Systematic examination of the cardiopulmonary, urogenital, muscular and gastrointestinal parasites of the Eurasian otters (Lutra lutra) in Denmark, a protected species recovering from a dramatic decline.

The Eurasian otter (Lutra lutra) is a protected species in Denmark and at present, the population is recovering due to conservation efforts. The Danish otters are mainly found in the continental part of Denmark (Jutland), but establishment in the main islands (Fyn and Zealand) has been observed. While there is a lack of systematic studies on the parasite fauna of otters in Denmark, this study aims to screen otters for their parasite fauna, especially those of zoonotic and/or veterinary importance. Thirty-three otter carcasses, road-killed (n = 30), found dead (n = 2) and shot (n = 1), were collected between June 2013 and May 2014 and examined for cardiopulmonary, urogenital, gastrointestinal, and muscle helminths by post mortem examination. Faecal samples were analysed by modified concentration McMaster technique and direct immunofluorescence test for Giardia and Cryptosporidium. At least one parasite was found in 75.8% of animals. The parasite fauna included 13 species, consisting of five nematodes: Molineus patens (30.3%), Aonchotheca putorii (27.3%), Strongyloides sp. (24.2%), Physaloptera sp. (12.1%), Eucoleus aerophilus (10.0%); one cestode: Schistocephalus solidius (6.1%); four trematodes: Metorchis bilis (33.3%), Isthimiophora melis (15.2%), Cryptocotyle sp. (3.0%), Plagiorchis sp. (3.0%); one acanthocephalan: Acanthocephalus ranae (18.2%); and two protozoans: Giardia spp. (3.1%), and Eimeria spp. (3.1%). The study showed that otters carry parasites of zoonotic and veterinary importance. Many of these parasites can also infect native carnivores and birds, and the distribution of these parasites may be affected if the otter population continue to increase in Denmark.

Estrogen receptors in urogenital schistosomiasis and bladder cancer: Estrogen receptor alpha-mediated cell proliferation.

Estrogen-like metabolites have been identified in S. haematobium, the helminth parasite that causes urogenital schistosomiasis (UGS) and in patients´ blood and urine during UGS. Estrogen receptor (ER) activation is enriched in the luminal molecular subtype bladder cancer (BlaCa). To date, the significance of ER to these diseases remains elusive. We evaluated ERα and ERß expression in UGS-related BlaCa (n = 27), UGS-related non-malignant lesions (n = 35), and noninfected BlaCa (n = 80). We investigated the potential of ERα to recognize S. haematobium-derived metabolites by docking and molecular dynamics simulations and studied ERα modulation in vitro using 3 BlaCa cell lines, T24, 5637 and HT1376. ERα was expressed in tumor and stromal cells in approximately 20% noninfected cases and in 30% of UGS-related BlaCa, predominantly in the epithelial cells. Overall, ERα expression was associated with features of tumor aggressiveness such as high proliferation and p53 positive expression. ERα expression correlated with presence of schistosome eggs. ERß was widely expressed in both cohorts but weaker in UGS-related cases. molecular dynamics simulations of the 4 most abundant S. haematobium-derived metabolites revealed that smaller metabolites have comparable affinity for the ERα active state than 17ß-estradiol, while the larger metabolites present higher affinity. Our in vitro findings suggested that ERα activation promotes proliferation in ERα expressing BlaCa cells and that this can be reverted with anti-estrogenic therapy. In summary, we report differential ER expression between UGS-related BlaCa and noninfected BlaCa and provide evidence supporting a role of active ERα during UGS and UGS-induced carcinogenesis.

Elevation of C-reactive protein, P-selectin and Resistin as potential inflammatory biomarkers of urogenital Schistosomiasis exposure in preschool children.

