1/131. Persistent damage to enterocytozoon bieneusi, with persistent symptomatic relief, after combined furazolidone and albendazole in AIDS patients.AIM: To investigate morphological changes in enterocytozoon bieneusi and the duration of symptomatic relief after combination treatment with furazolidone and albendazole in AIDS patients. methods: Four severely immunocompromised AIDS patients with symptomatic E bieneusi infection of the gut received an 18 day course of combined furazolidone and albendazole (500 800 mg daily). All patients were monitored for parasite shedding in stool by light microscopy at the end of treatment and monthly during follow up. At the end of treatment, duodenal biopsy specimens obtained from three patients were studied by transmission electron microscopy by two pathologists blind to the patients' treatment or clinical outcome. Duodenal biopsy specimens obtained from one of the patients two months after completion of treatment were also studied electronmicroscopically. RESULTS: All patients had long lasting symptomatic relief, with a major decrease--or transient absence--of spore shedding in stools from completion of treatment. After treatment, changes in faecal spores were persistently found by light microscopy in all cases, and there was evidence of both a substantial decrease in the parasite load and ultrastructural damage in the parasite in all biopsy specimens. The treatment was well tolerated, and no patient had clinical or parasitological relapse during follow up (up to 15 months). CONCLUSIONS: The long lasting symptomatic relief observed in all four treated patients correlated with the persistent decrease in parasite load both in tissue and in stool, and with the morphological changes observed in the life cycle of the protozoan. These data suggest that combined treatment with furazolidone and albendazole is active against E bieneusi and may result in lasting remission even in severely immunocompromised patients.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
2/131. encephalitozoon intestinale infection in an AIDS patient--a case report.The first case of one of the most frequent intestinal microsporidians, encephalitozoon intestinale, is reported from an AIDS patient in the czech republic. The patient experienced diarrhoea and was found to have microsporidia spores in stool. Species determination by electron microscopy confirmed the diagnosis of the microsporidian, E. intestinale. The CD4-count at the time of the diagnosis was 73 cells/mm3, IRI = 0.21. Only after symptomatic therapy and rehydration the patient stopped the complaining, and although he refused an antimicrosporidial therapy, the CD4-count one month later increased to 200 cells/mm3 and patient didn't suffered from diarrhoea. Six months after the first finding of microsporidia, the patient was admitted to the hospital care for progressive encephalopathy and developing wasting syndrome again with the intermittent diarrhoea. The patient was treated with albendazole at that time. Nevertheless, after 14 days of albendazole therapy, he still remained positive for E. intestinale spores in the stool (urine specimens remained negative for all the time). The patient died after a two-month hospitalisation and the apparent cause of death was purulent bronchopneumonia, wasting syndrome with microsporidiosis, and hiv encephalopathy. Generalised mycobacteriosis (MAC) was also found from the autopsy material.- - - - - - - - - - ranking = 4keywords = infection (Clic here for more details about this article) |
3/131. A case of gastric pseudoterranoviasis in a 43-year-old man in korea.A case of Pseudoterranova decipiens infection was found in a 43-year-old man by gastroendoscopic examination on August 20, 1996. On August 6, 1996, he visited a local clinic, complaining of epigastric pain two days after eating raw marine fishes. Although the symptoms were relieved soon, endoscopic examination was done for differential diagnosis. A white, live nematode larva was removed from the fundus of the stomach. The larva was 38.3 x 1.0 mm in size and had a cecum reaching to the mid-level of the ventriculus. A lot of transverse striations were regularly arranged on the cuticle of its body surface, but the boring tooth and mucron were not observed at both ends of the worm. The worm was identified as the 4th stage larva of P. decipiens.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
4/131. A case of strongyloides stercoralis infection.strongyloidiasis has been recognized as one of the life-threatening parasitic infections in the immunocompromised patients. We report an intestinal infection case of strongyloides stercoralis in a 61-year-old man. Rhabditiform larvae were detected in the stool examination and developed to filariform larvae having a notched tail through the Harada-Mori filter paper culture. The patient received five courses of albendazole therapy but not cured of strongyloidiasis.- - - - - - - - - - ranking = 6keywords = infection (Clic here for more details about this article) |
5/131. An incidental case of human Heterophyes nocens infection diagnosed by sectional morphology in a biopsy specimen of the small intestine.A case of human infection with Heterophyes nocens (heterophyidae) was incidentally found in a biopsy specimen of the Meckel's diverticulum at the upper part of the small intestine. The patient was a 58-year-old man living in a rural area of Talsonggun, Kyongsangbuk-do. He had gastrointestinal symptoms such as epigastric pain, indigestion, and abdominal discomfort for 3 months, and severe diarrhea, abdominal pain, and vomiting for about 1 month before hospitalization. endoscopy of the upper part of the small intestine revealed a Meckel's diverticulum, and it was excised and histopathologically examined. Three adult flukes were incidentally found sectioned in the mucosa, and they were identified as H. nocens. The patient had a history of eating raw mullets at a fish market in Pusan 6 months ago, and the mullets were presumed to be the source of infection. This case brings a considerable interest in that specific diagnosis of heterophyid infections could be done by sectional morphology of the worms.- - - - - - - - - - ranking = 7keywords = infection (Clic here for more details about this article) |
