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[Diarrhea and acquired immunodeficiency syndrome in the tropics (tropical AIDS). The place of digestive endoscopic examinations in diagnosing opportunistic infections].

A.I.D.S. has revealed some parasitic, microbiotic, mycotic or viral diseases causing diarrhea or has given a revival of interest to them. So are Cryptosporidium, Isospora belli, Salmonella typhi murium, Cytomegalovirus. Some easy techniques lead to the diagnosis of some pathogenic agents, such as parasitologic diagnosis of Cryptosporidium. Some other pathogenic agents call for a biopsy in view of an histopathology test: it is the case of Cytomegalovirus of which the diagnosis is stated positively by the histological picture with virus intranuclear inclusions. Then, it is necessary to make clear the actual indications of digestive endoscopic scanning when confronted by a diarrhea of tropical A.I.D.S.

Acquired Immunodeficiency Syndrome↗

Intestinal parasitic infections in pre-school children in the Niger Delta.

Stool specimens from 1,062 pre-school children in the Niger Delta were examined for the presence of intestinal parasites. Of that number, 77.6% harboured one or more than one species of intestinal parasites. Ascaris lumbricoides (51.9%) and Trichuris trichiura (41.7%) were the most prevalent species recorded. Other parasites harboured by these children included Hymenolepis sp. (18.3%), Giardia lamblia (9.2%), Entamoeba histolytica (4.6%), Strongyloides stercoralis (1.4%). Hookworm, Taenia sp., Isospora sp. and Trichostrongylus sp. occurred in less than 1% of the children examined. These high rates of infection are associated with poor sanitary conditions prevalent in the area. Improvement of environmental sanitation is advised to reduce human sufferings caused by parasites in that area particularly among children.

Age Factors↗

[Gastrointestinal manifestations of acquired immunodeficiency syndrome; case studies of 14 patients].

The gastrointestinal manifestations seen in acquired immune deficiency syndrome (AIDS) are discussed based on the observation of 14 patients with a positive serology for LAV/HTLV III antibody. AIDS was confirmed in 8 cases and AIDS related complex (ARC) in 6 cases. Risk groups included 6 homosexuals, 6 drug abusers and 2 patients from Zaïre. All the AIDS cases underwent gastrointestinal endoscopy and biopsy; in 5 patients a necropsy was performed. Evaluation of the immune status showed lymphopenia and a decreased ratio of OKT4/OKT8. Clinical and pathological observations are discussed sequentially. Acute esophagitis includes cases of Candida albicans super-infection, cytomegalovirus and herpes simplex. Acute enteritis and colitis were seen in association with cryptosporidium, Isospora belli and CMV. 3 cases were found to have chronic duodenitis and malabsorption. Digestive lesions of Kaposi's sarcoma were seen in 3 cases. Diagnosis and treatment of gastrointestinal infections in AIDS is important in view of the high morbidity and serious secondary complications.

Acquired Immunodeficiency Syndrome↗

A coprological survey of parasites of wild neotropical felidae.

In conjunction with an ecological study of jaguars in the Cockscomb Basin of Belize, Central America, fecal samples from jaguars (Panthera onca), jaguarundis (Felis yagouaroundi), ocelots (Felix pardalis), and pumas (Felix concolor) were examined for parasite products (eggs, larvae, and oocysts). Of the 45 samples examined, 39 (86.7%) were positive for parasite products, 23 of 25 (92%) jaguar samples were positive, as were all of the puma (4/4) and ocelot (8/8) samples. Four of 6 samples from unknown species were positive (66.7%). Two jaguarundis samples were negative. The following were identified in the samples: Paragonimus sp. eggs, Taeniidae eggs, Strongylate eggs, Toxocara cati eggs, Toxascaris sp. eggs, Capillaria sp. eggs, Spiruridae eggs, Aelurostrongylus sp. larvae, Oncicola sp. eggs, Hammondia pardalis oocysts, Isospora sp. oocysts, Toxoplasma gondii-like oocysts and Sarcocystis sp. sporocyst.

Animals↗

Gastrointestinal manifestations of the acquired immunodeficiency syndrome.

