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1.
Parasit Vectors ; 12(1): 515, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31685003

RESUMO

BACKGROUND: Strongyloidiasis is a health problem in Vietnam, but appropriate information is still limited. The aim of this study was to determine the prevalence, geographical distribution, epidemiological aspects, symptoms and other health indicators of Strongyloides stercoralis infections in patients from 27 provinces of northern Vietnam attending the Hanoi Medical University Hospital during 2016 and 2017. METHODS: Blood samples of 2000 patients were analyzed for S. stercoralis infection with an IgG ELISA test. Seroprevalence was analyzed by gender, age group, locality of origin (rural or urban areas) and symptoms. Stools from the seropositive patients were examined for the detection of worms which were subsequently used for species identification by morphology and rDNA ITS1 sequencing. RESULTS: A seroprevalence of 20% was detected, showing an increasing prevalence from young to older age groups but without significant gender difference. Seroprevalence was higher in rural areas than in urban areas, both in general and individually in all provinces without exception, and lower in the mountainous areas than in the large valley lowlands. The follow-up of the 400 patients showed eosinophilia in 100% of cases, diarrhoea in 64.5%, digestion difficulties in 58.0%, stomachache in 45.5%, stomach and duodenal ulcers in 44.5%, itching in 28.0% and fever in 9.5%. The prevalence of symptoms and signs were also higher in older age groups than in younger age groups. Worms were detected in stools of 10.5% of the patients. Sequencing of a 501-bp nuclear ribosomal DNA ITS1 fragment allowed for the verification of infection by Strongyloides stercoralis. CONCLUSIONS: To our knowledge, this study is the largest survey of human strongyloidiasis in Vietnam so far and the first molecular identification of this nematode species in this country. Long-term chronicity may probably be usual in infected subjects, mainly in the older age groups.


Assuntos
Strongyloides stercoralis/genética , Estrongiloidíase/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Animais , Anticorpos Anti-Helmínticos/sangue , DNA de Helmintos/análise , DNA de Helmintos/química , DNA Ribossômico/análise , DNA Ribossômico/química , Diarreia/epidemiologia , Diarreia/parasitologia , Eosinofilia/epidemiologia , Eosinofilia/parasitologia , Feminino , Geografia , Humanos , Imunoglobulina G/sangue , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , Estudos Soroepidemiológicos , Strongyloides stercoralis/imunologia , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/parasitologia , Vietnã/epidemiologia , Adulto Jovem
3.
Parasitol Int ; 72: 101944, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31220635

RESUMO

Climate change and other weather factors are associated with several infectious diseases, but are rarely reported as being associated with nematode infection. Eosinophilic meningitis (EOM) is an emerging disease worldwide caused by the nematode, Angiostrongylus cantonensis. It is transmitted through various agents such as snails and slugs. Temperature and rainfall are associated with snail population. There have been no previous studies on the relationship between weather and EOM. This was an ecological study. Numbers of EOM patients and weather data in Thailand's Loei province from 2006 to 2017 were obtained using a national database. A Spearman correlation was used to explore the relationship between EOM and weather variables. We developed a Poisson time series model combined with a distributed lag model (DLM) for estimating the effects of weather on EOM. We also created an autoregressive integrated moving average with exogeneous variable (ARIMAX) model for predicting future EOM cases over the following 12 months. There were 1126 EOM patients in the study. Among several weather factors, wind was significantly negatively correlated with the number of EOM patients (rs: -0.204, 95% CI: -0.361 to -0.058; p value: 0.014). The ARIMAX(3, 0, 0) model with wind speed as a variable was appropriate for predicting the number of EOM patients. The predicted and actual numbers of EOM patients in 2018 were highly concordant. In conclusion, wind speed is significantly negatively correlated with the number of EOM patients.


