. The patient studied was a 34-year old woman from Guayaquil, Ecuador who complained of ocular pain with conjunctivitis and visual difficulties of two-months duration. Biomicroscopic examination revealed a mobile body in the anterior chamber of the eye. The mobile body was surgically removed. The specimen was fixed in alcohol, cleared using the technique of Loos, stained with acetic carmine, and mounted on balsam between a slide and a coverslip. It was observed with stereoscopic and common light microscopes in combination with an automatic system for image analysis and processing. The morphologic and morphometric characteristics corresponded to the third-instar larval form of L. serrata. To our knowledge, ocular linguatuliasis has not been previously described in South America, with this being the first report for Ecuador and South America. The present study shows that computer morphometry can adequately contribute both to the morphologic study and to the systematic classification of Pentastomids, and L. serrata in particular.

[Toxoplasmic and chagasic meningoencephalitis in patients with human immunodeficiency virus infection: anatomopathologic and tomographic differential diagnosis]. / Meningoencefalites toxoplásmica e chagásica em pacientes com infecção pelo vírus da imunodeficiência humana: diagnóstico diferencial anatomopatológico e tomográfico.

Twenty-two HIV+ patients with encephalitis were studied. Of these, 7 had meningoencephalitis due to Toxoplasma gondii (MT) and 15 due to Trypanosoma cruzi (MC). Pathologic and computerized axial tomography (CAT) changes were compared. We found that focal necrotizing encephalitis due to Toxoplasma involved the cerebral cortex and the basal ganglia, whereas lesions due to Trypanosoma cruzi were centered in the white matter, sometimes extending into the cortex. Hemorrhages, myelin lesions and organisms were more pronounced in chagasic than in toxoplasmic encephalitis. These findings are consistent with the literature reviewed.

Meningoencefalites toxoplásmica e chagásica em pacientes com infecção pelo vírus da imunodeficiência humana: diagnóstico diferencial anatomopatológico e tomográfico / Toxoplasmic and chagasic meningoencephalitis in patients with human immunodeficiency virus infection: anatomopathologic and tomographic differential diagnosis

Em 22 pacientes com sorologia positiva para o vírus da imunodeficiência humana, com ou sem síndrome da imunodeficiência adquirida, dos quais 7 com meningoencefalite toxoplásmica e 15 com meningoencefalite chagásica associadas, procuraram-se dados diferenciais, entre as duas encefalopatias, tanto à anatomia patológica quanto à tomografia computadorizada do crânio. Os resultados observados e os dados da literatura nos permitiram concluir que enquanto na meningoencefalite necrosante focal por Toxoplasma gondii o acometimento dos núcleos da base é freqüente, na meningoencefalite necrosante focal causada pelo Trypanosoma cruzi, lesões dessas estruturas parecem não ocorrer ou ser excepcionais. De outro lado, o acometimento da substância branca parece nitidamente maior na meningoencefalite chagásica que na meningoencefalite toxoplásmica, ao passo que o parasitismo e a hemorragia do tecido nervoso, bem como as lesões das bainhas de mielina são mais freqüentes e intensos na meningoencefalite causada pelo Trypanosoma cruzi que naquela por Toxoplasma.

Twenty-two HIV+ patients with encephalitis were studied. Of these, 7 had meningoencephalitis due to Toxoplasma gondii (MT) and 15 due to Trypanosoma cruzi (MC). Pathologic and computerized axial tomography (CAT) changes were compared. We found that focal necrotizing encephalitis due to Toxoplasma involved the cerebral cortex and the basal ganglia, whereas lesions due to Trypanosoma cruzi were centered in the white matter, sometimes extending into the cortex. Hemorrhages, myelin lesions and organisms were more pronounced in chagasic than in toxoplasmic encephalitis. These findings are consistent with the literature reviewed.