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The association between weather, frenzied behaviour, percutaneous invasion by Strongyloides westeri larvae and Rhodococcus equi disease in foals.

Episodes of frenzy lasting approximately 30 minutes were observed among horses confined to enclosures surfaced with sand or soil. The probability of sighting these episodes increased by a factor of three when within 24 hours there was 0.2mm or more of rain, a maximum air temperature between 16.7 - 26.6 degrees C and a soil temperature of 16.3 - 23.9 degrees C at 30 cm. High egg counts of Strongyloides westeri appeared in faeces four to five days later and persisted for several days. Rhodococcus equi was recovered from all soil samples, and from the faeces of 76% of mares and 82% of foals. The youngest foal was five days old when the organism was isolated from rectal faeces. In contrast to the majority of reports, the lesions of R. equi in the foals were confined to limbs and peripheral lymph nodes. It is proposed that the percutaneous invasion of these foals by third stage larvae of S. westeri facilitated invasion of R. equi, and ubiquitous saprophytic opportunist pathogen.

Journal Article↗

Further observations on Strongyloides westeri dermatitis: recovery of larvae from soil and bedding, and survival in treated sites.

Two horses repeatedly underwent episodes of frenzy characterised by extreme discomfort and hyperactivity. Within 2 days of an attack the lower extremities of both hind legs of one subject were uniformly swollen, while on the second subject skin lesions erupted 3-4 days after an attack and swelling persisted for 2-3 weeks. Filariform larvae of Strongyloides westeri were cultured from soil and sawdust where the subjects were kept. Larvae were cultured from soil of low pH (4.5-5.8) but were absent from neutral or alkaline soils. Larvae were found in sawdust with a wide pH range. It is thought that the attacks were caused by a percutaneous invasion of filariform larvae of S. westeri, which required moist warm weather and low pH soils or sawdust to survive and resist desiccation.

Journal Article↗

The efficacy of ivermectin against Strongyloides westeri in foals.

Seven foals naturally infected with Strongyloides westeri were injected intramuscularly with ivermectin at a dosage rate of 200 mcg per kg body weight. No adverse effects to treatment were observed. Weekly faecal egg counts showed a greater than 99 per cent reduction of S. westeri egg output compared with 7 untreated foals during the 21 days following treatment.

Animals↗

The prevalence of Isospora suis and Strongyloides ransomi in suckling piglets in The Netherlands.

Faecal samples from suckling piglets from 113 litters on 25 farms in the Netherlands were examined to study the prevalence of gastrointestinal parasites, in particular Strongyloides ransomi and Isospora suis. S. ransomi was not found but I. suis was demonstrated in 17 of the 25 farms and in 41 out of 77 litters of these farms (53%). No other parasites were found. On the basis of these results, a longitudinal study on the incidence and significance of I. suis was performed on 10 farms (5 litters/farm). I. suis was found on 9 out of 10 farms and in 56% of the litters. Farms differed in infection levels, measured as the numbers of patent litters, and in the onset of patency. Other parasites were only found in faecal samples from the sows and from farrowing pens. These were, in order of prevalence, Balantidium coli, Ascaris suum, Eimeria spinosa, E. debliecki and E. suis.

Animals↗

Streptococcus bovis bacteremia and meningitis associated with Strongyloides stercoralis colitis in a patient infected with human immunodeficiency virus.

We present a case of human immunodeficiency virus (HIV) infection complicated by Streptococcus bovis meningitis and bacteremia and severe Strongyloides stercoralis colitis. The association between S. bovis infection and strongyloidiasis has not been described previously. This case highlights the importance of searching for larvae of S. stercoralis as part of the evaluation of the gastrointestinal tract of patients with bacteremia or meningitis due to certain enteric organisms. The role of HIV infection in the development of severe S. stercoralis colitis in association with S. bovis bacteremia and meningitis is unclear.

AIDS-Related Opportunistic Infections↗

Strongyloides stercoralis in chronic renal failure: safe therapy with thiabendazole.

The pharmacodynamics of thiabendazole (TBZ) and its metabolite, 5OH-thiabendazole (5OH-TBZ), were studied in an anephric patient with Strongyloides stercoralis pneumonitis. No toxic manifestations were noted in the patient, and serum TBZ and 5OH-TBZ levels were comparable to those in eunephric patients. We conclude that thiabendazole, in the usual recommended dose of 25 mg/kg twice daily, given to patients with compromised renal function is reasonable and safe.

Adult↗

Strongyloides stercoralis hyperinfection and central nervous system involvement in a patient with relapsing polychondritis.