6/131. capillaria philippinensis: an emerging parasite causing severe diarrhoea in egypt.Four cases with capillaria philippinensis have been reported from egypt during 1989-1992. The authors report here four other cases of severe diarrhoea caused by this parasite. A male and three female patients aged 12-45 years presented with severe diarrhoea of 1-7 months duration associated with vomiting and central abdominal colics. Stools were yellowish or greenish and voluminous. anorexia was profound with loss of weight. Bilateral painless ankle oedema developed early in the course of the disease and two cases had ascites and bilateral pleural effusion at presentation. There was hyponatraemia, hypocalcaemia and marked hypokalaemia and hypoalbulinaemia. Small bowel series showed a rapid transit time in 3 cases and malabsorption pattern in one. Duodenal biopsies showed non-specific chronic inflammation while jejunal biopsies from one case revealed grade II villous atrophy with moderate cellular infiltration of lamina propria. The infection was diagnosed by finding the eggs, larvae and adult worms of C. philippinensis in stool. patients were treated with mebendazole 400 mg/day in two divided doses for 28 days in addition to high protein diet and correction of electrolyte disturbance. vomiting stopped on the second day of treatment, appetite improved and diarrhoea regressed by the fourth day. Unfortunately, one case died two days after admission due to marked hypokalaemia. Clinico-pathological and epidemiological aspects of this infection in egypt are discussed.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
7/131. A human case of Stellantchasmus falcatus infection in korea.In an attempt to find the worm producing unidentified egg, one minute fluke was collect from a Korean patient after praziquantel administration. The fluke was identified to be Stellantchasmus falcatus by the expulsor. Brackish water fish was suggested to be a probable source of the infection.- - - - - - - - - - ranking = 5keywords = infection (Clic here for more details about this article) |
8/131. Ultrasound diagnosis of oesophagostomiasis.Human infection with oesophagostomum bifurcum, a parasitic intestinal helminth, is endemic in parts of West africa. oesophagostomum bifurcum juveniles develop in the colonic wall, causing pus-filled granulomas. The pathology has two distinct forms. Multinodular oesophagostomiasis comprises hundreds of small nodules within a thickened, oedematous wall of the large intestine. Uninodular oesophagostomiasis, called the Dapaong tumour, presents as a painful 30-60 mm granulomatous mass in the abdominal wall or within the abdominal cavity. diagnosis of oesophagostomiasis on clinical grounds alone is difficult. We describe cases illustrating the ultrasound appearance of these two presentations. Multinodular disease shows nodular "target" and "pseudokidney" colonic lesions. The Dapaong tumour is an echo-free ovoid lumen enveloped within a well defined poorly reflective wall.- - - - - - - - - - ranking = 1keywords = infection (Clic here for more details about this article) |
9/131. myxobolus sp., another opportunistic parasite in immunosuppressed patients?During a study of intestinal parasitic infections in human immunodeficiency virus-positive patients, a parasite belonging to the phylum myxozoa, recently described from human samples, was identified in one sample. When this parasite was stained by the modified Ziehl-Neelsen staining method, the features of the spores were identified: they were pyriform in shape, had thick walls, and had one suture and two polar capsules, with each one having four or five coils. The suture and two polar capsules were observed with the chromotrope-modified stain. The number of stools passed was more than 30 per day, but oocysts of isospora belli were also found. Upon reexamination of some formalin- or merthiolate-iodine-formaldehyde-preserved samples an identical parasite was found in another sample from a patient presenting with diarrhea. strongyloides stercoralis larvae and eggs of hymenolepis nana and ascaris lumbricoides were also found in this sample. Given that both patients were also infected with other pathogens that cause diarrhea, the possible pathogenic role of this parasite could not be established. The probable route of infection also could not be established.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
10/131. Intestinal amebiasis: a diagnosis not to be missed.entamoeba histolytica is a well-recognized cause of infectious colitis and disseminated amebic abscesses. Most prevalent in the tropics and subtropics, E. histolytica infections may also occur in the developed world. We describe a case of a North American traveler with intestinal amebiasis, a diagnosis first made by colonic biopsy. We review the available diagnostic tools and the role of the surgical pathologist in the detection of this infection.- - - - - - - - - - ranking = 2keywords = infection (Clic here for more details about this article) |
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