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3.
J R Coll Physicians Edinb ; 48(3): 198-201, 2018 Sep.
Article in English | MEDLINE | ID: mdl-30191906

ABSTRACT

BACKGROUND: Malaria remains an endemic disease in Pakistan with an estimated healthcare burden of 1.6 million cases annually, with Plasmodium vivax accounting for 67% of reported cases. P. vivax is the most common species causing malaria outside of Africa, with approximately 13.8 million reported cases worldwide. METHOD: We report a series of P. vivax cases with cerebral involvement that presented at Aga Khan University Hospital, Karachi, Pakistan. RESULTS: The majority of the patients presented with high-grade fever accompanied by projectile vomiting and abnormal behaviour, seizures, shock and unconsciousness. Seven of 801 patients with P. vivax monoinfection presented or developed cerebral complications. P. vivax infections were diagnosed based on peripheral smears and rapid diagnostic testing. CONCLUSION: P. vivax infection can lead to severe complications, although not with the frequency of Plasmodium falciparum infection. Current cases highlight an increasing trend of cerebral complications caused by P. vivax.


Subject(s)
Malaria, Vivax/complications , Nervous System Diseases/parasitology , Adult , Aged , Fever/parasitology , Humans , Magnetic Resonance Imaging , Malaria, Vivax/diagnosis , Malaria, Vivax/drug therapy , Male , Mental Disorders/parasitology , Middle Aged , Nervous System Diseases/complications , Nervous System Diseases/diagnostic imaging , Pakistan , Retrospective Studies , Seizures/parasitology , Shock/parasitology , Unconsciousness/parasitology , Vomiting/parasitology , Young Adult
4.
Exp Parasitol ; 185: 23-28, 2018 Feb.
Article in English | MEDLINE | ID: mdl-29309786

ABSTRACT

Little is known about the prevalence of Giardia duodenalis in human patients in Jordan and all previous studies have used direct microscopy, which lacks sensitivity. The present study developed a novel quantitative PCR (qPCR) assay at the ß-giardin (bg) locus and evaluated its use as a frontline test for the diagnosis of giardiasis in comparison with a commercially available ELISA using nested PCR and sequencing of the glutamate dehydrogenase (gdh) locus (gdh nPCR) as the gold standard. A total of 96 human faecal samples were collected from 96 patients suffering from diarrhoea from 5 regions of Jordan and were screened using the ELISA and qPCR. The analytical specificity of the bg qPCR assay revealed no cross-reactions with other genera and detected all the Giardia isolates tested. Analytical sensitivity was 1 Giardia cyst per µl of DNA extract. The overall prevalence of Giardia was 64.6%. The clinical sensitivity and specificity of the bg qPCR was 89.9% and 82.9% respectively compared to 76.5 and 68.0% for the ELISA. This study is the first to compare three different methods (ELISA, bg qPCR, nested PCR and sequencing at the gdh locus) to diagnose Jordanian patients suffering from giardiasis and to analyze their demographic data.


Subject(s)
Diarrhea/parasitology , Giardia lamblia/isolation & purification , Giardiasis/parasitology , Adolescent , Adult , Antigens, Protozoan/analysis , Child , Child, Preschool , Colic/parasitology , Cytoskeletal Proteins/genetics , DNA, Protozoan/chemistry , DNA, Protozoan/isolation & purification , Enzyme-Linked Immunosorbent Assay , Feces/parasitology , Female , Giardia lamblia/genetics , Giardia lamblia/immunology , Giardiasis/epidemiology , Glutamate Dehydrogenase , Humans , Infant , Jordan/epidemiology , Male , Middle Aged , Polymerase Chain Reaction , Prevalence , Protozoan Proteins/genetics , Real-Time Polymerase Chain Reaction , Sensitivity and Specificity , Vomiting/parasitology , Young Adult
5.
BMJ Case Rep ; 20162016 Sep 06.
Article in English | MEDLINE | ID: mdl-27600057

ABSTRACT

A 51-year-old woman presented with epigastric pain, vomiting and diarrhoea. Her sister was recently diagnosed with duodenal adenocarcinoma, manifesting similar symptoms. Imaging revealed thickened gastric antrum with enlarged local lymph nodes. Endoscopy illustrated 3 worms embedded in the antral wall, identified as Anisakis simplex larvae. Larvae removal and a 2-week albendazole regimen treated the symptoms. With globalisation of cultural culinary practices, physicians must be vigilant of anisakidosis. Its ability to mimic peptic ulcer disease, chronic gastritis and malignancy necessitates broader differential diagnoses and lower thresholds for endoscopy.


