Anisakiasis gastro-alérgica, primera descripción de un caso en Colombia y revisión bibliográfica / Gastro-allergic anisakiasis: The first case reported in Colombia and a literature review

Resumen La anisakiasis es una enfermedad parasitaria zoonótica causada por el consumo de pescados o mariscos crudos o poco cocidos infectados con nematodos de los géneros Anisakis, Pseudoterranova y Contracaecum. Se describe el primer caso de anisakiasis en Colombia y se resume la literatura médica disponible. Una mujer de 52 años de edad consultó por dolor epigástrico agudo de inicio abrupto, náuseas, vómitos, diarrea y urticaria después de consumir pescado. El examen físico reveló sensibilidad moderada en el epigastrio. El examen de laboratorio evidenció leucocitosis, en tanto que la radiografía simple y el electrocardiograma no reflejaron ninguna anormalidad. El diagnóstico se hizo mediante una endoscopia de vías digestivas altas, la cual reveló engrosamiento de la pared gástrica y un parásito en movimiento. Se encontró una larva de Anisakis y se la extrajo por endoscopia, lo que alivió el dolor de la paciente. Clínicamente, la anisakiasis puede presentarse como una enfermedad gástrica, intestinal, en otros sistemas o alérgica. El diagnóstico se hace con base en la elaboración del historial alimentario del paciente y la visualización directa de las larvas; el único tratamiento efectivo consiste en su extracción endoscópica.

Abstract Anisakiasis is a zoonotic parasitic disease caused by consumption of raw or undercooked fish or seafood infected with nematodes of the Anisakis, Pseudoterranova or Contracaecum genera. Here, we describe the first case of anisakiasis in Colombia and summarize the available literature. A 52-year-old female with a history of abrupt-onset sharp epigastric pain, nausea, vomit, diarrhea, and urticaria following fish consumption consulted the health service. The physical examination revealed moderate tenderness of the epigastric region; the laboratory evaluation showed leukocytosis and a simple X-ray and ECG showed no abnormalities. The diagnosis was made by endoscopic examination, which revealed a thickened gastric wall and a moving larval worm. An Anisakis larva was found and extracted endoscopically, which relieved the pain of the patient. Clinically, anisakiasis may present as a gastric, intestinal, extragastrointestinal or allergic disease. Diagnosis and treatment of anisakiasis are made by a dietary history, direct visualization and endoscopic extraction of possible larvae, which is the only effective therapy.

Gastrointestinal and external parasites of the white-crested elaenia Elaenia albiceps chilensis (Aves, Tyrannidae) in Chile / Parasitas gastrointestinais e externos de guaracava de crista branca Elaenia albiceps chilensis (Aves, Tyrannidae) de Chile

The objective of this study is to evaluate the ectoparasites and helminths of the white-crested elaenia, Elaenia albiceps chilensis. Feather mites Anisophyllodes elaeniae, Trouessartia elaeniae, and Analges sp. were detected in 51% of birds (n=106), whereas 24% were infected with lice (Tyranniphilopterus delicatulus, Menacanthus cfr. distinctus, and Ricinus cfr. invadens). Helminths Viguiera sp. and Capillaria sp. were found in five of the birds that were necropsied (n=20). With the exception of A. elaeniae, T. elaeniae, and T. delicatulus, all parasites represented new records found for the white-crested elaenia, and therefore for the Chilean repertoire of biodiversity.

O objetivo deste estudo foi avaliar a fauna de ectoparasitas e helmintos do guaracava de crista branca Elaenia albiceps chilensis. Em 51% das aves (n=106), foram detectados os ácaros de pena Anisophyllodes elaeniae, Trouessartia elaeniae e Analges sp. enquanto 24% foram infectadas por piolhos (Tyranniphilopterus delicatulus, Menacanthus cfr. distinctus e Ricinus cfr. invadens. Em contrapartida, em cinco aves necropsiadas foram encontrados os helmintos Viguiera sp. e Capillaria sp. Com exceção de A. elaeniae, T. elaeniae e T. delicatulus, todos os parasitas representam novos registros para a guaracava de crista branca e, portanto, para a diversidade da fauna parasitária do Chile.

