Ovarian Filariasis: Diagnosis by detection of microfilariae in follicular fluid, a case report.

Filariasis is a common parasitic infection in India. It is rare to find neglected cases of Filariasis nowadays. We reported the presence of microfilaria species in the follicular fluid of an egg donor undergoing an ovum pick up procedure. She was a 23-year-old egg donor who underwent stimulation using the GnRH antagonist protocol. Antagonist protocol is one of the standard protocols used for controlled ovarian hyperstimulation as a part of the IVF/ICSI(in-vitro fertilization / intracytoplasmic sperm injection) procedure where GnRH antagonist (cetrorelix) is used to suppress the endogenous LH surge. Her baseline investigations were normal, with no significant history suggestive of any worm infestations. During the ovum pickup procedure, follicular fluid revealed the presence of worm-like structures suggestive of larvae of some parasites. The follicular fluid was sent to the microbiology department along with the blood sample to confirm the parasite species. The parasite was found to be the larvae of W. Bancroft. The oocytes were of poor quality and were discarded. The patient was treated with Diethylcarbamazine citrate. There are so many reports about scrotal Filariasis, but rare literature quotes ovarian Filariasis.

Laparoscopic surgery for primary ovarian and retroperitoneal hydatid disease: A case report.

RATIONALE: Cystic echinococcosis (CE) is a parasitic zoonosis caused by echinococcus larvae. Manifestations of the disease include a severe damage to the liver and lung. Damages to the mesentery, omentum, spleen, brain, heart, bone, thyroid, kidney, and uterus are rarely observed. Moreover, primary ovarian and retroperitoneal hydatid disease is extremely rare, and is easily ignored or misdiagnosed. PATIENT CONCERNS: We present a case of CE in a 34-year-old female who presented with an adnexal mass detected by B-ultrasound. Adnexal and retroperitoneal masses were removed by laparoscopic surgery. Postoperative pathological report (retroperitoneal cyst) Echinococcus granulosus. DIAGNOSES: Primary ovarian and retroperitoneal hydatid disease. INTERVENTIONS: The patient received intravenous injection of dexamethasone (10 mg) before cyst resection to prevent allergic reactions and oral albendazole (600 mg BID) for 14 days to prevent relapse postsurgery. OUTCOMES: The patient revealed no recurrence of disease and no reportable significant changes in 3 months. LESSONS: We present here a case report of CE. This case described herein inhabited a nonendemic region. Gentle and careful operation, and avoiding cyst rupture is the key to insuring success of the surgery. For safety, dexamethasone may be used before cyst resection to prevent anaphylaxis, and mebendazole can be used postoperatively to prevent relapse.

Ovarian Manson's Schistosomiasis: Rare Diagnosis or Underestimated Prevalence? / Esquistossomose mansônica no ovário: diagnóstico raro ou prevalência subestimada?

Abstract The occurrence of Manson's schistosomiasis in organs of the female reproductive tract is an uncommon event, given that the etiological agent for this disease is a blood parasite that inhabits the mesenteric veins. In this case report, a 45-year-old female patient reported that her first symptoms had been strong pain in the left iliac region around two years earlier. An endovaginal pelvic ultrasonography showed that the left ovary was enlarged, and the report suggested that this finding might be correlated with clinical data and tumor markers. After being examined at several healthcare services, the patient was referred to an oncology service due to suspected neoplasia, where she underwent a left ovariectomy. The result from the histopathological examination showed the presence of granulomatous inflammatory processes surrounding both viable and calcified eggs of Schistosoma mansoni. There was no evidence of any neoplastic tissue. The patient was medicated and followed-up as an outpatient.

Resumo A ocorrência da esquistossomose mansônica em órgãos do aparelho reprodutor feminino é um evento pouco comum, tendo em vista que o agente etiológico desta doença é um parasito sanguíneo que habita as veias mesentéricas. Neste relato decaso, uma paciente de 45 anos referiu como primeira sintomatologia fortes dores na região ilíaca esquerda há cerca de 2 anos. Uma ultrassonografia pélvica endovaginal identificou aumento do ovário esquerdo, e o laudo sugeriu correlacionar tal achado com dados clínicos e marcadores tumorais. Após passar por vários serviços de saúde, a paciente foi encaminhada para um serviço de oncologia por suspeita de neoplasia, sendo submetida a uma ovariectomia à esquerda. O resultado do exame histopatológico evidenciou a presença de processos inflamatórios granulomatosos em torno de ovos viáveis e calcificados de Schistosoma mansoni. Não houve qualquer evidência de tecido neoplásico. A paciente foi medicada, e seguiu em acompanhamento ambulatorial.

Ovarian Manson's Schistosomiasis: Rare Diagnosis or Underestimated Prevalence?