BACKGROUND: Schistosomiasis is known to induce inflammatory immune responses. C-reactive protein (CRP), resistin and P-selectin are serological inflammatory markers that rise during the acute stages of infection. Here, we propose such inflammatory biomarkers have a potential for use in urogenital schistosomiasis diagnostic screening for exposure and infection in preschool-aged children. METHODS: As part of a larger study on urogenital schistosomiasis, 299 preschool children aged 1-5 years were included in this cross-sectional study. Parasitological diagnosis was conducted using urine filtration for Schistosoma haemtobium infection, and Kato Katz for S. mansoni infection. Serum levels of P-selectin, resistin, CRP, and antibodies against S. haematobium cercarial antigen preparation (CAP) and soluble worm antigen preparation (SWAP) were measured by ELISA. RESULTS: Of the 299 participants, 14% were egg positive for S. haematobium. Serology showed 46 and 9% of the participants to have been exposed to S. haematobium cercarial antigens and adult worm antigens, respectively. Levels of P-selectin were significantly higher in participants infected with S. haematobium (egg-positive) than in uninfected participants (p = 0.001). Levels of P-selectin were also higher in those exposed to cercarial antigen than in unexposed participants (p = 0.019). There was a positive correlation between P-selectin and infection intensity (r = 0.172; p = 0.002), as well as with IgM responses to CAP and SWAP (r = 0.183; p = 0.001); (r = 0.333; p < 0.0001) respectively. CRP significantly correlated with IgM responses to CAP (r = 0.133; p = 0.029) while resistin correlated with IgM responses to CAP and SWAP (r = 0.127; p = 0.016); (r = 0.197; p = 0.0004). CRP levels were higher in those exposed to cercarial and adult worm antigens than unexposed participants (p = 0.035); (p = 0.002) respectively, while resistin was higher in participants exposed to cercarial antigen than unexposed participants (p = 0.024). CONCLUSION: In this preschool population, P-selectin is significantly associated with urogenital schistosome infection and intensity; hence a potential biomarker for infection diagnosis and disease monitoring. The inflammatory biomarkers (P-selectin, Resistin and CRP) were significantly higher in participants exposed to cercarial antigens than unexposed individuals indicating an underlying inflammatory environment.

Adolescent home subsaharià de 15 anys amb dolor a fossa lumbar de 24 hores d'evolució / No disponible

No disponible

Human urogenital myiasis: A systematic review of reported cases from 1975 to 2017.

The public health importance of myiasis [infestation with dipterous (fly) larvae] remains unknown. This disease is spread worldwide in animals and humans, but baseline data on its prevalence are limited. In particular, knowledge on human urogenital myiasis (UGM) is scattered. As such, a systematic search was undertaken of five English and five Persian databases for publications describing UGM cases in English or Persian published between 1975 and 2017. In total, 45 papers reporting 59 UGM cases from various regions of the world are included in this review. All included papers were from the English databases. The age of patients ranged from 5 to 89 years, and the mean age was 40.6 years. Thirty-six of the patients were female and 19 were male. The highest number of cases (n = 12) was reported from Brazil. The most common genera causing UGM were Psychoda spp. (23.7%) and Cochliomyia spp. (11.8%). The vagina was the most commonly reported anatomical location of UGM for women, and the urogenital tract was the most commonly reported location for men. Thirteen cases were reported from rural areas and eight cases from urban areas; the location of other cases was not specified. The incidence of UGM is likely to be substantially underestimated when evaluated based on published case reports. Epidemiological studies, such as questionnaires to medical doctors, could help to gather the necessary baseline data on the occurrence of UGM.

Urogenital myiasis caused by Psychoda albipennis.

Myiasis is a parasitic infestation of vertebrate animals caused by the eggs and larvae of flies within the Diptera species. Psychoda albipennis is a rare cause of urogenital myiasis in humans. We present the case of a 42-year-old male diagnosed with urogenital myiasis caused by Psychoda albipennis.

Immunity in urogenital protozoa.

Innate and adaptive immunity play a significant role in urogenital infections. Innate immunity is provided by the epithelial cells and mucus lining along with acidic pH, which forms a strong physical barrier against the pathogens in female reproductive tract. Cells of innate immune system, antimicrobial peptides, cytokines, chemokines and adaptive immunity in the reproductive tract are evolved during infection, and a pro-inflammatory response is generated to fight against the invading pathogen Trichomonas vaginalis, a primary urogenital protozoa, the etiological agent of human trichomoniasis, a curable sexually transmitted infection. The involvement of the urogenital tract by other protozoal infections such as P. falciparum, Trypanosoma, Leishmania, Toxoplasma, Entamoeba histolytica and Acanthamoeba infection is rarely reported. Trichomonas induce pro-inflammatory and immunosuppressive responses in infected subjects. Multifactorial pathogenic mechanisms including parasite adherence, cysteine proteases, lipophosphoglycan, free radical, cytokine generation and Toll-like receptors appear to interplay with the induction of local and systemic immune responses that ultimately determine the outcome of the infection. However, the involvement of urogenital pathogen-specific immune mechanisms and effect of normal local resident flora on the outcome (symptomatic vs. asymptomatic) of infection are poorly understood. Moreover, immune interactions in trichomoniasis subjects co-infected with bacterial and viral pathogens need to be elucidated.

