Correlation between the values of circulating blood elements with the size of spleen in the presence of schistosomal splenomegaly

Abstract Purpose: To evaluate a possible relationship between the size of the spleen and values of circulating blood elements in patients with schistosomatic splenomegaly. Methods: ixty one patients with hepatosplenic schistosomiasis mansoni underwent a clinical exam and peripheral venous blood was collected for a hemogram. The erythrocyte, hemoglobin, hematocrit, leukocyte, and platelet values were determined. All patients underwent abdominal ultrasound to measure the spleen. The hematological test results were compared to the size of the spleen. Results: The size of the spleen varied from 14.0 to 28.4 (19.9 ± 3.7) cm according to the ultrasound image. Thrombocytopenia was observed 58 (95%) patients, leukopenia in 55 (90%) patients, and anemia in 32 (52.4%) patients. Leukopenia was proportional to splenomegaly. Conclusion: Schistosomal splenomegaly leads to leukopenia in direct proportion to the size of the spleen.

Histopathology of murine toxoplasmosis under treatment with dialyzable leukocyte extract

BACKGROUND Dialyzable leukocyte extracts (DLEs) contain molecules smaller than 10 kDa with biological activity in receptor organisms. Primarily, they participate in the regulation of the Th1 immune response, which is essential for the control of several intracellular infections, such as toxoplasmosis. This disease is associated with congenital infection, encephalitis or systemic infections in immunocompromised individuals. The clinical course of this infection fundamentally depends on a well-regulated immune response and timely treatment with the appropriate drugs. OBJECTIVE The aim of this study was to evaluate the effect of treatment with a leukocyte extract, derived from crocodile lymphoid tissue, on the histopathology and brain parasite load in NIH mice that had been infected with cysts of Toxoplasma gondii (ME-49 strain). METHODS The treatment was applied during the acute and chronic stages of the infection. Histopathological changes were evaluated in the ileum, liver and spleen at one, four and eight weeks after infection and in the brain at week 8. The parasite load was evaluated by counting the cysts of T. gondii found in the brain. FINDINGS Compared to the control mouse group, the mice infected with T. gondii and under treatment with DLE showed less tissue damage, mainly at the intestinal, splenic and hepatic levels. In addition, a greater percentage of survival was observed, and there was a considerable reduction in the parasite load in the brain. CONCLUSIONS The results suggest that DLE derived from crocodile is a potential adjunctive therapy in the conventional treatment of toxoplasmosis.

Influence of apoptosis on liver and spleen resistance in dogs with visceral leishmaniosis / Influência da apoptose na resistência hepática e esplênica de cães com leishmaniose visceral

Abstract The aim of this study was to evaluate apoptosis and parasite load in the liver and spleen of dogs with visceral leishmaniosis (VL), using immunohistochemistry. Liver and spleen samples from 71 dogs with VL were used. The parasite load in the spleen and liver showed significant difference between organs in infected group (P=0.0219). The density of the parasite load in the spleen (median=2.4) was higher than liver (median=0.8). Immunodetection of apoptotic cells was predominant in lymphocytes and differ between the infected and control group in spleen (P=0.0307) and liver (P=0.0346). There was a significant correlation between apoptosis and parasite load (P = 0.0084; r=0.3104) only in the spleen of the infected group, where it was observed that, when increasing the number of apoptotic cells increases the parasitic load. It was concluded that the liver and spleen of infected dogs presented greater numbers of cells undergoing apoptosis (lymphocytes) than the control group, thus suggesting that this process may be contributing towards the survival of Leishmania in these organs, because lymphocyte in apoptosis did not have the ability to present and recognize the antigen, allowing the survival of the parasite.

Resumo O objetivo deste estudo foi avaliar a apoptose e a carga parasitária no fígado e baço de cães com leishmaniose visceral (LV), pela técnica de imuno-histoquímica. Foram utilizadas amostras de fígado e baço de 71 cães com LV. A carga parasitária no baço e fígado mostrou diferença significativa entre os órgãos no grupo infectado (P=0,0219). A densidade da carga de parasita no baço (média=2,4) foi maior do que no fígado (média=0,8). A imunodetecção de células em apoptose foi predominante nos linfócitos, com diferenças entre o grupo infectado e controle no baço (P=0,0307) e fígado (P=0,0346). Houve uma correlação positiva fraca entre apoptose e carga parasitária (P=0,0084; r=0,3104) apenas no baço do grupo infectado, onde observou-se que quando aumentava o número de células em apoptose aumentava a carga parasitária. Concluiu-se que o fígado e o baço de cães infectados apresentam um maior número de células que sofrem apoptose (linfócitos) do que o grupo controle, sugerindo que este processo possa contribuir para a sobrevivência de Leishmania nestes órgãos, pois os linfócitos em apoptose não tiveram a capacidade de apresentar e reconhecer o antígeno, permitindo a sobrevivência do parasita.