The occurrence of Manson's schistosomiasis in organs of the female reproductive tract is an uncommon event, given that the etiological agent for this disease is a blood parasite that inhabits the mesenteric veins. In this case report, a 45-year-old female patient reported that her first symptoms had been strong pain in the left iliac region around two years earlier. An endovaginal pelvic ultrasonography showed that the left ovary was enlarged, and the report suggested that this finding might be correlated with clinical data and tumor markers. After being examined at several healthcare services, the patient was referred to an oncology service due to suspected neoplasia, where she underwent a left ovariectomy. The result from the histopathological examination showed the presence of granulomatous inflammatory processes surrounding both viable and calcified eggs of Schistosoma mansoni. There was no evidence of any neoplastic tissue. The patient was medicated and followed-up as an outpatient.

A ocorrência da esquistossomose mansônica em órgãos do aparelho reprodutor feminino é um evento pouco comum, tendo em vista que o agente etiológico desta doença é um parasito sanguíneo que habita as veias mesentéricas. Neste relato de caso, uma paciente de 45 anos referiu como primeira sintomatologia fortes dores na região ilíaca esquerda há cerca de 2 anos. Uma ultrassonografia pélvica endovaginal identificou aumento do ovário esquerdo, e o laudo sugeriu correlacionar tal achado com dados clínicos e marcadores tumorais. Após passar por vários serviços de saúde, a paciente foi encaminhada para um serviço de oncologia por suspeita de neoplasia, sendo submetida a uma ovariectomia à esquerda. O resultado do exame histopatológico evidenciou a presença de processos inflamatórios granulomatosos em torno de ovos viáveis e calcificados de Schistosoma mansoni. Não houve qualquer evidência de tecido neoplásico. A paciente foi medicada, e seguiu em acompanhamento ambulatorial.

Enterobius vermicularis infection of the ovary.

Enterobius vermicularis is an intestinal parasite, which may occasionally involve extraintestinal sites including the female genital tract. We report a rare case of ovarian involvement, which presented with chronic right iliac fossa pain in a 31-year-old woman. A transvaginal ultrasound scan was suggestive of a right adnexal dermoid cyst; however, histological examination of the subsequent salpingo-oophorectomy specimen showed an abscess containing viable E. vermicularis ova. E. vermicularis is the most prevalent human nematode worldwide. Its ova are ingested, larvae hatch and mature female worms journey to the perianal region where they lay eggs. Female worms may also migrate from the anus along the female genital tract. Although of low pathogenicity, complications such as infertility or peritonitis may arise.

Acute ovarian torsion and primary hypothyroidism.

A 12-year-old girl presented with acute abdominal pain due to an acute ovarian torsion. She required an oophorectomy. Clinical and laboratory assessment confirmed severe primary hypothyroidism. In this report, we review this rare complication of untreated primary hypothyroidism and the physiologic mechanisms proposed to explain this phenomenon.

[Tuboovarian abscess caused by hydatid cyst: a rare case]. / Nadir bir olgu: Tuboovaryan apseye neden olan hidatik kist.

Primary lesions of hydatid cysts caused by Echinococcus granulosus, are frequently localized in liver, followed by lungs, muscles, kidneys, spleen and bones. Pelvic inoculations are rare and usually occur as a secondary infection. In this report, a case of primary hydatid cyst in the abdomen, spleen and pelvic organs, clinically mimicking tuboovarian abscess, was presented. A nineteen-years-old female patient was admitted to the gynecology outpatient clinic with the complaint of abdominal pain for two days. The case was considered as tuboovarian abscess according to the initial examination findings and hospitalized for treatment and follow-up. In transabdominal ultrasound examination, 44 x 43 mm thin-walled septated cysts in the left ovary and 65 x 65 mm thin-walled multiloculated cysts in the spleen were detected. Abdominal computerized tomography also yielded multivesicular cystic masses in spleen, front abdominal wall and the left ovary. Since the clinical and vital findings worsened, she initially underwent ovarian cystectomy by laparoscopy, then abdominal cystectomy and splenectomy. The operation material examined macroscopically was compatible with hydatid cyst with the characteristics of a germinative membrane and hydatid sand. The diagnosis was confirmed by histopathological examination. The patient was discharged without complication on post-operative sixth day, with a recommendation of albendezol (15 mg/kg/day, 3 months) treatment. Since the patient had undergone emergency surgery, indirect hemaglutination (IHA) test had not been performed pre-operatively. However, post-operative third month serum sample revealed a positive (1/32) IHA titer. In conclusion, hydatid cyst should be kept in mind in the differential diagnosis of patients with abdominal pain, in response to the high prevalence of the parasite in our country.

