Case Report: Rare Presentation of Multivisceral Echinococcosis.

Cystic echinococcosis (CE) is a common, chronic, and endemic zoonotic disease usually localized in a single organ; multivisceral cases are rare, especially outside the liver or lung. Here, we describe an unusual case of a 43-year-old Tibetan man with echinococcosis of the infratemporal fossa, heart, liver, pancreas, abdomen, and pelvic cavity. He only presented with diminished vision of the left eye, especially when chewing. Computed tomography and magnetic resonance imaging revealed multivisceral CE. The patient underwent surgery for the excision of a cyst in the infratemporal fossa, as well as chemotherapy, and the diagnosis was confirmed by histopathological examination. The diagnosis, clinical features, treatment, and follow-up in this case are discussed. In areas with high echinococcosis prevalence, examination by full imaging is necessary for an accurate diagnosis, especially in cases of atypical localization. Chemotherapy for treatment, as well as prophylaxis against recurrence, can be effective when surgery is not possible.

Dissections of fresh skulls confirm low prevalence of Troglotrema acutum (Trematoda: Troglotrematidae) in German badgers (Meles meles).

We examined 131 European badgers Meles meles (Linnaeus, 1758) from 67 localities in central Germany for the presence of the cranial trematode Troglotrema acutum, as previous studies based on museum skulls might have underestimated the prevalence of the parasite in this host. We detected the flatworm in only three individuals that originated from the Rhoen Mountains (Thurigina and Bavaria). While the cranium of one host individual showed the lesions and the sponge-like widening of certain regions of the skullcap that are typical of a T. acutum infection, the skulls of the two remaining badgers did not show any deformations. The three badgers were infected by eight, 20, and 49 T. acutum individuals, respectively. Eggs of the trematode parasite were detected in the paranasal sinuses of two badgers. While badgers infected with T. acutum may not show any surface bone lesions, the results of the present study do not contradict the conclusion that the badger is only an accidental host of T. acutum.

Oral myiasis in an elderly patient.

BACKGROUND: Myiasis is the invasion of living tissue of humans and other mammals by eggs or maggots of flies of the order of Diptera. It occurs mainly in the Tropics and is associated with inadequate public and personal hygiene. Oral myiases in an older man appears to be rare. OBJECTIVE: To relate a case of oral myiases in a debilitated older man treated by mechanical removal of the maggots, identifying the adult insect that caused the infestation. METHODS: The diagnosis of oral myiasis was established by the clinical examination and it was detected that the infestation involved only soft tissue and the sinus cavity. The patient was submitted to two mechanical removal of the visible maggots. RESULTS: Total of 110 maggots was removed from the oral cavity of the patient and adult insects was identified as belonging to the Calliphoridae Family, Cochliomyia hominivorax species. The patient died two days after the second procedure by severe systemic complications. CONCLUSIONS: The mechanic removal and the identification of the maggots must be adopted as soon as possible to prevent further tissue damage and bacterial infection in cases of oral myiasis. Special attention should be given to the debilitated old patients that are particularly susceptible to oral myiasis infestation.

Root resorption caused by a maxillary sinus mucocele: a case report.

A maxillary sinus mucocele is an infrequent but benign lesion that develops from the obstruction of a seromucous glandular duct of the maxillary sinus mucosa. This clinical entity is generally asymptomatic and self-limited. Mucoceles are described as rounded dome-shaped soft tissue masses frequently located on the floor of the maxillary sinus. In this paper, we present a case of a slightly radiopaque well defined shadow arising from the left maxillary sinus floor that produced the root resorption of the upper second left molar. After the surgical removal of the lesion through a Caldwell-Luc approach, histologic study confirmed the initial diagnosis of mucocele. This case report emphasizes the need of clinical and radiologic follow-up to detect any complications associated with these benign lesions, because, in rare occasions, they can show an aggressive growth pattern.

Oral and maxillofacial myiasis associated with epidermoid carcinoma: a case report.

Myiasis is a term derived from the Greek word "myia", meaning invasion of vital tissue of humans or other mammals by fly larvae. The deposited eggs develop into larvae, which penetrate deep structures causing adjacent tissue destruction. It is an uncommon clinical condition, being more frequent in underdeveloped countries and hot climate regions, and is associated with poor hygiene, suppurative oral lesions, alcoholism and senility. Its diagnosis is made basically by the presence of larvae. This paper reports a case of oral and maxillofacial myiasis involving 273 larvae in a patient with epidermoid carcinoma without physical or neurological deficiency. The patient's management was antisepsis, larval removal and general care, before death after three months.

