Hepatic capillariasis in two captive Callithrix penicillata / Capilariose hepática em dois Callithrix penicillata de cativeiro

This study aimed to describe the occurrence of hepatic capillariasis in two non-human primates of the species Callithrix penicillata that were kept in captivity. Case 1 was in a young female, whose liver presented pale coloring, softening due to autolysis and several noticeably whitish areas. Case 2 was in a male of unknown age, whose liver was slightly pale and brownish. Histological analysis on the samples revealed extensive interstitial fibrosis with hemosiderotic areas. Adult nematodes of Capillaria hepatica and numerous eggs, morphologically characterized by their non-embryonic ellipsoid shape, with bipolar plugs that did not protrude from the shell, thick and birefringent, with a porous layer, thus giving a striated appearance to the eggs. Some cystic formations presented nematode eggs surrounded by numerous foreign-body giant cells. The literature consulted made little reference to reports of Capillaria hepatica in non-human primates. However, similar infections have been extensively studied in domestic rodents.(AU)

O presente trabalho relata a ocorrência de dois casos de capilariose hepática em primatas não-humanos da espécie Callithrix penicilatta mantidos em cativeiro. O caso 1 era uma fêmea jovem, que exibiu fígado de cor pálida, suavizada devido a autólise e algumas áreas múltiplas visivelmente esbranquiçadas. O caso 2 foi registrado em um macho adulto, de idade desconhecida, com fígado levemente pálido e acastanhado. A análise histológica das amostras revelou extensa fibrose intersticial com áreas de hemossiderose, exemplares de Capillaria hepatica adultos e numerosos ovos morfologicamente caracterizados pela sua forma elipsóide, não-embrionárias, com tampões bipolares que se sobressaem da casca, que é espessa, birrefringente e com uma camada porosa, dando uma aparência estriada ao ovo. Algumas formações císticas continham ovos do nematóide cercados por numerosas células gigantes do tipo corpo estranho. A literatura consultada possui poucas referências acerca da presença de Capillaria hepatica em primatas não-humanos. No entanto, infecções semelhantes são bem estudadas em roedores domésticos.(AU)

Study of the prevalence of capillaria hepatica in humans and rodents in an urban area of the city of Porto Velho, Rondônia, Brazil / Estudo da prevalência da Capillaria hepatica em humanos e roedores em área urbana da cidade de Porto Velho, Rondônia, Brasil

Introduction: Hepatic capillariosis, caused by Capillaria hepatica (Calodium hepaticum) (Bancroft, 1893), Travassos, 1915 (Nematoda, Trichinelloidea, Capillariidae), is a common zoonosis in rodents but is rare in humans. Seventy-two cases in humans have been reported worldwide since the first case was described by MACARTHUR in 192417,27. This study aimed to determine the prevalence of Capillaria hepatica in humans and rodents in an urban area of Porto Velho, the capital of Rondônia, in Brazil. Methods: After conducting a census of the area, 490 residents were randomly selected, and, after signing a term of consent, provided blood samples that were screened for anti-Capillaria hepatica antibodies. Simultaneously, rats were captured to assess the prevalence of this parasite in rodents by histopathological examination in liver sections. Results: A prevalence of 1.8% was found among residents who had specific antibodies at a dilution of 1:150, indicating exposure to parasite eggs; 0.8% of the subjects also had positive titers at a dilution of 1:400, indicating true infection. The prevalence in rats was 2%. Conclusions: The prevalence of infection with this parasite among humans and rats was low. While the prevalence encountered among humans was within the limits reported in the literature, the prevalence among rodents was much lower.

