Differential diagnosis of human Entamoeba infections: Morphological and molecular characterization of new isolates in Argentina / Diagnóstico diferencial de infecciones humanas por Entamoeba: caracterización morfológica y molecular de nuevos aislados en Argentina

Abstract Entamoeba infections occur worldwide, with higher frequency in countries of low socioeconomic status and poor public health. Since Entamoeba histolytica has long been recognized as the only pathogenic species, making a differential diagnosis of other morphologically identical Entamoeba is important. This study aimed to determine the prevalence of Entamoeba species in two populations from Argentina, make a differential diagnosis by PCR and characterize Entamoeba isolates at the SSU rRNA gene. A total of 493 serial fecal samples were obtained from individuals in the provinces of Buenos Aires (n=210) and Misiones (n=283). Samples were examined by conventional methods (formalin-ethyl acetate and Willis flotation) and specific PCRs to differentiate Entamoeba species. Entamoeba isolates were characterized by sequencing a fragment of the SSU rRNA gene. The overall prevalence of Entamoeba infection was 12.4%, being more prevalent in Buenos Aires than in Misiones (14.8% vs. 10.6%). A case of E. histolytica confirmed by PCR and sequence analysis was reported for the first time in Buenos Aires. Moreover, new genetic data on Entamoeba coli and Entamoeba dispar were recorded. The phylogenetic analysis revealed a congruence between morphological characteristics and SSU rRNA gene sequences. This study increases the amount of information on the distribution of these species in Argentina and the region of the Americas.

Resumen Las infecciones por Entamoeba se producen en todo el mundo, con mayor frecuencia en países de bajo nivel socioeconómico y salud pública deficiente. Dado que se ha reconocido a Entamoeba histolytica como la única especie patógena del género, es importante realizar un diagnóstico diferencial respecto de otras especies de Entamoeba morfológicamente idénticas. Este estudio tuvo como objetivos determinar la prevalencia de especies de Entamoeba en 2 poblaciones de Argentina, realizar su diagnóstico diferencial por PCR y caracterizar los aislados de Entamoeba secuenciando un fragmento del gen SSU ARNr. Se obtuvieron 493 muestras fecales seriadas de individuos de las provincias de Buenos Aires (n=210) y Misiones (n=283). Las muestras se examinaron por métodos convencionales (sedimentación de formalina-etil acetato y flotación de Willis) y mediante PCR específicas para diferenciar especies de Entamoeba. Los aislamientos de Entamoeba se caracterizaron por secuenciar un fragmento del gen SSU ARNr. La prevalencia general de la infección por Entamoeba fue del 12,4% y fue mayor en Buenos Aires que en Misiones (14,8 vs. 10,6%). Se informó por primera vez un caso de Entamoeba histolytica en Buenos Aires, confirmado por PCR y análisis de secuencia. Además, se registraron nuevos datos genéticos sobre Entamoeba coli y Entamoeba dispar. El análisis filogenético reveló una congruencia entre las características morfológicas y las secuencias del gen SSU ARNr. A través de este estudio, hemos sumado información acerca de la distribución de estas especies en nuestro país y en la región de las Américas.

Massive pleural empyema secondary to amoebic liver abscess in a child / Empiema pleural masivo secundario a absceso hepático amebiano en un niño

Abstract Background: Pleural empyema secondary to a ruptured amoebic liver abscess is a rare complication in the pediatric population. Case report: We report the case of a 13-year-old male with right flank abdominal pain, productive cough with foul-smelling sputum, fever, and respiratory distress. Physical examination revealed breathlessness, decreased vesicular murmur in the right hemithorax, abdominal distension, hepatomegaly, and lower limb edema. Laboratory tests revealed mild anemia, leukocytosis without eosinophilia, elevated alkaline phosphatase, hypoalbuminemia, and positive immunoglobulin G antibodies against Entamoeba histolytica in pleural fluid. He required a chest tube and treatment with metronidazole. After 2 months of follow-up, the abscesses disappeared, and the empyema decreased. Conclusions: Massive pleural empyema secondary to a ruptured liver abscess is a rare complication. The epidemiological link associated with the symptoms and serological tests can help in the diagnosis.

Resumen Introducción: El empiema pleural secundario a ruptura de absceso amebiano hepático es una complicación poco frecuente en la población pediátrica. Caso clínico: Se reporta el caso de un paciente de sexo masculino de 13 años que presentó dolor abdominal en flanco derecho, tos productiva con esputo de mal olor, fiebre y dificultad respiratoria. Al examen físico se encontró amplexación y murmullo vesicular disminuido en hemitórax derecho, distensión abdominal, hepatomegalia y edema de miembros inferiores. Los resultados del laboratorio evidenciaron anemia leve, leucocitosis sin eosinofilia, elevación de fosfatasa alcalina, hipoalbuminemia y anticuerpos IgG contra Entamoeba histolytica positivo en líquido pleural. Requirió tubo de drenaje torácico y tratamiento con metronidazol. A los dos meses de seguimiento los abscesos desaparecieron y el empiema disminuyó. Conclusiones: El empiema pleural masivo secundario a ruptura de absceso hepático es una complicación poco frecuente. El nexo epidemiológico asociado con la sintomatología y pruebas serológicas pueden ser de ayuda en el diagnóstico.