Subject(s)
Anisakiasis/diagnosis , Anisakis , Gastritis/diagnosis , Abdominal Pain/parasitology , Albendazole/therapeutic use , Animals , Anisakiasis/parasitology , Anthelmintics/therapeutic use , Diagnosis, Differential , Diarrhea/parasitology , Female , Gastritis/parasitology , Gastrointestinal Neoplasms/diagnosis , Humans , Lymph Nodes/diagnostic imaging , Middle Aged , Pyloric Antrum/diagnostic imaging , Vomiting/parasitology
6.
BMJ Case Rep ; 20162016 Sep 12.
Article in English | MEDLINE | ID: mdl-27620198

ABSTRACT

Hydatid disease (echinococcosis) is a worldwide zoonosis produced by the larval stage of the Echinococcus tapeworm. The disease is endemic in many parts of the world, particularly in the Middle East, Australia, New Zealand, South America and central and south Europe. Intracranial hydatid disease is considered a rare disease and may be sometimes very difficult to diagnose based on the clinical and laboratory findings. Therefore, it is important to be aware of the condition and the imaging findings even in the non-endemic parts of the world. We report the case of a 12-year-old boy who presented with headache and vomiting for a few months. The mass was totally excised, with no postoperative complications. We present MR spectroscopy (MRS) findings in this operatively proven case of hydatid cyst of the brain. We discuss imaging findings, in particular the findings on MRS, which is rarely reported in the literature.


Subject(s)
Brain Diseases/diagnostic imaging , Echinococcosis/diagnostic imaging , Magnetic Resonance Spectroscopy , Adolescent , Brain/diagnostic imaging , Brain/parasitology , Brain Diseases/parasitology , Echinococcosis/parasitology , Headache/parasitology , Humans , Male , Rare Diseases/diagnostic imaging , Rare Diseases/parasitology , Vomiting/parasitology
7.
Med Sante Trop ; 26(2): 142-4, 2016 May 01.
Article in English | MEDLINE | ID: mdl-27412975

ABSTRACT

Following an original case report of massive regurgitation of maggots and the difficulty of medical management, we return to the fecal contamination problem for troops in the field. The survey of maggots has allowed for the diagnosis of contamination by ingestion of house fly eggs as a major infection vector. The successive ingestion of anti-acid and gastric dressing can induce an important diminution of gastric acidity that can allow for the proliferation of germs. In an operational context or natural catastrophe andin addition to field hygiene rules that are very important, it can also be useful to propose exclusive field rationsfor few daysin order to limit the interhuman contamination.


Subject(s)
Houseflies , Larva , Vomiting/parasitology , Animals , Haiti , Humans , Male , Military Personnel , Young Adult
9.
Can Vet J ; 57(1): 76-9, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26740703

ABSTRACT

A 2-year-old Dachshund was presented for vomiting and diarrhea. Abdominal ultrasound revealed Dirofilaria immitis in the abdominal aorta and an avascular segment of small intestine. The dog was euthanized. Necropsy revealed D. immitis in the abdominal aorta and widespread necrotizing arteriolitis. This is a unique presentation of aberrant migration of D. immitis.


Migration aberrante du ver du cœur vers l'aorte abdominale et artériolite systémique chez un chien présentant des vomissements et une diarrhée hémorragique. Un Dachshund âgé de 2 ans a été présenté pour des vomissements et de la diarrhée. Une échographie de l'abdomen a révélé Dirofilaria immitis dans l'aorte abdominale et un segment avasculaire du petit intestin. Le chien a été euthanasié. La nécropsie a révélé D. immitis dans l'aorte abdominale et une artériolite nécrosante généralisée. Il s'agit d'une présentation unique de la migration aberrante de D. immitis.(Traduit par Isabelle Vallières).