Assuntos
Ecossistema , Eosinofilia/parasitologia , Meningite/parasitologia , Infecções por Strongylida/epidemiologia , Tempo (Meteorologia) , Vento , Angiostrongylus cantonensis/isolamento & purificação , Animais , Mudança Climática , Humanos , Meningite/epidemiologia , Distribuição de Poisson , Caramujos/parasitologia , Infecções por Strongylida/complicações , Temperatura Ambiente , Tailândia/epidemiologia
4.
Am J Case Rep ; 20: 499-502, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30971680

RESUMO

BACKGROUND Acute muscular sarcocystosis (AMS) is one of a spectrum of diseases caused by the Sarcocystis parasite which infects humans in regions where it is endemic. Infections present with non-specific signs and symptoms and have been known to occur in clusters. CASE REPORT A 51-year-old Vietnamese male presented to Tan Tock Seng Hospital, Singapore with 3 weeks of fever, urticarial rash, non-productive cough, and lower back pain. He had an extensive travel history prior to presentation. Magnetic resonance imaging (MRI) showed myositis involving the paravertebral and upper thigh muscles. The infection was confirmed on open muscle biopsy and Sarcocystis nesbitti was identified on molecular testing. The patient was treated with prednisone and methotrexate. CONCLUSIONS AMS must be considered in a patient with history of exposure to an endemic area. Diagnosis of the condition and identification of S. nesbitti as the causative organism will help to further study of this particular condition and guide treatment.


Assuntos
Miosite/diagnóstico por imagem , Miosite/parasitologia , Sarcocistose/diagnóstico , Creatina Quinase/sangue , DNA de Protozoário , Eosinofilia/parasitologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Mialgia/parasitologia , Reação em Cadeia da Polimerase , Sarcocystis/genética , Doença Relacionada a Viagens , Urticária/parasitologia
5.
Int J Infect Dis ; 83: 102-108, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30930185

RESUMO

OBJECTIVES: The pericardial effusion (PE) caused by paragonimiasis is rarely reported. This study aims to present experience in the diagnosis and surgical management of PE due to paragonimiasis. METHODS: Medical records of 57 children who were diagnosed with PE due to paragonimiasis and underwent surgery at Children's Hospital of Chongqing Medical University between January 2012 and August 2018 were retrospectively reviewed. RESULTS: The average age of this group was 7.6 ± 3.0 years. Patients were mainly from Chongqing and Sichuan areas. ELISA for Paragonimus skrjabini in all 57 patients showed positive results. Moderate or large PE were identified in 12 and 45 patients, respectively. All patients underwent surgery either by pericardectomy or thoracoscopic surgery. Pathological exams indicated massive eosinophil infiltration in all 57 specimens. After 3-4 courses of praziquantel therapy, the clinical outcomes were satisfactory. CONCLUSIONS: Typical endemic history, eosinophilia and multiple serous effusion raise suspicions of paragonimiasis. Once moderate to large PE is identified in patients with paragonimiasis, surgical treatment is necessary.


Assuntos
Paragonimíase/complicações , Derrame Pericárdico/diagnóstico , Derrame Pericárdico/cirurgia , Adolescente , Animais , Anti-Helmínticos/uso terapêutico , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Eosinofilia/parasitologia , Feminino , Humanos , Masculino , Paragonimus , Derrame Pericárdico/parasitologia , Praziquantel/uso terapêutico , Estudos Retrospectivos
6.
Nat Commun ; 10(1): 1429, 2019 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-30926803

RESUMO

Elimination of the helminth disease, river blindness, remains challenging due to ivermectin treatment-associated adverse reactions in loiasis co-infected patients. Here, we address a deficit in preclinical research tools for filarial translational research by developing Loa loa mouse infection models. We demonstrate that adult Loa loa worms in subcutaneous tissues, circulating microfilariae (mf) and presence of filarial biomarkers in sera occur following experimental infections of lymphopenic mice deficient in interleukin (IL)-2/7 gamma-chain signaling. A microfilaraemic infection model is also achievable, utilizing immune-competent or -deficient mice infused with purified Loa mf. Ivermectin but not benzimidazole treatments induce rapid decline (>90%) in parasitaemias in microfilaraemic mice. We identify up-regulation of inflammatory markers associated with allergic type-2 immune responses and eosinophilia post-ivermectin treatment. Thus, we provide validation of murine research models to identify loiasis biomarkers, to counter-screen candidate river blindness cures and to interrogate the inflammatory etiology of loiasis ivermectin-associated adverse reactions.


