Therapeutic effects of benznidazole in Swiss mice that are orally inoculated with Trypanosoma cruzi IV strains from the Western Brazilian Amazon.

Strains of Trypanosoma cruzi, etiological agent of Chagas disease, are classified into different discrete typing units that may present distinct dynamics of infection and susceptibility to benznidazole (BZ) treatment. Mice that were orally inoculated with T. cruzi IV strains exhibited a more intense course of infection compared with intraperitoneally inoculated mice, reflected by higher parasite loads. We evaluated the efficacy of BZ treatment in Swiss mice that were inoculated with T. cruzi IV strains from the Western Brazilian Amazon. The mice were orally (OR) or intraperitoneally (IP) inoculated with 2 × 106 culture-derived metacyclic trypomastigotes of the AM14, AM16, AM64, and AM69 strains of T. cruzi that were obtained from two outbreaks of orally acquired acute Chagas disease in the state of Amazonas, Brazil. The animals were treated with BZ (100 mg/kg/day for 20 days). Fresh blood examination, hemoculture, conventional and quantitative real-time polymerase chain reaction were performed to monitor the therapeutic effects of BZ. Significant reductions in five of 24 parameters of parasitemia and parasite load were found in different tissues in the OR group, indicating worse response to BZ treatment compared with the IP group, in which significant reductions in nine of those 24 parameters were observed. The cure rates in the OR groups ranged from 18.2% (1/11) to 75.0% (9/12) and in the IP groups from 58.3% (7/12) to 91.7% (11/12), for the AM14 and AM69 strains, respectively. These findings indicate that treatment with BZ had fewer beneficial effects with regard to reducing parasitemia and parasite load in different tissues of mice that were OR inoculated with four TcIV strains compared with IP inoculation. Therefore, the route of infection with T. cruzi should be considered when evaluating the therapeutic efficacy of BZ in patients with Chagas disease.

Development of Trichosomoides nasalis (Nematoda: Trichinelloidea) in the murid host: evidence for larval growth in striated muscle fibres.

Trichosomoides nasalis (Trichinelloidea) is a parasite of Arvicanthis niloticus (Muridae) in Senegal. Female worms that harbour dwarf males in their uteri, occur in the epithelium of the nasal mucosa. Young laboratory-bred A. niloticus were either fed females containing larvated eggs or intraperitoneally injected with motile first-stage larvae recovered from female uteri. Both resulted in successful infection. Organs examined during rodent necropsy were blood and lymphatic circulatory systems (heart, large vessels, lymphnodes), lungs, liver, kidneys, thoracic and abdominal cavities, thoracic and abdominal muscular walls, diaphragm, tongue, and nasal mucosa. Development to adult nasal stages took three weeks. Recovery of newly hatched larvae from the peritoneal fluid at four-eight hours after oral infection suggests a direct passage from the stomach or intestinal wall to the musculature. However, dissemination through the blood, as observed with Trichinella spiralis, cannot be excluded even though newly hatched larvae of T. nasalis are twice as thick (15 µm). Developing larvae were found in histological sections of the striated muscle of the abdominal and thoracic walls, and larvae in fourth moult were dissected from these sites. Adult females were found in the deep nasal mucosa where mating occurred prior to worms settling in the nasal epithelium. The present study shows a remarkable similarity between T. nasalis and Trichinella species regarding muscle tropism, but the development of T. nasalis is not arrested at the late first-larval stage and does not induce transformation of infected fibres into nurse cells. T. nasalis seems a potential model to study molecular relations between trichinelloid larvae and infected muscle fibres.

[Parietal complications of hydatid cyst of the liver. Report of two cases in Tunisia]. / Les complications pariétales du kyste hydatique du foie. À propos de deux cas en Tunisie.