Infections caused by Strongyloides stercoralis are not uncommon in the United States. Because of the many different manifestations of hyperinfection with this nematode, a high index of suspicion is essential, especially in immunocompromised patients, for whom such infections are frequently fatal. Patients originating from endemic areas and those who have traveled to such areas, even in the distant past, should have the possibility of strongyloidiasis evaluated before initiation of immunosuppressive therapy. Once considered, the diagnosis is not difficult and can be accomplished using readily available techniques and methods. Although thiabendazole has a high incidence of side effects and may not always eradicate infection, it remains the drug of choice for disseminated strongyloidiasis.

Aged↗

Persistent infection of Strongyloides venezuelensis and normal expulsion of Nippostrongylus brasiliensis in Mongolian gerbils, Meriones unguiculatus, with reference to the cellular responses in the intestinal mucosa.

The kinetics of daily faecal egg count, worm burdens, and intestinal cellular responses were examined in Mongolian gerbils after infection with either Strongyloides venezuelensis or Nippostrongylus brasiliensis alone, or concurrently with both parasites. The results show that, both in individual and concurrent infections, S. venezuelensis infection persisted for over 10 weeks and elicited a gradual increase in number of mast cells in the jejunal mucosa. On the other hand, N. brasiliensis worms were expelled by 3 weeks in association with goblet cell hyperplasia. These results suggest that effector/regulator cells involved in worm expulsion are different and highly selective depending on the genus of intestinal helminths.

Animals↗

Goblet cell mucins of four genera of the subfamily Cricetinae with reference to the protective activity against Strongyloides venezuelensis.

Goblet and mast cell responses in the jejunum of four genera, Mesocricetus auratus (Syrian hamster), Phodopus campbelli, Cricetulus griseus (Chinese hamster), and Tscherskia triton, belonging to the subfamily Cricetinae, were examined after infection with Strongyloides venezuelensis. Parasite eggs became detectable in faeces of all four genera on Day 7. Faecal egg count peaked around Day 8 in C. griseus and T. triton and around Day 14 in M. auratus and P. campbelli. In M. auratus and P. campbelli, faecal egg production persisted over 40 days, whereas that in C. griseus and T. triton rapidly terminated within 14 days. In all four genera examined, goblet cell hyperplasia and mastocytosis were observed at the time of expulsion of S. venezuelensis. However, in the comparative study of all four genera, neither the degree of goblet or mast cell hyperplasia nor the phenotype of mast cells correlated to the rapidity of the expulsion of S. venezuelensis. On the other hand, the rapidity of expulsion closely correlated with the degree of sulphation of goblet cell mucins because two genera, C. griseus and T. triton, having highly sulphated goblet cell mucins showed faster expulsion of S. venezuelensis than the other two genera, P. campbelli and M. auratus, having less sulphated mucins. These results suggest that physicochemical nature of mucins is critical for the expulsion of S. venezuelensis from the subfamily Cricetinae.

Animals↗

Dermatitis in a dairy herd caused by Pelodera strongyloides (Nematoda: Rhabditidae).

A high rate (25%) of infestation of heifers in a dairy cattle herd caused by the saprophytic nematode Pelodera strongyloides is described. Management (crowded) and environmental conditions (moist and filthy) as well as the climate (temperature) apparently favoured the existence and continuation of the nematodes. These infested a large number of heifers by causing dermatitis in skin areas, which were in contact with the contaminated environment. The dermatitis is characterized by a marked thickening of the skin, which became wrinkled and scurfy with alopecia. Pruritus was not observed.

Animal Husbandry↗

Dermatitis due to larvae of a soil nematode, Pelodera strongyloides.

A 6-month-old infant girl was seen because of failure to thrive and hyperpigmented papulonodules on the lower abdomen and thighs. Results of skin biopsy demonstrated dauer larvae of a soil nematode, Pelodera strongyloides, in the dermis. This is the second documented episode of human dermatitis due to this nematode, which more often invades the skin of dogs, cattle, horses, and sheep.

Female↗

Mucosal defense against gastrointestinal nematodes: responses of mucosal mast cells and mouse mast cell protease 1 during primary strongyloides venezuelensis infection in FcRgamma-knockout mice.

A possible role for the gamma subunit of immunoglobulin Fc receptors (FcR) in mucosal defenses against intestinal nematode parasites was studied using age-matched FcRgamma-knockout (FcRgamma(-/-)) and wild-type (FcRgamma(+/+)) C57BL/6 mice. Mice were infected subcutaneously with 3,000 infective larvae of Strongyloides venezuelensis, and the degree of infection was monitored by daily fecal egg counts and adult worm recovery on days 8 and 13 postinfection. Mucosal mast cell (MMC) responses were assayed by in situ intestinal mast cell counts in stained histological sections of the jejunum and by measuring mouse mast cell protease 1 (MMCP-1) release in serum using sandwich enzyme-linked immunosorbent assay. FcRgamma(-/-) mice had significantly higher egg counts (P<0.01) and numbers of adult worms (P<0.05) than FcRgamma(+/+) mice, but mastocytosis and serum MMCP-1 release were comparable. It was concluded that MMCP-1 release may be spontaneous, does not depend on mast cell degranulation via the FcRgamma signaling system, and appears to play no role in the expulsion of S. venezuelensis. The delay in worm expulsion in the FcRgamma(-/-) mice might be related to inability of the MMC to degranulate and release effector molecules other than MMCP-1, since FcRgamma deletion abrogates mast cell degranulative responses.