Antileishmanial activity of the essential oil from Tetradenia riparia obtained in different seasons

The herbaceous shrub Tetradenia riparia has been traditionally used to treat inflammatory and infectious diseases. Recently, a study showed that T. riparia essential oil (TrEO) obtained in summer has antileishmanial effects, although these results could be influenced by seasonal variation. This study evaluated the activity of the TrEO obtained in different seasons against Leishmania (Leishmania) amazonensis, in vitro and in vivo. The compounds in the TrEO were analysed by gas chromatography-mass spectrometry; terpenoids were present and oxygenated sesquiterpenes were the majority compounds (55.28%). The cytotoxicity and nitric oxide (NO) production were also tested after TrEO treatment. The TrEO from all seasons showed a 50% growth inhibitory concentration for promastigotes of about 15 ng/mL; at 30 ng/mL and 3 ng/mL, the TrEO reduced intracellular amastigote infection, independently of season. The TrEO from plants harvested in summer had the highest 50% cytotoxic concentration, 1,476 ng/mL for J774.A1 macrophages, and in spring (90.94 ng/mL) for murine macrophages. NO production did not change in samples of the TrEO from different seasons. The antileishmanial effect in vivo consisted of a reduction of the parasite load in the spleen. These results suggest that the TrEO has potential effects on L. (L.) amazonensis, consonant with its traditional use to treat parasitic diseases.

Parasite load and risk factors for poor outcome among children with visceral leishmaniasis. A cohort study in Belo Horizonte, Brazil, 2010-2011

Clinical and laboratory risk factors for death from visceral leishmaniasis (VL) are relatively known, but quantitative real-time polymerase chain reaction (qPCR) might assess the role of parasite load in determining clinical outcome. The aim of this study was to identify risk factors, including parasite load in peripheral blood, for VL poor outcome among children. This prospective cohort study evaluated children aged ≤ 12 years old with VL diagnosis at three times: pre-treatment (T0), during treatment (T1) and post-treatment (T2). Forty-eight patients were included and 16 (33.3%) met the criteria for poor outcome. Age ≤ 12 months [relative risk (RR) 3.51; 95% confidence interval (CI) 1.89-6.52], tachydyspnoea (RR 3.46; 95% CI 2.19-5.47), bacterial infection (RR 3.08; 95% CI 1.27-7.48), liver enlargement (RR 3.00; 95% CI 1.44-6.23) and low serum albumin (RR 7.00; 95% CI 1.80-27.24) were identified as risk factors. qPCR was positive in all patients at T0 and the parasite DNA was undetectable in 76.1% of them at T1 and in 90.7% at T2. There was no statistical association between parasite load at T0 and poor outcome.

Desestruturação da polpa branca do baço na leishmaniose visceral canina: células e citocinas envolvidas / Disruption of the white pulp of the spleen in canine visceral leishmaniasis: cells and cytokines involved

A leishmaniose visceral está associada às alterações arquiteturais esplênicas e redistribuição de populações celulares envolvidas na resposta imunológica. Os objetivos desta tese foram estudar a desestruturação da polpa branca do baço na leishmaniose visceral canina e quais as células e citocinas envolvidas nesse processo. Para isso, amostras de baços de cães de uma área endêmica para LV foram agrupadas em três categorias: TIPO1-CONT ou TIPO1-SIA (cães não infectados ou sem infecção ativa e com polpa branca organizada), TIPO1-INF (cães infectados com polpa branca organizada) e TIPO3-INF (cães infectados com polpa branca desorganizada). No capítulo 2 e 3, as secções de baço foram marcadas através de imunoistoquímica com anticorpos anti-CD3 (linfócitos T), anti-CD79-α (linfócitos B), anti-S100 (célula dendrítica folicular), anti-Ki-67...