In addition to abnormalities in systemic immune function, patients with the acquired immunodeficiency syndrome (AIDS) and the pre-AIDS syndromes have significant abnormalities in the distribution of T-cell subsets in the intestinal tract. Such immune deficits predispose such patients to opportunistic infections and tumors, many of which involve the gastrointestinal tract. For example, Candida albicans often causes stomatitis and esophagitis. Intestinal infections with parasites (Cryptosporidium, Isospora belli, Microsporidia) or bacteria (Mycobacterium avium-intracellulare) are associated with severe diarrhea and malabsorption, whereas viruses like cytomegalovirus and herpes simplex virus cause mucosal ulcerations. Clinically debilitating chronic diarrhea develops in many AIDS patients for which no clear cause can be identified. Enteric pathogens like Salmonella and Campylobacter can be associated with bacteremias. Kaposi's sarcoma and lymphoma involving the intestinal tract are now well-recognized complications of AIDS. Although AIDS is not associated with a pathognomonic liver lesion, opportunistic infections and Kaposi's sarcoma or lymphoma may involve the liver.

Acquired Immunodeficiency Syndrome↗

Toxoplasma gondii infection of cats in Beirut, Lebanon.

The prevalence of serum antibodies to Toxoplasma gondii was determined by the indirect fluorescent antibody (IFA) test in cats of Beirut, Lebanon from September 1980 to July 1983 (35 months). Testing revealed that 253/324 (78.1%) cats had antibodies in the IFA test. While the prevalence of Toxoplasma antibodies in stray cats was considerably greater than in owned cats at the beginning of the study, this difference diminished over time, and prevalence was similar by the end of the study. Faecal shedding of Toxoplasma-like oocysts was found in 31/313 (9.9%) of cats, while 38/313 (12.1%) shed other Isospora spp. oocysts. The occurrence of dual infections was statistically significant.

Animals↗

[Endoparasites of calves in large herds].

The authors present preliminary results of the coprological examination of calves in large-capacity calf-houses. In a new large-capacity calf-house in the Benesov district in the Central-Bohemian region, 200 samples of faeces were examined according to Breza (1957) and further examinations were performed regularly in a group of 42 calves from the age of 0.5 to 6 months. The tests revealed 13 species of endoparasites, including eight species of coccidia: Eimeria auburnensis, E. alabamensis. E. bovis, E. cylindrica, E. elliposidalis, E. subspherica, E. zuernii, Isospora spp., and five species of helminths: Strongyloides papillosus, Oesophagostomum radiatum, Trichocephalus ovis, Cooperia spp., and Ascaris suum. The following conclusions were derived from these findings: 1. The calves may carry the germs of coccidia and helminths on their hooves already during transportation to the new calf-house; 2. twelve- to twenty-day-old calves, coming to the calf-houses, are often already attacked by several species of coccidia and helminths; 3. the number of parasite species increases and the extensity of invasion rises with age; 4. it has been demonstrated that the invasion process of eight species of coccidia and five species of worms can take place under the conditions of modern calf-house; 5, stronglyloidosis, oesophagostomosis, and trichocephalosis can be treated as typical stable helminthoses; 6. some other speceis of helminths and coccidia occur in calves after transition to green forage with which they are probably carried to the calf-house.

Animal Husbandry↗

The opossum (Didelphis virginiana) as a host for Sarcocystis debonei from cowbirds (Molothrus ater) and grackles (Cassidix mexicanus, Quiscalus quiscula).

Sarcocystis-infected muscles from ducks, cowbirds, and grackles were fed to cats, opossums, rats, and a dog. Only the opossum (Didelphis virginiana) was a suitable definitive host. All opossums that were fed Sarcocystis-infected cowbirds (Molothrus ater) and grackles (Cassidix mexicanus and Quiscalus quiscula) passed sporocysts in their feces. Opossums that ate the cowbirds had prepatent periods of 5 and 10 days and remained patent for at least 105 days. Opossums that ate the grackles became patent on day 10 after the infective meal and remained patent for over 90 (Quiscalus) and 105 (Cassidix) days. A single opossum fed infected muscle from a pintail duck (Anas acuta) passed sporocysts in the feces from days 13 through 18 after infection. No sporocysts were passed by opossums fed infected muscle from the green-winged teal (Anas carolinensis) and shoveller (Spatula clypeata). Sporocysts of duck, cowbird, and grackle origin were structurally similar. Mean dimensions of sporocysts were: duck-origin, 11.2 by 8.2 micron; cowbird-origin, 11.4 by 7.8 micron; Cassidix-origin, 11.2 by 7.8 micron; and Quiscalus-origin, 11.6 by 7.7 micron. We designate the sporocysts of cowbird and grackle origin as Sarcoycstis debonei Vogelsang, 1929 (Syn. Isospora boughtoni Volk, 1938).

