Identificación de amebas de vida libre en tanques de almacenamiento de agua de edificios del área metropolitana de Ambato / Identification of free-living amoebas in water storage tanks of buildings in the metropolitan area of Ambato

Naegleria fowleri, Acanthamoeba spp. y Balamuthia mandrillaris, son especies de ameba de vida libre (AVL) que causan enfermedades en el sistema nervioso central grave y puede ser fatal en humanos y otros animales. Todos los géneros de AVL tienen dos etapas: quiste y trofozoíto. Los trofozoítos se dividen por fisión binaria, se alimentan activamente y es la etapa infecciosa del organismo. En el medio ambiente, los acanthopodios permiten que los trofozoítos se adhieran a las superficies de las bacterias, hongos, algas y detritos en los que se encuentran su alimento. Acanthamoeba spp. Parecen mantener una relación endosimbiótica con algunas de las bacterias que consumen. Muchas de estas bacterias, como la Legionella, Pseudomonas, Vibrio y algunas micobacterias parecen adquirir factores de virulencia mientras están viviendo dentro de las amebas, lo que les permite sobrevivir y prosperar dentro de otras células fagocíticas (por ejemplo, macrófagos humanos). La tenacidad de AVL para proliferar en ecosistemas hostiles y sobrevivir a la desecación o desinfección hace de estos organismos una fuente potencial transmitida por el agua, por los alimentos y el aire. Conocidos por su ubicuidad, los AVL han sido aislados de diversas matrices ambientales, como suelo, agua dulce y salobre, aguas residuales, aguas termales, polvo y otros. En función de lo antes comentado, este trabajo tiene como objetivo identificar amebas de vida libre en tanques de almacenamiento de agua de edificios del área metropolitana de la ciudad de Ambato (Ecuador), con el fin de aplicar soluciones correctivas en cualquiera de sus puntos. Según el sitio de muestreo, el género de AVL identificado con mayor frecuencia en la superficie fue Balamuthia sp (70,59%) y Acanthamoeba sp., con un 37,78 %. El fondo estuvo caracterizado por Naegleria sp. con un 44,44%(AU)

Naegleria fowleri, Acanthamoeba spp. and Balamuthia mandrillaris are species of free-living amoeba (FLA) that cause severe central nervous system disease and can be fatal in humans and other animals. All genera of FLA have two stages: cyst and trophozoite. Trophozoites divide by binary fission, actively feed, and is the infective stage of the organism. In the environment, acanthopods allow trophozoites to adhere to the surfaces of bacteria, fungi, algae, and detritus on which their food is found. Acanthamoeba spp. they appear to maintain an endosymbiotic relationship with some of the bacteria they consume. Many of these bacteria, such as Legionella, Pseudomonas, Vibrio, and some mycobacteria appear to acquire virulence factors while living inside amoebas, allowing them to survive and thrive inside other phagocytic cells (eg, human macrophages). FLA's tenacity to proliferate in hostile ecosystems and survive desiccation or disinfection makes these organisms a potential waterborne, foodborne, and airborne source. Known for their ubiquity, FLAs have been isolated from various environmental matrices, such as soil, fresh and brackish water, wastewater, hot springs, dust, and others. Based on the aforementioned, this work aims to identify free-living amoebas in water storage tanks of buildings in the metropolitan area of the city of Ambato (Ecuador), in order to apply corrective solutions at any of its points. According to the sampling site, the FLA genus most frequently identified on the surface was Balamuthia sp (70.59%) and Acanthamoeba sp., with 37.78 %. The background was characterized by Naegleria sp. with 44.44%(AU)

Encefalitis por ameba de vida libre: reporte de caso / Free-living amoeba encephalitis: case report