Necrotizing amebic colitis in an elder patient: an unexpected autopsy finding

ABSTRACT Necrotizing amebic colitis is an uncommon amebiasis complication associated with high mortality. We present a case of necrotizing amebic colitis in an old patient whose diagnosis was revealed at postmortem examination. An 81-year-old man died at home without medical attention. The postmortem examination revealed ulcers involving the entire colon and intestinal perforation. The ulcers were large, geographic, and necrotizing, extending from the cecum to the rectum. The histological examination disclosed the infectious etiology by showing amebic trophozoites at the base of the ulcers. No extra-intestinal lesions were found. No information about previous episodes of dysentery or travel could be obtained. The potential role of aging or drug-causing immunosuppression and the evolution of chronic and latent intestinal infection to a severe and invasive form of amebiasis is discussed. This case reinforces the value of postmortem examination for diagnosing diseases not clinically identified.

Oral parasitic protozoan Entamoeba gingivalis in periodontal disease patients, northeastern Thailand

@#Entamoeba gingivalis is present in the oral cavity of humans and is associated with periodontal disease. Consequently, this study aimed to comprehensively investigate the E. gingivalis infection and the associated risk factors among individuals suffering from periodontal conditions. A cross-sectional descriptive study was carried out within a cohort of periodontal patients. Dental plaque specimens were meticulously collected and subsequently subjected to thorough examination using the polymerase chain reaction (PCR)-based technique targeting the small subunit ribosomal RNA (SrRNA) gene of the organism. The occurrence of risk factors for E. gingivalis infection was analyzed by the chi-square test and binary logistic regression. Out of the 230 participants, 60 were clinically diagnosed with periodontitis, while 170 were afflicted with gingivitis. Out of the 230 patients, 25 (10.9%) tested positive for E. gingivalis infections. An in-depth analysis unveiled that a significant majority of infections were recorded within subgroups characterized by a marital status (15.45%), manifestation of periodontitis (25.00%), and concomitant presence of underlying disease (20.83%). Furthermore, the high risk factor associated with E. gingivalis infection was the female (ORadj = 13.65, 95% CI = 1.08-173.21), followed by periodontitis (ORadj = 3.30, 95% CI = 1.21-9.00), respectively. The study employs a molecular diagnostic approach to screen for E. gingivalis enrichment within a subset of periodontal patients with advancing disease. The findings emphasize the necessity for further research to elucidate the pathogenesis of E. gingivalis and advocate for vigilant surveillance within a substantial population of periodontal patients.

Inhibition of choline kinase as an antiamoebic approach in Entamoeba histolytica infection

@#Entamoeba histolytica is the parasite responsible for amoebiasis, which can result in amoebic colitis or amoebic liver abscess. Metronidazole has been the conventional treatment for intestinal amoebiasis, but concerns regarding resistance have emerged due to the identification of resistance pathways in E. histolytica. This study investigates a novel anti-amoebic approach targeting the CDP-choline pathway. Inhibition studies were conducted using potential choline kinase (CK) inhibitors to inhibit the EhCK enzyme, and RNA interference was employed to knock down the EhCK gene. Km and Vmax of purified EhCK and hCKa2 proteins were determined by pyruvate kinase-lactate dehydrogenase (PK-LDH) coupled assay. The IC50 values for EhCK and hCKa2 were determined with several commercial CK inhibitors. Selected inhibitors were incubated with E. histolytica trophozoites for 48 hours to determine the EC50 for each inhibitor. Silencing of gene encoding EhCK was carried out using duplex siRNA and the gene expression level was measured by real-time qPCR. Based on the IC50 values, three of the inhibitors, namely CK37, flavopiridol and H-89 were more potent against EhCK than hCKa2. Trophozoites growth inhibition showed that only HDTAB, H-89 and control drug metronidazole could penetrate and induce cell death after 48-hour incubation. siRNA concentration of 10 µg/mL was used for the transfection of positive control GAPDH, EhCK, and non-targeting GFP siRNAs. RNAi experiment concluded with positive control GAPDH downregulated by 99% while the level of EhCK mRNA was downregulated by 47%. In this study, potential inhibitors of EhCK and siRNA have been identified, paving the way for further refinement and testing to enhance their potency against EhCK while sparing hCK. The utilization of these specific inhibitors and siRNA targeting EhCK represents a novel approach to impede the growth of E. histolytica by disrupting its phospholipid synthesis pathway.