Genitourinary schistosomiasis: life cycle and radiologic-pathologic findings.

Genitourinary schistosomiasis is produced by Schistosoma haematobium, a species of fluke that is endemic to Africa and the Middle East, and causes substantial morbidity and mortality in those regions. It also may be seen elsewhere, as a result of travel or immigration. S haematobium, one of the five fluke species that account for most human cases of schistosomiasis, is the only species that infects the genitourinary system, where it may lead to a wide spectrum of clinical symptoms and signs. In the early stages, it primarily involves the bladder and ureters; later, the kidneys and genital organs are involved. It rarely infects the colon or lungs. A definitive diagnosis of genitourinary schistosomiasis is based on findings of parasite ova at microscopic urinalysis. Clinical manifestations and radiologic imaging features also may be suggestive of the disease, even at an early stage: Hematuria, dysuria, and hemospermia, early clinical signs of an established S haematobium infection, appear within 3 months after infection. At imaging, fine ureteral calcifications that appear as a line or parallel lines on abdominopelvic radiographs and as a circular pattern on axial images from computed tomography (CT) are considered pathognomonic of early-stage schistosomiasis. Ureteritis, pyelitis, and cystitis cystica, conditions that are characterized by air bubble-like filling defects representing ova deposited in the ureter, kidney, and bladder, respectively, may be seen at intravenous urography, intravenous ureteropyelography, and CT urography. Coarse calcification, fibrosis, and strictures are signs of chronic or late-stage schistosomiasis. Such changes may be especially severe in the bladder, creating a predisposition to squamous cell carcinoma. Genital involvement, which occurs more often in men than in women, predominantly affects the prostate and seminal vesicles.

[Urogenital myiasis caused by Psychoda albipennis]. / Psychoda albipennis'in Sebep Oldugu Bir Ürogenital Myiasis.

Myiasis cases are often encountered in humans, especially in tropical and subtropical regions. Urogenital myiasis is one of the facultative myiasis cases that may be seen in humans. Psychoda albipennis is an insect species that causes urogential myiasis in humans Adults of this species, belongs to the Psychodidae subfamily, lives especially in humid toilets and domestic bathrooms. This case, presented as urogenital myiasis caused by P. albipennis in a fifteen year old male. The person, who was a student, was living in the city center reported to have passed five-six larvae for three months. The patient had normal urinalysis, stool microscopy and urine culture. Larvae were examined under a microscope and were identified as fourth period larvae of P. albipennis. Therefore, it should not be forgotten that P. albipennis may be an agent in urogenital myiasis.

Unusual presentation of the urogenital myiasis caused by Luciliasericata (Diptera: Calliphoridae).

INTRODUCTION AND OBJECTIVE: The case report describes the unusual presentation of the urogenital myiasis caused by Luciliasericata in two Slovakian men. MATERIAL AND METHODS: The first patient, aged 66, who suffered from a locally advanced and inoperable urinary bladder dedifferentiated TCC with bilateral ureteral obstruction, chronic renal insufficiency and non-functioning left kidney. After surgical exploration the patient developed a malignant vesico-intestino-cutaneous fistula with stool leakage through the open wound. Because of very poor hygiene, and unsatisfactory attendance by staff, a fly deposited ova in the patient's necrotic wound. The patient died three months later of metastatic cancer disease. The second patient, a 43-year old homeless alcoholic male had gangrene of the scrotum and penis, urethro-cutaneous urinary fistula with numerous live and motile larvae on the surfaces. In both patients, some larvae were removed and sent to the lab for identification. The larvae were identified as maggots of the fly Luciliasericata. Antibiotic therapy, disinfection and debridement with sterile covering of the wound were used. RESULTS: For both patients, complex treatment of myiasis was successful and patient recovered without parasitic consequences. CONCLUSIONS: To our knowledge, this is the first report of the unusual presentation of the urogenital myiasis in Slovakian men with poor social habits and hygiene.

