RESUMO
Background: Traditionally, human coenurosis has been ascribed to Taenia multiceps while neurocysticercosis has been attributed solely to Taenia solium infection. Historically, however, the identification and differentiation of cestodal infection was primarily based on inaccurate morphological criteria. With the increasing availability of molecular methods, the accuracy of identification of the larval cestode species has improved, and cestodal species not typically associated with central nervous system (CNS) infection are now being identified as aetiological agents. Case report: We present a case of a 5-year-old male patient who presented with acute hydrocephalus. Initial MRI revealed multiple cysts in the cerebrospinal fluid (CSF) spaces with a predominance of clumped grape-like cysts in the basal cisterns with resultant acute obstructive hydrocephalus. The child underwent an emergency ventriculo-peritoneal (VP) shunt. A presumptive diagnosis of neurocysticercosis racemosus was made and the child was started on empiric albendazole (15 mg/kg/day) and praziquantel (30 mg/kg/day) treatment, along with concomitant prednisone (1 mg/kg) treatment. Despite prolonged anti-helminthic therapy, the child continued to deteriorate, and endoscopic removal of the 4th ventricular cysts was required. Post-operative MRI revealed radiological improvements, with a reduction in the number and size of cysts, especially in the basal cisterns, with no cysts visualized in the fourth ventricle. DNA was extracted from CSF and cyst tissue using the QiAMP DNA mini kit (Qiagen). The PCR performed on the extracted DNA displayed a band of 275 bp on an agarose gel. The consensus sequence had 97.68% similarity to Taenia serialis 12S ribosomal RNA gene. The child, unfortunately, continued to do poorly, requiring multiple VP shunt revisions for repeated blockage of the VP shunt system, and ultimately demised, despite the 'successful' surgical intervention and continued maximal medical management. Discussion and conclusions: There have been approximately 40 reported cases of human CNS coenurosis, with the assumed etiological agent being confined to T. multiceps. In 2020, the first case of human CNS coenurosis caused by T. serialis was reported. This case involved a single parenchymal lesion in the occipital lobe, which, following complete surgical excision, was confirmed to be T. serialis by mitochondrial gene sequencing. The case we present is the first case of disseminated subarachnoid coenurosis caused by T. serialis. It appears that T. serialis infection can mimic either of the two basic pathological forms of neurocysticercosis, namely, cysticercosis cellulosae or cysticercosis racemosus. We postulate that the term coenurosis racemosus is applicable if CNS T. serialis infection presents with extensive, multiple grape-like bladders proliferating within the subarachnoid space.
RESUMO
African horse sickness virus (AHSV) is the causative agent of the often fatal disease African horse sickness in equids. The non-structural protein NS4 is the only AHSV protein that localizes to the nucleus. Here we report that all AHSV reference and representative field strains express one of the two forms of NS4, i.e. NS4-I or NS4-II. Both forms of NS4 are nucleocytoplasmic proteins, but NS4-I has a stronger nuclear presence whilst NS4-II has a proportionally higher cytoplasmic distribution. A subtype of NS4-II containing a nuclear localization signal (NLS), named NLS-NS4-II, displays distinct punctate foci in the nucleus. We showed that NS4 likely enters the nucleus via passive diffusion as a result of its small size. Colocalization analysis with nuclear compartments revealed that NS4 colocalizes with promyelocytic leukaemia nuclear bodies (PML-NBs), suggesting a role in the antiviral response or interferon signalling. Interestingly, we showed that two other AHSV proteins also interact with nuclear components. A small fraction of the NS1 tubules were present in the nucleus and associated with PML-NBs; this was more pronounced for a virus strain lacking NS4. A component of nuclear speckles, serine and arginine rich splicing factor 2 (SRSF2) was recruited to viral inclusion bodies (VIBs) in the cytoplasm of AHSV-infected cells and colocalized with NS2. Nuclear speckles are important sites for cellular mRNA transcript processing and maturation. Collectively, these results provide data on three AHSV non-structural proteins interacting with host cell nuclear components that could contribute to overcoming antiviral responses and creating conditions that will favour viral replication.