Sicarius uncinipenis and Deletrocephalus cesarpintoi in captive greater rheas of Minas Gerais State, Brazil / Sicarius uncinipenis e Deletrocephalus cesarpintoi em emas de cativeiro no Estado de Minas Gerais, Brazil

The present study details the pathological and parasitological findings of parasitic ventriculitis and nematode infections in the large intestines of two female Rhea americana americana birds. The birds were housed in captivity, and both exhibited poor body condition and lethargy. The rheas were sent to the Veterinary Hospital of the Veterinary School, Universidade Federal de Minas Gerais (UFMG) and, despite medical care, the clinical condition of the birds did not improve. The birds died two days after admission, and were submitted to necropsy. Gross, histopathology and parasitological analysis resulted in the identification of Sicarius uncinipenis, which is associated with parasitic ventriculitis, while Deletrocephalus cesarpintoi was identified in the large intestine of both rheas. The apparent clinical indications, including loss of appetite and death, combined with the discovery of numerous parasites and other pathology changes, supported the conclusion that the death of the birds was caused by the parasitic infection. Further investigations of these infections in free-living and captive rheas are required, such that accurate data on the incidence and pathogenicity of these parasites can be obtained.

O presente estudo relata os achados patológicos e parasitológicos de ventriculite parasitária e da infecção por nematódeo no intestino grosso em duas fêmeas Rhea americana americana. As aves eram mantidas em cativeiro e ambas apresentaram condição corporal ruim e inapetência. As emas foram encaminhadas para o Hospital Veterinário da Escola de Veterinária da UFMG e, apesar dos cuidados médicos, não houve melhora na condição clínica. As aves morreram dois dias após a internação e foram encaminhadas para a necropsia. Ao exame macroscópico, histopatológico e parasitológico, Sicarius uncinipenis foi identificado e associado com ventriculite parasitária, enquanto Deletrocephalus cesarpintoi foi identificado no intestino grosso. Possivelmente, o quadro de inapetência e morte foi causado pela infecção parasitária, pois os parasitos eram numerosos. Mais investigações dessa infecção são necessárias em emas de vida livre e cativeiro, para a obtenção de informações mais precisas da incidência e patogenicidade desses parasitos.

Toxoplasmose gástrica em paciente infectado pelo vírus da imunodeficiência humana. Relato de caso / Gastric toxoplasmosis in patient infected with human immunodeficiency virus. Case report

A toxoplasmose é uma zoonose altamente disseminada. A maio­ria das infecções em imunocompetentes é assintomática. Porém, em pacientes imunodeprimidos, a infecção adquire um curso variável. Em pacientes com contagem de CD4 abaixo de 100 e que foram previamente expostos ao Toxoplasma gondii, pode haver reativação da doença em diversos tecidos. Envolvimento do trato gastrintestinal por Toxoplasma gondii é raramente relatado. Embora os sintomas gastrintestinais sejam comuns entre os pacientes com síndrome da imunodeficiência adquirida, a maioria é causada por infecções entéricas que não o Toxoplasma gondii. O objetivo deste estudo foi relatar um caso raro de toxoplasmose gástrica. Paciente do gênero feminino, 38 anos, com diagnóstico recente de vírus da imunodeficiência humana, iniciou sintomas gástricos inespecíficos como: epigastralgia, náuseas, vômitos e perda ponderal. O diagnóstico definitivo foi fechado com o estudo anatomopatológico da lesão na mucosa gástrica. Foi instituído tratamento para a toxoplasmose com clindamicina, pirimetamina e ácido folínico (devido à mielotoxicidade), com melhora parcial dos sintomas. Embora raro, a toxoplasmose gástrica deve entrar no diagnóstico diferencial de dor epigástrica em pacientes portadores da síndrome da imunodeficiência adquirida com contagem de CD4 baixa. Seu diagnóstico pre­suntivo pode ser dado pelo quadro clínico, mas o diagnóstico definitivo é obtido pela biópsia da lesão...

