Solitary Neurocysticercosis Presenting with Focal Seizure and Secondary Generalized Tonic-Clonic Seizure.

BACKGROUND Neurocysticercosis is the most common central nervous system infection in developing countries. A wide array of clinical manifestations, ranging from asymptomatic to severe neurological symptoms, is observed in patients diagnosed with neurocysticercosis, depending on the number of lesions, cyst location, cyst stage, parasite genotype, and host immunity. CASE REPORT We report the case of a 25-year-old Burmese man who presented with focal seizure and secondary generalized tonic-clonic seizure. Brain imaging studies revealed a 1-cm cyst, which showed rim enhancement, an eccentric scolex, and surrounding brain edema at the left superior frontal gyrus. His serum cysticercus antibody was positive. Thus, the patient was diagnosed with solitary neurocysticercosis based on clinical manifestations, neuroimaging findings, and positive serology. The patient received anti-parasitic and anti-seizure medications before surgical excision of the cyst via computed tomography (CT) scan navigation. Stereomicroscopic examination of the cyst revealed a parasite larva in a fluid-filled cyst, containing a scolex with hooks and 4 suckers, identical to that of Taenia solium. Molecular characterization of the parasite based on T. solium cytochrome c oxidase subunit 1 (COX-1) gene identified the species as being 99.7% identical to T. solium Asia genotype previously reported from pigs in Thailand. CONCLUSIONS Although the prevalence of neurocysticercosis seems to be declining, sporadic cases have been reported throughout the world and the prevalence may be underestimated. Differential diagnosis of neurocysticercosis in patients presenting with adult-onset epilepsy should be considered in disease-endemic areas.

Viability and morphological changes of Acanthamoeba spp. cysts after treatment with Effective microorganisms (EM).

Acanthamoeba is a free-living opportunistic protozoan parasite that is found in diverse environments. It can cause keratitis, mostly related to inappropriate use of contact lenses, as well as life threatening diseases including encephalitis, disseminated sinusitis, and skin ulcers. This study investigated morphological changes and fine structures of the cyst form of Acanthamoeba spp. after treatment with effective microorganisms (EM™) using light and scanning electron microscopies. Acanthamoeba cysts treated with 1:2, 1:4, 1:6, and undiluted EM™ showed higher percentages of non-viable cysts than those treated with 1:8, 1:10, 1:100, 1:200, and 1:400 EM™ and at 5 days post-treatment developed from cystic stage to trophozoite stage. Acanthamoeba cysts treated at concentrations of 1:2, 1:4, 1:6, and undiluted EM™ exhibited cytoplasmic clumping and shrinkage of amoeba cells away from cyst walls. The effective EM™ concentration lethal to Acanthamoeba spp. cyst could provide information to monitor the environmental control system.

Stereo and scanning electron microscopic studies of the third stage larvae of Anisakis simplex.

This study was to demonstrate the surface anatomy of the third stage larvae of Anisakis simplex in marine fish using stereo and scanning electron microscopes (SEM). The round worm is slender, elongated and of cylindrically shaped. The head of this worm is a globular structure. The mouth is triangularly shaped and surrounded by three lips. A boring tooth projects dorsally at the anterior end. There are four pairs of tactoreceptors, the labial papillae, enclosing the lips. The tail end is blunt and acquires a distinct slender process, the mucron. Stereomicroscopy revealed the esophagus is elongated, bulbous and club shaped, subdivided into an anterior muscular part and a posterior glandular part or ventriculus. The intestine is a long straight tube where the digestion and absorption occur. Waste pass through the intestine and is stored in the rectum until excreted via the anus. A SEM is a powerful tool in distinguishing worm species, as was seen when examining that the mouth of Anisakis simplex, which is triangular shaped and enclosed by three lips with one boring tooth; other species are different. The mucron projection at the distal end is another distinctive structure revealed by SEM.

Situs inversus totalis and ultrastructure of respiratory cilia: report of a cadaveric case.

