A natural zoonotic giardiasis: Infection of a child via Giardia cysts in pet chinchilla droppings.

Here, we report a case of direct zoonotic transmission of giardiasis between a pet chinchilla and a human. Microscopic and molecular examinations of stool samples from a child and samples of chinchilla droppings revealed cysts/DNA of Giardia intestinalis. The transmission from the chinchilla to the child has been confirmed as coprophagous after the 1-year-old toddler ingested pet chinchilla droppings. Molecular analysis of the gdh gene from both hosts classified the G. intestinalis cysts into the assemblage B genetic group, which has been previously shown to be characteristic of both human and chinchilla giardiasis. Both Giardia sub-assemblages BIII and BIV were present in the chinchilla droppings, whereas only the sub-assemblage BIV was isolated from the child's stool sample. To the best of our knowledge, this is the first report of a true zoonotic transmission of giardiasis, supporting the zoonotic potential of assemblage B.

Coprophagic Asphyxiation in an Intellectually Disabled Woman.

The ingestion of one's own feces is referred to as coprophagia. In this report, the author discusses a case of coprophagia-associated death in a 36-year-old woman. The woman had a history of intellectual disability, bipolar disorder, and schizoaffective disorder and was living in a group home. At autopsy, examination of the upper airway revealed 4 distinct spherical boli of impacted fecal matter in the oral cavity and pharynx. Death was attributed to asphyxia due to aspiration of stool bolus during an episode of coprophagia. This is now the second reported case of coprophagic-related death, illustrating the need for careful monitoring of eating activities in individuals with mental disorders.

Coprophagia in neurologic disorders.

We report on the unusual behavior of coprophagia (eating one's own feces) in neurologic disorders. The Mayo Clinic Health Sciences-computerized clinical database was queried for all patients evaluated at our institution between 1995 and 2015 in which coprophagia was documented in the medical records. Twenty-six patients were identified of which 17 had coprophagia. Of the 17 patients, five were excluded due to age at onset less than 10 years, leaving 12 adult patients for this study. The median age at onset of coprophagia in the 12 patients was 55 years (range 20-88 years), and half were female. Additional behaviors were common including scatolia (fecal smearing), hypersexuality, aggression, and pica (eating objects of any kind). Coprophagia was associated with neurodegenerative dementia in six patients, developmental delay in two, and one each with seizures, steroid psychosis, frontal lobe tumor, and schizoaffective disorder. Brain imaging in the six patients with dementia showed moderate-to-severe medial temporal lobe atrophy, as well as mild frontal lobe atrophy. Autopsy examination was performed in one patient and revealed frontotemporal lobar degeneration pathology. Many different behavioral and pharmacologic therapies were implemented, yet only haloperidol was associated with discontinuation of the behavior. Coprophagia is associated with different neurologic disorders, particularly neurodegenerative dementias. The behavior may be related to medial temporal lobe atrophy, similar to the Klüver-Bucy syndrome. Haloperidol appears to be effective in treating the behavior, at least in some patients.

Pesticide contamination of Tenebrio molitor (Coleoptera: Tenebrionidae) for human consumption.

The use of pesticides contributes to the productivity and the quality of the cultivated crop. A large portion of the agricultural produce is not consumed as it is not an edible part or the quality of the product is too low. This waste of agricultural produce can be valorised as a substrate for the production of certain insects for human consumption. However, pesticides applied on the plants might accumulate during the life cycle of the insects fed on the waste materials and may cause a health risk to humans consuming the insects. Pesticide residues in larvae of the yellow mealworm, Tenebrio molitor, were investigated. We monitored the accumulation of pesticides in the larvae upon consumption of contaminated fresh produce. An increased uptake rate by the insects was found for pesticides with higher Kow-values. Excretion of pesticides by the insect was inversely related to the log(Kow) values of the pesticides.

Ictal Coprolalia: A Case Report and Review of Ictal Speech as a Localizing Feature in Epilepsy.

BACKGROUND: Recognizing ictal semiology is an essential component to localization of seizure onset, especially in intractable epilepsy where surgical therapies may be beneficial. Ictal speech can be a common component of seizure semiology, but the various forms of ictal speech may have different lateralizing and localizing value. Coprolalia is a very rare form of ictal speech. METHODS: We present a 15 year old with medically intractable seizures characterized by agitation and coprolalia. RESULTS: The patient underwent surgical evaluation including video EEG, MRI, and functional neuroimaging. These studies indicated onset within the dominant frontal lobe which was further localized using stereo-electroencephalography prior to focal cortical resection. CONCLUSIONS: Ictal coprolalia is a rare presentation of ictal speech. We review the various forms of ictal speech and their value in localizing seizure onset.