Toxoplasmosis is a highly disseminated zoonosis. Most infections are asymptomatic in immunocompetent patients. However, in immunocompromised patients, infection acquires a variable course. In patients with CD4 counts lower than 100 and who have been previously exposed to Toxoplasma gondii, there may be reactivation of the disease in various tissues. Involvement of the gastrointestinal tract by Toxoplasma gondii is rarely reported. Although gastrointestinal symptoms are common among patients with acquired immunodeficiency syndrome, most are caused by enteric infections other than Toxoplasma gondii. The aim of this study was to report a rare case of gastric toxoplasmosis. A 38-year-­old female patient, recently diagnosed with immunodeficiency human virus, presented with nonspecific gastric symptoms such as epigastric pain, nausea, vomiting and weight loss. The definitive diagnosis was reached with anatomopathological examination of gastric mucosa damage. She was treated for toxoplasmosis with clindamycin, pyrimethamine and folinic acid (due to myelotoxicity), with partial improvement of symptoms. Although rare, gastric toxoplasmosis should enter the differential diagnosis of epigastric pain in patients with acquired immunodeficiency syndrome with low CD4 count. Its presumptive diagnosis can be made on a clinical basis, but the definitive diagnosis is reached with biopsy...

Morphology and histology of the adult Paramphistomum gracile Fischoeder, 1901

In the present study, we evaluated the histological morphology of the adult Paramphistomum (P.) gracile. Adult flukes with bodies 5~15 mm in length and 2~7 mm in width were subjected to histological analysis. Longitudinal and transversal serial-sections were stained with hematoxylin and eosin, and examined. The body surface and longitudinal section of P. gracile were also assessed using scanning electron microscopy. In this species, the anterior sucker and posterior sucker (acetabulum) were present on an anterior and posterior part of the body, respectively. The major folds were located in the areas of the anterior sucker, genital canal, and posterior sucker. The fluke membrane was spineless at the tegument surface and in the tegument tissue. Histological data showed structural-systematic characteristics of the digestive tract, reproductive tract, excretory tract, copulatory organs, connective tissues, and muscle tissues. We attempted to elucidate the histological characteristics of P. gracile that might increase the knowledge and understanding of rumen fluke morphology.

The Mucosal Changes and Influencing Factors in Upper Gastrointestinal Anisakiasis: Analysis of 141 Cases / 대한소화기학회지

BACKGROUND/AIMS: Anisakiasis is a well known parasitosis resulted from eating raw seafoods and there were many reports of cases. However, its endoscopic and clinical characteristics have not been reviewed well. The aim of this study was to clarify the gastric mucosal changes and influencing factors of upper gastrointestinal (UGI) anisakiasis. METHODS: We analyzed retrospectively the endoscopic and clinical characteristics of 141 cases with UGI anisakiasis diagnosed during UGI endoscopy, based on the review of medical records. The patients' data were collected consecutively from October 1999 through September 2006. RESULTS: In the 141 patients with UGI anisakiasis, the peak age was the 40s (44.7%). The female to male ratio was 1.82:1. The most prevailed season was winter (41.1%). The most frequent symptom was acute epigastric pain and 76.6% of the patients developed symptoms within 12 hours after the ingestion of raw seafoods. The greater curvature of body was the most preferred site of anisakid larvae. The median time from meal to symptom onset was shortest in esophageal location and longest in fundus location (3 vs. 18.7 hours). The various mucosal changes were observed and the most frequent mucosal change was edema (90.8%). Submucosal tumor was also found in 31.9% of the patients. The severity of mucosal change was related inversely with the time interval from meal to endoscopy (p=0.048). CONCLUSIONS: Anisakiasis presented various mucosal changes depending on the time interval from ingestion of raw seafood to endoscopy. Delayed endoscopy may lead chronic mucosal change and cause difficulty in the detection of anisakiasis. Therefore, the prompt endoscopic examination is required for the patients presenting acute gastrointestinal symptoms after taking raw fish.