Visceral leishmaniasis is associated with splenic architectural changes and redistribution of cell populations involved in the immune response. The objectives of this thesis was to study the disruption of the white pulp of the spleen in canine visceral leishmaniasis and which cells and cytokines are involved in this process. For this, samples of spleens of dogs from an endemic area for VL were grouped into three categories: TYPE1-CONT or TYPE1-NIF (non-infected dogs or without active infection with organized white pulp), TYPE1-INF (infected dogs with pulp organized white) and TYPE3-INF (infected animals with disorganized white pulp). In Chapter 2 and 3 the spleens sections were stained by immunohistochemistry with anti-CD3 (T lymphocytes), anti-CD79 (B lymphocytes), anti-S100 (follicular dendritic cells), anti-Ki-67...

Alteration of Cytokine Production during Visceral Larva Migrans by Toxascaris leonina in Mice

To determine alteration of immune responses during visceral larva migrans (VLM) caused by Toxascaris leonina at several time points, we experimentally infected mice with embryonated eggs of T. leonina and measured T-helper (Th) cell-related serial cytokine production after infection. At day 5 post infection (PI), most larvae were detected from the lungs, spleen, intestine, and muscle. Expression of thymic stromal lymphopoietin (TSLP) and CCL11 (eotaxin) showed a significant increase in most infected organs, except the intestine. However, expression of the CXCL1 (Gro-alpha) gene was most highly enhanced in the intestine at day 14 PI. Th1-related cytokine secretion of splenocytes showed increases at day 28 PI, and the level showed a decrease at day 42 PI. Th2-related cytokine secretion of splenocytes also showed an increase after infection; in particular, IL-5 level showed a significant increase at day 14 PI, and the level showed a decrease at day 28 PI. However, levels of Th17-related cytokines, IL-6 and IL-17A, showed gradual increases until day 42 PI. In conclusion, Th1, Th2, and Th17-related cytokine production might be important in immune responses against T. leonina VLM in experimental mice.

Expression of non-TLR pattern recognition receptors in the spleen of BALB/c mice infected with Plasmodium yoelii and Plasmodium chabaudi chabaudi AS

The spleen plays a crucial role in the development of immunity to malaria, but the role of pattern recognition receptors (PRRs) in splenic effector cells during malaria infection is poorly understood. In the present study, we analysed the expression of selected PRRs in splenic effector cells from BALB/c mice infected with the lethal and non-lethal Plasmodium yoelii strains 17XL and 17X, respectively, and the non-lethal Plasmodium chabaudi chabaudi AS strain. The results of these experiments showed fewer significant changes in the expression of PRRs in AS-infected mice than in 17X and 17XL-infected mice. Mannose receptor C type 2 (MRC2) expression increased with parasitemia, whereas Toll-like receptors and sialoadhesin (Sn) decreased in mice infected with P. chabaudi AS. In contrast, MRC type 1 (MRC1), MRC2 and EGF-like module containing mucin-like hormone receptor-like sequence 1 (F4/80) expression decreased with parasitemia in mice infected with 17X, whereas MRC1 an MRC2 increased and F4/80 decreased in mice infected with 17XL. Furthermore, macrophage receptor with collagenous structure and CD68 declined rapidly after initial parasitemia. SIGNR1 and Sn expression demonstrated minor variations in the spleens of mice infected with either strain. Notably, macrophage scavenger receptor (Msr1) and dendritic cell-associated C-type lectin 2 expression increased at both the transcript and protein levels in 17XL-infected mice with 50% parasitemia. Furthermore, the increased lethality of 17X infection in Msr1 -/- mice demonstrated a protective role for Msr1. Our results suggest a dual role for these receptors in parasite clearance and protection in 17X infection and lethality in 17XL infection.