Animals↗

Diarrhoea among infants in a crowded area of Djakarta, Indonesia. A longitudinal study from birth to two years.

Diarrhoeal diseases are common in Djakarta, Indonesia, especially among infants and young children. A study has been made of possible bacterial and parasitic causes of outbreaks in a group of 156 infants in a crowded area of the city. Before the study was complete, 60 infants had left the area and 30 had died; diarrhoea was probably the direct or indirect cause of 13 of the deaths.Diarrhoea was associated with pathogenic Escherichia coli in about 20% of the cases studied; other causes of diarrhoea were Shigella, less frequent, and rare among infants below the age of 6 months; Salmonella, insignificant; Giardia lamblia, common, but not usually associated with diarrhoea; Entamoeba histolytica and Isospora belli, relatively rare. The role of Trichuris trichiura was probably important, but was difficult to assess.Many diarrhoea cases were not associated with either pathogenic bacteria or parasites. Other potential causes, not considered in this study, include enteropathogenic virus infection, parenteral infections, faulty diet and malnutrition. Further investigation is considered desirable.

Bacteria↗

Toxoplasmosis.

Recent research has shown that Toxoplasma gondii, the cause of human toxoplasmosis, is a protozoan close to the genus Isospora, whose life cycle involves cats as the definitive host, and other mammals, including man, and birds as intermediate hosts. Cats shed oocysts in their faeces; these are infective to the intermediate hosts when ingested. But the non-felid intermediate hosts can also become infected by eating other intermediate hosts. Probably most human infections occur in this manner and result from eating raw or insufficiently cooked meats. Most people become infected during their life time, but most infections are benign and unnoticed. Occasionally the disease picture may simulate infectious mononucleosis. However, in intrauterine or neonatal infections the disease may be most severe and chorioretinitis, encephalomyelitis, hydrocephalus or microcephaly may result. Diagnosis depends upon demonstrating the parasite in biopsy material or through changing titres in serological tests.

Animals↗

Experimental transmission of intestinal coccidiosis to piglets: clinical, parasitological and pathological findings.

Twenty-eight piglets coming from a "specific pathogen free" herd were inoculated at three days of age with 50 000 or 100 000 sporulated oocysts of Isospora suis. Fecal samples were examined for oocyst shedding daily and several clinical parameters were recorded. Ten piglets were used as normal controls. Groups of piglets were euthanized from three days to 12 days postinoculation and routine necropsies were performed. Bacteriological, virological, parasitological and histopathological examinations were made on the intestinal tracts. The incubation period was four to five days. Clinical signs and microscopic intestinal lesions observed in the experimentally infected animals were similar to those reported in spontaneous cases of porcine neonatal coccidiosis. Lesions of villous atrophy in the small intestine seemed to result from the destruction of villous epithelial cells mainly during the peak of asexual reproduction which occurred around four to five days postinoculation. Intracellular coccidial organisms were difficult to find during the late atrophic and villous regrowth stages of the intestinal lesions. The prepatent period varied from four to seven days and the most common was five days. Eighty percent of the piglets kept alive more than four days postinoculation have shed oocysts. Piglets dosed with old sporulated oocysts (ten months old) shed many more oocysts than those infected with a fresh inoculum (less than two months old). The patent period was not determined precisely with the design of the experiment but some of the infected piglets shed oocysts for at least five days.

Animals↗

Feline respiratory tract disease in Louisiana.

