Pelvic retroperitoneal echinococcal cyst. a case report

Introduction: Echinococcosis or hydatidosis is a parasitic zoonosis endemic in Chile that poses an important public health concern. It mainly affects the liver and lungs; however, it may involve diverse areas, with the isolated pelvic location being exceptional and difficult to manage. Case presentation: A 41-year-old female consulted the emergency department of a hospital in Chile due to lumbosacral pain and was diagnosed with hydatidosis. The patient received surgical treatment and medication, but the disease recurred twice: the first time, a year after the first intervention, and the second time, two months after the second. Therefore, she required a multidisciplinary approach that included long-term antibiotic therapy and a radical approach to the lesion, achieving an adequate control of the disease. Conclusion: Pelvic echinococcosis is difficult to diagnose due to its low frequency. This disease should be considered in the event of any cystic lesion in endemic areas. A multidisciplinary management reduces possible complications and recurrence.

Introducción. La hidatidosis es una zoonosis parasitaria endémica en Chile que representa un importante problema de salud pública. Esta enfermedad afecta principalmente el hígado y los pulmones; no obstante, su compromiso puede ser diverso, siendo excepcional y de difícil manejo la ubicación pélvica aislada. Presentación del caso. Mujer de 41 años quien consultó al servicio de urgencias de un hospital de Chile por dolor lumbosacro y fue diagnosticada con hidatidosis. La paciente recibió tratamiento quirúrgico y manejo con medicamentos pero presentó recidiva en dos ocasiones, la primera al año de la primera intervención y la segunda a los dos meses de la segunda intervención, por lo que requirió un abordaje multidisciplinario que consistió en un manejo antibiótico prolongado y un abordaje radical de la lesión con el cual se logró un adecuado control de la enfermedad. Conclusión. La hidatidosis pélvica es difícil de diagnosticar dada su baja frecuencia, por lo que su diagnóstico debe considerarse ante cualquier lesión quística en zonas donde esta enfermedad sea endémica. El manejo multidisciplinario de la hidatidosis disminuye posibles complicaciones y recidivas.

Infection and seroconversion of susceptible animals introduced into a babesiosis endemic area.

The study aimed to determine the incubation period of Babesia sp. infection in naive cattle and to monitor the serological response once exposed to natural Boophilus microplus (Rhipicephalus microplus)-infested paddocks. The study was carried out on a farm located in Veracruz, Mexico. Five groups of five steers were relocated every 3 months from a tick-free area to a tick-infested paddock. Animals were introduced in October, January, April, July, and October. Blood samples were taken daily until day 21 to determine packed cell volume (PCV), percentage of parasitized erythrocytes (PPE), and antibody titers to Babesia bigemina and B. bovis by the indirect fluorescent antibody procedure. Detection of Babesia in blood was also performed by species-specific PCR. The estimated incubation period was 6-14 days post introduction to paddocks (PIP), with fever (41 degrees C) for at least 3 days. PCV decreased by >25% and Babesia parasites were observed during the clinical phase of the disease. The highest individual PPEs (0.44% and 0.22% for B. bovis and B. bigemina, respectively) were observed from animals introduced in October. The four other groups showed a mean PPE ranging from 0.002-0.146% at day 14 PIP. All animals were detected as PCR positive between 8-14 days PIP. The highest antibody titers were 1:3328. The environmental conditions were favorable throughout the year for tick reproduction as the farm showed enzootic stability and hyperendemic conditions for bovine babesiosis. In this type of farm, strategic tick control could be accompanied by babesiosis vaccination, particularly for cattle relocated from tick-free areas.

Evaluation of cattle inoculated with Babesia bovis clones adhesive in vitro to bovine brain endothelial cells.

A comparative assessment of the virulence of Babesia bovis clones that adhere or not to bovine brain endothelial cells was done using two clones of B. bovis: (1) a clone phenotypically characterized as virulent (2F8) and (2) a clone of reduced virulence (RAD). Of these subpopulations, we selected those that had adhesive characteristics (a) or nonadhesive characteristics (na) in cultured endothelial cells. Twenty Holstein cattle, 12 months of age or older, were used in this study, and these cattle were randomly assigned to five groups of four animals each. The clones and their respective subpopulations were inoculated via intramuscular injection at a 0.5 x 10(7) infected erythrocyte dosage. Group A was inoculated with aRAD, group B with naRAD, group C with a2F8, group D with na2F8, and group E remained as a control. All inoculated animals showed a decrease in the packed cell volume (PCV), with group D showing the largest decrease (39.53%) and longest time (7 days) with rectal temperature above 39.5 degrees C. Babesia was observed in stained blood smears from only six cattle. While the four parasite subpopulations were pathogenic, significant differences were not noted among them, despite that the subpopulations considered to be virulent caused the greatest reduction in PCV per individual.

Field challenge of cattle vaccinated with a combined Babesia bovis and Babesia bigemina frozen immunogen.

To determine the optimal dose of a combined, frozen immunogen containing in vitro culture-derived strains of Babesia bovis and Babesia bigemina, twenty-four 14-month-old Bos taurus steers from a Boophilus microplus-free area in Northern Mexico were used in this experiment. Cattle were randomly allocated into six groups with four animals each, and were intramuscularly inoculated as follows: group 1 (control animals) were administered with normal bovine erythrocytes; group 2 received 1 x 10(7) B. bovis- and B. bigemina-infected erythrocytes as a combined fresh immunogen. Groups 3-6 were inoculated with a combined frozen immunogen containing (previous to cryopreservation at -196 degrees C) 1 x 10(7), 5 x 10(7), 1 x 10(8), and 5 x 10(8) infected erythrocytes of each parasite species, respectively. Four months after immunization, principal and control animals were translocated to a bovine babesiosis endemic zone for field challenge. This was carried out by introducing the experimental cattle to tick-infested pastures for 30 days without ixodicide treatment. Cattle were monitored from day 8 postintroduction to the field (PIF) by recording the manifestation of clinical disease, rectal temperature values (RT), packed cell volume index (PCV), and percent of parasitized erythrocytes (PPE). At challenge, all experimental cattle became infected with both Babesia bovis and B. bigemina. However, except for two animals from group 6, none of the vaccinated animals showed signs of acute clinical babesiosis; therefore, no treatment was instituted. Out of six animals showing acute clinical babesiosis (four group 1 controls and two group 6 vaccinates), two animals (one from each group) died, despite babesiacide treatment, as they manifested classical cerebral babesiosis caused by B. bovis. Regardless of the dose or type of immunogen used (combined fresh or frozen), 90% of vaccinated cattle were determined to be protected against the virulent Babesia sp. field isolates. Nevertheless, by evaluating clinical parameters, such as average of maximum drop in PVC index (28.5%), average duration of parasitemia (3 days for B. bovis; 8.5 days for B. bigemina), and average duration of RT values > or = 39.5 degrees C (2 days), animals receiving 1 x 10(8) infected erythrocytes, as combined frozen immunogen, were more efficaciously protected against challenge with virulent B. bovis and B. bigemina field isolates.