La encefalitis amebiana granulomatosa es una enfermedad considerada atípica debido a la baja incidencia desde que fue descubierta. Sin embargo, conforme han avanzando los métodos diagnósticos, en retrospectiva, se ha descrito la presencia de esta enfermedad desde principios del siglo XX, identificando a Acanthamoeba spp y Balamuthia mandrillaris como agentes más comunes.Es una enfermedad de difícil diagnóstico debido al amplio abanico clínico que puede presentar, siendo el sitio anatómico dentro del sistema nervioso central quien determinará estas características. El conocimiento y sospecha de la misma permitirá un abordaje terapéutico oportuno aunque, en la mayoría de los casos, con un desenlace fatal para el paciente.A continuación se presenta el caso clínico de un paciente masculino de 26 años de edad originario de la ciudad de Durango, México, sin antecedentes de importancia, de ocupación ladrillero, quien sufre golpe con ladrillo en región naso-orbitaria, ingresando al hospital al tercer día del evento con diagnóstico de celulitis periorbitaria izquierda y nasal, cefalea de leve intensidad, rinorrea abundante, hemiparesia fasciocorporal izquierda, parestesia de extremidad superior izquierda, diplopía y vértigo postural. Los estudios imagenológicos revelaron lesiones heterogéneas en el lóbulo occipital, hemisferio cerebeloso izquierdo y tallo cerebral. Se realizó escisión de lesión tumoral cerebelar, con estudio anatomopatológico, reportando encefalitis granulomatosa por presencia de ameba de vida libre. El paciente evolucionó hacia deterioro rostro-caudal declarándose su fallecimiento a los 16 días de su estancia intrahospitalaria.En el Estado de Durango, México, no se cuenta con casos reportados por infección de ameba de vida libre

Granulomatous amoebic encephalitis is a disease considered atypical due to the low incidence since it was discovered. However, as diagnostic methods have progressed, in retrospect, the presence of this disease has been described since the beginning of the 20th century, identifying Acanthamoeba spp. and Balamuthia mandrillaris as the most common agents.A disease that is difficult to diagnose due to the wide clinical range that it can present, being the anatomical site within the central nervous system that will determine these characteristics. The knowledge and suspicion of it will allow a timely therapeutic approach although, in most cases, with a fatal outcome for the patient.The clinical case is presented below of a 26 year old male patient from the city of Durang, México, with no significant history, of brick occupation, who suffers a blow with a brick in the naso-orbital region, follows, entering our hospital on the third day of the event with a diagnosis of left periorbital and nasal cellulitis, mild headache, profuse rhinorrhea, left fasciocorporeal hemiparesis, left upper limb parestesia, diplopia, and postural vertigo.Imaging studies were performed observing heterogeneous lesions in the occipital lobe, left cerebellar hemisphere and brain stem; excision of the cerebellar tumor lesion being carried out, with pathological study, reporting granulomatous encephalitis due to the presence of free-living amoeba. The patient progresses to face-caudal deterioration, declaring his death after 16 days of hospital stay.Within the state of Durango, Mexico, there are no reported cases of free-living amoeba infection

Primer informe clínico de Balamuthia mandrillaris en el distrito de Camaná, Arequipa, Perú / First case report of the Balamuthia mandrillaris in the Camaná district of Arequipa, Peru

Resumen Las infecciones por amebas de vida libre causan compromiso cutáneo y neurológico. Estas afecciones presentan una baja frecuencia pero una alta letalidad, mayor al 98%. Gene ralmente el cuadro clínico es inespecífico y los exámenes de laboratorio no son de gran ayuda, por lo que representa un reto diagnóstico y terapéutico. En este informe presentamos el caso de un paciente de 21 años que fue hospitalizado por un síndrome convulsivo con tumoraciones cerebrales, además de una lesión cutánea en el muslo derecho. El análisis histopatológico, PCR y el cuadro clínico permitieron el diagnóstico de encefalitis amebiana granulomatosa. A pesar del tratamiento, el paciente tuvo un desenlace fatal.

Abstract Infections by free-living amoebas cause cutaneous and neurological compromise. These conditions have a low frequency, but a high lethality more than 98%. Generally, the clinical picture is nonspecific; the laboratory tests dont help, so it represents a diagnostic and therapeutic challenge. In this report, we present the case of a 21-year-old patient, who was hospitalized for a convulsive syndrome with brain tumors, in addition to a cutaneous lesion on the right thigh. Histopathological analysis, PCR and the clinical picture allowed the diagnosis of granulomatous amebic encephalitis. Despite the treatment, the patient had a fatal outcome.