Assuntos
Loíase/patologia , Animais , Doença Crônica , Modelos Animais de Doenças , Eosinofilia/complicações , Eosinofilia/tratamento farmacológico , Eosinofilia/parasitologia , Feminino , Inflamação/complicações , Inflamação/tratamento farmacológico , Inflamação/patologia , Ivermectina/uso terapêutico , Loa/efeitos dos fármacos , Loa/fisiologia , Loíase/complicações , Loíase/tratamento farmacológico , Linfopenia/complicações , Linfopenia/parasitologia , Linfopenia/patologia , Masculino , Camundongos Endogâmicos BALB C , Camundongos SCID , Microfilárias/efeitos dos fármacos , Parasitemia/complicações , Parasitemia/parasitologia
7.
PLoS One ; 14(3): e0213244, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30845271

RESUMO

The 14-3-3 proteins are cerebrospinal fluid (CSF) markers of neuronal damage during infectious meningitis and Creutzfeldt-Jakob disease. Little is known about dynamic changes in the individual isoforms in response to parasitic eosinophilic meningitis. The purposes of this study were to determine the 14-3-3 protein isoform patterns, examine the kinetics and correlate the severity of blood brain barrier (BBB) damage with the expressions of these markers in mice with eosinophilic meningitis. Mice were orally infected with 50 A. cantonensis L3 via an oro-gastric tube and sacrificed every week for 3 consecutive weeks after infection. The Evans blue method and BBB junctional protein expressions were used to measure changes in the BBB. Hematoxylin and eosin staining was used to analyze pathological changes in the mice brains following 1-3 weeks of infection with A. cantonensis. The levels of 14-3-3 protein isoforms in serum/CSF and brain homogenates were analyzed by Western blot, and immunohistochemistry (IHC) was used to explore the different isoform distributions of 14-3-3 proteins and changes in BBB junctional proteins in the mice brain meninges. Dexamethasone was injected intraperitoneally from the seventh day post infection (dpi) until the end of the study (21 dpi) to study the changes in BBB junctional proteins. The amounts of Evans blue, tight junction and 14-3-3 protein isoforms in the different groups of mice were compared using the nonparametric Kruskal-Wallis test. There were significant increases in 14-3-3 protein isoforms ß and γ in the CSF in the second and third weeks after infection compared to the controls and first week of infection, which were correlated with the severity of BBB damage in brain histology, and Evans blue extravasation. Using IHC to assess the distribution of 14-3-3 protein isoforms and changes in BBB junctional proteins in the mice brain meninges, the expressions of isoforms ß, γ, ε, and θ and junctional proteins occludin and claudin-5 in the brain meninges increased over a 3-week period after infection compared to the controls and 1 week after infection. The administration of dexamethasone decreased the expressions of BBB junctional proteins occludin and claudin-5 in the mice brain meninges. Our findings support that 14-3-3 proteins ß and γ can potentially be used as a CSF marker of neuronal damage in parasitic eosinophilic meningitis caused by A. cantonensis.


Assuntos
Proteínas 14-3-3/metabolismo , Angiostrongylus cantonensis/patogenicidade , Barreira Hematoencefálica/metabolismo , Encéfalo/metabolismo , Eosinofilia/metabolismo , Meningite/metabolismo , Infecções por Strongylida/metabolismo , Animais , Biomarcadores/sangue , Biomarcadores/líquido cefalorraquidiano , Barreira Hematoencefálica/parasitologia , Encéfalo/parasitologia , Modelos Animais de Doenças , Eosinofilia/epidemiologia , Eosinofilia/parasitologia , Feminino , Incidência , Masculino , Meningite/epidemiologia , Meningite/parasitologia , Camundongos , Camundongos Endogâmicos BALB C , Isoformas de Proteínas , Infecções por Strongylida/complicações , Infecções por Strongylida/parasitologia
8.
PLoS Negl Trop Dis ; 13(3): e0007230, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30860995