Subject(s)
Aorta, Abdominal/parasitology , Diarrhea/veterinary , Dirofilariasis/complications , Dog Diseases/parasitology , Gastrointestinal Hemorrhage/veterinary , Vomiting/veterinary , Animals , Aorta, Abdominal/pathology , Diarrhea/etiology , Diarrhea/pathology , Dirofilariasis/parasitology , Dirofilariasis/pathology , Dog Diseases/etiology , Dog Diseases/pathology , Dogs , Gastrointestinal Hemorrhage/etiology , Gastrointestinal Hemorrhage/pathology , Male , Vomiting/etiology , Vomiting/parasitology , Vomiting/pathology
10.
BMJ Case Rep ; 20152015 Dec 18.
Article in English | MEDLINE | ID: mdl-26682841

ABSTRACT

Neurocysticercosis (NCC) is a significantly neglected tropical disease and, with increasing globalisation, a notable emerging infection in the developed world. We describe a case of ventricular NCC in a 22-year-old Mexican-American woman with a history of seizures, who presented with 2 weeks of headaches and intermittent fevers progressing to altered mental status and vomiting. Initial imaging revealed a cystic mass at the posteroinferior aspect of the third ventricle superior to the aqueduct of Sylvius, calcifications scattered throughout the parenchyma, and enlargement of the lateral and third ventricles. Initial laboratories were unrevealing and serum investigations for Taenia solium antibody were negative, but T. solium antibody was subsequently returned positive from cerebrospinal fluid. This case highlights important issues regarding the clinical presentation, diagnostic evaluation and treatment of NCC relevant to providers not only in areas with endemic disease but, importantly, in locales with diverse immigrant populations.


Subject(s)
Neurocysticercosis/parasitology , Taenia solium , Animals , Antibodies/cerebrospinal fluid , Cerebral Aqueduct/parasitology , Female , Fever/parasitology , Humans , Mental Disorders/parasitology , Mexican Americans , Neurocysticercosis/cerebrospinal fluid , Seizures/parasitology , Third Ventricle/parasitology , Vomiting/parasitology , Young Adult
11.
BMJ Case Rep ; 20152015 Jun 24.
Article in English | MEDLINE | ID: mdl-26109619

ABSTRACT

Infectious complications represent an important cause of morbidity and death in patients with transplant. Parasitic infections are less frequent than viral and bacterial agents, and are often overlooked. We describe the case of a 13-year-old adolescent, born in São Tomé Island, who was under immunosuppressive therapy after a cardiac transplant. The patient had an intermittent course of diarrhoea, abdominal pain and vomiting. She was admitted dehydrated, and Strongyloides stercoralis, Schistosoma intercalatum and Cystoisospora belli were isolated in her stools. The patient was treated with ivermectin, albendazole, praziquantel and ciprofloxacin with clinical and microbiological resolution. Her immunosuppressive therapy was reduced during hospitalisation. We believe that the parasitic infection was a result of a recrudescence of dormant infections acquired in her homeland. To the best of our knowledge, there are no reports of cystoisosporiasis or schistosomiasis in heart transplant recipients.


Subject(s)
Abdominal Pain/parasitology , Diarrhea/parasitology , Heart Transplantation , Schistosoma/isolation & purification , Schistosomiasis/diagnosis , Strongyloides stercoralis/isolation & purification , Strongyloidiasis/diagnosis , Transplant Recipients , Adolescent , Albendazole/administration & dosage , Animals , Anthelmintics/administration & dosage , Diarrhea/complications , Feces/parasitology , Female , Humans , Ivermectin/administration & dosage , Praziquantel/administration & dosage , Schistosomiasis/complications , Schistosomiasis/drug therapy , Strongyloidiasis/complications , Strongyloidiasis/drug therapy , Treatment Outcome , Vomiting/parasitology
12.
Am J Trop Med Hyg ; 92(6): 1261-4, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25870426

ABSTRACT

Bruns syndrome is an unusual phenomenon, characterized by attacks of sudden and severe headache, vomiting, and vertigo, triggered by abrupt movement of the head. The presumptive cause of Bruns syndrome is a mobile deformable intraventricular mass leading to an episodic obstructive hydrocephalus. Intraventricular tumors have been associated with Bruns syndrome; however, few cases of intraventricular neurocysticercosis have been reported to present with Bruns syndrome. We report the first series of fourth ventricular neurocysticercosis presenting with Bruns syndrome in the United States and review the other published cases where surgery was indicated.