Meningoencephalitis due to Naegleria fowleri in cattle in southern Brazil / Meningoencefalite por Naegleria fowleri em um bovino no sul do Brasil

Abstract Naegleria fowleri is a free-living amoeba commonly found in the environment, mainly in fresh water and soil. This protozoon is occasionally involved in cases of fatal central nervous system disease in humans and other animal species. We describe here a case of meningoencephalitis due to Naegleria fowleri in cattle, in southern Brazil. A four-year-old Angus cow presented a clinical history of initial mild neurological signs that progressed to paddling movements, opisthotonus and lateral recumbency after five days. This animal had been kept in an irrigated rice stubble paddock. Grossly, the main lesions consisted of multiple areas of malacia in the right olfactory bulb, piriform lobes, hippocampus, frontal lobe cortex and fornix, along with severe thickening of the mesencephalon and rhombencephalon leptomeninges. Microscopically, severe multifocal necrosuppurative and hemorrhagic meningoencephalitis associated with a large quantity of amoebic trophozoites was present. The latter were confirmed to be Naegleria spp., through immunohistochemistry. Based on the strong congruence with the histopathological data of known cases reported in the literature, a probable association with Naegleria fowleri was established. To our knowledge, this is only the second report of Naegleria fowleri-associated meningoencephalitis in cattle in South America, and it is the first in southern Brazil.

Resumo Naegleria fowleri é uma ameba de vida livre, comumente encontrada no meio ambiente, principalmente em água doce e no solo. Este protozoário é ocasionalmente associado a casos fatais de doença do sistema nervoso central em seres humanos e espécies animais. No presente trabalho, um caso de meningoencefalite por Naegleria fowleri em um bovino na região sul do Brasil é descrito. Uma vaca Angus, de quatro anos de idade apresentou histórico clínico caracterizado inicialmente por sinais neurológicos leves que progrediram para movimentos de pedalagem, opistótono e decúbito lateral após cinco dias. Este animal era mantido em um piquete em resteva de arroz irrigado. Macroscopicamente, as principais lesões foram caracterizadas por múltiplas áreas de malacia no bulbo olfatório direito, lobos piriformes, hipocampo, córtex do lobo frontal e no fórnix, bem como acentuado espessamento das leptomeninges do mesencéfalo e rombencéfalo. Microscopicamente, meningoencefalite necrossupurativa e hemorrágica associada à grande número de trofozoítos amebianos foram observadas. Estes foram confirmados como Naegleria spp. através de imuno-histoquímica. Baseado na forte congruência apresentada entre os dados histopatológicos provenientes de casos conhecidos publicados na literatura, uma provável associação com Naegleria fowleri foi estabelecida. O presente trabalho trata-se do segundo relato de meningoencefalite associada à Naegleria fowleri em bovinos na América do Sul e o primeiro na região sul do Brasil.

Amebiasis intestinal y hepática / Intestinal and hepatic amebiasis

Amebiasis is the infection by Entamoeba histolytica, a protozoan capable of invading the colonic mucosa causing a diarrheic syndrome, although most of the time is mild, it can lead to a fulminating colitis. Sometimes it can spread to other organs; among extra-intestinal manifestations of this parasite, the most frequent is the amebic liver abscess. In the next pages, general aspects of this protozoan, its epidemiology, clinical findings, diagnosis and treatment are reviewed, emphasizing the possibilities of diagnosis and treatment available in Chile.

La amebiasis corresponde a la infección por Entamoeba histolytica, protozoo capaz de invadir la mucosa del colon provocando un cuadro diarréico que, si bien la mayoría de las veces es leve, puede llegar a una colitis fulminante. En algunas oportunidades puede diseminarse a otros órganos; dentro de las manifestaciones extra-intestinales de este parásito, la más frecuente es el absceso hepático amebiano. A continuación se revisan aspectos generales de este protozoo, su epidemiología, cuadro clínico, diagnóstico y tratamiento, destacando las posibilidades de diagnóstico y tratamiento disponibles en Chile.