RESUMO

BACKGROUND: Strongyloides stercoralis infection, a neglected tropical disease, is widely distributed. Autochthonous cases have been described in Spain, probably infected long time ago. In recent years the number of diagnosed cases has increased due to the growing number of immigrants, travelers and refugees, but endemically acquired cases in Spain remains undetermined. METHODOLOGY: We systematically searched the literature for references on endemic strongyloidiasis cases in Spain. The articles were required to describe Strongyloides stercoralis infection in at least one Spanish-born person without a history of travel to endemic areas and be published before 31st May 2018. Epidemiological data from patients was collected and described individually as well as risk factors to acquisition of the infection, diagnostic technique that lead to the diagnosis, presence of eosinophilia and clinical symptoms at diagnosis. FINDINGS: Thirty-six studies were included, describing a total of 1083 patients with an average age of 68.3 years diagnosed with endemic strongyloidiasis in Spain. The vast majority of the cases were described in the province of Valencia (n = 1049). Two hundred and eight of the 251 (82.9%) patients in whom gender was reported were male, and most of them had current or past dedication to agriculture. Seventy percent had some kind of comorbidity. A decreasing trend in the diagnosed cases per year is observed from the end of last decade. However, there are still nefigw diagnoses of autochthonous cases of strongyloidiasis in Spain every year. CONCLUSIONS: With the data provided by this review it is likely that in Spain strongyloidiasis might have been underestimated. It is highly probable that the infection remains undiagnosed in many cases due to low clinical suspicion among Spanish population without recent travel history in which the contagion probably took place decades ago.


Assuntos
Doenças Endêmicas , Eosinofilia/diagnóstico , Eosinofilia/epidemiologia , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/diagnóstico , Estrongiloidíase/epidemiologia , Idoso , Animais , Eosinofilia/induzido quimicamente , Eosinofilia/parasitologia , Fezes/parasitologia , Feminino , Humanos , Masculino , Fatores de Risco , Espanha/epidemiologia , Escarro/parasitologia , Estrongiloidíase/parasitologia
9.
Acta Trop ; 193: 206-210, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30710532

RESUMO

Hepatic capillariasis is a rare and neglected parasitic disease caused by infection with Capillaria hepatica in human liver. The disease is not well described and the information for the disease's clinical manifestation, laboratory findings and disease management strategy is not well reported. The limited information for this neglected infection often results in the delay of diagnosis or misdiagnosed to other diseases, therefore the real prevalence or severity of the infection may be underestimated. More case report with systemic analysis and features summary of this disease is needed to better understand the serious zoonotic disease. This study included systemic analysis of 16 patients infected with hepatic capillariasis in China between 2011-2017, including clinical manifestations, laboratory/radiative image findings and treatment results. Clinical manifestation included sustained fever (56.25%), respiratory disorder (37.5%), abdominal pain (37.5%), diarrhea (25%), leukocytosis (93.75%) and eosinophilia (100%). No egg was detected in feces of all patients. Over 60% patients showed elevated level of hepatic enzymes and proteins related to liver fibrosis in sera. Ultrasound and MRI examinations displayed scattered parasitic granuloma leisure in affected liver. Liver biopsy revealed parasite eggs, necrotized parasitic granulomas and septal fibrosis. Treatment with albendazole combined with corticoids for several treatment courses cured all patients with capillariasis. The difficulty of diagnosis, apparent damage of liver functions and potential fibrosis make the disease's prevalence and severity underestimated.


Assuntos
Capillaria , Infecções por Enoplida/diagnóstico , Infecções por Enoplida/tratamento farmacológico , Hepatopatias Parasitárias/diagnóstico , Hepatopatias Parasitárias/tratamento farmacológico , Dor Abdominal/parasitologia , Adolescente , Corticosteroides/uso terapêutico , Adulto , Alanina Transaminase/sangue , Albendazol/uso terapêutico , Animais , Anti-Helmínticos/uso terapêutico , Aspartato Aminotransferases/sangue , Criança , Pré-Escolar , Diarreia/parasitologia , Infecções por Enoplida/sangue , Infecções por Enoplida/complicações , Eosinofilia/parasitologia , Feminino , Febre/parasitologia , Humanos , Lactente , Leucocitose/parasitologia , Cirrose Hepática/sangue , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/parasitologia , Hepatopatias Parasitárias/sangue , Hepatopatias Parasitárias/complicações , Masculino , Pessoa de Meia-Idade , Doenças Respiratórias/parasitologia , Adulto Jovem
10.
Am J Trop Med Hyg ; 100(3): 588-590, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30628571