Introdução: Capilaríase hepática é causada pela Capillaria hepatica (syn. Calodium hepaticum) (Bancroft, 1893), Travassos, 1915 (Nematoda, Trichinelloidea, Capillariidae), sendo uma zoonose comum entre roedores, porém rara em humanos. Setenta e dois casos humanos foram relatados na literatura mundial desde o primeiro caso descrito por MACARTHUR em 192417,27. O objetivo desse estudo é determinar a prevalência da Capillaria hepatica em humanos e roedores de área urbana da cidade de Porto Velho, capital de Rondônia, Brasil. Método: Após realizar um censo da área, 490 moradores foram aleatoriamente selecionados e assinaram termo de consentimento, foram colhidas amostras de sangue para testar anticorpos anti-Capillaria hepatica. Simultaneamente, ratos foram capturados para determinação da prevalência deste parasita através do exame histopatológico em cortes de fígado. Resultados: Foi encontrada entre humanos prevalência de 1,8% de positividade para anticorpos específicos em diluição de 1:150, indicando exposição aos ovos do parasito; 0,8% desses também deram testes positivos quando seus soros sofreram diluição de 1:400, indicando infecção verdadeira. Nos ratos, a prevalência foi de 2%. Conclusão: A prevalência encontrada para o parasito entre homens e roedores foi baixa. Enquanto a prevalência encontrada entre humanos esteve dentro dos limites encontrados na literatura, a prevalência entre roedores foi bem menor.

Human intestinal capillariasis: A rare case report from non-endemic area (Andhra Pradesh, India).

Human intestinal capillariasis is caused by Capillaria philippinensis. This disease is endemic in Philippines and Thailand. To the best of our knowledge, we report the third case of human intestinal capillariasis from India and the first case from Andhra Pradesh, which is a non-endemic area. A 40-year-old female presented with diarrhoea, vomiting, decreased urinary output, ascitis, pedal oedema, hypoalbuminemia, and electrolyte imbalance. Microscopic examination of stool sample revealed the presence of ova, larvae, and adult worms of C. philippinensis. Patient recovered from the disease after taking albendazole 400 mg daily for 1 month along with supportive treatment.

An Indigenous Case of Intestinal Capillariasis with Protein-Losing Enteropathy in Korea

We encountered an indigenous case of intestinal capillariasis with protein-losing enteropathy in the Republic of Korea. A 37-year-old man, residing in Sacheon-si, Gyeongsangnam-do, admitted to the Gyeongsang National University Hospital (GNUH) due to long-lasting diarrhea, abdominal pain, anasarca, and weight loss. He recalled that he frequently ate raw fish, especially the common blackish goby (Acanthogobius flavimanus) and has never been abroad. Under the suspicion of protein-losing enteropathy, he received various kinds of medical examinations, and was diagnosed as intestinal capillariasis based on characteristic sectional findings of nematode worms in the biopsied small intestine. Adults, juvenile worms, and eggs were also detected in the diarrheic stools collected before and after medication. The clinical symptoms became much better after treatment with albendazole 400 mg daily for 3 days, and all findings were in normal range in laboratory examinations performed after 1 month. The present study is the 6th Korean case of intestinal capillariasis and the 3rd indigenous one in the Republic of Korea.

Primer hallazgo de infección humana por Paracapillaria (Crossicapillaria) philippinensis (Chitwood, Velázquez y Salazar, 1968) en Cuba / First finding of human infection with Paracapillaria (Crosscapillaria) philippinensis (Chitwood, Velázquez y Salazar, 1968) in Cuba

INTRODUCCIÓN: la infección por Paracapillaria philippinensis (Capillaria philippinensis), se caracteriza clínicamente como una enteropatía progresiva, con pérdida masiva de proteínas y un síndrome de malabsorción que puede llegar a ser mortal. OBJETIVO: reportar por primera vez en Cuba el hallazgo de infección humana por P. philippinensis. MÉTODOS: se describió el caso de un paciente de 21 años de edad, del sexo masculino, procedente de Ciudad de La Habana, y que nunca había viajado fuera del país. Ingresa porque después de la ingestión de un pescado empanado comenzó a presentar un cuadro diarreico que se fue intensificando con el transcurrir de los días, llegando a tener más de 15 deposiciones líquidas diarias, abundantes en cantidad, sin flemas ni sangre, acompañado de un cuadro de desnutrición severa, y síntomas generales de astenia y anorexia intensas. RESULTADOS: el diagnóstico de laboratorio confirmó la presencia en heces de huevos de P. philippinensis. CONCLUSIONES: las características clínicas del paciente y el hallazgo de una eosinofilia moderada, coinciden con lo descrito en la literatura. En nuestro conocimiento, este es el primer hallazgo de infección autóctona por P. philippinensis en humanos que se realiza en Cuba, y en el continente americano. Es importante la alerta epidemiológica sobre la posible emergencia de esta parasitosis en nuestra zona geográfica, sobre todo en aquellos lugares donde la costumbre de comer pescado crudo o mal cocido sea parte del contexto cultural.

