Infection of an infant with an adult Toxocara cati (Nematoda).
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Biomedical subjects
Publications and source records attributed to P C Beaver.
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A 4-month-old girl was admitted to hospital with extensive ulceration and erosion of the left eyelid where 17 days earlier the skin had been broken when hit by a ball. Despite antibiotic therapy the lesion expanded to involve the orbit. Biopsy of the eyelid on the 4th day in hospital, and examination of the eye and attached tissues removed on the 6th, failed to detect amebae until after the infant's death due to a blood transfusion 2 weeks later. Re-examination of the tissues revealed abundant amebae with characteristic morphology of Entamoeba histolytica in subcutaneous tissues of the biopsy and in the loose exudate and necrotic tissues attached to the eye at all levels from lids to base.
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Two areas of intradermal swelling removed from the upper thigh and iliac crest of a 43-year-old man in Louisiana were each found to contain a larval trematode about 0.5 mm in length. Based on morphology reconstructed from serial sections, the two worms were identified as a mesocercaria of an undescribed species belonging to the subfamily Alariinae.
A 9-year-old boy in Teheran, Iran developed severe asthmatic symptoms, productive cough, and moderate eosinophilia. Lung biopsy demonstrated a helminth in a granulomatous lesion with foreign-body type cellular reaction leading to a tentative diagnosis of visceral larva migrans. Diethylcarbamazine, thiabendazole, and steroids were given, rapidly relieving the symptoms. In a subsequent review of the biopsy the helminth was identified as a Capillaria, probably Capillaria (Thominx) aerophila, a nematode parasite of dogs, cats, and other carnivores, apparently the ninth such infection to be reported in man.
Surgical repair of an inguinal hernia in a 19-year-old man in Honduras revealed massive numbers of small granulomata containing trematode eggs on the omentum and other peritoneal surfaces. The eggs resembled those of Achillurbainia recondita Travassos, 1942, a species found in the maxillary sinuses of the opossum, Didelphis marsupialis. Species of Achillurbainis (syn. Poikilorchis Fain and Vandepitte, 1957) have been reported in retroauricular cysts or abscesses in residents of West Africa and Southeast Asia.
A mature male filarial worm was found in sections of an enlarged, painful retroauricular lymph node removed from an 18-year-old resident of New Jersey. On the basis of its morphology and location in an obstructed lymph vessel, the worm was identified as probably a species of Brugia, possibly Brugia beaveri, a parasite of the raccoom. The infection in this case resembled one reported earlier from the same general area of the country, New York City. In the absence of demonstrable microfilaremia in this and other cases of zoonotic filariasis acquired in the United States, specific drug treatment after surgical removal of the worm is usually unnecessary.
Although infection with tissue nematodes is a significant health problem in many parts of the world, such cases are unusual in the continental United States. This report describes a case of Onchocerca volvulus infection, acquired by a 38-year-old female missionary in northern Brazil, that manifested as subcutaneous nodules in the groin and flank two years after the patient's return to the United States. A year previously, a wrong diagnosis of Wuchereria bancrofti was made at biopsy. At that time, treatment with diethylcarbamazine citrate had to be discontinued because of intense pruritus. Examination of a wet saline impression smear of a new biopsy specimen showed the adult worms to have regularly arranged outer annular ridges, which, together with the pruritus after treatment with diethylcarbamazine (a positive Mazzotti test), led to the diagnosis of onchocerciasis. Retreatment with diethylcarbamazine again caused pruritus, but this was tolerated as were subsequent treatments.
Microfilariae were observed in 25 of 187 blood leucocyte-culture preparations made for chromosome studies on 28 Piaroa and 159 Yanomama Indians living near the Brazilian border of Amazonas, Venezuela. Among the Yanomama, 17 (10.7%) were infected, all with Mansonella ozzardi. Among the Piaroa, 8 (28.6%) were infected--3 with M. ozzardi, 4 with Dipetalonema perstans, and 1 with both species.
Soil-transmitted helminth infections when light-to-moderate usually are well tolerated, but heavy-to massive infections invariably cause disease. A massive infection with Ascaris lumbricoides may cause intestinal obstruction, liver abscess, or some other condition requiring surgical treatment; more regularly, however, ascaris disease is a form of malnutrition. Trichuris trichiura causes diarrhea and dysentery and, at times, rectal prolapse. The hookworms, Necator americanus and Ancylostoma duodenale, cause blood-loss from the intestine resulting in anemia. Necator infection is acquired percutaneously, and is more frequently massive than is that of Ancylostoma which may be acquired percutaneously or orally. Estimates of egg output in the feces, based on egg-counts by dilution, direct smear, or thick-film techniques, provide a reliable index of light, medium, or heavy infection. Acquisition of heavy infection with Ascaris and Trichuris depends on favorable qualities of the soil, and on the sorting action of rain which transports and concentrates the eggs of helminths in locations where survival and transmission are favored. The high frequency of heavy hookworm infection in southeastern United States and probably elsewhere may depend largely on the presence of feces-burying dung beetles. Human infection with soil-transmitted helminths of dogs and cats has become a serious public health problem attributable to the persistence of rural mores in the urban setting.
The persistence and precise location of Ancylostoma caninum larvae in tissues of vertebrate paratenic hosts and the nature of host responses were studied in mouse, cat, and monkey. Mice were infected percutaneously and examined at various intervals up to 260 days after exposure. Long-persisting larvae were found only in the muscles. Histologic sections revealed that within 4 hr after exposure some larvae had migrated through the skin and had entered individual fibers of the underlying muscles. After the 1st day nearly all larvae found in muscles were within fibers. Granuloma formation and encapsulation were not observed, suggesting that inside the fibers the larvae produced no direct inflammatory reaction. Only diffuse infiltration of inflammatory cells was observed in muscles and this appeared to be in response to destruction of muscle fibers. Larvae were similarly located in muscles of a cat and a rhesus monkey examined 16 and 17 days, respectively, after cutaneous exposure. The histologic changes observed in muscle fibers invaded by A. caninum larvae are similar to those observed in early Trichinella spiralis infections. The larvae of A. canninum lying coiled within the muscle fibers also bear superficial resemblance to the larvae of T. spiralis. A. caninum larvae were also recovered by tissue digestion from muscles of naturally infected dogs, which suggests that larvae reside in this location in the bitch prior to transfer to the neonate via the milk.
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