RESUMO

A 23-year-old recent emigrant from Afghanistan presented in August 2017 with severe wheezing and dyspnea that required hospital admission. Her illness was associated with marked peripheral blood eosinophilia (9,900-15,600/µL; 45.2-68%), as well as mild nausea, epigastric pain, and decreased appetite. She had lived until 3 months earlier in close proximity to cattle in her home in Kabul and did not recall eating watercress or other leafy plants associated with Fasciola hepatica transmission. Computerized tomography scanning showed bilateral ground-glass lung consolidations and multiple distinctive hypo-attenuating linear, tubuliform, and nodular liver lesions, including a large subcapsular hematoma. Numerous tests for rheumatological and malignant disorders were negative. Fasciola hepatica infestation was suspected on epidemiological, clinical, and radiographic grounds, and was confirmed by immunoblotting at the Centers for Disease Control (CDC). Multiple stool ova and parasite examinations were negative and endoscopic retrograde cholangiopancreatography did not identify trematodes. Her acute respiratory illness resolved with asthma-targeted therapies and her eosinophilia resolved with triclabendazole, which was obtained from CDC via an FDA Investigational New Drug application. Fascioliasis is uncommon in the United States, but the prolonged warfare and civil strife in Afghanistan and adjacent areas may lead to increased incidence outside the endemic region. Her case also demonstrates how hepatic imaging features of fascioliasis can be pathognomonic in clinical scenarios with eosinophilia and appropriate epidemiology and clinical features. We also highlight her relatively unusual presentation with symptoms of Loeffler-like syndrome alone.


Assuntos
Dispneia/etiologia , Eosinofilia/parasitologia , Fasciolíase/diagnóstico , Hepatopatias Parasitárias/parasitologia , Afeganistão/epidemiologia , Fasciolíase/epidemiologia , Feminino , Humanos , Hepatopatias Parasitárias/epidemiologia , Adulto Jovem
11.
J Helminthol ; 93(2): 149-153, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29409550

RESUMO

Trichostrongylus spp. are primarily parasites of ruminants, but humans can become infected as accidental hosts. Information about the clinical aspects of human trichostrongyliasis is limited. This study investigated the clinical and haematological characteristics of a large number of trichostrongyliasis patients. In the Fouman district of Guilan Province in northern Iran, during 2015-2016, 60 patients were identified as positive for Trichostrongylus spp., using stool examination methods. The clinical manifestations and demographic data of all patients were recorded and further analysed. Twenty-three patients (38.3%) were male and 37 (61.7%) were female. Among the individuals infected only with Trichostrongylus, only nine patients (16.4%) were asymptomatic. Forty-six patients (83.6%) presented with gastrointestinal (76.3%), pulmonary (30.9%) and cutaneous (12.7%) symptoms. No statistically significant relationship was found between clinical manifestations and sex or age groups. Ten patients (18.1%) revealed eosinophilia and five (9.1%) presented with hypochromic microcytic anaemia. The relationship between eosinophilia and age group, sex and clinical manifestations showed no statistical significance. Our study indicated that trichostrongyliasis may be a major parasitic aetiology for gastrointestinal symptoms and eosinophilia in rural residents of endemic areas.


Assuntos
Gastroenteropatias/etiologia , Tricostrongilose/sangue , Tricostrongilose/epidemiologia , Adolescente , Adulto , Idoso , Anemia/etiologia , Anemia/parasitologia , Animais , Criança , Doenças Endêmicas , Eosinofilia/etiologia , Eosinofilia/parasitologia , Fezes/parasitologia , Feminino , Gastroenteropatias/parasitologia , Testes Hematológicos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Trichostrongylus , Adulto Jovem
12.
Clin Pediatr (Phila) ; 58(1): 13-16, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30280584

RESUMO

Enterobius vermicularis, the common pinworm, is well known in North America as a parasitic infection, mainly affecting children. It is a very contagious organism, and it is responsible for a high number of infections in the United States each year. A rise in eosinophilia is linked to most parasitic infections. However, the correlation between eosinophilia and enterobiasis infections is not well documented in the literature. In this article, we present 3 cases involving patients seen for pediatric gastroenterology consultation with concern for inflammatory bowel disease. As part of their evaluation, each patient was found to have eosinophilia of unknown significance with an ultimate diagnosis of pinworm infections made by endoscopy. Their illness presentation did not include classic enterobiasis symptoms such as rectal pruritus or nighttime irritability. These cases support a link between eosinophilia and enterobiasis that may be instructive for pediatric providers seeing patients with eosinophilia for which there is no readily apparent underlying cause.