An investigation of feline respiratory tract disease (FRD) was made involving 65 affected cats (group 1) and 65 control cats (group 2) matched for age, sex, and residence. Feline calicivirus strains (FCV), feline herpesvirus-1 (FHV-1), or both, were isolated from 59% of group 1 cats and from 7% of group 2 cats. Isolation of these viruses showed a significantly greater (P < 0.05) relative risk for group 1 cats. Virus isolations were three times more frequent from males than from females older than 1 year (both groups), but were equally distributed between males and females younger than 1 year. Bacteria and fungi had a secondary role in both FCV- and FHV-1 associated FRD. Intestinal infections of Ancylostoma spp, Dipylidium caninum, and Toxocara cati were diagnosed more frequently in group 1 cats than in control (group 2). Paragonimus kellicotti was diagnosed in 3 group 1 cats, Taenia taeniaeformis in 1 group 1 cat, Isospora rivolta in 1 group 1 cat, and Giardia cati in 1 control cat. The present study supports the current concept of a primary viral cause for development of FRD.

Age Factors↗

Neonatal diarrhea of pigs in Quebec: infectious causes of significant outbreaks.

To evaluate the relative importance of the various enteropathogens causing neonatal diarrhea in Quebec farrowing operations, observations were made on 749 diarrheic pigs from 325 outbreaks of diarrhea. They were one to 15 days of age, and were obtained alive for necropsy generally within 48 hours of the onset of diarrhea. Some pigs were from severe, explosive outbreaks of diarrhea with high morbidity and mortality rates, while others were from herds with chronic neonatal diarrhea with lower morbidity and mortality rates. A combination of bacteriological, virological and histological methods were used to study the pigs. Viruses were incriminated in 60%, bacteria in 23% and coccidia in 15.3% of the 325 diarrhea outbreaks. Transmissible gastroenteritis virus was by far the most common enteropathogen with a prevalence of 52%; rotavirus was implicated in 9.2% of the outbreaks while adenovirus was incriminated in 0.30% of the outbreaks. Enterotoxigenic Escherichia coli were involved in 22.4% of the cases while Clostridium perfringens type C was an occasional finding. Coccidia involved in our herds were identified as Isospora suis. The disease was attributed to infection with a single etiologic agent in 590 diarrheic pigs (78%) while combinations of agents were present in only 90 (12%). The age-specific occurrence of the various enteropathogens was evaluated. Transmissible gastroenteritis virus was the most common enteropathogen in all age groups. Colibacillosis was common in pigs which became diarrheic under five days of age; in this age group, the enterotoxigenic E. coli were frequently found alone, but were usually combined with other agents in older pigs. The prevalence of coccidia was high in pigs which became diarrheic between five and 15 days of age. Rotavirus infection was common in diarrheic pigs older than ten days of age. Although individual baby pigs were commonly infected with a single enteropathogen, it was very common to see more than one agent involved in an outbreak of diarrhea, particularly when pigs of different ages were affected. Observations on the occurrence of the enteropathogens according to the seasons were also made. Occurrence of transmissible gastroenteritis was throughout the year with the highest prevalence during the fall, winter and spring months. Colibacillosis and coccidiosis were more common in the summer, fall and early winter months with the lowest prevalence in the spring months.

Adenoviridae↗

Epidemiology of porcine neonatal steatorrhoea in Sweden. 1. Prevalence and clinical significance of coccidal and rotaviral infections.

A study of neonatal steatorrhoea in unweaned piglets was carried out in randomly visited herds. Isospora suis and rotavirus were shown to be incriminated in this type of enteric disease and these agents may be considered important enteropathogens for 1-3-week-old piglets in Sweden. More extensive studies of I. suis were undertaken in one large herd. It was found that steatorrhoea may appear in 4-day-old piglets but oocysts were not detected until some days latter. Piglets that were shedding I. suis were not necessarily steatorrhoeic but oocysts were more frequently found in steatorrhoeic faeces than in faeces of normal consistency. The earliest oocyst output was detected at 5 days of age, the average litterage at first appearance being 12.8 +/- 4.0 days. The occurrence of I. suis oocysts in piglets did not correlate with the oocyst output in sows, which almost exclusively included genus Eimeria. Repeated parasitological and virological examination of steatorrhoeic faecal samples from 5-10 litters per herd at an age of 1-3 weeks would be helpful for making a herd diagnosis.