INTRODUCTION: the infection caused by Paracapillaria philippinensis (Capillaria philippinensis) is clinically characterized as a progressive enteric illness with massive loss of proteins and a malabsorption syndrome that may become fatal. OBJECTIVE: the first report in Cuba of human infection with P. philippinensis. METHODS: the case of a Cuban male patient aged 21 years from the City of Havana, who had never been abroad, was described. This young man was admitted to the hospital because after having eaten one breadcrumb-covered fish, he started having diarrheic episodes that progressively increased up to more than 15 abundant diarrheas per day, without phlegm or blood, and a clinical picture of severe malnutrition and general symptoms of intensive asthenia and anorexia RESULTS: the lab diagnosis confirmed the presence of P. philippinensis eggs in feces. CONCLUSIONS: the clinical features of the patient and the finding of moderate eosinophilia in the hematological study agreed with published information. As far as we know, this is the first finding of a human infection caused by P. philippinensis in Cuba, and in the American continent as well. The epidemiological alert on the possible emergence of new cases of this parasitic infection in our geographic zone is important, mainly in those places where the habit of eating raw or undercooked fish is part of the local culture.

Parasitismo por Calodium hepaticum em dois cães / Calodium hepaticum parasitism in two dogs

Calodium hepaticum já foi relatado parasitando o parênquima hepático de diversas espécies de mamíferos, porém é infrequente em cães. O presente artigo tem o objetivo de descrever dois casos de capilariose hepática em cães, diagnosticados em um período de um mês na região de Santa Maria, Rio Grande do Sul, Brasil. O primeiro cão apresentava sintomatologia clínica de insuficiência cardíaca, e ovos de Calodium hepaticum foram encontrados ocasionalmente no exame histopatológico do fígado. O segundo animal apresentava mucosas ictéricas e ascite. No hemograma, ficou evidente a presença de anemia arregenerativa e, na avaliação de bioquímica sérica, percebeu-se aumento de fosfatase alcalina, alanina aminotransferase e hipoalbuminemia. A análise do liquido cavitário foi compatível com transudato modificado. No exame histopatológico, foram observados numerosos ovos bioperculados de Calodium hepaticum, dispostos aleatoriamente pelo parênquima hepático, com reação granulomatosa e fibrosa adjacente aos ovos. A existência de maior número de cães infectados demonstra a necessidade de controle da população de roedores.

Calodium hepaticum has been reported as a parasite of the hepatic parenchyma of many mammal species, but it is not frequent in dogs. The present article aimed to describe two cases of hepatic capillariasis in dogs, diagnosed in a period of one month, in e Santa Maria city, Rio Grande do Sul state, Brazil . The first dog presented clinical sintomathology of cardiac insufficiency and Calodium hepaticum eggs were occasionally found by histopathological examination of the liver. The second animal presented icteric mucous membranes and ascites. The hemogram revealed non-regenerative anaemia and in the biochemistry serum were observed elevation of alkaline phosphatase, alanina aminotransferase and hypoalbuminemia. The cavitary liquid analysis was compatible with modified transudate. In the histopathological examination, numerous bioperculated eggs of Calodium hepaticum were observed aleatorily distributed in the hepatic parenchyma, with granulomatous and fibrous reaction adjacent to the eggs. The occurrence of two cases in a short period of time suggests that other dogs may be infected and requires a rodent population control.