Subject(s)
Neurocysticercosis/complications , Taenia solium , Adult , Animals , Brain/parasitology , Brain/surgery , Cerebral Ventricles/parasitology , Cerebral Ventricles/pathology , Female , Head Movements , Headache/etiology , Headache/parasitology , Humans , Magnetic Resonance Imaging , Neurocysticercosis/diagnosis , Neurocysticercosis/parasitology , Neurocysticercosis/surgery , Neuroimaging , Syndrome , United States/epidemiology , Vertigo/etiology , Vertigo/parasitology , Vomiting/etiology , Vomiting/parasitology
13.
Postgrad Med J ; 91(1074): 200-5, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25748520

ABSTRACT

AIMS: To review the clinical and pathological factors associated with fulminant amoebic colitis (FAC) requiring colonic resection and its outcome. METHODS: We retrospectively identified adult patients admitted to our centre between June 2007 and December 2011 with FAC who underwent colonic resection and were diagnosed with amoebic colitis based on the presence of trophozoites on histological examination. The clinical details were extracted from the medical notes and correlated with the pathological findings. RESULTS: Thirty patients (18 men and 12 women) met the inclusion criteria. Their mean age was 50.1 years (range 21-89). The most frequent symptoms were abdominal pain, vomiting and fever. More than half the patients (16/30) had underlying conditions associated with immunosuppression including diabetes mellitus and tuberculosis. Pathological investigation of colonic resections showed predominantly right-sided involvement with geographic colonic ulcers covered with a creamy-white pseudomembrane, perforations, gangrenous changes, amoeboma and lesions mimicking inflammatory bowel disease. All showed basophilic dirty necrosis with abundant nuclear debris and amoebic trophozoites on histological examination. 21/30 patients (70%) had involvement beyond the caecum. 17/30 patients (57%) died. Those with involvement beyond the caecum were more likely to die (15/21, 71.4%) than those with less extensive disease. CONCLUSIONS: FAC presents as acute abdomen and can mimic appendicitis, ischaemic bowel disease, tuberculosis and malignancy. Comorbidities causing immunosuppression frequently associated. Mortality remains high despite surgery, so FAC should be suspected in every case of acute abdomen with colonic perforation if associated with typical gross and microscopic findings and a history of stay in an endemic area.


Subject(s)
Cecum/pathology , Colectomy/methods , Dysentery, Amebic/complications , Dysentery, Amebic/diagnosis , Abdominal Pain/parasitology , Adult , Aged , Aged, 80 and over , Cecum/parasitology , Diagnosis, Differential , Dysentery, Amebic/pathology , Female , Fever/parasitology , Humans , Immunohistochemistry , India/epidemiology , Length of Stay , Male , Middle Aged , Retrospective Studies , Survival Rate , Treatment Outcome , Vomiting/parasitology
14.
World J Gastroenterol ; 20(38): 14058-62, 2014 Oct 14.
Article in English | MEDLINE | ID: mdl-25320546

ABSTRACT

Ascaris lumbricoides infection is rare among children in developed countries. Although large numbers of adult Ascaris in the small intestine can cause various abdominal symptoms, this infection remains asymptomatic until the number of worms in the intestine considerably increases in most cases. Ascaris causing bilious vomiting suggesting ileus is rare, especially in developed countries. A 6-year-old boy who lived in Japan, presented with abdominal colic, bilious vomiting at the pediatric emergency room. He appeared pale, and had no abdominal distention, tenderness, palpable abdominal mass, or findings of dehydration. He experienced bilious vomiting again during a physical examination. Laboratory tests showed mild elevation of white blood cells and C-reactive protein levels. Antigens of adenovirus, rotavirus, and norovirus were not detected from his stool, and stool culture showed normal flora. Ultrasonography showed multiple, round-shaped structures within the small intestine, and a tubular structure in a longitudinal scan of the small intestine. Capsule endoscopy showed a moving worm of Ascaris in the jejunum. Intestinal ascariasis should be considered as a cause of bilious vomiting in children, even at the emergency room in industrial countries. Ultrasound examination and capsule endoscopy are useful for diagnosis of pediatric intestinal ascariasis.


