ABSTRACT
Strongyloides stercoralis es un nematodo común causante de parasitosis intestinal en la población ecuatoriana, pero no se han documentado casos de infección pulmonar por este helminto en el Ecuador. El primer caso de estrongiloidiasis pulmonar causada por larvas filariformes de S. stercoralis en un paciente de sexo masculino de la provincia de Manabí (Ecuador) y con síntomas clínicos de síndrome pulmonar terminal es reportado en este estudio. Previo al deceso del paciente, las larvas fueron identificadas por el método de frotis directo en fresco de una muestra de aspirado bronquial obtenida del paciente. En el análisis microscópico se observó hiperinfección por larvas filariformes (L3) con una abundancia de hasta cuatro larvas por campo microscópico.Sugerimos que un tratamiento anticipado del paciente con un antihelmíntico de amplio espectro podría haberle salvado la vida. La estrongiloidiasis pulmonar puede ser infradiagnosticada, si no se lleva a cabo el análisis parasitológico de muestras húmedas de aspiración bronquial de pacientes mostrando síntomas de bronquitis crónica y síndrome pulmonar para investigar la posible presencia de S. stercoralis. El entrenamiento para diagnóstico microbiológico por métodos directos clásicos, así como la constante investigación de esta parasitosis y otras helmintiasis son aún vitales y relevantes para el personal técnico de salud pública y microbiólogos en países en vías de desarrollo, con el fin de proveer un tratamiento temprano de las parasitosis infradiagnosticadas.
Strongyloides stercoralis is a common nematode causing intestinal parasitosis in the Ecuadorian population, but cases of lung infection by this helminth have not been documented in Ecuador. We document the first case of pulmonary strongyloidiasis caused by S. stercoralis filariform larvae in a male patient from Manabí Province (Ecuador), showing clinical symptoms of terminal pulmonary syndrome. Previous to the decease of the patient, the larvae were identified by the direct smear method of a fresh bronchial aspirate sample collected from the patient. Hyperinfection by filariform larvae (L3) was observed, exhibiting an abundance of up to four larvae per microscopic field. We suggest that an earlier treatment of the patient with a high spectrum anthelmintic could have saved his life. Strongiloidiasis pulmonar can be underdiagnosed, if the parasitological analysis of wet mounts of bronchial aspirate from patients suffering of chronic bronchitis and pulmonary syndrome to investigate the possible presence of S. stercoralis is not conducted. The training for microbiological screening using classic direct methods, as well as the constant investigation of this parasitosis and other helminthiasis are still vital and relevant for public health personnel and microbiologists in developing countries in order to provide an early diagnosis of underdiagnosed parasitosis.
Subject(s)
Humans , Male , Strongyloides stercoralis , Hantavirus Pulmonary Syndrome , Helminths , Nematoda , Signs and Symptoms , Bronchial Arteries , InfectionsABSTRACT
Chewing lice were collected from small shorebirds (Charadriformes: Scolopacidae) overwintering in foraging grounds of coastal Ecuador. On 27 occasions at least one louse (3.7%) was collected from six host species. Based on external morphological characters, at least two species of chewing lice could be preliminary identified (family: Menoponidae), including Actornithophilus umbrinus (Burmeister, 1842) and Austromenopon sp. A. umbrinus was found in the Western Sandpiper (Calidris mauri), Least Sandpiper (C. minutilla), Stilt Sandpiper (C. himantopus), Semipalmated Plover (Charadrius semipalmatus) and Wilson's phalarope (Phalaropus tricolor), while Austromenopon sp. is presumably the first record collected from the Surfbird (Aphriza virgata). These findings indicate that the distribution of these chewing lice species covers at least the regions around the equator (latitude 0°) until the Arctic in the north, but probably also includes the entire winter distribution area of the host species. This is the first study of chewing lice from Ecuador's mainland coast and more research is required to understand the host-parasite ecology and ectoparasitic infection in shorebirds stopping over the region.
