Eosinophilic meningitis caused by Angiostrongylus cantonensis: an emergent disease in Brazil

Eosinophilic meningitis (EoM) is an acute disease that affects the central nervous system. It is primarily caused by infection with the nematode Angiostrongylus cantonensis. This infection was previously restricted to certain Asian countries and the Pacific Islands, but it was first reported in Brazil in 2007. Since then, intermediate and definitive hosts infected with A. cantonensis have been identified within the urban areas of many states in Brazil, including those in the northern, northeastern, southeastern and southern regions. The goals of this review are to draw the attention of the medical community and health centres to the emergence of EoM in Brazil, to compile information about several aspects of the human infection and mode of transmission and to provide a short protocol of procedures for the diagnosis of this disease.

Monitoring of parasitic cysts in the brains of a flock of sheep in Egypt / Monitoramento de cistos parasitários no cérebro de um rebanho de ovinos no Egito

Cerebral parasitic cysts constitute a major problem for livestock. Among these, coenurosis and toxoplasmosis are predominant. Here, a total number of 60 sheep obtained from a private farm in Suez province, Egypt, were examined postmortem to detect visible parasitic cysts, and microscopically to detect small-sized entities. Necropsy revealed bladder-like cysts measuring 0.5-6.5 cm in diameter that were filled with a translucent fluid containing a large number of protoscolices. Accordingly, the cysts were identified as the metacestode Coenurus cerebralis. Among the sheep examined, 11 animals (7 males and 4 females) (18.3%) were infected. Most of the cysts were located in the cerebral hemispheres, with numbers ranging from one to three per infected animal. The effect of the presence of cysts in the brain tissue was evaluated. Histopathologically, pseudocysts of the apicomplexan Toxoplasma gondii were found in two animals with no detectable inflammatory cell reactions. In conclusion, coenurosis and toxoplasmosis are serious parasitic problems that play a significant role in sheep management in Egypt, as a result of close contact between livestock and dogs and cats, which play a critical role in the life cycle of these parasites.

Cistos cerebrais parasitários constituem um grande problema para o gado. Entre estes, coenurosis e toxoplasmose são predominantes. Aqui, um número total de 60 ovelhas obtidas em uma fazenda particular na província Suez, Egito, foram examinadas post-mortem para a detecção de cistos parasitários visíveis e microscopicamente para detectar cistos de pequenas dimensões. A necropsia revelou cistos medindo entre 0,5-6,5 cm de diâmetro, preenchidos com um fluido transparente, contendo um grande número de protoscolices. Por conseguinte, os cistos foram identificados como o metacestóide Coenurus cerebralis. Entre as ovelhas examinadas, 11 animais (7 machos e 4 fêmeas) (18,3%) estavam infectados. A maior parte dos cistos estavam localizados nos hemisférios cerebrais, com números variando de um a três em ovinos infectados. O efeito da presença de cistos no tecido do cérebro foi avaliado. Histopatologicamente, pseudocistos de Toxoplasma gondii foram encontrados em dois animais sem reações inflamatórias detectáveis. Em conclusão, coenurosis e toxoplasmose são graves problemas parasitários que desempenham um papel significativo no manejo de ovelhas no Egito, como resultado do contacto íntimo dos animais com os cães e gatos, que desempenham um papel crítico no ciclo de vida desses parasitas.

A Recombinant Matrix Metalloproteinase Protein from Gnathostoma spinigerum for Serodiagnosis of Neurognathostomiasis

Neurognathostomiasis is a severe form of human gnathostomiasis which can lead to disease and death. Diagnosis of neurognathostomiasis is made presumptively by using clinical manifestations. Immunoblotting, which recognizes antigenic components of molecular mass 21 kDa and 24 kDa in larval extracts of Gnathostoma spinigerum (Gs 21/24), has high sensitivity and specificity for diagnosis of neurognathostomiasis. However, only very small amounts of the Gs 21/24 antigens can be prepared from parasites harvested from natural or experimental animals. To overcome this problem, we recently produced a recombinant matrix metalloproteinase (rMMP) protein from G. spinigerum. In this study, we evaluated this rMMP alongside the Gs 21/24 antigens for serodiagnosis of human neurognathostomiasis. We studied sera from 40 patients from Srinagarind Hospital, Khon Kaen University, Thailand, with clinical criteria consistent with those of neurognathostomiasis, and sera from 30 healthy control adults from Thailand. All sera were tested for specific IgG antibodies against both G. spinigerum crude larval extract and rMMP protein using immunoblot analysis. The sensitivity and specificity for both antigenic preparations were all 100%. These results show that G. spinigerum rMMP protein can be used as an alternative diagnostic antigen, in place of larval extract, for serodiagnosis of neurognathostomiasis.

Cisticercose intramedular: relato de caso e revisão da literatura / Intramedullary spinal cysticercosis: a case report and review of the literature

Os autores relatam um caso raro de neurocisticercose intramedular em um paciente do sexo masculino, de 36 anos de idade. Foram realizadas tomografia computadorizada e ressonância magnética do crânio, que evidenciaram múltiplas lesões de tamanhos variados, com realce periférico após injeção de meio de contraste. Também foi realizada ressonância magnética da coluna cervical, que evidenciou formação cística com escólex em seu interior ao nível de C5-C6 na região intramedular.

The authors report a rare case of intramedullary spinal cord cysticercosis in a 36-year-old male patient. Computed tomography and magnetic resonance imaging examinations of the brain showed multiple ring enhanced lesions. Magnetic resonance imaging of the cervical spine showed a cystic intramedullary formation at C5-C6 level containing a scolex.

Isolated cerebral hydatid cysts: a comparative study of two different types of presentations.

OBJECTIVES: To demonstrate the existence of two imaging patterns of cerebral hydatidosis and discuss its clinical importance. MATERIAL AND METHODS: A retrospective review of six cases of cerebral hydatidosis using various imaging techniques including CT, MRI, angiography and cystogram. RESULTS: Clinically the most common findings included papilloedema, headache and vomiting. Two of the cases reported recurrence of symptoms and were reoperated. The first 4 cases presented the classical signs of unilocular well defined cysts while the last two cases had multilocular, often polygonal cysts with perifocal edema, calcification and membrane detachment. CONCLUSION: Two radiologically and pathologically distinct subtypes of hydatidosis exist. Division into groups may assist decision over treatment protocol.