Animals↗

[Acquired immunodeficiency syndrome, chronic coccidiosis and Salmonella typhimurium septicemia in a couple from Zaire. Immunological functions and attempt at immunostimulation by thymopentin].

A clinical review of a young couple from Zaïre with acquired immunodeficiency syndrome (AIDS) is reported. Both had opportunistic infections such as Salmonella typhimurium septicemia, genital herpes and digestive candidiasis. The husband was hospitalized for diarrhea from Isospora belli infection and for hemoptysis from an aspergilloma. His wife was admitted for a thoracic herpes zoster infection and left hemiplegia preceding subacute encephalitis. In both patients the biological immune functions were compatible with AIDS: presence of antibody against lymphadenopathy virus, decreased in OKT4+/OKT8+ ratio, and lack of lymphocyte response to mitogens which was partially restored in vitro after addition of interleukin 2 and thymopentin (TP-5) in the husband. In vitro monocyte cultures showed increased production of prostaglandins E2 (PGE2) and a slight decrease in interleukin 1 production. The symptomatic treatments and an attempt at immunostimulation with TP-5 in the husband are described.

Acquired Immunodeficiency Syndrome↗

Host specificity and host range of the genus Sarcocystis in three snake-rodent life cycles.

Three Sarcocystis species with snake-rodent life cycles were studied for their host range and host specificity in systematically related intermediate and definitive hosts. While S. singaporensis and S. villivillosi developed only in murids closely related to the genus Rattus, a third Sarcocystis species (natural definitive host: Bitis nasicornis - syn. Isospora dirumpens ?) showed a broad intermediate host range. This species was found to use several Bitis species as definitive hosts. S. singaporensis and S. villivillosi in contrary produced sporocysts only in three Python species and in Aspidites melanocephalus .

Animals↗

[Incidence of coccidia in dogs in Brno and the surrounding area].

In the course of two years, 663 dogs from Brno and its vicinity were subjected to clinical and parasitological examination with a special reference to the occurrence of coccidia. A saturated sugar solution with the specific weight of 1150 was used as the flotation medium. Coccidia were found in 2.17% of the dogs examined. The oocysts of the groups Isospora ohioensis, I. burowsi and I. neorivolta were identified most frequently (2.11% of the dogs). Four dogs (0.60%), all alike, eliminated the oocysts of Hammondia heydorni and sporocysts of Sarcocystis species, and two dogs oocysts of Hammondia heydorni and sporocysts of Sarcocystis species, and two dogs (0.30%) excreted oocysts of I. canis. Out of the animals infected, 58% were younger than six months. Clinical signs were observed only at a medium to strong invasion with oocysts of the species I. ohioensis, I. burowsi and I. neorivolta. The digestive tract was affected most severely--the animals suffered from bloodless diarrhoeas lasting two to twelve days, from occasional vomiting and systemic dehydration. Invasion by I. canis, Hammondia heydorni and Sarcoystis sp. did not cause any clinical changes.

Animals↗

[Prevalence of protozoans helminths among cats purchased for experimental use in the Kanto Area].

Prevalence of protozoan and helminth parasites in adult cats for experimental use obtained from Kanto area, Japan during the period of 1973-74 (91 cats) and 1980-81 (80 cats) was investigated by means of autopsy, fecal examination and serological tests. No protozoa were found in blood smear specimens. The rate of positive Toxoplasma antibody tests was 65.4% (hemagglutination test) in 1973-74 and 26.3% (latex agglutination test) in 1980-81. Oocysts of coccidia found in feces were Isospora felis and I. rivolta. In the intestine of 63.7% (1980-81) and 69.2% (1973-74) of the cats, one or more species of helminth parasites were found. The helminth parasites found in the intestine were Toxocara cati, Ancylostoma tubaeforme, Taenia taeniaeformis, Dipylidium caninum, Spirometra erinacei and Pharyngostomum cordatum. Physaloptera sp., Dirofilaria immitis, Clonorchis sinensis and Capillaria plica were found in the stomach, heart, bile duct and urinary bladder, respectively. Differences between the results in 1973-74 and that in 1980-81 were discussed.

Animals↗