Prevalence and risk factors for infection with Entamoeba histolytica/dispar/ moshkovskii complex in people living in the slightest and outermost islands of Indonesia

@#Entamoeba histolytica (E. histolytica), the causative agent of amoebiasis, is still a global public health problem that cannot be controlled, especially in tropical and subtropical countries. This study was conducted to obtain information about the incidence of Entamoeba histolytica/dispar/ moshkovskii complex infection and the factors that influence it. The prevalence of infection with the Entamoeba histolytica/dispar/moshkovskii complex and the factors that influence it in people living on the smallest and outermost island of Indonesia, Sabang Island, Aceh Province. This study involved 335 respondents aged > 10 years. Respondents were selected by non-probability sampling technique. Interviews and observations were conducted to identify risk factors. The Entamoeba histolytica/dispar/ moshkovskii complex was identified by direct examination, concentration, and Whitley’s trichrome staining techniques. A Chi-Square test was performed to analyze the correlation of risk factors with the incidence of infection. The prevalence of infection with the Entamoeba histolytica/dispar/ moshkovskii complex in the people of Sabang Island was 26.6% (89/335). Source and adequacy of clean water correlated with the incidence of Entamoeba histolytica/dispar/moshkovskii complex infection. Demographic variables are not correlated with the incidence of infection. However, the group of women aged > 61 years, unemployed, unmarried, and earning less than the regional minimum wage tend to be more likely to be found with Entamoeba histolytica/dispar/moshkovskii complex infections. Thus it can be concluded that the prevalence of infection with the Entamoeba histolytica/dispar/moshkovskii complex on Sabang Island is in the high category. The prevalence of E. histolytica as the causative agent of amoebiasis cannot be explained with certainty because the two identical non-pathogenic Entamoeba species cannot be distinguished by microscopic identification. Sources and adequacy of clean water correlate with the incidence of Entamoeba histolytica/dispar/moshkovskii complex infection in the people of Sabang Island.

Establishment of duplex TaqMan RT-PCR method for detection of Entamoeba histolytica and Giardia lamblia in fecal sample / 中国热带医学

@#Abstract: Objective To establish the duplex TaqMan RT-PCR method for detection of Entamoeba histolytica and Giardia lamblia in fecal samples. Methods Primer pairs and probes for Entamoeba histolytica and Giardia lamblia were designed and duplex TaqMan RT-PCR amplification system was constructed. PCR products were inserted into the pUC57 plasmid, and the lower limit of detection of the method was determined. Clinical stool samples were tested in order to evaluated the efficacy of the method. Results The detection limits of duplex TaqMan RT-PCR were 31.6 copies/μL for Entamoeba histolytica and 32 copies/μL for Giardia lamblia, respectively. Of the total of 212 clinical stool samples tested, all 3 samples with E. histolytica-positive patients by microscopy were positive by PCR, while 1 from 209 samples with E. histolytica-negative patients by microscopy were positive by PCR, and the remaining samples were negative. For Giardia lamblia, all 8 samples positive by microscopy were positive by PCR, and 1 from 204 sample with a microscopy-negative patient was positive by PCR, and the remaining samples were negative. The amplification product sequencing and blast analysis were used to confirm that the amplified sequence in the specimen of a patient with negative microscopy but positive PCR belongs to the targeted pathogen, supported by clinical symptoms and laboratory test results. PCR results for other diarrhea-causing pathogens were negative, indicating no cross-reactivity. Conclusions The dual TaqMan RT-PCR method developed in this study can not only detect microscopy-positive samples of Entamoeba histolytica and Giardia lamblia but also can detect samples that were missed by microscopy, with higher sensitivity than the microscopy method. Further, this detection method does not cross-react with other diarrhea-causing pathogens, including cross-react with other diarrhea-causing pathogens including Iodamoeba butschlii, Blastocystis hominis, Plesiomonas, Aeromonas, Salmonella, Shigella, Sphaerozoum fuscum, and Entamoeba hartmani, thus has a good specificity.