Genital schistosomiasis mansoni concomitant to genital tumor in areas of low endemicity: challenging diagnosis.

Genital infection by Schistosoma mansoni is usually misdiagnosed in individuals who reside in, or travel to endemic areas. We describe two cases of genital tumor associated with S. mansoni infection manifested by methrorragy. Surgical specimens revealed leiomyomas in both cases associated with S. mansoni. In one of them, granulomas were found in the ovary and in the other they were found in the uterine tube. Although none presented intestinal/hepatic disease, fecal egg excretion was detected in one. Both had elevated pretreatment antibody reactivity to S. mansoni antigen, but follow-up showed different outcomes. Schistosomiasis should be considered as a diagnosis in individuals with methrorragy residing in or having traveled to endemic areas. Since diagnosis follows genital amputation, and cure control is troublesome, improvement of diagnostic tools and follow-up markers are important priorities to decrease schistosomiasis morbidity.

Genital schistosomiasis mansoni concomitant to genital tumor in areas of low endemicity: challenging diagnosis

Genital infection by Schistosoma mansoni is usually misdiagnosed in individuals who reside in, or travel to endemic areas. We describe two cases of genital tumor associated with S. mansoni infection manifested by methrorragy. Surgical specimens revealed leiomyomas in both cases associated with S. mansoni. In one of them, granulomas were found in the ovary and in the other they were found in the uterine tube. Although none presented intestinal/hepatic disease, fecal egg excretion was detected in one. Both had elevated pretreatment antibody reactivity to S. mansoni antigen, but follow-up showed different outcomes. Schistosomiasis should be considered as a diagnosis in individuals with methrorragy residing in or having traveled to endemic areas. Since diagnosis follows genital amputation, and cure control is troublesome, improvement of diagnostic tools and follow-up markers are important priorities to decrease schistosomiasis morbidity.

Ovarian hydrobursitis in female camels (Camelus dromedaries): biochemical, bacterial and protozoal evaluation.

The aim of this study was to evaluate female camels affected with ovarian hydrobursitis (n = 31) for hematological and biochemical findings and for bacterial and protozoal infections. Blood samples were obtained and surgical ablation of the affected bursa was performed. Bursal fluid, follicular fluid, and serum were subjected to hormonal and biochemical analyses. Bursal fluids were cultured and colonies were identified using BioMérieux Vitek two compact system. Passive haemagglutination test was used for detection of Trypanosoma evansi. Indirect ELISA technique was carried out for detection of anti-Hydatid cysts anti-bodies. Neutrophilia was found in the affected animals (P = 0.01) with tendencies for monocytosis (P = 0.06) and eosinophelia (P = 0.05). Bursal fluid had a tendency for high estradiol-17ß concentration compared to blood serum (P = 0.07). Progesterone and cholesterol concentrations were similar in bursal fluid, follicular fluid and serum. Total protein, phosphorus, and magnesium concentrations were greater (P < 0.05) in the bursal fluid than in serum. Oligella urethralis, Alloiococcus otitis, Granulicatella adicens, Escherichia coli, Sphingobacterium thalpophilum, Streptococcus sanguinis, Aeromonas salmonicida, Pseudomonas stutzeri, Staphylococcus warneri, Staphylococcus hominis, and Rhizobium radiobacter were isolated from 46.7% of bursal fluids. T. evansi was positive in 9.7% of cases. None were positive for hydatid cyst. Accordingly, we suggest that the ovarian hydrobursitis syndrome is initially an inflammatory process and the accumulated bursal fluid is partially originated from follicular fluid.

Ectopic schistosomiasis: description of five cases involving skin, one ovarian case and one adrenal case / Esquistossomose ectópica: descrição de cinco casos de envolvimento da pele, um do ovário e um da glândula supra-renal

Seven cases of patients with ectopic schistosomiasis from the State of Sergipe, Brazil, are presented (five involving skin, one ovarian and one adrenal). Data were collected from surveying the clinical records and anatomopathological reports in the files of the dermatology and pathology clinics of the University Hospital of the Federal University of Sergipe, from 1995 to 2005. The patients' mean age at diagnosis was 21.1 years. In the dermatological cases, full cures were achieved after treatment with oxamniquine. In the ovarian case, there was an association with embryonic carcinoma: this patient underwent surgery with adjuvant chemotherapy and praziquantel treatment, with satisfactory evolution. The adrenal case was associated with adenoma.