Subject(s)
Ascariasis/parasitology , Ascaris lumbricoides/isolation & purification , Intestinal Diseases, Parasitic/parasitology , Jejunum/parasitology , Animals , Antinematodal Agents/therapeutic use , Ascariasis/complications , Ascariasis/diagnosis , Ascariasis/drug therapy , Ascaris lumbricoides/drug effects , Capsule Endoscopy , Child , Emergency Service, Hospital , Humans , Intestinal Diseases, Parasitic/complications , Intestinal Diseases, Parasitic/diagnosis , Intestinal Diseases, Parasitic/drug therapy , Intestinal Pseudo-Obstruction/parasitology , Japan , Jejunum/diagnostic imaging , Jejunum/drug effects , Male , Predictive Value of Tests , Pyrantel Pamoate/therapeutic use , Treatment Outcome , Ultrasonography , Vomiting/parasitology
15.
Niger Postgrad Med J ; 21(2): 115-21, 2014 Jun.
Article in English | MEDLINE | ID: mdl-25126864

ABSTRACT

AIMS AND OBJECTIVES: The objective of this study was to determine an algorithm for malaria diagnosis using presenting signs and symptoms of children (aged 0-13 years) with uncomplicated malaria in Gwagwalada Area Council of Abuja, Nigeria. MATERIALS AND METHODS: A validated questionnaire was used to obtain relevant data from 400 children diagnosed presumptively of simple malaria by clinicians and 400 other children of similar sex and age considered as not having malaria. Giemsa-stained thick blood films were used to determine parasitaemia. Data obtained was analysed using Epi-Info version 3.3.2. RESULTS: Thirty-eight per cent of children with presumptive diagnosis of malaria had parasitaemia. Fever, rigor, vomiting, jaundice, pallor and spleen enlargement had significant statistical relationship with parasitaemia on bivariate analysis, but only fever (p=0.00), rigor (p=0.00), vomiting (p=0.00), and pallor (p=0.00) maintained the relationship when subjected to logistic regression analysis. But these symptoms individually had low sensitivity and/or specificity. Candidate algorithms (combinations of symptoms) were then successively subjected to bivariate, logistic and validity analyses. Fever with vomiting gave the highest sensitivity (56.2%), specificity (76.4%) and PPV (60.0%) and were therefore adopted as the algorithm of choice. CONCLUSION AND RECOMMENDATIONS: Children presenting with fever and vomiting without any other obvious cause in health facilities without laboratory support in the research area should receive antimalarial treatment, to help reduce the malaria scourge. This algorithm should be field-tested and if found reliable should be adopted to ease the problem of malaria diagnosis in peripheral health facilities.


Subject(s)
Algorithms , Malaria/diagnosis , Parasitemia/diagnosis , Adolescent , Child , Child, Preschool , Clinical Laboratory Services/supply & distribution , Cross-Sectional Studies , Female , Fever/parasitology , Humans , Infant , Jaundice/parasitology , Malaria/complications , Male , Muscle Rigidity/parasitology , Nigeria , Pallor/parasitology , Parasitemia/complications , Sensitivity and Specificity , Splenomegaly/parasitology , Vomiting/parasitology
17.
Article in English | MEDLINE | ID: mdl-25571670

ABSTRACT

BACKGROUND: Toxoplasmosis is the most frequent opportunistic infection of the central nervous system among individuals with the acquired immunodeficiency syndrome. Radiographic modalities include brain CT, MRI and PET scan. The differential diagnosis are usually: primary CNS lymphoma, cerebral metastasis, Progressive multifocal leukoencephalopathy, cytomegalovirus. It indicates severe immunodeficiency and, if it remains untreated, it may lead to death. CASE DESCRIPTION: A 65 year old immunodeficiency woman with a Non Hodgkin Lymphoma treated with Chemotherapy. She had been suffering from vomiting, headache and vertigo. Treatment she received Dafalgan, Betaserc, neupogen and nexiam. CONCLUSION: This case illustrates that a brain biopsy is compulsory before starting any treatment.


