Human pulmonary dirofilariasis with secondary myocarditis

Abstract Dirofilariasis is a little-known zoonosis, with dogs and cats as definitive hosts. It is caused by nematodes and transmitted by mosquito bites. We report the case of a 67-year-old man with a consumptive syndrome with two subpleural pulmonary opacities. A transthoracic lung biopsy revealed a Dirofilaria worm. Myocardial nuclear magnetic resonance (NMR) demonstrated dilated cardiomyopathy after myocarditis related to dirofilariasis. Human infection is rare and occurs accidentally. The most common radiological alteration is a mainly subpleural coin lesion. Dirofilariasis is a neglected emergent disease and knowledge about it is important for differential diagnoses from neoplastic pulmonary nodules.

Infección pulmonar por Lophomonas sp en una paciente con leucemia mieloide aguda / Lung infection by lophomonas spp. in a female patient with acute myeloid leukemia

RESUMEN Las infecciones por protozoos son prevalentes a nivel mundial, en particular en pacientes inmunosuprimidos. Comunicamos el caso de una paciente procedente de la ciudad de Viña del Mar, Chile, portadora de leucemia mieloide aguda en quiense confirmó una infección por Lophomonas sp. en lavado bronquioalveolar. Se manejó con antibióticos, pero falleció decomplicaciones de su enfermedad de base. Existe poca literatura disponible respecto a este microorganismo. Concluimos que debe considerarse a Lophomonas sp. como posibilidad diagnóstica si se encuentran protozoos en lavados bronquioalveolares de pacientes inmunosuprimidos.

ABSTRACT Protozoic infections are prevalent worldwide, particularly in immunosuppressed patients. We reported the case of a patient from the city of Viña del Mar, Chile, a carrier of acute myeloid leukemia in whom an infection by Lophomonas sp. was confirmed by bronchoalveolar lavage. She was treated with antibiotics but died of complications of the underlying disease. There is little literature available on this microorganism. We conclude that Lophomonas sp. should be considered as a diagnostic possibility if protozoa are found in bronchoalveolar lavage of immunosuppressed patients.

Hepato-pulmonary amebiasis: a case report

Infections with Entamoeba histolytica are seen worldwide and are more prevalent in the tropics. About 90 percent of infections are asymptomatic, and the remaining 10 percent produce a spectrum of clinical syndromes, ranging from dysentery to abscesses of the liver or other organs. Extra-intestinal infection by E. histolytica most often involves liver. Pleuro-pulmonary involvement, seen as the second most common extra-intestinal pattern of infection, is frequently associated with amebic liver abscess. Pulmonary amebiasis occurs in about 2-3 percent of patients with invasive amebiasis. We report herein the case of a 45-year-old male presenting with hepato-pulmonary amebiasis. The diagnosis was established from direct examination of sputum, in which trophozoites of E. histolytica were detected, and by serology. Following treatment with metronidazole and chloroquine, the clinical evolution improved significantly. On regular follow-up visits, the patient was asymptomatic. This case report reiterates the need for collaboration between clinicians and microbiologists for timely diagnosis of such infections.

Hypereosinophilia and abdominopulmonary gnathostomiasis.

A 16-year-old Thai male presented with sudden onset severe epigastric and right upper quadrant pain, fever (39 degrees C), chills and malaise. He gave no history of underlying disease, migratory swelling or urticarial skin rash. He had a history of frequently eating raw pork. Physical examination revealed a soft abdomen with markedly tender hepatomegaly. His blood count showed extreme leukocytosis with hypereosinophilia. After admission he developed a non-productive cough with left sided chest pain, a chest x-ray showed a left pleural effusion. Serological findings were positive for Gnathostoma larval antigen but not Fasciola antigen. The patient recovered completely after albendazole treatment. His clinical presentation is compatible with abdominopulmonary hypereosinophilic syndrome or visceral larva gnathostomiasis. The presented case is interesting not only for physicians who work in endemic areas of gnathostomiasis but also for clinicians who work in travel medicine clinics in developed countries, to consider abdominopulmonary gnathostomiasis when patients present with the signs and symptoms of visceral larva migrans.

Coinfection of Cryptosporidium and Geotrichum in a case of AIDS.

A 32 year old male, positive for human immunodeficiency virus (mY) antibodies, was found to be positive for multiple opportunistic infections by a parasite and a fungi, which is a very rare occurrence. Cryptosporidium and Geotrichum were simultaneously detected from his stool and sputum respectively.

A Case of Pulmonary Microsporidiasis in an Acute Myeloblastic Leukemia (AML) -M3 Patient

Reported here is a case of microsporidiasis that occurred in an acute myeloblastic leukemia (AML) -M3 patient who underwent chemotherapy. Fever, cough, expectorate and dyspnea were observed during the therapy. Since this case was considered as adult respiratory distress syndrome due to the chest X-ray and arterial blood gas findings, the male patient was bounded to a mechanical ventilator. As coagulation tests showed compatible findings with disseminate intravascular coagulation (DIC), it was thought to be a case of sepsis originating from the lungs and DIC. Pseudomonas aeruginosa and Staphylococcus aureus were found in the sputum of the patient. Although he was given combined antibiotic therapy, there was no reduction in the fever. A bronchoalveolar lavage (BAL) sample was taken and Microsporidia sp. was found upon staining with Giemsa. The patient died due to sepsis and DIC just before receiving therapy for microsporidiasis. Pulmonary infection with Microsporidia, although classically occurring in patients with HIV infection, may occur rarely in leukemia patients, especially if previously treated with systemic immune suppression. This case reinforces the need to consider Microsporidia as a possible pathogen in immunocompromised patients with pulmonary infections.