Exames parasitológicos, imunoistoquímicos e histopatológicos para detecção de Leishmania chagasi em tecidos esplênicos de cães com leishmaniose visceral / Parasitological, immunohistochemical and histopathological study for Leishmania chagasi detection in spleenic tissues of dogs with visceral leishmaniasis

O propósito do presente trabalho foi o estudo da Leishmaniose Visceral Canina - LVC por meio de métodos parasitológicos e imunoistoquímicos para a detecção de formas amastigotas de Leishmania (L.) chagasi em baço, além de descrever a histopatologia das lesões esplênicas em 34 cães, com diferentes manifestações clínicas da LVC, eutanasiados pelo Centro de Controle de Zoonoses de Ilha Solteira, SP. Esses animais foram examinados clinicamente antes da eutánásia e de acordo com os sinais clínicos da LVC, foram classificados em três grupos: assintomáticos (8 cães), oligossintomáticos (17 cães) e sintomáticos (9 cães). Após a realização desses exames, dos 34 cães, 22 (64,7 por cento) estavam positivos e 12 (35,3 por cento) negativos. Desses cães positivos, 1/22 (4,5 por cento) era assintomático, 12/22 (54,5 por cento) eram oligossintomáticos e 9/22 (40,1 por cento) sintomáticos. Pela histopatologia, os cães, especialmente os sintomáticos apresentavam o baço com inflamação crônica e espessamento na região capsular e trabecular, além de extensa alteração morfológica na polpa vermelha e branca pela presença de grande quantidade de macrófagos repletos de amastigotas, pela reação granulomatosa inflamatória e pelas áreas hemorrágicas. Os exames histopatológicos e a detecção microscópica direta da L. (L.) chagasi revelaram que o baço é um órgão útil para auxiliar no diagnóstico da LVC. A coloração imunoistoquímica foi a que detectou o maior número de tecidos esplênicos positivos com amastigotas, além de elucidar os casos suspeitos pelos exames parasitológicos, principalmente, nos animais assintomáticos ou oligossintomáticos.

The purpose of this work was a Canine Visceral Leishmaniasis - CVL study by parasitological direct examination of Leishmania (L.) chagasi (imprinting and histological), immunohistochemical test and histopathological analysis using spleen tissues from 34 dogs euthanized by the Zoonotic Disease Control Centre from Ilha Solteira, SP, Brazil. According to the clinical signs, the dogs were divided in three groups: asymptomatics (8 dogs), oligosymptomatics (17 dogs) and symptomatics (9 dogs). After the accomplishment of all diagnostic tests, 22 dogs were considered positives (64.7 percent) and 12 (35.3 percent) were negatives to CVL. From these positive dogs, 1/22 (4.5 percent) was asymptomatic, 12/22 (54.5 percent) were oligosymptomatics and 8/22 (40.1 percent) were symptomatics. The histopathological study in spleen tissues from positive, especially symptomatic dogs, showed a diffuse chronic inflammation with thickness of capsular and trabecular regions and there was extense morphologic alteration of the red and white pulp by the presence of abundant macrophages full with amastigotes, the granulomatous inflammatory reaction and haemorragic areas. The data of this work from histopathologic examination and direct microcopic visualization of L. (L.) chagasi showed that the spleen was an useful organ to collect sample tissues for CVL diagnosis. The immunostaining detected the highest number of positive dogs and were considered an important and conclusive method to be used in addition to parasitological methods for CVL, particularly in asymptomatic or oligosymptomatic dogs.

Primary perisplenic hydatid cyst

Splenic parasitic cysts due to flat worm Ecbinococi resuling in hydatid disease are a rare presentation as primary site even in the endemic regions. Primary splenic parasitic cysts have an incidence of 0.5-4%. A 21-year-old male with pet dogs at home, presented with 3 months history of gradually increasing discomfort in the left hypochondrium and tender splenomegaly. He had marked eosinophilia with normal liver function tests and positive serum IgM Echinococcus antibodies. Ultrasonography showed a cyst in the hilar region of spleen having septations with internal echos. An upper midline laparotomy was performed and a perisplenic cyst was removed along with spleen from the sub-diaphragmatic location. Histopathological examination confirmed acellular fibrous wall of hydatid cyst with germinal layer and scolices in the centre. Postoperatively, patient was continued on oral Albendazole for one month

A new strategy for elimination of kala-azar from rural Bihar.