Subject(s)
Antineoplastic Agents/therapeutic use , Immunocompromised Host , Infratentorial Neoplasms/diagnosis , Infratentorial Neoplasms/parasitology , Lymphoma, Non-Hodgkin/drug therapy , Toxoplasmosis/complications , Aged , Biopsy , Diagnosis, Differential , Female , Headache/parasitology , Humans , Magnetic Resonance Imaging , Positron-Emission Tomography , Tomography, X-Ray Computed , Vertigo/parasitology , Vomiting/parasitology
18.
Eur Rev Med Pharmacol Sci ; 18(24): 3916-20, 2014.
Article in English | MEDLINE | ID: mdl-25555884

ABSTRACT

OBJECTIVE: Anisakidosis is a parasitic infection caused by the ingestion of row or uncooked fish, containing larval nematodes from the Anisakidae family. Intestinal anisakidosis represents about 4% of all cases, the majority being localized in the small bowel, with rare colonic involvement. Here we present an infrequent case of chronic anisakidosis, presenting with intestinal intussusception. CASE REPORT: A 52 years old woman, chronically treated with immunosuppressants, presented to our Institution with acute abdominal pain and vomiting, due to colocolic intussusception. Colonoscopy successfully reduced the intussusception and revealed the presence of a voluminous colonic submucosal mass, near the hepatic flexure. Therefore, the patient underwent laparoscopic right hemicolectomy. The diagnosis of anisakidosis was made when the histological examination of the surgical specimen revealed the infestation of the intestinal wall by a nematode of the Anisakidae family, with an intense erosive-inflammatory adjacent reaction.


Subject(s)
Anisakiasis/diagnosis , Intussusception/parasitology , Abdominal Pain/parasitology , Female , Humans , Middle Aged , Vomiting/parasitology
19.
Turkiye Parazitol Derg ; 38(4): 278-80, 2014 Dec.
Article in Turkish | MEDLINE | ID: mdl-25732890

ABSTRACT

This study was conducted to report the digestive system infestation caused by the larvae of Coleoptera in a female pediatric patient. She was admitted to our hospital with the complaints of emergence of insect larvae from her vomit and feces, abdominal pain, inguinal pain, lack of appetite, hair loss, excessive cleaning behavior, extreme irritability, and distractibility. The larvae observed typically had the morphology of the larvae of insects related to the Cantharidae family in the Coleoptera order. For treatment, a single dose of albendazole (400 mg) was used. Consequently, in the present case, it was seen that the larvae of Coleoptera incidentally taken orally could continue to live for a period in the digestive tract of people, without losing vitality, and the larvae caused a variety of symptoms due to both their toxic agents and the possible irritation they caused.


Subject(s)
Coleoptera , Digestive System/parasitology , Parasitic Diseases/parasitology , Abdominal Pain , Albendazole/therapeutic use , Animals , Antiparasitic Agents/therapeutic use , Child , Feces/parasitology , Female , Humans , Larva , Parasitic Diseases/drug therapy , Vomiting/parasitology
20.
J Indian Med Assoc ; 111(9): 621-2, 2013 Sep.
Article in English | MEDLINE | ID: mdl-24968530

ABSTRACT

One of the most common parasitic infections in humans is ascariasis. While most infectionsare asymptomatic, mild to moderate symptoms may occur due to migration of adult worms. The frequency of single worm infection seems to be increasing. Ascaris eggs are not found in the faeces of most cases infected with a single worm because it is an immature male or female. Diagnosis of such single worm infection is challenging.


Subject(s)
Ascariasis/diagnosis , Ascaris lumbricoides , Abdominal Pain/parasitology , Adult , Animals , Ascariasis/complications , Ascariasis/drug therapy , Ascaris lumbricoides/isolation & purification , Fever/parasitology , Humans , Male , Vomiting/parasitology
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