Situs inversus totalis is the complete reversal of positions of major thoracic and abdominal organs. The present study reports the reversed structures and histology of the epithelium of bronchus of a female cadaver 87 years of age, which was found during the dissection in a medical course of gross anatomy. Opening the thoracic cage, the apex of heart was projected to the right side (dextrocardia) while the right and left lungs were alternated. Intra-abdominal organs were also completely alternated, as the liver situated on the left while spleen on the right and the same as the abdominal intestinal tract. The superior and inferior vena cavae located on the left side and drained blood into the left atrium. The azygos vein was on the right. The histology of the epithelium of bronchus and the transmission electron microscopy of the cilium ultrastructure were normal. Cardiac displacement seems to be associated with malrotation of the heart tube leads to dextrocardia and causes the inversion of positions of the thoracic and abdominal organs. The incidence of situs inversus totalis is approximately 1:10,000 and may be associated with primary ciliary dyskinesia (PCD) which refers to the dysfunction of cilia. PCD is also known as Kartagener syndrome (KS) which is characterized by situs inversus, bronchiectasis, chronic sinusitis and infertility, KS represents 20-25% of situs inversus totalis. However in the present study, the histology and ultrastructure of cilia appear normal.

Comparison of Pouzolzia indica methanolic extract and Virkon against cysts of Acanthamoeba spp.

The present study was conducted to investigate the morphological and structural changes of Acanthamoeba cysts after being treated with various concentrations of Pouzolzia indica methanolic extract fraction 3 (methanol eluted) and Virkon solution. Changes in the Acanthamoeba cysts were detected by light microscopy, scanning electron microscopy and transmission electron microscopy. The results show Acanthamoeba cysts were killed by Pouzolzia indica methanolic extract fraction 3 at a concentration of 1:8 and by Virkon solution at a concentration of 0.25%, with a minimal cysticidal concentration (MCC) by 24 hours. Both agents caused similar structural damage to Acanthamoeba cysts in the same sequence. Step by step structural alterations occurred within the cyst. First, the cyst shrank, collapsed and had clumping of cytoplasmic stuctures inside the cyst walls. Second, the cysts began to bulge, swell, have a decrease in wrinkles in the cyst walls and spill the cytoplasmic contents into the environment. Finally, the cyst walls broke into small pieces. This study may be beneficial to compare with future studies of pharmaceutical agents against Acanthamoeba keratitis.

Pouzolzia indica methanolic extract fraction 2 and povidone-iodine induced changes in the cyst of Acanthamoeba spp.: light and electron microscopic studies.

OBJECTIVE: To compare the minimal cysticidal concentration (MCC) between Pouzolzia indica methanolic extract fraction 2 and Povidone-lodine (PVP-I) on the Acanthamoeba cyst and to illustrate the morphological changes of the cyst after being treated by light and electron microscopies. MATERIAL AND METHOD: Acanthamoeba spp were isolated from patients with Acanthamoeba keratitis and cultured on a non-nutrient agar plate (NNA) seeded with heat killed Escherichia coli (NNA-E.coli) at 37 degrees C for 7 days, adjusted to a final concentration of 10(4) cysts/ml. Several concentrations of PVP-I and fraction 2 of Pouzolzia indica methanolic extract were tested to find the minimal cysticidal concentrations (MCC) of both agents, at these concentrations there was no viable cyst which was confirmed by no excystment after further incubation for 7 days. The cysts were prepared for routine transmission and scanning electron microscopic studies. RESULTS: Structural damages of the treated cysts by MCC of PVP-I and fraction 2 of Pouzolzia indica methanolic extract showed a series of damages. Starting from shrinkage, destruction or rupture of the cyst walls and opercula, withdrawal of the cytoplasm or edema cyst by the outside solution passed through the damaged wall caused a decrease in wrinkle ridges of the ectocyst. Then the cyst was ripped and torn into small pieces CONCLUSION: MCC of PVP-I solution and the fraction 2 of Pouzolzia indica methanolic extract were 0.04% and 1:4, respectively. The structural damages were somewhat similar, such as the shrinkage, ruptured cyst wall and opercula, edema and end by breaking up of the cyst wall and degeneration of the inside cytosol. Pouzolzia indica may be modified as an effective disinfectant solution for a contact lens case if the active ingredients are more purified.

Rapid identification of Acanthamoeba from contact lens case using loop-mediated isothermal amplification method.

A method employing loop-mediated isothermal amplification (LAMP) of 18S ribosomal RNA gene was developed to detect Acanthamoeba in contact lens cases. A prevalence of 7% (10/150) was detected, with 100% sensitivity and 100% specificity when compared with the standard culture technique. Using visual inspection of turbidity a minimum of 10pg of Acanthamoeba DNA could be detected, 10 times more sensitive than quantitative PCR employing two of the LAMP primers. The production of LAMP amplicons was confirmed by gel-electrophoresis and ethidium bromide staining. The LAMP procedure takes less than 2h to perform and will be useful for incorporation into a point-of-care screening of suspected Acanthamoeba infection.

