1/69. 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 = rate (Clic here for more details about this article) |
2/69. 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 = 1keywords = rate (Clic here for more details about this article) |
3/69. Ultrasonographic appearance of colon taeniasis.We present the case of a 50-year-old woman with abdominal pain, nausea, loss of appetite, and frequent stools in whom the routine ultrasonographic examination demonstrated a double-reflective, ribbon-like structure in the lumen of the initial segment of the ascending colon, which suggested colon taeniasis. Because the initial parasitologic analysis yielded negative results and application of albendazol did not have any therapeutic effect, the diagnosis was confirmed by barium enema and subsequently by parasitologic examination of proglottids passed in the stool after application of niclosamide. The double-reflective, ribbon-like structure in the lumen of the intestine seems to be specific to the ultrasonographic appearance of intestinal taeniasis. Transcutaneous ultrasonography of the gastrointestinal tract, performed as a screening method before conventional radiologic or endoscopic examination, can point to the ultimate diagnosis of colon taeniasis.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
4/69. delusions of intestinal parasitosis.delusions of parasitosis, though uncommon, are an important cause of distress for affected patients and frequently of frustration for their physicians. They occur primarily in middle-aged or older women, who have the delusional belief that they are infested with parasites. Although the vast majority of cases involve dermatologic manifestations, some patients may have delusions of intestinal infection, as illustrated by this case.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
5/69. epidemiology of hookworm infection in Soong nern district, Korat province, thailand.Stool surveys in Soong Nern district, Korat Province, were done by the MF concentration technique. The intensity of hookworm infection, egg counts, results of treatment by anthelminthic drugs, observations on new infections and reinfections following treatment throughout the year and the density of nematode larvae in soil in the study area were investigated. Hookworm infection rates were high in Na-Glang village, both in adult villagers and school-aged children. The intensity of hookworm infections was considered mild and after treatment the numbers of eggs in the stools diminished or disappeared. New cases and reinfection increased during the rainy month, due to socio-environmental factors in the village that favoured the development of hookworm larvai in the soil. Although in this study it was impossible to distinguish hookworm larvae among the nematode larvae collected form soil it was highly probable that hookworm larvae were present. Control of hookworm infection in the study area was proposed by improvement of environmental sanitation and health education.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
6/69. Ultrasonographic features of pseudotumorous form of ascariasis.We report the ultrasonographic findings of a 60 year old woman with pseudotumorous form of ascariasis. Real-time ultrasonographic examination using a curved array transducer revealed grossly thickened small bowel loops, multiple small circular deposits throughout the peritoneal cavity, and a moderate amount of ascites. The English literature on the different forms of abdominal ascariasis is reviewed. Specific signs, which include the 'strip' sign, the 'four-lines', 'inner tube', or 'double tube' sign, the 'bull's eye' or 'target' sign, a 'worm mass' or 'spaghetti-like' appearance, and the 'zig-zag' sign can be present in any form of abdominal ascariasis, as they represent the image of the Ascaris worms visualized under ultrasonographic examination. However, the non-specific signs are not peculiar to A. lumbricoides infections, but are results of secondary changes due to A. lumbricoides infections in the corresponding organs.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
7/69. Hepatobiliary and pancreatic complications of ascariasis in children: a study of seven cases.OBJECTIVES: This study presents seven cases of severe hepatobiliary and pancreatic complications of ascariasis in children. The authors describe the clinical, laboratory, and imaging findings, as well as the patients' clinical evolution. methods: These cases were studied within a period of approximately 1 year and included children younger than 11 years (mean age, 4.4 years). The authors reviewed their medical history and evaluated the results of their main diagnostic examinations. RESULTS: All of the patients had vomiting, abdominal pain, pallor, and abdominal distension at presentation. Passage of ascaris lumbricoides in