Prevalence of gastrointestinal parasitic infection in cows and buffaloes in Lower Dir, Khyber Pakhtunkhwa, Pakistan

Abstract Gastrointestinal (GI) Parasitic infection is a hot issue for cattle management. There is variation of GI parasites effects in sex, age of cattle, drinking water condition, nutrition, and severity of infection. Studies on prevalence of GI parasites among cattle population in Dir Lower are lacking. A total of 40 farms were selected randomly in six tehsil namely Tehsil Adenzai, Tehsil Timergara, Tehsil Balambat, Tehsil Munda ,Tehsil Lalqala, Tehsil Khall. Freshly cattle fecal samples were collected randomly from the selected farms during March 2018 till December 2018. Out of 314 buffaloes and cattle examined 58.59% (184/314) were positive for eggs, cyst/oocyst of one or more species of GI Parasites. The prevalence of parasitic infection was higher in Buffaloes 63.55% (75/118) as compared to Cow 55.61% (109/196) but the difference was not significant (p>0.05) Entamoeba,spp, Moniezia spp, Haemonchus spp and Coccidian spp were found in this study. The non-treated animals indicated the highest percentage of infection in cow 57.71% (101/175) and buffalo 68.13% (62/91).GI parasite prevalence in female animal were higher female cow 62.58% (87/139) and female buffalo 77.33% (58/75) as compared to male. But the difference is non-significant (p> 0.05) Yearling calves had the lower rate of GI parasitic infection than adults. Future investigations are necessary to evaluate the economic loss due to GI parasites in cattles.

Resumo A infecção gastrointestinal (GI) parasitária é um assunto importante para o manejo do gado. Existem variações nos efeitos dos parasitas GI quanto a sexo, idade do gado, condição da água potável, nutrição e gravidade da infecção. Faltam estudos sobre a prevalência de parasitas GI entre a população de gado em Lower Dir. Um total de 40 fazendas foi selecionado aleatoriamente em seis tehsil, nomeadamente Tehsil Adenzai, Tehsil Timergara, Tehsil Balambat, Tehsil Munda, Tehsil Lalqala, Tehsil Khall. Amostras fecais de gado fresco foram coletadas aleatoriamente das fazendas selecionadas de março de 2018 até dezembro de 2018. Dos 314 búfalos e bovinos examinados, 58,59% (184/314) foram positivos para ovos, cisto/oocisto de uma ou mais espécies de parasitas GI. A prevalência de infecção parasitária foi maior em Buffaloes 63,55% (75/118) em comparação com vaca 55,61% (109/196), mas a diferença não foi significativa (p > 0,05). Entamoeba spp, Moniezia spp, Haemonchus spp e Coccidian spp foram encontrados neste estudo. Os animais não tratados indicaram a maior porcentagem de infecção em vacas 57,71% (101/175) e búfalos 68,13% (62/91). A prevalência do parasita GI em fêmeas foi maior em vacas fêmeas 62,58% (87/139) e búfalas 77,33% (58/75) em comparação ao masculino. Mas a diferença não é significativa (p > 0,05). A modelagem linear geral mostrou que o tratamento do animal estava significativamente relacionado com a prevalência de parasitas GI. Bezerros de um ano tiveram a maior taxa de infecção parasitária gastrointestinal. Futuras investigações são necessárias para avaliar a perda econômica devido aos parasitas GI em bovinos.

Prevalencia de Entamoeba gingivalis y Trichomonas tenax en adolescentes de edad escolar / Prevalence of Entamoeba gingivalis and Trichomonas tenax in school-age adolescents

Entamoeba gingivalis y Trichomonas tenaxson protozoos que generalmente se encuentran en la cavidad oral de los humanos. E. gingivalis vive en la superficie de los dientes y las encías, bolsas gingivales cerca de la base de los dientes y rara vez en las criptas de las amígdalas. Por lo general, se transmiten por contacto directo de una persona a otra al besarse, rociarse con gotas o compartir utensilios para comer. Se sabe que hasta el 95% de las personas con poca higiene bucal pueden estar infectadas con esta ameba. Por otro lado, Trichomonas tenax es una pequeña tricomona que generalmente se encuentra en la cavidad oral del 5 al 10% de los humanos. Aunque se consideran comensales anaeróbicos no patógenos, el refugio de este protozoo es más común entre personas con mala higiene bucal o enfermedades. Los informes epidemiológicos demostraron variables tasas de prevalencia de la infección por E. gingivalis entre los niños, y su ocurrencia puede variar de acuerdo a la edad, presencia de gingivitis, periodontitis y condiciones inmunosupresoras. Los niños y adolescentes en edad escolar son extremadamente susceptibles a una amplia gama de infecciones gingivales como bacterias y protozoos. El objetivo de este trabajo es determinar la prevalencia de los protozoarios E. gingivalis y T. tenax en adolescentes con edades comprendidas entre 10 y 19 años en una población de 185 pacientes de la ciudad peruana de Huancayo, Perú. La prevalencia fue mayor en la población femenina (14,05%) que en la población masculina (11,35%), con un mayor porcentaje de prevalencia entre las edades de 17 a 19 años (12,43%), pH salival menor a 6,7 y con enfermedades periodentales (16,22%). Los resultados estadísticos demostraron que la edad (p=0,001), pH salival (p=0,024) y diagnóstico de otras patologías periodentales (p<0,001) fueron estadísticamente significativas(AU)