BACKGROUND & OBJECTIVE: Bihar State of India has been an endemic State for kala-azar. There has been many phases of DDT sprays for vector control. An outbreak of kala-azar occurred in Goanpura, 6 km from Patna, Bihar, in 2003. We undertook this study with a new approach of kala-azar elimination in this village with priority to treatment of cases followed by supplementation with supervised DDT spray for vector control. METHODS: This study included a camp approach to collect patients at in the camp, screening of patients with rK-39, transporting the patients to the hospital of Balaji Utthan Sansthan, Patna, Bihar, confirming the diagnosis by demonstration of Leishman-Donovan (LD) bodies in splenic aspirates after proper clinical and pathological investigations, and treatment with amphotericin B (Fungizone) at a dose of 1mg/kg body wt for 20 days. If parasites persisted after 20 days, five more infusions were given. The State Government was persuaded to do supervised DDT spray as per the guidelines. All patients were followed up for 6 months for any relapse, and the village of Goanpura for 3 years for occurrence of any new case. RESULTS: A camp was held in that village on September 11, 2003 after due publicity. A total of 368 patients having different ailments, attended the camp; 25 patients were screened with rk-39 for kala-azar and 21 patients gave positive results. All 21 patients were shifted to Balaji Utthan Sansthan for treatment. After thorough clinical examination and pathological tests splenic aspiration was done. All 21 patients were positive for LD bodies. One patient died and the remaining 20 completed full course of treatment and were cured. No patients relapsed within six months of follow up. Two rounds of supervised DDT spray were done. No new case occurred in the village during three years of follow up. No sandfly was detected in the village during the years of follow up. INTERPRETATION & CONCLUSION: Camp strategy to collect patients at one place, screening of patients with rk-39, transporting rk-39 positive patients to the hospital, treatment with an effective drug amphotericin B with no incidence of unresponsiveness and relapsed minimized transmission of the disease; only two rounds of supervised intensive spray of DDT eliminated sandflies from the village. This new cost effective approach in which treatment of patients was done with an effective drug followed by supervised DDT spray may be adopted for elimination of kala-azar from Bihar.

Cystic echinococcosis in Thailand with a special note on detection by serology in one family.

Thailand is a nonendemic area of echinococcosis. We report, herein, 3 cases with a special note on the use of serology in detection of the disease in one family. All cases were Thais. The first case was a man, having a cystic mass in the liver. He was subsequently diagnosed as having echinococcosis following positive serology. The second case, a male, had a renal hydatid cyst revealed by histopathology, and a positive serological test. The third case, a wife of case 2, was positive by serological screening for echinococcosis and subsequently proven to have splenic and liver echinococcal cysts. The present findings support the use of serology in the case detection of echinococcosis in Thailand.

Myxobolus platanus n. sp. (Myxosporea, Myxobolidae), a parasite of Mugil platanus Günther, 1880 (Osteichthyes, Mugilidae) from Lagoa dos Patos, RS, Brazil

Myxobolus platanus n. sp. infecting the spleen of Mugil platanus Günther, 1880 (Osteichthyes, Mugilidae) from Lagoa dos Patos, Brazil is described The parasites formed round or slightly oval whitish plasmodia (about 0.05-0.1mm in diameter) on the surface of the organ. The spores were round in frontal view and oval in lateral view, 10.7µm (10-11) long, 10.8µm (10-11) wide and 5µm thick, and presented four sutural marks along the sutural edge. The polar capsules, equal in size, were prominent, surpassing the mid-length of the spore, and were oval with the posterior extremity rounded, and converging with their anteriorly tapered ends. They were 7.7µm (7-8) long and 3.8µm (3.5-4) wide. A small intercapsular appendix was present. The polar filament formed five to six coils obliquely placed to the axis of the polar capsule. No mucous envelope or distinct iodinophilous vacuole were found

Descreve-se Myxobolus platanus n. sp. infectando o baço de Mugil platanus Günther, 1880 (Osteichthyes, Mugilidae) da Lagoa dos Patos, Brasil. Os parasitas formavam plasmódios brancos redondos ou ligeiramente ovais (diâmetro de cerca de 0,05-0,1mm) à superfície do órgão. Os esporos eram circulares em observação frontal e ovais em obervação lateral, medindo, em média, 10,7µm (10-11) de comprimento, 10,8µm (10-11) de largura e 5µm de espessura, e tinham quatro marcas suturais ao longo da linha de sutura. As cápsulas polares eram grandes e do mesmo tamanho ultrapassando a zona média do esporo. Eram de forma oval, tendo a extremidade posterior arredondada, e convergiam pelas extremidades anteriores afiladas, medindo 7,7µm (7-8) de comprimento por 3,8µm (3,5-4) de largura. Um pequeno apêndice intercapsular estava presente. O filamento polar formava cinco a seis dobras colocadas obliquamente em relação ao eixo da cápsula. Não havia envelope mucígeno nem vacúolo iodofílico

Immunohistochemical study of acute and chronic toxoplasmosis in experimentally infected mice.