Piolhos mastigadores foram coletados em pequenas aves marinhas (Charadriformes: Scolopacidae) que invernavam na zona de forrageamento na costa do Equador. Em 27 ocasiões, pelo menos um piolho (3,7%) foi coletado em seis espécies de hospedeiros. Com base em caracteres morfológicos externos, pelo menos duas espécies de piolhos mastigadores foram preliminarmente identificados (família: Menoponidae), incluindo Actornithophilus umbrinus (Burmeister, 1842) e Austromenopon sp. A. umbrinus foi encontrado em Pilrito-miudo (Calidris mauri), Pilrito-anão (C. minutilla), Pilrito-pernilongo (C. himantopus), Borrelho-semipalmado (Charadrius semipalmatus) e o Falaropo de Wilson (Phalaropus tricolor), enquanto Austromenopon sp. é, presumivelmente, o primeiro registro coletado na Ave-Surfista (Aphriza virgata). Esses resultados indicam que a distribuição dessas espécies de piolhos mastigadores abrange pelo menos as regiões ao redor do Equador (latitude 0°) até o Ártico, no Norte, mas provavelmente também inclui toda a área de distribuição de inverno essas espécies hospedeiras. Este é o primeiro estudo de piolhos de aves marinhas da área continental do Equador e mais pesquisas são necessárias para compreender a ecologia parasita-hospedeiro e ectoparasitose destas aves que invernam na região.
Subject(s)
Animals , Birds/parasitology , Phthiraptera/physiology , Animal Migration , Ecuador , SeasonsABSTRACT
Introducción. La gnathostomiasis humana fue reportada en Ecuador en 1981 a partir del hallazgo del tercer estadio larvario de Gnathostoma en Hoplias microlepis. Debido a que esta zoonosis es transmisible a humanos, su vigilancia y estudio ecoepidemiológico en sus huéspedes silvestres son de particular importancia en salud pública y control sanitario en Ecuador. Objetivo. Contribuir con la evidencia más reciente de infección natural por Gnathostoma en el pez dulceacuícola Hoplias microlepis y su ciclo biológico en sistemas acuáticos de la provincia del Guayas, Ecuador. Materiales y métodos. Se examinaron 74 peces obtenidos en dos localidades (campo de arrozales y mercado de peces) del Cantón Samborondón, provincia del Guayas. La presencia de Gnathostoma fue investigada en músculos de Hoplias microlepis. Se estimaron la abundancia y la prevalencia parasitarias, así como la comparación estadística de la intensidad parasitaria en los dos sitios estudiados y correlaciones de la carga parasitaria versus la talla de los peces. Resultados. La prevalencia total de Gnathostoma fue de 69%, con una abundancia media de 1,70 larvas por pez. La prevalencia parasitaria fue relativamente mayor en los campos de cultivo de arroz (77%) en relación con el mercado local (62%). No se observaron diferencias significativas en las abundancias media de larvas y en las prevalencia entre los dos sitios de estudios (p>0,05). Se encontró una relación directa y significativa entre la carga parasitaria y la longitud del pez (Spearman p<0,05). Conclusiones. La gnathostomiasis sigue siendo prevalente en la zona costera de Ecuador y el agente patógeno es aún encontrado en el huésped intermediario. Diversos mamíferos neotropicales estarían actuando como huésped reservorio definitivo en el ciclo biológico de Gnathostoma en Ecuador.
Introduction. Human gnathostomiasis has been reported in Ecuador since the early 1980s, when natural infections by Gnathostoma third larval stages were found in muscles of the second intermediary host, Hoplias microlepis (tigerfish). In Ecuador, this zoonotic disease is occasionally detected in humans, and its monitoring and eco-epidemiological assessment is of particular interest for its detection and control. Objective. The most recent evidence is provided with respect to natural infections by Gnathostoma as it occurs in the tigerfish (Hoplias microlepis), including insights into its biological cycle. Materials and methods. A total of 74 fish were collected from two localities (rice fields-wetlands and local fish market) of Samborondón County (Guayas Province). Each was examined for the presence of Gnathostoma in muscle of Hoplias microlepis. The abundance intensity and prevalence of parasites was estimated. Statistical comparisons between the two sites and correlations of parasite load versus fish size were conducted. Results. The infection prevalence by Gnathostoma was 69% (95% CI: 57-78%). The overall abundance intensity of parasites averaging the 2 sites was 1.7 larvae per fish. The proportion of infected fish was higher in rice fields (77%) when compared to those from the local fish market (62%). No statistically significant differences between the abundance intensity and prevalence were found between the sites (p>0.05). Parasite load and fish length were significantly correlated (Spearman p<0.05). Conclusions. Gnathostomiasis is a prevalent zoonosis in coastal Ecuador, and its etiologic agent is commonly found in the second intermediary host. Several Neotropical mammals are candidates as definitive reservoir hosts in the Gnathostoma biological cycle.