The aim of this study is to consider the parietal complications of the hydatid cyst of the liver: the subcutaneous rupture of the cyst and spontaneous cutaneous fistula of liver hydatid cyst. 1(st) case: A 24-year-old woman, who underwent surgery 10 years ago for hydatid cyst of the liver, was admitted for a right hypochondrium mass and a fistula draining clear liquid containing cystic elements. Computed tomography (CT) showed a large cystic lesion in the subcutaneous tissue communicating with another cystic mass in the liver. The diagnosis of a cyst-cutaneous fistula due to a peritoneal hydatid cyst was established. The patient underwent surgical treatment and recovered uneventfully. 2(nd) case: A 40-year-old woman presented with a mass in her right hypochondrium. The diagnosis of subcutaneous rupture of a hydatid cyst of liver was established by ultrasonography and CT-scan. The patient underwent surgical treatment and recovered uneventfully. Parietal complications of hydatid cyst of the liver are extremely rare, clinical presentation can be derailing. The diagnosis is usually established by ultrasonography and CT-scan.

Sparganosis: an under-recognised zoonosis in Australia?

Sparganosis is a rare zoonotic parasitosis that is sporadically reported worldwide. In Australia, the causative tapeworms are considered endemic in wildlife animals, however, there have been only five reported human infections. We present three additional cases of sparganosis, involving two Australian born gentlemen who have never travelled overseas and a woman who emigrated from Ethiopia. The first man presented with two unusual subcutaneous lumps that migrated along the anterior abdominal wall connected by a tunnel. The second man presented with two separate lumps, one on the thigh and the other on the left upper abdomen over a 4-week interval. The woman presented with 6 weeks of intermittent fevers, night sweats, abdominal pain and passing intestinal worms. This series of patients suggests that sparganosis is under-recognised in Australia and serves as a reminder for clinicians to the varied presentations that can be characteristic of this lesser known zoonosis.

An unusual presentation of hydatid cyst in anterior abdominal wall.

Hydatid disease is a parasitic infestation caused by the larval form of the cestode worm Echinococcus. The most commonly encountered form of the disease is visceral hydatid cyst caused by Echinococcus granulosus or dog tapeworm. Muscular involvement has been reported in only 3-4% cases. We are reporting this case because of its rarity, difficulty to diagnose clinically, dramatic response to medical treatment and to alert the reader of this rare infestation so that open biopsy will be avoided.

An unusual abdominal wall mass in a child.

Abdominal tumors are one of the most common types of pediatric cancer. Therefore, they should always be included in the differential diagnosis of abdominal masses. Here, we present the case of a child whose initial hypothesis of diagnosis contemplated this possibility. Later, it was demonstrated that the abdominal mass found was secondary to a common parasitosis. A 2-year old, moderately malnourished and pale white boy was referred with a history of a rapidly growing, well-limited, middle abdominal mass. The mass was 10 by 3 cm, hard and poorly movable, apparently involving both abdominal rectus muscles. A complete resection was performed, revealing an abdominal wall abscess, with intense eosinophilic proliferation, secondary to a local and intense reaction to innumerous Ascaris lumbricoides eggs. Extra luminal infestations with Ascaris, that usually form peritoneal granulomas have been previously described. However, neither external trauma nor fistula, that could explain the superficial presence of the eggs, was found. This description reinforces the relevance of infectious diseases within the differential diagnosis of abdominal masses, particularly in areas with high prevalence of parasitic infestations.

A rare primary location of echinococcal disease: report of a case.

A case of primary hydatid disease, a rare location, is presented. The patient was a 20 year old female who presented with complaining of painful mass in the right hypochondrium 2 months before presantation. This cyst was strongly adherent to the two layers of m.rectus abdominis fascias. It was completely removed. No other site of hydatid disease was found and the patient remained well postoperatively.

Hidatidosis muscular primaria de pared abdominal con extensión intra-peritoneal. a próposito de un caso / Primary muscle hydatid disease in abdominal wall with intraperitoneal communication. a case report

La hidatidosis está causada por la familia Equinococcus, más frecuentemente E. granulosus. Su localización más común es en el hígado, seguida del pulmón. La localización muscular es extremadamente rara (< 1%). Presentamos el caso de una mujer cardiópata, en tratamiento anticoagulante que presenta tumoración dolorosa de crecimiento progresivo en pared abdominal, sospechando inicialmente hematoma en evolución y siendo estudiada por TAC, donde se aprecia tumoración parietal con comunicación intraperitoneal contactando con colon y mesocolon transverso. Se realiza exéresis quirúrgica sospechando intraoperatoriamente hidatidosis muscular, confirmada posteriormente según estudio anatomo-patológico. La hidatidosis forma parte del diagnóstico diferencial ante una masa de partes blandas en regiones endémicas. Su sintomatología varía en función de la localización. A nivel muscular, se presenta habitualmente con dolor y aumento de volumen. Es imprescindible la sospecha clínica, junto con las pruebas de imagen y serologías para su diagnóstico