Coprophagia in a patient with borderline personality disorder

Background and Objectives: Human coprophagia is a rare phenomenon with severe medical and social consequences. So far, coprophagia has mainly been associated with severe mental retardation, schizophrenia, dementia, and depression. We report a caseof coprophagia in a 30-year-old woman with Borderline Personality Disorder (DSM-IV).This case report illustrates the severity of symptoms and maladaptive social consequences of severe personality disorders, comparable to those of patients with schizophrenia. Pharmacological interventions and, particularly intensive psychotherapy might be effective for patients diagnosed with borderline personality disorder displaying severe behavior disorders. The treatment of choice for coprophagia is aversive behavioral intervention (AU)

Effect of ivermectin on the survival and fecundity of Euoniticellus intermedius (Coleoptera: Scarabaeidae)

The State of Veracruz in Mexico is one of the main cattle producers, and uses several veterinary products for disease and parasite control. For parasite control, ivermectin is one of the most frequently used substances. Nevertheless, even though previous research conducted in other countries has found that this product has negative effects on beneficial coprophagous fauna, no studies have descry ibed its effects on coprophagous insects at a local scale in Veracruz, Mexico. This study evaluated Euoniticellus intermedius survival, fecundity, fertility and preimaginal development under laboratory conditions when ivermectin was added to cattle dung at three different concentrations. The design included two controls (spiked dung), and the following product concentrations: 0.01, 1.0 and 100ppm, which were homogenized with wet cattle dung. 20 female-male E. intermedius couples between five and 15 days old were used and kept at 27°C, 70% RH, and 12h light for 10 days. The survival of all specimens, the fertility of 20 females and the gonadal maturity of 17 males were verified. The larval development in 162 pieces of brood-mass was examined, and a total of 974 larvae developed and reached adulthood. The highest ivermectin concentration was toxic at 1.0ppm dose, the survival of adults was reduced to almost the half, and at 100ppm, total mortality was observed. The effects on specimen reproductive systems showed that the ovary was not affected, that the testicle size increased, and that the fecundity and weight of brood-masses were reduced. Pre-imaginal development increased 0.5 times at 0.01ppm concentration, and the width of the cephalic capsule in third instar larvae diminished. The prolonging of development time may cause a phase lag in the field activity cycle, this lag may reduce the number of E. intermedius individuals and the efficiency of the environmental services that they provide.

El estado de Veracruz en México, es uno de los principales productores de ganado vacuno en México, asimismo utiliza diversas medicinas veterinarias para el control de enfermedades y parásitos. La ivermectina es una de las substancias más utilizadas para el control de parásitos. Sin embargo, se sabe por estudios hechos en otros países, que esta substancia tiene efectos negativos sobre la fauna coprófaga benéfica como los escarabajos del estiércol, pero no se han estudiado sus efectos sobre la fauna coprófaga de Veracruz o de México. Este estudio se realizó en condiciones de laboratorio, en donde se utilizó el estiércol vacuno a tres diferentes concentraciones de ivermectina para determinar su efecto sobre la supervivencia, fecundidad, fertilidad y desarrollo preimaginal de Euoniticellus intermedius. Por lo tanto, las tres concentraciones que se emplearon fueron: 0.01, 1.0 y 100ppm de ivermectina homogeneizada en estiércol vacuno fresco y dos testigos. Además, se utilizaron 20 parejas hembramacho por tratamiento, entre cinco y 15 días de edad y mantenidos por 10 días a 27°C, 70% HR y 12hr luz. Se determinó la supervivencia de todos, la fertilidad en 20 hembras y el estado de madurez gonádica en 17 machos. Se determinó el desarrollo preimaginal en 162 masas-nido y 974 se dejaron continuar el desarrollo hasta la emergencia de los adultos. La ivermectina es tóxica a mayor concentración. La supervivencia de adultos se redujo casi a la mitad a dosis de 1.0ppm y fue nula a 100ppm. El ovario no fue afectado. Los testículos incrementaron de tamaño. La fecundidad y el peso de las masas-nido se redujeron. El desarrollo preimaginal se incrementó 0.5 veces a concentración 0.01ppm y las larvas del tercer estadio redujeron el ancho de la cápsula cefálica. El alargamiento del tiempo de desarrollo puede causar desfase de su ciclo de actividad en campo, lo que podría reducir su número y la eficiencia de los servicios ambientales que proporcionan.

Functional analysis and treatment of coprophagia.

In the current investigation, functional analysis results suggested that coprophagia, the ingestion of fecal matter, was maintained by automatic reinforcement. Providing noncontingent access to alternative stimuli decreased coprophagia, and the intervention was generalized to two settings.

Rectocele in children: a case report.

Rectocele is an abnormal protrusion of the anterior wall of the rectum into the vagina. When symptomatic, it will typically cause obstructed defecation. It is almost exclusively found in females with rare reports in males and never been described in the literature in children younger than 18 years of age so far. We are presenting 3 cases of rectocele with obstructed defecation in the pediatric population. These children presented with the complaints of constipation along with refractory straining. They were diagnosed by defecography. Two were treated surgically and one conservatively. Surgical intervention completely cured the problem with uneventful postoperative course. Further multicenter studies with the aid of radiologic studies on children with "hard to treat" constipation should be considered to better define that disorder in the pediatric age group. A more vigilant approach may have implications in the prevention of more severe rectal and uterovaginal prolapse in the future.