São apresentados sete casos de esquistossomose ectópica (cinco de pele, um de ovário e um de supra-renal) procedentes do Estado de Sergipe, coletados a partir de pesquisa de prontuários e laudos anátomo-patológicos nos arquivos dos Serviços de Dermatologia e de Patologia do Hospital Universitário da Universidade Federal de Sergipe, entre os anos de 1995 e 2005. A média de idade dos pacientes ao diagnóstico foi de 21,1 anos. Nos casos dermatológicos, houve melhora total das lesões após tratamento com oxamniquine. No caso de ovário houve associação com carcinoma embrionário; a paciente foi submetida à cirurgia com quimioterapia adjuvante e praziquantel, evoluindo satisfatoriamente. O caso de supra-renal estava associado a adenoma.

Ectopic schistosomiasis: description of five cases involving skin, one ovarian case and one adrenal case.

Seven cases of patients with ectopic schistosomiasis from the State of Sergipe, Brazil, are presented (five involving skin, one ovarian and one adrenal). Data were collected from surveying the clinical records and anatomopathological reports in the files of the dermatology and pathology clinics of the University Hospital of the Federal University of Sergipe, from 1995 to 2005. The patients' mean age at diagnosis was 21.1 years. In the dermatological cases, full cures were achieved after treatment with oxamniquine. In the ovarian case, there was an association with embryonic carcinoma: this patient underwent surgery with adjuvant chemotherapy and praziquantel treatment, with satisfactory evolution. The adrenal case was associated with adenoma.

[Hydatid cyst of ovary. Report of 7 cases]. / Le kyste hydatique de l'ovaire. A propos de 7 cas.

Hydatid disease is a wide spread disease. It is endemic in Tunisia. Man is contaminated by digestif way and by living with dogs. The disease affects usually liver and lung. Other localisations are rare. Hydatid cyst of the ovary is uncommon and clinically they present like malignant tumour of ovary. We present 7 cases of hydatid cyst of the ovary and we discuss the characteristics of this site of the hydatic disease.

Abdominal and pelvic hydatid disease during pregnancy.

BACKGROUND: Hydatid disease is an infection of sheep and cattle. Affected human beings are only chance intermediate hosts. It is a rare condition in pregnancy. CASE REPORT: We present a 15-week pregnant patient with cysts in the liver and in the right adnexa identified by ultrasonography and magnetic resonance imaging. Diagnosis of hydatid disease was confirmed by an indirect hemagglutination test. OUTCOME: The patient underwent laparotomy and a healthy baby was delivered at term.

[Enterobiasis of the female pelvi-genital tract: a report of three cases]. / Entérobiase pelvi-génitale: à propos de trois cas.

Ectopic localization of oxyuriasis is rare and frequently does not cause clinical problems. It has been reported in the vagina, endometrium, fallopian tube, peritoneal surface and ovary; In these localizations it often causes pseudo-tumoral granulomas. The aim of our study was to describe etiopathogenic and clinical criteria of this rare pathology. We report one case of endometrial enterobiasis which developed in a 28-year-old women and two cases of tubo-ovarian pseudotumoral abscesses containing the ova of enterobius which appeared as a latero-uterin mass in women aged 28 and 38 years. Enterobius vermicularis may cause tubo-ovarian abscess formation with necrotizing epitheloid granulomas mimicking tumors. Antihelminth therapies are successful.

Adnexal fascioliasis masquerading as ovarian cancer.

BACKGROUND: Preoperative diagnosis of ovarian cancer is still problematic as multiple disease processes may present with pelvic mass. Fascioliasis is a parasitic disease producing unique clinical manifestations. CASE REPORT: A 49-year-old female patient admitted to our hospital with the complaint of occasional abdominal pain. Pelvic examination revealed a right adnexal mass. Serum CA-125 level was elevated. Explorative laparotomy was performed with the initial diagnosis of ovarian tumor. Final diagnosis was adnexal fascioliasis. CONCLUSION: In the setting of a newly diagnosed pelvic mass, care should be taken when interpreting an elevated CA-125 level. While ovarian cancer is high on the list of differential diagnoses, atypical clinical presentation of fasciola may give rise to a misdiagnosis of malignancy.

Early developmental stages of a protozoan parasite, Marteilioides chungmuensis (Paramyxea), the causative agent of the ovary enlargement disease in the Pacific oyster, Crassostrea gigas.

A paramyxea, Marteilioides chungmuensis, causes the irregular enlargement of the ovary in the Pacific oyster, Crassostrea gigas in Korea and Japan. The knowledge about the life cycle of the parasite has been limited to the sporulation stages within the oocyte of oysters. In this study, we used the parasite-specific DNA probes and electron microscopy to experimentally infected oysters in a field and successfully clarified early developmental stages of the parasite. The parasite invaded the oysters through the epithelial tissues of the gills, mantle and labial palps. Extrasporogony repeatedly occurred in the connective tissues by binary fusion. The inner cell of the extrasporogonic stage migrated into the gonadal epithelium, invaded the oocyte to start sporulation.