Assuntos
Enterobíase/complicações , Enterobius , Eosinofilia/parasitologia , Adolescente , Albendazol/uso terapêutico , Animais , Anti-Helmínticos/uso terapêutico , Criança , Enterobíase/diagnóstico , Enterobíase/tratamento farmacológico , Feminino , Humanos , Masculino
13.
Parasitology ; 146(1): 42-49, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29925459

RESUMO

Angiostrongylus cantonensis (rat lungworm), a parasitic nematode, is expanding its distribution. Human infection, known as angiostrongyliasis, may manifest as eosinophilic meningitis, an emerging infectious disease. The range and incidence of this disease are expanding throughout the tropics and subtropics. Recently, the Hawaiian Islands have experienced an increase in reported cases. This study addresses factors affecting the parasite's distribution and projects its potential future distribution, using Hawaii as a model for its global expansion. Specimens of 37 snail species from the Hawaiian Islands were screened for the parasite using PCR. It was present on five of the six largest islands. The data were used to generate habitat suitability models for A. cantonensis, based on temperature and precipitation, to predict its potential further spread within the archipelago. The best current climate model predicted suitable habitat on all islands, with greater suitability in regions with higher precipitation and temperatures. Projections under climate change (to 2100) indicated increased suitability in regions with estimated increased precipitation and temperatures, suitable habitat occurring increasingly at higher elevations. Analogously, climate change could facilitate the spread of A. cantonensis from its current tropical/subtropical range into more temperate regions of the world, as is beginning to be seen in the continental USA.


Assuntos
Angiostrongylus cantonensis/isolamento & purificação , Caramujos/parasitologia , Infecções por Strongylida/epidemiologia , Angiostrongylus cantonensis/genética , Animais , Área Sob a Curva , Mudança Climática , Ecossistema , Eosinofilia/epidemiologia , Eosinofilia/parasitologia , Sistemas de Informação Geográfica , Saúde Global , Hawaii/epidemiologia , Humanos , Modelos Lineares , Meningite/epidemiologia , Meningite/parasitologia , Modelos Biológicos , Reação em Cadeia da Polimerase , Chuva , Análise de Regressão , Caramujos/classificação , Infecções por Strongylida/parasitologia , Temperatura Ambiente
14.
J Helminthol ; 93(1): 21-25, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29179791

RESUMO

Alcoholic patients are more susceptible to Strongyloides stercoralis infection. The chronic use of alcohol raises the levels of endogenous corticosteroids, which regulates the development of larvae and stimulates the differentiation of rhabditiform into infective filariform larvae, thus inducing internal autoinfection. Therefore, early diagnosis is important to prevent severe strongyloidiasis. The aim of this study was to evaluate the efficacy of parasitological methods, according to the parasite load and the number of stool samples, for diagnosis of S. stercoralis infection, as well the peripheral blood eosinophil count in alcoholic patients. A total of 330 patients were included in this study. The diagnosis was established using three parasitological methods: agar plate culture, Baermann-Moraes method and spontaneous sedimentation. Peripheral eosinophilia was considered when the level was >600 eosinophils/mm3. The agar plate culture (APC) had the highest sensitivity (97.3%). However, the analysis of multiple samples increased the sensitivity of all parasitological methods. The sensitivities of the methods were influenced by the parasite load. When the larval number was above 10, the sensitivity of APC was 100%, while in spontaneous sedimentation the sensitivity reached 100% when the larval number was above 50. In the present study, 15.4% of alcoholic patients infected with S. stercoralis (12/78) had increased peripheral blood eosinophil count (above 600 eosinophils/mm3). For an efficient parasitological diagnosis of S. stercoralis infection in alcoholic patients, repeated examination by two parasitological methods must be recommended, including agar plate culture due to its higher sensitivity. Moreover, S. stercoralis infection was associated with eosinophilia, mostly in patients excreting up to 10 larvae/g faeces.