Parasitic Diseases in Children

Some parasitic diseases are more prevalent in children than in adults. Such agespecific diseases usually result from the mode of infection. Enterobiasis and head lice infestations are contact-borne. Congenital toxoplasmosis is a transplacental infection. Hepatic capillariasis results from contact with an environment contaminated with cat stools. Enterobiasis is the most common helminthic disease in children. The diagnosis and treatment is difficult because of its characteristic life cycle: eggs are present at the end of the life of the female adult worm. Vigorous screening and repeated chemotherapy for the entire family and contact group are required. Recently, there have been reports of congenital toxoplasmosis. There may be an increase in the number of cases of toxoplasmosis owing to the increase in the number of stray cats. Cryptosporidiosis does not evoke serious illness in immunocompetent children, while severe diarrhea can occur in immunocompromised children. One case of hepatic capillariasis has been reported in Korea. Owing to its high morbidity and mortality, prompt diagnosis and treatment are required. Head lice infestation is easy to diagnose and is still an indication of public health status. Mass screening and prevention are required. In local clinics, parasitic diseases are rarely suspected, since their incidence is very low and the symptoms are usually non-specific, except in a few parasitic diseases. Therefore, a thorough evaluation of the symptoms and past history and appropriate laboratory tests are necessary.

An Imported Case of Intestinal Capillariasis Presenting as Protein-Losing Enteropathy

Intestinal capillariasis is caused by a small trichurid nematode, Capillaria philippinensis, which infects freshwater fish as intermediate hosts and subsequently fish eating birds as definitive hosts. It has occurred in areas such as the Philippines and Thailand where people eat raw fish. We report an imported case of intestinal capillariasis in a 31-year-old Korean man who lived in Saipan for ten years. He suffered from diarrhea with weight loss, abdominal distension, and pitting edema in the lower extremities for two years. He ate raw freshwater fish in the Saipan 2 years ago. The diagnosis was confirmed by jejunal biopsy. Flat mucosal surface without villi contained sections of numerous round worms with stichosome, larvae, and eggs which were identified as Capillaria philippinensis. The patient was successfully treated with albendazole.

The intradermal test in the diagnosis of human intestinal capillariasis

Capillaria adult worms amounting to 4 ml were collected from the contents of the small intestines of a case who died and was autopsied and the material was made into a crude antigen for the intradermal test. This was tried on human intestinal capillariasis cases confined in 2 hospitals as well as among non-cases. Male subjects were found to be more reactive to the intradermal test than females, a finding similar to schistosomiasis intradermal test. Hence, it is suggested that a set of limits for positive and negative be prepared separately for the two sexes. The capillaria antigen employed in the test did not show any cross-reaction with trichuris, hookworm, schistosoma and trichinella. The test appeared to be highly sensitive and species specific, hence we recommend its use not only for epidemiological surveys but also for diagnosis of individual cases. It is felt that the test could pick up more cases in a shorter period than stool examination would, particularly among asymptomatic cases. The practicability of the test will become even more evident the moment the life cycle and biology of the parasite have neem elucidated, because transfer of the parasite into experimental animals would serve as sources of antigen. In the event that the parasite can not be transferred to animals the use of heterologous antigens such as animal capillaria might have to be resorted to. This method has been used in filariasis and schistosomiasis intradermal tests. (Summary and conclusion)

A preliminary report on levo-tetramisole: a new drug for intestinal capillariasis

Levo-tetramisole was found most effective in the treatment of C. philippinensis infection when given at a dose of 2.5 mg./kg. day for as long as 30 days. The exact value of this drug, however, depends on the further treatment evaluation. Side effects of the drug administration were, however, mild and transient and did not interfere with the completion of the treatment

Capillariasis

This study shows that the typical capillaria patient is a case of chronic malnutrition brought about by more or less long-standing diarrhea and accentuated by a malabsorption syndrome. The primary cause, until proved otherwise, appears to be the capillaria parasite infection in the intestines. This has been shown by autopsy findings. There seems to be no liver involvement Therapy consists of the replacement of fluids, nutritional deficiencies, and electrolyte losses, especially potassium. Specific therapy shows Thiabendazole to be the most effective among several drugs treated. If given at a 30 mg./k body weight dose, untoward reactions are minimal. (Conclusion)