Gastrointestinal parasites of ostrich [struthio camelus domesticus] raised in Iran

Introduction of ostrich [Struthio camelus domesticus], a new exotic host species to a new ecosystem like Iran, necessitates the study of its infectious diseases including parasitic infestations. For a period of one year, from 2002-03, faecal samples of 254 ostriches on 5 farms located at different parts of Iran, including Garmsar, Semnan province [n = 85]; Nashtaroud, Maz and aran province [n = 29]; Saveh, Central province [n = 47]; Eshtehard, Ghazvin province [n = 8] and around Tehran, Tehran province [n = 85] were examined for gastrointestinal parasites. Our findings revealed the presence of Libostrongylus douglasii in 55% of the examined birds in Nashtaroud and 25% of birds of Eshtehard farms. In the latter farm, 12.5% in the ostriches harboured Heterakis dispar in their alimentary canals. Oocyst of Eimeria sp. was found in ostrich on farm of Garmsar. All these parasites are reported for the first time from ostriches in Iran

A case of acute gastric anisakiasis provoking severe clinical problems by multiple infection

Acute gastric anisakiasis with multiple anisakid larvae infection is reported. A 68-year-old woman residing in Busan, Korea, had epigastric pain with severe vomiting about 5 hours after eating raw anchovies. Four nematode larvae penetrating the gastric mucosae in the great curvature of the middle body and fundus were found and removed during gasteroendoscopic examination. Another one thread-like moving larva was found in the great curvature of upper body on the following day. On the basis of their morphology, the worms were identified as the 3rd stage larvae of Anisakis simplex. This case is acute gastric anisakiasis provoking severe clinical problems by the multiple infection and the greatest number of anisakid larvae found in a patient in Korea.

A human case of gastric infection by Pseudoterranova decipiens larva

We report a case of gastric pseudoterranoviasis proven by gastrofiberscopy on Dec. 13, 1994. The 34-year-old male patient, residing in Chungju-shi, was admitted to Konkuk University Hospital complaining of prickling epigastric pain. The symptoms suddenly attacked him two days after eating raw marine fish at Chonan-shi. By the gastrofiberscopic examination, a long white-yellowish nematode was found from the fundus region of stomach. The worm was 34.50 x 0.84 mm in size, and was identified as a 3rd stage larva of Pseudoterranova decipiens judging from the position of the intestinal cecum. This is the 12th confirmed case of human pseudoterranoviasis in Korea.

Gastric strongyloidiasis

Involvement of the gastric antral mucosa by Strongyloides stercoralis is reported in a 55-year-old female with adult onset diabetes mellitus. Her symptoms were dyspepsia and non-specific epigastric pain. Observation of the larvae of this parasitic helminth in sites other than the small intestinal mucosa has been previously reported in disseminated forms, in patients with underlying disabling disease or immunosuppression. Few reports are available on the infestation of the gastric mucosa. Involvement of this anatomic site may be attributed to achlorhydria and/or her diabetes mellitus. It is concluded that S. stercoralis infection should be considered as a potential cause of upper gastrointestinal symptoms in tropical and sub-tropical areas

Estrongiloidiasis fatal en paciente inmunodeprimido pos-transplante renal / Fatal strongyloidiasis in immunodepressed patient after kidney transplantation

Se describe en el presente trabajo, un caso de estrongilodiasis fatal, en un paciente inmunodeprimido pos-trasplante renal. Se analizan los mecanismos fisiopatologicos en la enfermedad, destacandose la gravedad del sindrome de "hiperinfeccion". Se resalta el valor diagnostico de la endoscopia con toma biopsia duodenal.