Entamoeba gingivalis and Trichomonas tenax are protozoa that are usually found in the oral cavity of humans. E. gingivalis lives on the surface of the teeth and gums, gum pockets near the base of the teeth, and rarely in the crypts of the tonsils. They are usually spread by direct person-to-person contact through kissing, dousing, or sharing eating utensils. It is known that up to 95% of people with poor oral hygiene may be infected with this amoeba. On the other hand, Trichomonas tenax is a small trichomona that is usually found in the oral cavity of 5-10% of humans. Although they are considered non-pathogenic anaerobic commensals, the harborage of this protozoan is more common among people with poor oral hygiene or disease. Epidemiological reports have shown variable prevalence rates of E. gingivalis infection among children, and its occurrence may vary according to age, presence of gingivitis, periodontitis, and immunosuppressive conditions. School-age children and adolescents are extremely susceptible to a wide range of gingival infections including bacteria and protozoa. The objective of this work is to determine the prevalence of the protozoa E. gingivalis and T. tenax in adolescents between the ages of 10 and 19 in a population of 185 patients from the Peruvian city of Huancayo, Peru. The prevalence was higher in the female population (14.05%) than in the male population (11.35%), with a higher percentage of prevalence between the ages of 17 to 19 years (12.43%), lower salivary pH to 6.7 and with periodontal diseases (16.22%). The statistical results showed that age (p=0.001), salivary pH (p=0.024) and diagnosis of other periodontal pathologies (p<0.001) were statistically significant(AU)

Evaluation of parasite contamination on toothbrushes in children in Southeastern Brazil / Evaluación de la contaminación parasitaria en cepillos de dientes en niños del sudeste de Brasil

ABSTRACT Introduction : The toothbrush is an important object for the hygiene of the oral cavity and an effective mechanism to remove the oral waste. Objective : To evaluate the perception of care, storage and parasitic contamination of toothbrushes in children with special health care needs (CSHCN) and children without special health care needs (CWSHCN) in Southern of Minas Gerais State. Material and Methods : This is an observational cross-sectional non-randomized study. The population consisted in 54 children, with age between 7 and 14 years. The questionnaire was distributed to patients to evaluate the perception of care and storage of children's toothbrushes. Investigation of toothbrushes contamination was performed by parasitological examination and real-time polymerase chain reactions. Results : Regarding the procedures performed after brushing, 50.0% of children with special health care needs (CSHCN) and 56.3% of children without special health care needs (CWSHCN) report washing their brush bristles with water (p <0.001). Both groups did not use an antiseptic solution on toothbrushes. 73.3% of (CSHCN) and 58.7% of (CWSHCN) answered that they use some protection (brush holder and bathroom cabinet) to avoid exposure of brushes to the environment (p <0.001). Conclusion : The children investigated by the study presented good conditions of care and storage of their toothbrushes. No contamination by pathogenic parasites was found during the study period.

RESUMEN Introducción : El cepillo de dientes es un objeto importante para la higiene de la cavidad bucal y un mecanismo eficaz para eliminar los residuos bucales. Objetivo : Evaluar la percepción del cuidado, almacenamiento y contaminación parasitaria de los cepillos dentales en niños con necesidades especiales de salud (CSHCN) y niños sin necesidades especiales de salud (CWSHCN) en el sur del estado de Minas Gerais. Material y Métodos : Se trata de un estudio observacional transversal no aleatorio. La población consistió en 54 niños, con edad entre 7 y 14 años. El cuestionario fue distribuido a los pacientes para evaluar la percepción del cuidado y almacenamiento de los cepillos dentales de los niños. La investigación de la contaminación de los cepillos dentales se realizó mediante un examen parasitológico y reacciones en cadena de la polimerasa en tiempo real. Resultados : En cuanto a los procedimientos realizados tras el cepillado, el 50,0% de los niños con necesidades especiales de atención sanitaria (NCNEAS) y el 56,3% de los niños sin necesidades especiales de atención sanitaria (NSNEAS) refieren lavar las cerdas del cepillo con agua (p <0,001). Ambos grupos no utilizaron una solución antiséptica en los cepillos de dientes. El 73,3% de los (NCNEAS) y el 58,7% de los (NSNEAS) contestaron que utilizan alguna protección (portacepillos y mueble de baño) para evitar la exposición de los cepillos al medio ambiente (p <0,001). Conclusiones : Los niños investigados por el estudio presentaron buenas condiciones de cuidado y almacenamiento de sus cepillos dentales. No se encontró contaminación por parásitos patógenos durante el período de estudio.