Effective treatment of coprophagia in a patient with schizophrenia with the novel atypical antipsychotic drug perospirone.

Here we report on a patient with schizophrenia who suffered from medication-refractory coprophagia. Although there were few cases in which psychotropic medication was effective against coprophagia, we encountered a patient with schizophrenia in whom coprophagia rapidly disappeared after treatment with perospirone, a novel atypical antipsychotic drug of the serotonin-dopamine antagonist (SDA) type. Perospirone has a uniquely high affinity for serotonin-1A receptors, and it could be speculated that perospirone, as a serotonin-1A receptor agonist combined with SDA, may have greater efficacy for treatment-refractory symptoms of schizophrenia. Thus, perospirone is an agent with possible efficacy for medication-refractory schizophrenia.

Coprophagia in an elderly man: a case report and review of the literature.

OBJECTIVE: Coprophagia or the ingestion of feces has long been associated with psychiatric illness. It is considered to be a variant of pica. This behavior requires an extensive medical and psychiatric differential diagnosis. Medical disorders associated with coprophagia include seizure disorders, cerebral atrophy, and tumors. Psychiatric disorders associated with coprophagia include mental retardation, alcoholism, depression, obsessive compulsive disorder, schizophrenia, fetishes, delirium, and dementia. In animals, coprophagia is associated with boredom, thiamine deficiency, and lesions of the amygdala. METHODS: A case of coprophagia in an elderly man is reported here. A 77-year-old man with mild mental retardation was referred for urgent psychiatric evaluation due to coprophagia. The case is discussed and the literature reviewed. RESULTS: Psychiatric evaluation revealed cognitive dysfunction and depression. Physical examination and laboratory evaluation were noncontributory. He was started on sertraline 25 mg daily with resolution of his coprophagia. Coprophagia has been treated using behavioral interventions, supportive psychotherapy, elemental diets, tricyclic anti-depressants, carbamazepine, haloperidol, and electroconvulsive therapy. CONCLUSIONS: Use of Selective Serotonin Reuptake Inhibitors (SSRIs) may also be an effective treatment for coprophagia, particularly in the setting of depression or anxiety.

More on Merde.

Whereas food has always received much attention in conversation, commerce, and the literature, the subject of feces has been comparatively neglected. To fill this lacuna, a small book on comparative coprology was recently published (Lewin 1999). The present article aims to supplement this book with a review of overlooked or new items relating to biological and medical aspects of coprology, notably chemical and microbial components of human and animal feces, their uses as fertilizers, and a few other sociological impacts.

Coprophagic café coronary.

A 74-year-old man who had been institutionalized for severe multiinfarct dementia was found dead in bed. He had a history of compulsive ingestion of food and other materials, including feces. At autopsy, a 65-g bolus of fecal material was impacted within the laryngopharynx, occluding the inlet of the larynx. This case demonstrates an unusual coprophagic variant of cafe coronary syndrome and emphasizes that demented individuals with pica are at risk of sudden death from ingestion of a wide variety of materials, including, but not limited to, food.

A case of coprophagia presenting with sialadenitis.

PRESENTATION: a 94-year-old woman with dementia was admitted to an acute geriatric ward with increasing confusion and falls. On two occasions she developed submandibular masses. Faeces were aspirated from her mouth and a diagnosis made of recurrent submandibular sialadenitis secondary to coprophagia. OUTCOME: the submandibular mass settled with antibiotics and oral care. Coprophagia was not observed on the ward, but faecal smearing was noted. With regular toileting, this behaviour ceased and sialadenitis did not recur.

Malingering uncommon psychiatric symptoms among defendants charged under California's "three strikes and you're out" law.

This paper describes an epidemic of uncommon psychiatric symptoms among nine criminal defendants charged under California's new "Three Strikes and You're Out" law. The defendants were facing a minimum sentence of 25 years to life in prison. The defendants exhibited the following uncommon psychiatric symptoms: coprophagia (eating feces), eating cockroaches and many reported seeing little green men. The defendants, all of whom we believe were malingering, were evaluated by the authors for competency to stand trial. Thus far, eight of the nine defendants were found competent to stand trial; only one defendant was found incompetent to stand trial. The authors created a database which included information on the defendants from court documents and from our interview with the defendants. We summarized the data and outcomes of the case. Also included is a brief review of the "Three Strikes Law" and a paradigm for how we ruled out relevant psychiatric diagnoses before we arrived at our opinion of malingering.

Scatolia: psychosis to protest.

This paper presents the case of a female patient in a special hospital who engaged in faecal smearing whilst in seclusion. A management investigation followed a complaint by a Nurse Manager regarding the reluctance of staff to clean the room whilst the patients remained disturbed. The investigation team adopted a triangulated method of interviews, literature review, survey and case presentations to study the issues involved. The results presented here suggest the emergence of similar issues from both the interview commentary and the tabulated data from the survey. There appears an intricate and complex dilemma facing those managing situations involving scatolic behaviour. There are issues of concern from diverse organizational settings that overlap between those persons who engage in scatolia who may be deemed mentally impaired, psychiatrically disordered, or protest behaviour.