[Urogenital myiasis caused by Psychoda albipennis]. / Psychoda albipennis'in neden oldugu ürogenital myiasis.

Myiasis is a cause of urogenital parasitosis. In this study, a 29 year-old male patient who was admitted to our hospital with urinary discharge of worms has been presented. Larvae were examined parasitologically and urogenital myiasis caused by Psychoda albipennis larvae was diagnosed. No other pathological findings were detected in the patient and the symptoms resolved spontaneously within a few days. Despite the fact that urinary myiasis is very rare in humans, it should be considered in patients with urinary complaints. Apparently, a quick recovery without treatment is possible in most cases.

[A case of urogenital myiasis caused by Psychoda albipennis (Diptera: Nematocera)]. / Psychoda albipennis'in (Diptera: Nematocera) neden oldugu ürogenital miyazis olgusu.

Myiasis which is a parasitic disease of humans and vertebrates, is caused by dipterous fly larvae feeding on the host's necrotic or living tissue. Although infestation by fly larvae is much more prevalent in animals, it occurs relatively frequently in humans in rural, tropical and subtropical regions of Africa and America. Myiasis is usually associated with poor general health and hygiene, restricted mobility and ulcerating lesions. The pathophysiology of the human infection differs depending on the fly species and where the larvae are located. It could be external or internal, and the invasion by the maggot could be obligatory, facultative and sometimes acci-dental. Myiasis is a self-limiting infestation with minimal morbidity in the vast majority of cases. Urogenital myiasis, associated with urinary obstruction, poor hygiene of the local site and ulcerating lesions has been infrequently reported. In this report, a case of 29 year-old male patient who presented with genitourinary myiasis caused by Psychoda albipennis (Diptera: Nematocera), was presented. The patient was admitted to the hospital with the complaints of urinary incontinence of one week duration and presence of small, thin, motile, grayishwhite objects in his urine. Physical examination, blood and urine examination and stool microscopy revealed no pathology. No growth was detected in his urine culture. The examination of discharged larva in urine sample at Refik Saydam National Public Health Agency, Parasitology Laboratory led to the diagnosis of urogenital myiasis. No risk factor was identified in the patient who had proper hygienic conditions, was living in urban area and was of high socioeconomic status. This case was presented to withdraw attention to myiasis which is frequent in Turkey, however, is usually overlooked.

[Treatment of patients with resistant urogenital infection].

In our trial 43 patients with urogenital infections resistant to standard therapy received the same basic therapy (4 tablets of safocid a day for 5 days) which, on demand, was combined with pathogenetic and symptomatic treatment. The effect was achieved by both subjective and objective parameters: pathogenic microflora was not detected after 10 days in 39 (90.7%) patients; none of the patients discharged protozoa, fungi. Tests for chlamidia were negative in all the carriers in 2 months, for ureaplasma--in 94.1% males and 83.3% females, respectively. A significant response was observed in 38 of 43 (88.4%) patients, improvement was seen in 5 (11.6%) patients. The above results persisted for 2 months of follow-up.

[Descriptive epidemiology of extrapulmonary hydatid cysts: a report of 265 Tunisian cases]. / Profil epidémiologique descriptif des kystes hydatiques extra pulmonaires: a propos d'une série tunisienne de 265 cas.