Sociodemographic and Clinical Profile of Amoebic Liver Abscess observed at a Tertiary Referral Hospital over 10 Years

Aim: To study the sociodemographic factors, clinical features and treatment outcome of patients with amebic liver abscess. Methods: Prospective analysis of 163 consecutive patients with liver abscesses (mean age 39.5 years, 140 males). Amoebic aetiology was determined by various combinations of history of dysentery, radiological appearance, aspirated pus study, amebic serology, colonoscopy findingsand response to treatment. Sociodemographic factors associated with amoebic liver abscess included education, income, eating hygiene and alcohol consumption. All patients were treated with fine needle pus aspiration and intravenous metronidazole for at least 7 days. Results: 109(63.9%) abscesses were treated in the first 5 years. Antecedent diarrhoea was present in 27 (16.6%). 146 patients (89.6%) took nitroimidazoles frequently. Jaundice, mostly mild, occurred in 35%.E. histolytica was demonstrated in stool in 11 patients (6.7%) and in aspirated pus in 35 patients (21.5%). Serology was positive (>1:160) in 53(32.5%) patients and was related to abscess size > 10 cm, presence of amoeba in pus and stool and positive colonoscopy findingsbut not to the number of abscesses. Colonoscopy revealed colitis in 21(12.9%) and caecal mass in 7(4.3%). All patients had prompt symptom relief with treatment without recurrence. 80% belonged to the lower middle class hailing from rural areas. 128(78.5%), all males, consumed 60 – 80 ml indigenously brewed liquor daily and they had poor personal and eating hygiene with higher antibody levels. 32 patients (19.6%) drank potable water. Conclusion: Though decreasing, amebic liver abscess continues to afflict heavy alcohol drinkers of lower socioeconomic strata, living in unhygienic conditions. Alcohol might influence seropositivity. Aspiration irrespective of size gives a lasting cure.

TREATMENT DIFFICULTIES WITH LIVER ABSCESS IN PREGNANCY A RARE CASE REPORTTREATMENT DIFFICULTIES WITH LIVER ABSCESS IN PREGNANCY A RARE CASE REPORT

Liver abscess in pregnancy is a rare entity and can be a life threatening condition. Here we present A case of amoebic liver abscess in 25 years old lady in of pregnancy, with highlights on treatmentthird trimester difficulties which we had faced in the management and timely intervention leads to good fetomaternal outcome

Identificación molecular de Entamoeba histolytica, Entamoeba dispar y Entamoeba moshkovskii en niños con diarrea en Maracaibo, Venezuela / Molecular identification of Entamoeba histolytica, E. dispar, and E. moshkovskii in children with diarrhea from Maracaibo, Venezuela

Resumen | Introducción. Las amebas no patógenas Entamoeba dispar, Entamoeba moshkovskii y Entamoeba bangladeshi son morfológicamente idénticas a Entamoeba histolytica, parásito responsable de la amebiasis, por lo cual se necesitan técnicas moleculares para diferenciarlas. Objetivo. Determinar la frecuencia de las diferentes especies de Entamoeba mediante reacción en cadena de la polimerasa (Polymerase Chain Reaction, PCR) en muestras fecales de niños menores de cinco años con diarrea, provenientes de Maracaibo (Venezuela). Materiales y métodos. Se recolectó una muestra fecal por individuo en 75 niños con diarrea (grupo de casos) y en 25 niños sin diarrea (grupo control). Las heces se evaluaron mediante examen microscópico, método de concentración de formól-éter y PCR múltiple anidada en una sola ronda para identificar E. histolytica, E. dispar y E. moshkovskii. Además, se hizo una encuesta en la que se recopilaron los datos demográficos, signos, manifestaciones clínicas y estrato socioeconómico de los niños. Resultados. El 48 % de los participantes (38 del grupo de casos y 10 del grupo de control) tenían enteroparásitos. Solo en las muestras de cuatro de los niños, se encontraron quistes del complejo Entamoeba (tres en el grupo de casos y uno en el de control). Mediante PCR se amplificaron nueve muestras (9 %) para la detección de las amebas estudiadas. En el grupo de casos se registraron tres (28,13 %) de E. histolytica, cuatro (30,50 %) de E. dispar y una (9,37 %) de E. moshkovskii, en tanto que solo una (25 %) muestra amplificó para E. dispar en el grupo de control. Conclusión. En general, predominó E. dispar; sin embargo, todos los infectados con E. histolytica se detectaron en el grupo de niños con diarrea y se detectó el primer caso de E. moshkovskii en la región.