Acute and chronic Toxoplasma infections were evaluated in mice using stage specific antibodies and immunocytochemistry. Mice with acute toxoplasmosis were less active, had erectile body hair and seldom took food or water resulting in weight loss. All mice died within 7 days post-inoculation. The immunohistochemical technique enhanced visualization of parasites allowing their distribution to be accurately followed. Following intraperitoneal infection, tachyzoites were initially identified on the surface of the liver and spleen. There was a rapid increase in the number of tachyzoites associated with invasion from the surrounding connective tissue into the organs with formation of inflammatory lesions in the liver. The focal inflammatory lesions showed increasing numbers of tachyzoites with the period post-inoculation. Similar increases in tachyzoites were observed for the spleen. In contrast, only a few individual tachyzoites were seen in the brain at the final time point. In chronic infections, the mice were asymptomatic but tissue cysts containing large numbers of bradyzoites were observed in all brains with the average number of 295 tissue cysts per half brain and the average cystic size of 46.02 +/- 5.08 microm. By histology and immunostaining, the tissue cysts were readily identifiable along with a mild inflammatory cell infiltration into the meninges and perivascular cuffing. Double immunocytochemical labelling confirmed the exclusive presence of tachyzoites during the acute phase and bradyzoites during the chronic phase.

Perfis de resposta imune-inflamatória na pele e no baço, associados à leishmaniose visceral canina / Profiles of immune-inflammatory response in skin and spleen, associated with canine visceral leishmaniasis

O cão doméstico é considerado o principal reservatório da Leishmania chagasi. Nesta tese, estudamos a resposta imuno-inflamatória, in situ, no baço e na pele de cães naturalmente infectados por L. chagasi, visando contribuir com a definição de novos marcadores de resistência e susceptibilidade à leishmaniose visceral canina que possam ser utilizados na avaliação da eficácia de protocolos de imunoprofilaxia e imunoterapia. Setenta e dois cães, provenientes de Jequié (BA), foram classificados em quatro grupos, de acordo com o perfil de resposta à infecção por L chagasi: (1) Potencialmente resistentes: animais com ausência de parasitismo esplênico e com teste cutâneo da leishmanina positivo. (2) Potencialmente suceptíveis: com presença de parasitismo esplênico e teste cutâneo da leishmanina negativo. (3) Indeterminado: com parasitismo esplênico e teste cutâneo da leishmanina positivo. (4) Potencialmente não infectados: com ambos os parâmetros negativos e sorologia negativa. Espécimens de baço e da pele desses animais foram analisados quanto às alterações morfológicas, excetuando quatorze cães cujas amostras de pele não estavam disponíveis. Animais do grupo potencialmente susceptível apresentaram mais freqüentemente periesplenite (18/25, P<0.0001), granuloma (7/25, P=0.0102), desorganização arquitetural da polpa branca (14/25, P=O.0001), folículos linfóides com menor freqüência (20/25, P=0,001), tamanho (20/25, P<0,0036) e com atrofia dos centros germinativos (21/25, P=0,0015), além de atrofia da zona marginal (15/25, P=0,0025) do que os outros grupos. A análise da pele revelou dermatite que foi mais freqüentemente em cães com cultura esplênica positiva (28/48, P=0,04) para Leishmania ou com emagrecimento (24/47, P=0,05). A dermatite difusa foi mais freqüente em animais com sorologia positiva (9/12, P=O,0086), parasitismo histológico verificado no baço (5/12, P=0,02), perisplenite (7/12, P=0,0188), atrofia de folículos linfóides (9/12, P=0,03) e da zona marginal (7/12, P=0,05) esplênicos. Presença de amastigotas de Leishmania na pele, verificada histológicamente, foi associada com emagrecimento (07/08, P=0,02), infiltrado inflamatório macrofágico na pele (04/08, P=0,05), sorologia positiva (07/08, P=0,03), periesplenite (05/07, P=0,02) e presença de amastigotas no baço (05/08, P=O,0007). Nossos dados demonstram a existência de alterações morfológicas significativas na pele e no baço de cães infectados com L. chagasi indicativas de um estado de susceptibilidade ao desenvolvimento da doença.