Animals↗

Infection with Strongyloides venezuelensis induces transient airway eosinophilic inflammation, an increase in immunoglobulin E, and hyperresponsiveness in rats.

Infection by nematode parasites with a pulmonary migration in their life cycle and allergic asthma are two highly prevalent diseases in humans; therefore, one may expect both may occur concomitantly. There is a predominant and essential role of Th2 lymphocytes in the mechanisms underlying the control of parasite elimination as well as in the pathology observed in the asthmatic lung. The consequences of such situations have been explored, with controversial results, justifying the development of experimental models in which the relationship between allergic airway inflammation and helminth infection might be evaluated. The present work describes the inflammatory, humoral, and functional changes that occur in the lung of rats after single (subcutaneous inoculation of 1,500 L3 larvae) or multiple (five weekly subcutaneous inoculations of 1,500 L3 larvae) Strongyloides venezuelensis infections. The results show that the migration of S. venezuelensis larvae through the lungs of infected rats induces a local eosinophilic inflammation process which is mostly focal and parenchymal for rats infected a single time and which is peribronchial after multiple infections. The inflammatory process is accompanied by mucus hypersecretion, thickening of bronchial epithelial and muscle layers, and local increase in immunoglobulin E concentrations that peak after 5 to 7 days and are resolved after 12 days of single or multiple infections. The peak of lung immunopathologic changes observed in infected rats coincides with lung airway hyperresponsiveness (AHR), a key functional alteration in asthma. We propose that this experimental model is ideal to carry out further studies on immunoprotection against nematode infection versus immunopathology of allergic airway inflammation.

Animals↗

Changes in pulmonary function and parasite burden in rats infected with Strongyloides venezuelensis concomitant with induction of allergic airway inflammation.

The prevalence of allergic diseases such as asthma has increased markedly over the past few decades. To evaluate the possible mutual influence of helminth infection and allergy, the combined effects of experimental allergic airway inflammation and infection with Strongyloides venezuelensis on various parasitological and inflammatory indices were evaluated in the rat. A challenge of immunized rats with aerosolized ovalbumin (OVA) resulted in eosinophilic inflammation that peaked 48 h after the challenge and was accompanied by airway hyperresponsiveness (AHR) to an intravenous acetylcholine challenge. S. venezuelensis infection concomitant with an OVA challenge of immunized rats resulted in prolonged pulmonary inflammation with increased eosinophil infiltration in bronchoalveolar lavage fluid but not in the lung tissue. These rats also showed a significant parasite burden reduction, especially during parasite migration through the lungs. However, the fecundity rates of worms that reached the intestine were similar in allergic and nonallergic animals. Despite airway inflammation, the increased responsiveness of the airways in the experimental asthma model was suppressed during parasite migration through the lungs (2 days). In contrast, parasite-induced AHR was unchanged 5 days after infection in immunized and challenged rats. In conclusion, infection with S. venezuelensis interfered with the onset of AHR following an antigen challenge of immunized rats. The ability of parasites to switch off functional airway responses is therapeutically relevant because we may learn from parasites how to modulate lung function and, hence, the AHR characteristic of asthmatic patients.

Animals↗

Parasitic arthritis induced by Strongyloides stercoralis.

A 40-year-old man presented with palpable purpura and symmetrical polyarticular arthritis. Histological examination of the synovial membrane and fluid unexpectedly disclosed Strongyloides stercoralis infestation of the ankle joint.

Adult↗

Strongyloides stercoralis hyperinfection in an HIV positive patient.

A 25 year old British man of previous good health presented with persistent generalised lymphadenopathy and was found to be human immunodeficiency virus (HIV) antibody positive. Three years later after weight loss and loose stools Strongyloides stercoralis was identified in the latter and successfully treated with thiabendazole. Shortly afterwards, a further episode again responded rapidly, but was swiftly followed by a final and fatal illness with severe debility and metabolic imbalance unresponsive to all treatment. Necropsy showed widespread and heavy strongyloidiasis with pulmonary haemorrhage, bronchopneumonia, and meningitis.

Adult↗