Assuntos
Alcoolismo/complicações , Eosinofilia/etiologia , Carga Parasitária , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/complicações , Estrongiloidíase/diagnóstico , Alcoolismo/parasitologia , Animais , Brasil , Eosinofilia/parasitologia , Fezes/parasitologia , Humanos , Sensibilidade e Especificidade
15.
Med Sante Trop ; 28(3): 334-336, 2018 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30270843

RESUMO

Causes of hypereosinophilia among travelers returning from North Africa are dominated by helminth infections, especially when associated with gastrointestinal signs. Non-infectious causes must nonetheless be investigated after negative microbiological assessment and failure of a broad empiric antiparasite treatment. We report the case of a young man with epigastralgia and major weight loss since a stay in Tunisia. Empiric treatment with albendazole was not successful. Eosinophilic gastroenteritis was diagnosed and resolved under corticosteroid treatment.


Assuntos
Enterite/diagnóstico , Eosinofilia/diagnóstico , Gastrite/diagnóstico , Helmintíase/diagnóstico , Doença Relacionada a Viagens , Adulto , Diagnóstico Diferencial , Enterite/complicações , Enterite/parasitologia , Eosinofilia/complicações , Eosinofilia/parasitologia , Gastrite/complicações , Gastrite/parasitologia , Helmintíase/complicações , Humanos , Masculino , Dor/etiologia , Tunísia
16.
Am J Trop Med Hyg ; 99(6): 1602-1605, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30277205

RESUMO

Visceral larva migrans (VLM) is one of the clinical syndromes of human toxocariasis. We report a case of hepatic VLM presenting preprandial malaise and epigastric discomfort in a 58-year-old woman drinking raw roe deer blood. The imaging studies of the abdomen showed a 74-mm hepatic mass featuring hepatic VLM. Anti-Toxocara canis immunoglobulin G (IgG) was observed in enzyme-linked immunosorbent assay (ELISA) and western blot. Despite anthelmintic treatment, the patient complained of newly developed cough and skin rash with severe eosinophilia. Hepatic lesion increased in size. The patient underwent an open left lobectomy of the liver. After the surgery, the patient was free of symptoms such as preprandial malaise, epigastric discomfort, cough, and skin rash. Laboratory test showed a normal eosinophilic count at postoperative 1 month, 6 months, 1 year, and 4 years. The initial optical density value of 2.55 of anti-T. canis IgG in ELISA was found to be negative (0.684) at postoperative 21 months. Our case report highlights that a high degree of clinical suspicion for hepatic VLM should be considered in a patient with a history of ingestion of raw food in the past, presenting severe eosinophilia and a variety of symptoms which reflect high worm burdens. Symptom remission, eosinophilia remission, and complete radiological resolution of lesions can be complete with surgery.


Assuntos
Anticorpos Anti-Helmínticos/sangue , Tosse/cirurgia , Eosinofilia/cirurgia , Exantema/cirurgia , Larva Migrans Visceral/cirurgia , Fígado/cirurgia , Toxocara canis/isolamento & purificação , Animais , Anti-Helmínticos/administração & dosagem , Tosse/tratamento farmacológico , Tosse/parasitologia , Tosse/patologia , Cervos/parasitologia , Eosinofilia/tratamento farmacológico , Eosinofilia/parasitologia , Eosinofilia/patologia , Exantema/tratamento farmacológico , Exantema/parasitologia , Exantema/patologia , Feminino , Humanos , Imunoglobulina G/sangue , Larva Migrans Visceral/tratamento farmacológico , Larva Migrans Visceral/parasitologia , Larva Migrans Visceral/patologia , Fígado/parasitologia , Fígado/patologia , Pessoa de Meia-Idade , Alimentos Crus/parasitologia , Toxocara canis/imunologia
17.
Am J Trop Med Hyg ; 99(5): 1170-1173, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30328410