Ocular and sinus microsporidial infection cured with systemic albendazole.

PURPOSE: To report treatment of a patient with acquired immunodeficiency syndrome (AIDS) and ocular and paranasal sinus microsporidial infection. METHOD: Case report. RESULTS: A patient with AIDS and ocular microsporidial infection experienced resolution of ocular symptoms with topical fumagillin, but symptoms recurred upon cessation of therapy. Paranasal sinus microsporidial infection was diagnosed. The patient received sequential systemic treatment with itraconazole followed by albendazole. Sinus symptoms resolved with albendazole. He remained symptom-free with a normal examination 17 months after concluding therapy. CONCLUSIONS: Although fumagillin and itraconazole may have played a role, systemic albendazole appears to be responsible for clinical resolution of microsporidial infection.

[Iatrogenic cervicofacial hydatid cysts. Apropos of a case]. / Hydatidose cervico-faciale iatrogénique. A propos d'un cas.

The writers give an account of a cervicofacial hydatid dissemination case, provoked by iterative ponctions of hydatid cyst initially isolated in the left maxillary sinus. They state diagnostic and therapeutic difficulties sometimes found and they insist on the role that must be played by immunologic tests in diagnostic approach and treatment monitoring of this disease which is unfortunately current and serious.

Multiorgan microsporidiosis: report of five cases and review.

We describe five cases and review 34 reported cases of multiorgan microsporidiosis. Most of the patients with multiorgan involvement have been adults with AIDS. Organs most commonly infected include the small intestine, urinary tract, biliary tree, and eye; involvement of the respiratory tract, nasal sinuses, and central nervous system is also described but appears to be less frequent. Although patients with multiorgan disease may be asymptomatic, clinical presentation usually relates to the involved organs. Enterocytozoon bieneusi and Septata intestinalis are the most frequently identified species of pathogens. An affinity for certain tissues is observed among different microsporidial species. In all but one case of E. bieneusi infection, infection was limited to intestinal and hepatobiliary tracts, a finding suggestive of local extension. In contrast, the patients infected with S. intestinalis had widespread involvement, suggesting true hematogenous or lymphatic dissemination. Treatment may have to be based on findings regarding which organs and specific microsporidial species are involved. Further investigation of the pathogenic tendencies and route of acquisition of these organisms and the therapeutic agents active against them is needed.

Trichomoniasis in birds of prey (order Falconiformes) in Bahrain.

Of 5360 falcons examined at the Sulman Falcon Hospital in Bahrain between 1987 and 1993, 1675 (31.2 per cent) had lesions of trichomoniasis. These lesions were commonly found in the oral and nasal cavities, the infraorbital sinuses, the crop and oesophagus and, more rarely, in the coelomic cavity, attached to the wall of the abdominal air sacs, and in the trachea, partially obstructing its lumen. Several therapeutic methods and the results obtained are described.

Oestrus ovis myiasis in Libyan sheep and goats.

The heads of 1,489 sheep and 320 goats were examined for larvae of Oestrus ovis at 17 abattoirs in northern Libya in July to November 1988. The prevalence of O. ovis in sheep was 22.6% and in goats it was 18.4 per cent. Up to 14 and 11 larvae were collected from individual sheep and goats respectively. All larvae were recovered from the nasal passages and frontal sinuses, but only second and third instars were seen.

Experimental heteroxenous cycle of Lagochilascaris minor Leiper, 1909 (Nematoda: Ascarididae) in white mice and in cats.

Reports of natural infections of sylvatic carnivores by adult worms of species similar to Lagochilascaris minor in the Neotropical region led to attempts to establish experimental cycles in laboratory mice and in cats. Also, larval development was seen in the skeletal muscle of an agouti (Dasyprocta leporina) infected per os with incubated eggs of the parasite obtained from a human case. In cats, adult worms develop and fertile eggs are expelled in the feces; in mice, larval stages of the parasite develop, and are encapsulate in the skeletal muscle, and in the adipose and subcutaneous connective tissue. From our observations, we conclude that the larva infective for the mouse is the early 3rd stage, while for the final host the infective form is the later 3rd stage. A single moult was seen in the mouse, giving rise to a small population of 4th stage larvae, long after the initial infection.

Nasal myiasis due to Oestrus ovis larvae.

Herein we report our experiences in managing nasal infestation due to fly larvae in an urban population. The nasosinus location is infrequently seen in cases with human infection. The life cycle of the fly (Oestrus ovis) is discussed in view of the clinical features of our case.