Abstract | Introduction: Entamoeba histolytica is an amebiasis-producing parasite. However, Entamoeba dispar, Entamoeba moshkovskii, and Entamoeba bangladeshi are non-pathogenic amoebae morphologically identical to it and, therefore, molecular techniques are required for their differentiation. Objective: To determine the frequency of Entamoeba species by polymerase chain reaction (PCR) in fecal samples from children under five years with diarrhea from Maracaibo (Venezuela). Materials and methods: A fecal sample per individual was collected from 75 children with diarrhea (case group) and 25 children without diarrhea (control group). Stools were evaluated by microscopic examination, formol-ether concentration method, and nested-multiplex PCR in a single round for the identification of E. histolytica, E. dispar, and E. moshkovskii. In addition, a survey was conducted in which demographic data, signs, clinical manifestations, and socioeconomic status were registered. Results: In total, 48% of the children (38 from the case group and 10 from the control group) had intestinal parasites. Only four children presented cysts of the Entamoeba complex in their samples (three from the case group and one from the control group). By means of PCR, nine samples (9%) amplified for the studied amoebae. In the case group, three (28.13%) amplified for E. histolytica, four (30.50%) for E. dispar, and one (9.37%) for E. moshkovskii while only one (25%) sample amplified for E. dispar in the control group. Conclusion: In general, E. dispar predominated. Nevertheless, all those infected with E. histolytica were detected within the group of children with diarrhea and we reported the first case of E. moshkovskii in the region.

Colitis amebiana necrosante, presentación de un caso / Necrotizing amebian colitis, case report

Resumen Introducción: La Organización Mundial de la Salud (OMS) y la Organización Panamericana de la Salud (OPS) han definido la amebiasis como la infección por Entamoeba histolytica, independientemente de los síntomas. La colitis amebiana necrosante es una forma rara de amebiasis que se asocia con una alta morbilidad y mortalidad. Caso clínico: Presentamos a un paciente femenino de 68 años, con antecedentes de diabetes mellitus tipo 2, con colitis amebiana necrosante con múltiples perforaciones, que fue sometida a una hemicolectomía derecha con íleo-transverso anastomosis. Conclusiones: Se necesitan intervenciones efectivas para prevenir la colitis amebiana y terapias adicionales para tratar la colitis amebiana fulminante y mejorar los resultados.

Abstract Background: Amebiasis has been defined by World Health Organization (WHO) and Pan American Health Organization (PAHO) as the infection with Entamoeba histolytica regardless of symptoms. Necrotizing amoebic colitis is a rare clinical form of amebosis that is associated with high morbidity and mortality. Case Report: We present a 68-years-old-female patient with necrotizing amoebic colitis with multiple perforations who survived after right hemicolectomy with ileus-transverse anastomosis. Conclusions: Effective interventions to prevent amebic colitis, and additional therapies to treat fulminant amebic colitis are needed to improve outcomes.

Pavonia odorata Derived Phytochemicals against Entamoeba histolytica Causing Dysentery

Phytochemicals from Pavonia odorata plant extract are traditionally used to cure Dysentery. It is caused by Entamoeba histolytica. Molecular docking method applied using “Biovia Discovery Studio”. “High positive values of -CDOCKER energy and -CDOCKER interaction energy” suggested that palmitic acid can effectively deactivate the Alcohol dehydrogenase enzyme thereby interrupting the life cycle of the organism

Bixa orellana Derived Phytochemicals against Entamoeba histolytica Causing Dysentery

Phytochemicals from Bixa orellana plant extract are traditionally used to cure Dysentery. It is caused by Entamoeba histolytica. Molecular docking method applied using “Biovia Discovery Studio”. “High positive values of -CDOCKER energy and -CDOCKER interaction energy” suggested that benzoin acid can effectively deactivate the alcohol dehydrogenase enzyme thereby interrupting the life cycle of the organism

Alta prevalência de Balantidium coli em crianças de uma Escola Municipal de Moreira Sales - Pr / High prevalence of balantidium coli in children of a Municipal School in Moreira Sales - Pr

As doenças causadas por parasitos intestinais estão entre os mais frequentes agravos do mundo, pois é um problema de saúde pública que atinge a maioria da população. O presente estudo teve como objetivo verificar a prevalência de parasitos em crianças de 4 a 6 anos de uma escola municipal de Moreira Sales, PR. A pesquisa foi composta por inquérito parasitológico e epidemiológico em crianças matriculadas em uma escola municipal em julho de 2017. O critério para inclusão no estudo foi: coletar a amostra de fezes, responder o questionário socioepidemiológico e ter o Termo de Consentimento Livre e Esclarecido (TCLE) assinado pelos pais e/ou responsáveis. Participaram do estudo 42 crianças com idades entre 4 e 6 anos, das quais 66,7% eram meninas. Dos participantes, dez crianças (23,8%) apresentaram infecção por Balantidium coli, sendo que destas, duas apresentaram infecção mista por Entamoeba coli. Foi observado que a maioria dos infectados possuíam animais de estimação (60%), roíam unhas (60%), consumiam hortaliças (80%) e todas as crianças brincavam na terra, sendo esses alguns fatores de risco para a infecção. Diante dos resultados apresentados, é possível perceber que existem vários fatores que podem estar associados à infecção por Balantidium coli, sendo os principais: falta de saneamento básico e os hábitos de higiene inadequado. Portanto, fatores importantes para se promover a conscientização e ação profilática da população, com o intuito de minimizar as parasitoses, principalmente nas crianças.