Acute amebic appendicitis: Report of a rare case.

Acute appendicitis of amebic origin is considered a rare cause of acute appendicitis. We report a case of amebic appendicitis presenting with fever, severe pain in the right lower quadrant of the abdomen and rebound tenderness. Lab investigations revealed neutrophilic leukocytosis. The patient underwent appendectomy. Histopathological examination revealed numerous Entameba histolytica trophozoites in the mucosa of the appendix. Acute appendicitis of amebic origin does not appear frequently. Appendicular amebiasis can give the clinical features of acute appendicitis and should be treated accordingly.

Parasitismo intestinal en una escuela primaria de Bata, Guinea Ecuatorial / Intestinal parasitism in an elementary school in Bata, Equatorial Guinea

Con el objetivo de precisar el grado de parasitismo intestinal según la edad, así como identificar los parásitos intestinales más frecuentes en la escuela primaria "Amiguitos de Jesús" de la ciudad de Bata, Guinea Ecuatorial, en el periodo septiembre 2002 a Junio 2003, se realizó un estudio descriptivo y prospectivo. En el mismo se encontró que el grado de parasitismo intestinal fue de un 29.9 % del total de análisis realizados, predominando sobre todo en los menores de 6 años; un 44.7% de éstos estaban infestados. Se encontró un predominio de los vermes: el más frecuente fue Trichuris trichiura, para el 95.1 % del total de niños infestados, y el áscaris lumbricoides, con un 75.6% del total de 41 infestados. De los protozoos, el más frecuente fue la ameba, existiendo en un 17.07 % de los infestados. El grado de infestación encontrado es elevado, requiriéndose programas educativos para fomentar el cuidado de los hábitos higiénicos de los niños. El predominio de los parásitos encontrados podría deberse a la contaminación de la tierra con heces fecales y a la falta de un adecuado tratamiento de las aguas para el consumo, y de infraestructura sanitaria.

With the aim of defining exactly the grade of intestinal parasitism according to age, as well as identifying the most frequent intestinal parasites in "Amiguitos de Jesús" Elementary School in Bata City, Equatorial Guinea, during septembre 2002 to June 2003, a descriptive, prospective study is carried out. In the study it was found that the parasitism grade was 29.9% from the total of the analysis performed, predominating in those under 6 years of age: 44.7% of these cases were infected. A prevalence of vermes was observed, Trichuris trichiuria was the most frequent species found, representing 95,1% from the total of infected children and Ascaris lumbricoides 75,6% from the total of 41 infected. Among protozoa, amoeba was the most frequent specie observed, being present in 17,07% of infected cases. A high-grade infection was found, requiring educative programs for increasing hygienic habits in children. The prevalence rate of parasites should be caused by the ground pollution with stools, as well as the lack of a proper treatment of drinking water and health infrastructure.

Identification of differentially expressed cDNAs in Acanthamoeba culbertsoni after mouse brain passage

Free-living amoebae of the genus Acanthamoeba are causative agents of granulomatous amebic encephalitis and amebic keratitis. Because the virulence of Acanthamoeba culbertsoni cultured in the laboratory is restored by consecutive brain passages, we examined the genes induced in mouse brain-passaged A. culbertsoni by differential display reverse transcriptase polymerase chain reaction (DDRT-PCR). Enhanced A. culbertsoni virulence was observed during the second mouse brain passage, i.e., infected mouse mortality increased from 5% to 70%. Ten cDNAs induced during mouse brain passage were identified by DDRT-PCR and this was confirmed by northern blot analysis. BlastX searches of these cDNAs indicated the upregulations of genes encoding predictive NADH-dehydrogenase, proteasomal ATPase, and GDP-mannose pyrophosphorylase B, which have previously been reported to be associated with A. culbertsoni virulence factors.