stool occurred in five cases, emesis with worms in three, fever in three, and hepatomegaly in two. Five patients had pancreatitis, of which two were necrohemorrhagic and one had pseudocyst of the pancreas. In three patients, A. lumbricoides was present in the pancreatic duct. Two patients had hepatic abscess (28.6%), and one of them also had cholangitis. One of the patients with pancreatitis also had signs of cholecystitis at presentation. CONCLUSIONS: ultrasonography was the imaging diagnostic method of choice and demonstrated the presence of A. lumbricoides in the biliary and the pancreatic ducts, as well as signs of pancreatitis, cholecystitis, and hepatic abscess. Endoscopic retrograde cholangiopancreatography, used to confirm the diagnosis, was a fundamental procedure in the treatment, allowing the removal of worms from the biliary duct in four of seven patients.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
8/69. Uvitex 2B stain for the diagnosis of isospora belli infections in patients with the acquired immunodeficiency syndrome.OBJECTIVE: Fluorescent stains with Uvitex 2B or other fluorochromes are widely used today, especially for the diagnosis of microsporidian infections in human immunodeficiency virus (hiv)-infected patients. Our objective was to ascertain whether the fluorescent stain with Uvitex 2B is also able to detect isospora belli in stool samples and duodenal/bile juice of hiv-infected patients. DESIGN: Case study. SETTING: University hospital of the University of Cologne, germany. patients: Two hiv-infected patients with chronic diarrhea who had intestinal infections with I. belli. methods: Stool was concentrated by a modified water-ether sedimentation method, and duodenal/bile juice was concentrated by centrifugation. Wet-mount preparations were examined by phase-contrast and bright-field microscopy, and smears were stained with a modified acid-fast stain and a fluorescent stain with Uvitex 2B. RESULTS: Using the fluorescent stain with Uvitex 2B, the oocysts of I. belli stained bright white/blue fluorescent and showed a structure similar to that of the oocysts in acidfast stains. CONCLUSIONS: Staining with Uvitex 2B is a suitable method for the diagnosis of I. belli infections. This technique can be used for the diagnosis of three important gastrointestinal parasites (viz, microsporidia, cryptosporidia, and I. belli) responsible for diarrhea in hiv-infected patients.- - - - - - - - - - ranking = 2keywords = rate (Clic here for more details about this article) |
9/69. Intestinal myiasis due to Musca domestica: a report of two cases.myiasis is the infestation of live human and vertebrate animals with dipterous larvae, which, at least for a certain period, feed on the host's dead or living tissue, liquid body substances, or ingested food. Intestinal myiasis is usually an accidental phenomenon, which occurs due to the ingestion of eggs or larvae present in food. Usually the patient is asymptomatic and the larvae are excreted harmlessly in the feces. In some cases, however, the passage of larvae may be associated with symptoms. The present paper describes two such cases.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
10/69. Human intestinal anisakiosis due to consumption of raw salmon.Anisakiosis is a parasitic infection that follows consumption of raw or insufficiently pickled, salted, smoked, or cooked wild marine fish infected with anisakis sp. larvae. We report a case of intestinal anisakiosis in a 50-year-old man from quebec who presented with abdominal pain and peripheral eosinophilia after eating raw wild-caught salmon from the pacific ocean off canada. Abdominal CT scan showed bowel distension proximal to a segmental jejunal wall thickening, which was resected. The jejunum segment showed a localized area of serositis with mucosal edema and a submucosal abscess rich in eosinophils surrounding a parasite consistent with the third larval stage of anisakis sp. Diagnostic morphologic characteristics included an unpaired excretory gland (renette cell), Y-shaped lateral epidermal cords, no apparent reproductive system, and a ventriculus (glandular esophagus). These features and the absence of lateral alae excluded Ascaris sp. The absence of ventricular appendage and intestinal cecum excluded other anisakids of the genera Pseudoterranova and Contracaecum. As the popularity of eating raw fish is growing in north america, anisakiosis may be diagnosed more frequently in surgical specimens. This parasitic infection should be considered in the differential diagnosis of acute abdominal syndromes and eosinophilic infiltrates of the stomach, small intestine, colon, omentum, and mesentery, especially with a history of raw marine fish consumption.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
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