Diseases caused by intestinal parasites are among the most frequent ones in the world, since it is a public health issue affecting most of the population. The purpose of this study was to verify the prevalence of parasites in children aged 4 to 6 years at a school in the municipality of Moreira Sales, in the state of Paraná, Brazil. The study was comprised by the parasitological and epidemiological investigation in children enrolled in a school in the city in July 2017. The criteria for inclusion in the study was to collect the stool sample, answer the socio-epidemiological questionnaire and sign a Free and Clarified Consent Form. A total of 42 children took part in this study, with ages ranging between 4 and 6 years, of which 66.7% were female. From the participants, ten children (23.8%) presented infection by Balantidium coli, and among which, two of them presented mixed infection by Entamoeba coli. It was observed that most of the infected children had pets (60%), bit their nails (60%), consumed vegetables (80%) and all children played on dirt, which are some of the risk factors for infection. Considering the results, it is possible to observe that there are several factors that can be associated to infection by Balantidium coli, among which: basic sanitation and hygiene habits. Therefore, raising awareness and presenting prophylactic action to the population is essential in order to minimize intestinal parasitosis, especially in children.

Guava Seeds Derived Phytochemicals against Dysentery

Phytochemicals are the secondary metabolites that are known as nonnutritive but extremely beneficial for the defensive system for the organism. These phytochemicals can be obtained from all the plants and they play a major role in curing differnt diseases. The extract of the guava seed contains various phytochemicals that can cure the disease like dysentery, caused by the protozoa parasite, namely Entamoeba histolytica. “Biovia Discovery Studio” was used for the molecular docking process. “High positive values of -CDOCKER energy and -CDOCKER interaction energy” suggested that Heptadecanoic acid can effectively deactivate the alcohol dehydrogenase enzyme further inhibiting the biological process of the causative organism

Murraya koenigii Derived Phytochemicals against Dysentery

Phytochemicals are any of various biologically active compounds found in plants. These are produced by plants and have biological activity. It has been reported that Murraya koenigii leaf extract is traditionally used to cure dysentery. Dysentery is an intestinal inflammation, primarily of the colon. It can lead to mild or severe stomach cramps and severe diarrhoea with mucus or blood in the faeces. It is the infection in the intestinal tract. One enzyme, which is involved in its biochemical pathway, is known as alcohol dehydrogenase (which have pdb id.1Y9A). The molecular docking was studied by biovia discovery studio. In which the interaction is done between the phytochemical of the plant with the enzyme. The stability of the interaction was evaluated based on –CDocker energy and –CDocker interaction energy.

Intestinal parasitic infections and prevalence of anaemia among tribal school going children: a one year study

Background: Intestinal parasitic infections are one of the neglected tropical diseases listed by world health organization. Parasitic infections among school going tribal children cause significant anaemia and malnutrition. Our study mainly focused on estimating the prevalence of intestinal parasitic infections and focused on iron deficiency anaemia among the tribal school going children.Methods: A prospective study for one year was conducted at a tertiary care hospital and study group was tribal children from hostels and schools. Ethical committee approval was obtained and study included collection of socio demographic data, anthropometric data, stool examination for intestinal parasitic infections, Hb% estimation by 'Hemocue globinometer Hb 301 System' a portable hemometer for Hb estimation. S. iron, S. transferrin and Total iron binding capacity were also estimated. Statistical analysis was performed by using SPSS version 20 and analyzed. P value <0.05 was considered significant.Results: This 428 study participants with 66.36% boys and 33.64% girls were enrolled. The prevalence of parasitic infections was 42.06%. Protozoal infections were 41.11% when compared to helminthic infections (26.67%) and mixed infections in 32.22%.' Entamoeba histolytica was the predominant protozoal parasite identified (30%) and Ascaris lumbricoides among the helminthic infection (13.3%). Presence of anaemia in the present study population was 11.21% and among the study group with parasitic infections it was 66.67%.Conclusion: To conclude, regular deworming practices, awareness regarding hand washing practices, iron and folic acid supplementation irrespective of nutritional status and health education could significantly reduce the incidence of anaemia associated with intestinal parasitic infections.