BACKGROUND: Hydatidosis is a parasitic endemic disease in Tunisia. The liver and lung are the most common sites of involvement; however, it can develop anywhere in the body. AIM: The aim of the present study was to analyse the epidemiological features of extrapulmonary hydatid cysts and compare our results with those reported in literature. METHODS: A retrospective study of 265 extrapulmonary hydatid cysts collected over the 18-year period from 1990 to 2007 was undertaken. RESULTS: There were 101 male and 164 female patients (sex ratio M/F = 0.61) ranging in age from 2 to 84 years (mean age = 38.7). In our series, hydatid cysts involved mainly the kidney (24.1%), the central nervous system (22.6%), the liver (19.6%) and the spleen (11.3%). The other less frequent sites included the peritoneum (n = 9), heart (n = 9), bone (n = 6), adrenal gland (n = 4), epiploon (n = 4), orbit (n = 4), ovary (n = 3), prostate (n = 2), bladder (n = 2), breast (n = 2), Douglas' cul-de-sac (n = 2), diaphragm (n = 1), testis (n = 1), broad ligament (n = 1), mediastinum (n = 1), nasal cavity (n = 1), soft tissue (n = 1), abdominal wall (n = 1), parotid gland (n = 1), psoas muscle (n = 1), synovia (n = 1), thymus (n = 1) et le pancreas (n = 1). CONCLUSION: In contrast to literature, our results show that hydatid cysts of the kidney and of the central nervous system are more frequent than hepatic location which occupies the 3rd rank.

Ultrasonographical findings in the urogenital organs in women and men infected with Schistosoma haematobium in northern Madagascar.

Ultrasonography (US) was applied in this community-based study in northern Madagascar to compare urogenital findings in Schistosoma haematobium-positive individuals (105 women and 116 men) from the high-endemic Sirama village, with urinary egg negative controls (100 women and 108 men) from the neighboring low-endemic Mataipako village. In addition to examination of the urinary tract, the female genitals were examined by transvaginal US, whereas the male genitals were examined by transrectal and transscrotal US. Pathology of the urinary tract was significantly more prevalent among women and men in Sirama. There were no differences in female genital tract between the two study populations, whereas significantly higher proportions of men in Sirama were detected with hyperechogenic and calcified lesions in the seminal vesicles and the prostate. Moreover, the mean size of the seminal vesicles was significantly larger in Sirama. There were no differences with respect to the external male genitals. Six months after anti-schistosome treatment, no changes were observed in the female genital tract in Sirama, whereas hyperechogenicity of the prostate and the seminal vesicles, in addition to size of the seminal vesicles, declined significantly. This study has provided new insight into genital pathology in S. haematobium-infected men and women. However, the clinical significance of these findings needs further exploration.

[Clinical and microbiological efficacy of metronidazole and ornidazole in the treatment of urogenital trichomoniasis in men].

The aim of the study was to compare the efficacy of metronidazole and ornidazole in the treatment of urogenital trichomoniasis in men. The drugs were used randomly in usual doses as monotherapy: 210 patients, metronidazole and 217 patients, ornidazole. The clinical efficacy of metronidazole and ornidazole was stated in 57.6 and 94.5% of the patients and the microbiological efficacy was stated in 77.1 and 98.2% of the patients respectively. The side effects were recorded in 59.0 and 3.7% of the patients respectively. Thus, ornidazole proved to be a more efficient and safe agent vs. metronidazole in the treatment of urogenital trichomoniasis.

[Spontaneous urogenital infection in macaques].

Rates of natural infection of macaques with microorganisms that cause urogenital tract infections (UGT)--chlamydias, mycoplasms, ureaplasms and trichomonades--have been assessed. 198 macaques (rhesus, javan and lapunder) aged from newborn to 25 years (born healthy or from females with complicated pregnancy or labour) were examined. High rate of infection (40%) was observed in healthy macaques by PCR assay. In animals born from females with complicated pregnancy or labour (abortion, complicated labour, stillbirth or inflammatory postdelivery complications) rate of pathogens detection was significantly higher (up to 54,5 - 64,5%). In such animals mixed infection with 2 - 4 microorganisms in association was commonly observed. Births of weak, low weight and vitality monkey's calves was observed in infected macaques aged 17 - 25 years. Pathogens' nucleotide sequences that were analogous to ones detected in mothers were detected in calves that died during 1st month of life. This finding can be the evidence of the intrauterine infection of calves.

[Urogenital bilharziasis: imaging diagnosis]. / Bilharziose urogénitale: diagnostic par imagerie.

Urogenital bilharziasis is a well-known disease that seldom is encountered in western countries. Therefore, bilharziasis usually only is considered after tuberculosis, the main differential diagnosis, has been excluded. Using this case, we will discuss the value of different imaging techniques (especially that of CT combined with transrectal US) for diagnosing bilharziasis and review specific criteria to more easily distinguish both pathologies.