Morphological features of Acanthamoeba causing keratitis contaminated from contact lens cases.

OBJECTIVE: To study the morphological characteristics of genus Acanthamoeba which is an opportunistic organism associated with wearing contact lenses that the biofilm phenomenon in contact lens cases contained Acanthamoeba causing keratitis by conventional culture technique. MATERIAL AND METHOD: A total of 150 contact lens cases were biofilm scraped in March till September 2007, at an institution in Nakhornpathom Province, Thailand. The 'gold standard' culture technique was used for the excystation growth development observation. Cysts of Acanthamoeba spp. contained 50 microlitres of Escherichia coli and contact lens solution were incubated and observed for the presence of cysts and/or trophozoites for 12 days. An infected slide was stained with giemsa solution and other non-stained and non-fixed slides were carried out for morphological characteristics study by different microscopes. RESULTS: The prevalence of Acanthamoeba spp. in scraping of contact lens cases was 6.7% (10/150). These Acanthamoeba isolates at temperature around 37 degrees C were consisted of all three groups, which in summary; the average diameter of cysts in Astronyxids (group I) was relatively large. They were > or = 18 micrometers, while those of Polyphagids (group II) and Culbertsonids (group III) were < or = 18 micron. The typical morphology of Acanthamoeba trophozoites moving freely in water were recognized by the presence of lobopodium and acanthopodia within 12 observed days. The average size of Acanthamoeba trophozoites was in the range of 12-45 micron. Three different images of cyst were feature studied. CONCLUSION: Three Acanthamoeba groups by biofilm scraping from contact lens cases should be differentiated. Morphological characteristics cysts and trophozoites should be confirmed. In addition, to improve contact lens wearer education, compliance with contact lens cases, hygiene recommendations and regular disposal of contact lens cases might help to solve contact lens cases.

Comparison of blood feeding response and infection of Aedes aegypti to Wuchereria bancrofti using animal membranes and direct host contact.

Comparison of an artificial, whole-blood membrane feeding procedure was performed by feeding Aedes aegypti (Liverpool strain) on the blood of patients infected with Wuchereria bancrofti microfilariae with the use of 3 types of membranes produced from chicken and mouse skin and swine intestine. Direct feeding of Ae. aegypti on the skin of infected human patients served as control. For all 3 types of membranes, mosquito survival, infection, and number of infective-stage larvae per mosquito did not differ significantly from the control. However, the blood feeding response between swine intestine layer (32%) compared to chicken skin (75.3%), mouse skin (70%), and direct feeding (84%) differed significantly. The response in direct feeding method was significantly higher than those in all membranes tested (F = 18.89; df = 3; P < 0.05) Chicken skin preparation was shown to be the preferred membrane for blood feeding Ae. aegypti and experimental infection with W. bancrofti.

The ultrastructure of the gravid uterus of Brugia pahangi, another rich source of antigen of the filarial parasite.

The gravid uterus with zygotes and microfilariae in utero of Brugia pahangi, a rich source of antigen as revealed by a recent immunofluorescent technique, were studied ultrastructurally. The epithelial cells of uterus show ultrastructural features of synthetically active cells. Their secretions may provide nutrients for the egg in utero. On the basal side, the uterine epithelial cells may also secrete substances to form the basal lamina of the uterus which is rather thick and irregularly fused with the basal lamina lining the body wall where the pseudocoelomic cavity is obliterated. For the most part, the uterine basal lamina contains uniform granular material of moderate electron density. There are also elongated visceral muscle cells embeded in it, and which surround the uterus, with adjacent cells overlapping. The gravid uterus contains several stages of developing microfilariae within its lumen, the cleaving zygotes are also present at another level. The morula of zygotes are composed of several closely packed cells surrounded loosely by their own egg shell membranes. The egg shell becomes more convoluted as development proceeds. The egg shell surrounding the developing microfilariae in utero is secreted by the uterine epithelium. This structure later becomes the sheath of circulating microfilariae, and is highly antigenic as indicated by intense labeling with fluorescent antibodies.