Hydatid Disease Involving Some Rare Locations in the Body: a Pictorial Essay

Hydatid disease (HD) is an endemic illness in many countries, and it poses an important public health problem that's influenced by peoples' socioeconomic status and migration that spreads this disease. Although rare, it may occur in any organ or tissue. The most common site is the liver (59-75%), followed in frequency by lung (27%), kidney (3%), bone (1-4%) and brain (1-2%). Other sites such as the heart, spleen, pancreas and muscles are very rarely affected. Unusual sites for this disease can cause diagnostic problems. This pictorial essay illustrates various radiological findings of HD in the liver, spleen, kidney, pancreas, peritoneal cavity, omentum, adrenal, ovary, lung, mediastinum and retroperitoneum. Familiarity with the imaging findings of HD may be helpful in making an accurate diagnosis and preventing potential complications.

Viscerotropic growth pattern of Leishmania tropica in BALB/c mice is suggestive of a murine model for human viscerotropic leishmaniasis

Leishmania (L.) tropica is a causative agent of cutaneous leishmaniasis, and occasionally of visceral or viscerotropic leishmaniasis in humans. Murine models of Leishmania infection have been proven to be useful for elucidation of mechanisms for pathogenesis and immunity in leishmaniasis. The aim of this study was to establish a murine model for human viscerotropic leishmaniasis, and the growth pattern of L. tropica was studied in different tissues of BALB/c mice in order to find out whether the parasite visceralizes in this murine model. L. major was used as a control as this species is known to cause a progressive infection in BALB/c mice. L. tropica or L. major was injected into the footpad of mice, and thickness of footpad, parasite loads in different tissues, and the weight of the spleen and lymph node were determined at different intervals. Results showed that L. tropica visceralizes to the spleen and grows there while its growth is controlled in footpad tissues. Dissemination of L. tropica to visceral organs in BALB/c mice was similar to the growth patterns of this parasite in human viscerotropic leishmaniasis. The BALB/c model of L. tropica infection may be considered as a good experimental model for human diseases.

Pre- & post-treatment evaluation of immunological features in Indian visceral leishmaniasis (VL) patients with HIV co-infection.

BACKGROUND & OBJECTIVE: The risk of human immunodeficiency virus (HIV) co-infection in patients with visceral leishmaniasis (VL) or kala-azar in endemic areas has posed a major challenge in control programmes. We undertook this study to identify the high risk groups vulnerable to Leishmania-HIV co-infection in VL endemic State of Bihar, India. Further, immunological responses were also evaluated in these patients before and after treatment for VL to see the immune impairment associated with CD4 T cell count. METHODS: A total of 1511 subjects attending Voluntary Counselling and Testing Centre (VCTC) at Patna, Bihar were included in this study. VL was confirmed by splenic or bone marrow aspirates testing for parasite. HIV states was confirmed by two kits. Immunological parameters (CD4, CD8, IFN-gamma, IL-4) were studied in co-infection patients. RESULTS: Of the 280 (18.53%) HIV-positive individuals, eight were diagnosed serologically and pathologically as VL patients co-infected with HIV. The humoral and cellular immune responses were evaluated in 18 Indian VL patients with (n = 8) or without HIV (n = 10) and 10 HIV seropositive subjects. Among the eight confirmed cases of VL, false negative direct agglutination test (DAT) result was observed in two who had HIV co-infection (sensitivity 80%), while none in 10 other VL cases who were HIV negative (sensitivity 100%). A very low CD4 cell count was observed in VL cases that had HIV co-infection compared to HIV negative VL or controls. All VL cases with or without HIV infection had lower Th1/Th2 ratio compared to controls. VL patients with or without HIV infection responded well to anti-leishmanial/anti-retroviral therapy with considerable degree of immunological reconstitution. INTERPRETATION & CONCLUSION: A different immune response was noticed in patients with co-infection of HIV and Leishmania. Anti-leishmanial drug treatment led to improvement in immunological response in co-infected patients. Further studies need to be done to see the effect of combined therapy for VL and HIV on immunological parameters in these patients.