RESUMO
Human babesiosis caused by parasitic protozoan Babesia spp. is sporadic zoonotic vector-borne infection. The course of babesiosis and prognosis depend on the type of pathogen and on the patient's immunological status. Significance this disease is a severe, often fatal course with immunocompromissed patients resembling complicated falciparum malaria. In Europe to date, more than 50 cases of confirmed human babesiosis have been reported in most cases caused by Babesia divergens. Possible there are unrecognized cases. Pathogen is an obligate intraerythrocyte parasite of vertebrate animals. The organism is transmitted from animal to man through bite of Ixodidae tick. Asexual reproduction of the parasite occurs in a vertebrate host. The pathogenesis of babesiosis is caused by the destruction of host cells. Intensive haemolysis of red blood cells leads to the development of haemolytic anemia, haematuria, jaundice, and polyorgan failure may develop. The clinical manifestations of the disease are nonspecific. Detection of intraerythrocyte parasites in blood smears stained Gimsa-Romanovsky confirms the proposed diagnosis. Blood smears and some laboratory signs from fatal cases were analyzed in the Reference-centre of E. I. Martsinovskii Institute. Original microphotographs B. divergens are shown. The main morphological forms of the parasite are shown. In addition to the well-known tetrades of parasites «Maltese Cross¼, for the first time, the parasites dividing into 6 interconnected trophozoites - "sextet" - were found. Originally, the invasion of Babesia in a normoblast is shown. An unusually high multiple invasion (14 parasites) of erythrocytes is noted. Because the patients, initially, were incorrectly diagnosed with malaria, the differential diagnosis of Babesia with Plasmodium is described step-by-step. It is important, since the treatment with antimalarial drugs is ineffective. Deviation laboratory signs are discussed. Complex morphological characteristics allowed us to speciated the parasites as B. divergens. DNA was detected in the sample with specific primers Bab di hsp70F/Bab di hsp70R and the probe Bab di hsp70P. The sequence demonstrated 99-100% and 98% similarity to the 18S rRNA gene fragment of B. divergence and Babesia venatorum, respectively. Molecular biological and serological methods of laboratory diagnosis of babesiosis are considered.
Assuntos
Babesia , Babesiose/diagnóstico , Animais , Técnicas de Laboratório Clínico , Primers do DNA , Diagnóstico Diferencial , Eritrócitos/parasitologia , Humanos , Malária Falciparum , Carrapatos/parasitologiaRESUMO
The paper describes a case of disseminated strongyloidosis in a 52-year-old woman living in Volgograd. Filariform and. rhabditiform larvae of the nematode Strongyloides stercoralis were found when analyzing her urine, sputum, and feces. She had been followed up and treated for duodenal ulcer for more than 15 years. During that time, the patient periodically underwent radiographic and ultrasonic studies and clinical and biochemical blood tests. Fecal tests were not been carried out. This case could convince that there was a risk for human strongyloidosis in the arid region having a temperate climate in European Russia and when timely detection of invasion and specific treatment were not performed, there might be disseminated strongyloidosis. The reason for late diagnosis was epidemiological history (possible contact with soil) underestimation and improper-patient examination.
Assuntos
Strongyloides stercoralis/patogenicidade , Estrongiloidíase/parasitologia , Estrongiloidíase/urina , Animais , Fezes/parasitologia , Feminino , Humanos , Larva/patogenicidade , Pessoa de Meia-Idade , Federação Russa , Escarro/parasitologia , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/fisiopatologiaRESUMO
The paper gives the results of treatment with micronized albendazole (Gelmodol-BM, World Medicine, UK) in 87 patients of the Department of Medical Parasitology and Tropical Diseases, Clinical and Diagnostic Center, Clinical Center, I.M.Sechenov First Moscow State Medical University. Thirty-two patients with echinococcosis 8 with alveococcosis (including 4 inoperable patients), 10 with ascariasis, 10 with toxocariasis, 15 with enterobiasis, and 12 people diagnosed with larva migrans were treated in 2013-2014. The drug's routine doses and dosage regimens were used. Albendazole (Gelmodol, World Medicine, UK) showed a high efficacy with good tolerability, which is highly competitive with that of the drugs manufactured by IPCA Laboratories Ltd., India (such as nemozole). Both medicaments above-mentioned may be successfully used in the treatment of many helminthisms.