Hydatid disease is caused by Equinococcus family, the most common is E. Granulosus. The most common location is the liver, follow the lung. Muscle tissue is extremely rare location(< 1%). We present a woman with cardiac disease and anticoagulant treatment who had a painful and progressive growth tumour in the abdominal wall. Our first idea it's a chronic hematoma and in the computed tomography we observed the tumour had intraperitoneal communication in contact with colon. Surgical resection was performed, intraoperatively suspecting muscle hydatidosis, which was confirmed later in patologic study. Hydatid disease is one of the differencial diagnosis in endemic areas. Symptoms depend on location, for example in the muscle being the pain and the increased in volumen the most usual. Clinical suspicion, combined with imaging and serology test, are essential for the diagnosis

Unusual sites for primary hydatid cysts: self experience with five cases.

Hydatid disease is a zoonotic disease caused by the tapeworm Echinococcus granulosus. It is common in the sheep-raising countries including Iraq. The usual site for involvement is the liver, followed by the lungs. Other sites may be affected less commonly and require a high index of suspicion for diagnosis. We present our experience with five cases of unusual sites of primary hydatid cyst, including the pancreas, the abdominal wall, the spleen, the back and the thigh. Three patients were females and two patients were males; their ages were between 15 and 39 years. All the patients were operated at our centre, and after a period of follow-up ranging between 2 and 6 years, there was no reported recurrence in any of the patients, neither at the primary site nor at other sites.

Primary abdominal wall hydatid cyst: a case report.

Hydatid disease is endemic in our country. A case of a 13-year-old girl with primary intermuscular hydatid cyst in the abdominal wall without other organ involvement is presented and discussed. At laparotomy, the entire endocyst, seen to push the peritoneum inwards, was totally extracted from the abdominal muscle planes without destroying the cyst wall. The postoperative course was uneventful. She is currently disease-free with a follow-up of two years. Hydatid cyst should be considered in endemic areas in patients presenting with a soft tissue mass in the abdominal wall.

An unusual abdominal wall mass in a child

ABSTRACT Abdominal tumors are one of the most common types of pediatric cancer. Therefore, they should always be included in the differential diagnosis of abdominal masses. Here, we present the case of a child whose initial hypothesis of diagnosis contemplated this possibility. Later, it was demonstrated that the abdominal mass found was secondary to a common parasitosis. A 2-year old, moderately malnourished and pale white boy was referred with a history of a rapidly growing, well-limited, middle abdominal mass. The mass was 10 by 3 cm, hard and poorly movable, apparently involving both abdominal rectus muscles. A complete resection was performed, revealing an abdominal wall abscess, with intense eosinophilic proliferation, secondary to a local and intense reaction to innumerous Ascaris lumbricoides eggs. Extra luminal infestations with Ascaris, that usually form peritoneal granulomas have been previously described. However, neither external trauma nor fistula, that could explain the superficial presence of the eggs, was found. This description reinforces the relevance of infectious diseases within the differential diagnosis of abdominal masses, particularly in areas with high prevalence of parasitic infestations.

Primary cutaneous amoebiasis: case report with review of the literature.

BACKGROUND: Primary cutaneous amoebiasis is a rare clinical entity. The lesions can be successfully treated if suspected and correctly diagnosed. We report an interesting case with review of the literature. METHODS: A 25-year-old man presenting with primary cutaneous amoebiasis with extensive involvement of the anterior abdominal wall is described. Correct diagnosis eluded us for 2 years. Clinical suspicion and a simple bedside test (wet drop preparation examination) were sufficient to diagnose the lesion. Successful treatment was achieved with oral Metronidazole followed by split skin grafting. Only six cases of primary cutaneous amoebiasis could be traced in the literature. CONCLUSIONS: Primary cutaneous amoebiasis is extremely rare. Diagnosis is usually not suspected because of its rarity. Cutaneous amoebiasis responds readily to proper treatment, yet, if unrecognized and neglected, produces significant morbidity and may be fatal.