RESUMO

Dientamoeba fragilis is an intestinal protozoan, usually considered nonpathogenic. However, in the last years, there has been an attempt to clarify its possible pathogenic role. We aim to evaluate the clinical and epidemiological characteristics of D. fragilis-infected patients. Adults with D. fragilis detection in feces who attended the Vall d'Hebron University Hospital (Barcelona, Spain) were evaluated retrospectively from April 2009 to March 2014. We classified the patients in asymptomatic, symptomatic without other causes except infection of D. fragilis, and symptomatic with another cause. Among symptomatic patients, treatment response was evaluated. One hundred eight patients were included. Sixty-three percent of the patients were immigrants, 29.6% were autochthonous, and 7.4% were travelers. Forty-nine (45.3%) patients presented symptoms, and eosinophilia was observed in 26 (24.1%) patients. Overall, 59 (54.7%) patients were asymptomatic, 15 (13.8%) presented symptoms which were attributable to other causes, and 34 (31.5%) patients presented symptoms with no other causes. In this last group, 29 patients received specific treatment and 65.5% of them presented a complete resolution of the symptoms. The group of symptomatic patients with no other cause had more proportion of women, more proportion of autochthonous people, and were older compared with the group of asymptomatic patients. Dientamoeba fragilis infection should be considered as pathogenic when other causes are ruled out.


Assuntos
Dientamoeba/patogenicidade , Dientamebíase/epidemiologia , Fezes/parasitologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções Assintomáticas/epidemiologia , Dientamoeba/efeitos dos fármacos , Dientamoeba/isolamento & purificação , Dientamebíase/tratamento farmacológico , Eosinofilia/parasitologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Espanha/epidemiologia , Centros de Atenção Terciária , Adulto Jovem
18.
Clin Lab ; 64(10): 1773-1776, 2018 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-30336527

RESUMO

BACKGROUND: Rhabditis (Rhabditellae) axei is a common species in soil, which has been reported repeatedly in human urine and the digestive system. Humans exposed to sewage or mistakenly polluted sewage is the cause of larvae infecting the digestive tract or via the urethra. We reported a patient infected with Rhabditis axei and Enterobius Vermicularis. The migration of the nematodes caused true signs of hematuria, diarrhea, and high eosinophilia. METHODS: Stool and urine are collected to detect parasite eggs and genotype. Specimens are sent for polymerase chain reaction (PCR)-based species identification. Amplification of the 18S ribosomal RNA gene was performed by PCR as described [1]. RESULTS: Morphological features and PCR amplification of the 18S ribosomal RNA gene confirmed Rhabditis axei and Enterobius vermicularis as the pathogen of infection. CONCLUSIONS: Herein, we presented a case that confirmed Rhabditis axei and Enterobius vermicularis infection in humans can be associated with high eosinophilia.


Assuntos
Enterobíase/diagnóstico , Infecções por Rhabditida/diagnóstico , Animais , Pequim , Pré-Escolar , Diarreia/parasitologia , Enterobíase/parasitologia , Enterobius/genética , Enterobius/fisiologia , Eosinofilia/parasitologia , Hematúria/parasitologia , Humanos , Masculino , RNA Ribossômico 18S/genética , Infecções por Rhabditida/parasitologia , Rhabditoidea/genética , Rhabditoidea/fisiologia
20.
Medicine (Baltimore) ; 97(37): e12361, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30212995

RESUMO

Blood eosinophilia is a common clinical finding. Helminthic infections, including toxocariasis, are a common cause of eosinophilia; however, the clinical course of toxocariasis associated with eosinophilia is not fully understood. Thus, controversies exist regarding treatment indications.To evaluate the clinical features and natural course of various types of eosinophilia, with a particular focus on toxocariasis, we retrospectively reviewed the medical records of 1000 patients with peripheral blood eosinophilia who were referred to the allergy clinic at Asan Medical Center between 2007 and 2012. Clinical parameters and imaging study findings were evaluated. The treatment response to albendazole and resulting changes in eosinophilia and imaging studies were analyzed in patients diagnosed with toxocariasis.Among the 1000 subjects, toxocariasis was the most common cause of eosinophilia (n = 534; 53.4%), followed by allergic disease and adverse drug reactions. The majority of patients with toxocariasis were men, and they were mostly asymptomatic. More than one-third of patients (n = 215; 40.3%) with toxocariasis exhibited organ involvement, particularly hepatic involvement. In most cases of eosinophilia and organ involvement due to toxocariasis, the symptoms normalized regardless of treatment.Most cases of eosinophilia related to toxocariasis displayed a self-remitting course regardless of treatment. With the exception of several clinical situations, including ocular involvement, the clinical need for anti-helminthic therapy in toxocariasis is not that significant.


Assuntos
Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Eosinofilia/tratamento farmacológico , Toxocaríase/complicações , Adulto , Idoso , Animais , Eosinofilia/parasitologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
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