1/167. Expression of Th1 and Th2 cytokine mRNAs in freshly isolated peripheral blood mononuclear cells of a patient with cutaneous paragonimiasis. Using semiquantitative reverse transcriptase polymerase chain reaction, we examined the levels of various cytokine mRNAs of freshly isolated peripheral blood mononuclear cells (PBMCs) from a cutaneous paragonimiasis patient in the course of successful treatment with praziquantel administration. The pre-treatment levels of Th2 cytokines such as interleukin (IL)-4, IL-5, IL-10 and IL-13 mRNAs in PBMCs of the patient were much higher than those of healthy controls. The levels of IL-4, IL-5 and IL-13 mRNAs slightly elevated on day 2 of the treatment and then declined to the control levels on day 25. The IL-10 mRNA level rapidly decreased after the chemotherapy. In contrast, the mRNA levels of interferon (IFN)-gamma, a Th1 cytokine, remained in the control levels during the course. Peripheral eosinophil counts and levels of total IgE and eosinophil cationic protein in the sera correlated well with the levels of these Th2 cytokine mRNAs. These results suggested the major role of Th2 cytokines in clinical manifestation of human helminthic infection. ( info) |
2/167. Presence of dirofilaria repens and an insect immunocyte (plasmatocyte) in a human subcutaneous nodule, induced by a mosquito bite. It is well known that the nematode dirofilaria repens is transmitted to humans by vector mosquito bite. Examination of a fine needle aspiration biopsy drawn from a month-old nodule on the chest of a woman, residing in Garlasco, province of Pavia, Northern italy, revealed the presence of not only one immature female of D. repens, but also some scattered cells that we believe to be mosquito's blood cells, plasmatocytes (immunocytes). We presume that plasmatocytes were carried into the bite wound with the mosquito's hemolymph that had oozed from a rupture in its mouthparts during feeding. Because aedes albopictus recently colonized certain areas in the above region, we suspect that the nodule resulted from the bite of this mosquito. ( info) |
| Human sparganosis is a rare parasitic disease infected by plerocercoid larva (sparganum) of spirometra species. It was usually diagnosed accidentally and has long been underestimated. In this report, we describe a 53-year-old woman presenting as an enlarging subcutaneous nodule in the right thigh for 3 months, which was excised in the belief that it was a lipoma. Characteristic sparganum accompanied by granulomatous inflammation, eosinophilic infiltrate and sinus tract in the subcutaneous tissue were discovered under microscopic examination of the excised tissue. Contaminated drinking water was presumed to be the infectious source. Complete excision is a curative treatment. We also review previously documented 19 human sparganosis in taiwan to provide the clinical context for this report. ( info) |
4/167. Cutaneous acanthamoebiasis in AIDS. acanthamoeba is a recognized pathogen in the immunocompromised patient, commonly presenting as chronic or subacute encephalitis. However, cutaneous disease in the absence of CNS involvement is increasingly recognized, especially in the setting of chronic, nonhealing skin lesions in the patient with AIDS. We describe a patient with AIDS and cutaneous acanthamoebiasis and review our experience with treatment and diagnosis. ( info) |
| A woman from bangladesh who had lived in germany for more than 2 years presented with migratory, painful swellings on her left hand and arm of 5 months duration. Laboratory examinations yielded a marked eosinophilia and a grossly elevated IgE level in combination with an inflammatory reaction restricted to the subcutaneous tissues. A preliminary diagnosis of gnathostomiasis was established and confirmed by a positive gnathostoma serology by enzyme immunoassay (EIA). Treatment was initiated with albendazole, leading to the outward migration of a larva and complete resolution of clinical disease. Currently, there is no definitive therapy that has been proved to be both safe and highly effective. A wide range of potential agents has been used in clinical studies, but only albendazole has proved to be reliably effective to date, stimulating the outward migration of larvae in a proportion of cases of cutaneous disease, as observed in the present case. ( info) |
6/167. Subcutaneous cysticercosis involving the eyelid: sonographic diagnosis. A 25-year-old man and a 14-year-old boy presented with neurocutaneous cysticercosis involving the eyelid. Both patients had hundreds of scattered subcutaneous cysticerci. They were arranged in clusters over the sternocleidomastoid muscle in the neck. Such clustering of cysticerci is highly suggestive of central nervous system (CNS) involvement, as both the sternocleidomastoid muscle and the CNS are supplied by the carotid artery and cysticerci travel via the hematogenous route. We used ultrasonography to diagnose subcutaneous cysticercosis, which showed characteristic low reflective cysts and high reflective scolices inside. Although subcutaneous cysticerci are inconsequential, their verification is important in the diagnosis of more severe CNS involvement. They may be confused with other painless swellings such as lymphadenopathies, neurofibromas, and epidermoid cysts. ( info) |
| A 24-year-old man developed slow-growing lesions on subungual and plantar areas that appeared a few weeks after returning from a trip to south america. The diagnosis of tungiasis was established by microscopic examination of a lesion. tungiasis is rarely seen in non-endemic areas. ( info) |
8/167. Exotic myiasis with Lund's fly (Cordylobia rodhaini). After a four-week holiday in East africa, a woman was diagnosed with furuncular myiasis: a third-instar larva of the fly Cordylobia rodhaini (Lund's fly) was found in a skin lesion. This is the first report of exotic myiasis and importation of this species of fly into australia, and reflects the increasing risk of introducing exotic flies of public health and veterinary importance to australia. ( info) |
| Cutaneous disease is a previously reported but unusual presentation for schistosomiasis. We report a case of schistosoma haematobium infection that appeared 3 years after exposure, with skin lesions as the sole manifestation. The diagnosis was made on the basis of a routine skin biopsy and the patient did well after therapy with praziquantel. Dermatologists should be aware of this presentation of schistosomiasis when evaluating patients with unusual skin lesions who have traveled in areas where schistosomiasis is endemic. ( info) |
| Ectopic late cutaneous schistosomiasis is usually preceded or accompanied by visceral schistosomiasis infection. Our patient presented the very rare case of late cutaneous schistosomiasis as an isolated skin manifestation. Perigenital lesions occurred 1 year after contact with infested water. Identification of the few eggs remaining in the late lesion among the dense cellular infiltrate was difficult. Electron-microscopic studies clearly demonstrated the characteristic eggshell ultrastructure. ( info) |