Pulmonary paragonimiasis and tuberculosis in Sorsogon, Philippines.

The clinical epidemiology of pulmonary paragonimiasis and tuberculosis was investigated in a known endemic municipality of Sorsogon, Philippines. Records of diagnosed tuberculosis patients on treatment and follow up at the local Rural Health Unit over a two year period from 1993 to 1994 were reviewed to provide an overview of pulmonary tuberculosis in the area, specifically to describe the population at risk, the basis for diagnosis and the proportion of case notification who were sputum negative. Patients from the same group of individuals as well as undiagnosed tuberculosis patients with productive cough, fever with chest and/or back pain, or hemoptysis were examined to look into clinical manifestations, duration of symptoms, history of crab-eating and sputum examination results for acid-fast bacilli and Paragonimus. There was difficulty in determining the number of non-responders as the records did not have any provision for the recording of such. Annual tuberculosis case notification rates for the two years (374 and 401 per 100,000 population) were higher than the national figure in 1991 (325 per 100,000 population) indicating that tuberculosis is still a major health problem in the area and tuberculosis control efforts may have to be more aggressive to better contain the disease. Twenty-six out of 160 individuals surveyed were sputum smear positive for Paragonimus. Paragonimiasis rates were not significantly different in the two groups (15.6% vs 16.9%, respectively) indicating that there is a need for routine sputum examination for Paragonimus which is not available at present. Only six patients surveyed were sputum smear positive for acid-fast bacilli. A high index of suspicion is necessary to diagnose paragonimiasis and to be able to differentiate it from tuberculosis. The diagnosis may be suggested by a patient's place of origin being a known endemic area, a long period of chronic cough and the habit of eating raw or insufficiently cooked crabs or crayfish. Laboratories in endemic areas should have the capacity to differentiate between the two infections by being able to provide the routine laboratory procedures necessary for definitive diagnosis and treatment.

Parasitósis y desnutrición en escolares de primer grado de la parroquia de Julio Andrade

Este estudio lo realizamos en la parroquía Julio Andrade, tomando en cuenta a los niños de primeros grados de las escuelas de la localidad, partiendo de un universo de 117 niños, de los cuales el 58.97 por ciento son mujeres y el 41.02 por cientos son hombres. De este universo el 15.38 por ciento son de bajo peso según el índice de QUETELET, y de éstos el 77.77 por ciento están parasitados; el 82.05 por ciento se encuentran en parámetros normales y de éstos el 87.50 por ciento están parasitados, el 2.56 por ciento son considerados como de peso elevado, de los cuales el 66.66 por ciento se encuentran parasitados...

Pneumopatias parasitárias: protozoários / Pulmonary paraistosis: protozoa

Os autores fazem uma atualizaçäo das protozooses pulmonares mais freqüentes e estudam os aspectos clínicos e terapêuticos

Forma pulmonar crônica da esquistossomose mansoni: avaliaçäo clínico-radiológica / Chronic pulmonary form of schistosomiasis mansoni: clinico-radiologic evaluation

Foram estudados 115 pacientes esquistossomóticos, 31 com radiologia torácica normal sem sinais de hipertensäo pulmonar (HP); 73 com alteraçöes radiológicas cardiopulmonares sem sinais de HP e 11 com alteraçöes clínicas de HP. A forma pulmonar crônica (FPC) sem HP é de alta incidência e benigna. Näo se associa à forma hepatosplênica (FHE) da esquistossomose mansoni, à faixa etária, sexo ou naturalidade. As alteraçöes radiológicas torácicas predominantes säo hilares, seguidas das parenquimatosas (micronodulaçäo, especialmente base direita). Associa-se às cargas parasitárias baixa ou média. A FPC com HP é de baixa incidência, mas determina repercussäo cardíaca significativa. Associa-se à faixa etária superior a 12 anos e a FHE; näo se relaciona ao sexo, cor e naturalidade. As alteraçöes radiológicas torácicas säo observadas no hilo e parênquima em igual proporçäo (arco médio abaulado e micronodulaçäo em ambas as bases)

Diagnóstico da estrongiloidíase pulmonar pelo lavado broncoalveolar em paciente com SIDA: relato de um caso / Pulmonary strongyloidiasis diagnosis by bronchoalveolar lavage in patient with AIDS: report of a case

os autores reportam o caso de um paciente de 60 anos de idade que apresentou insuficiêntes respiratória devida a estrongiloidíase disseminada. Esse paciente era homossexual e positivo para anticorpos HIV. Os autores enfatizam o valor do lavado broncoalveolar na identificaçäo do nematódeo e chamam a atençäo para a baixa freqüência de estrongiloidíase disseminada em pacientes aidéticos