1
|
Large Colon Polyp as the Only Manifestation of Chronic Schistosomiasis Infection. ACG Case Rep J 2022; 9:e00889. [PMID: 36237280 PMCID: PMC9553396 DOI: 10.14309/crj.0000000000000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/06/2022] [Indexed: 11/17/2022] Open
|
2
|
Histologic features of colonic infections. DER PATHOLOGE 2021; 43:16-30. [PMID: 34767063 PMCID: PMC8588779 DOI: 10.1007/s00292-021-01015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
Background The histopathologic diagnosis of infectious colitis remains relevant despite recent advances in microbiologic techniques. Objective This article aims to describe the histologic features of selected infectious diseases of the colon. Materials and methods Existing reports on histopathologic and clinical aspects of colonic infectious agents were reviewed. Results While histology alone may not be as sensitive as current microbiologic methods, tissue identification of infectious agents still plays an important role in patient care. Infectious colitis can have a variety of clinical manifestations, ranging from strongyloidiasis, which can cause a smoldering, subclinical infection for decades, to syphilis, which can clinically mimic cancer or inflammatory bowel disease. Therefore, the histopathologic identification of infection as the cause of a patient’s colitis has a considerable impact on treatment decisions. Morphologic overlap can occur between infection and other diseases, however. Moreover, some infections can elicit various tissue responses beyond acute colitis. Immunosuppressed patients may not mount an inflammatory response to pathogens such as cytomegalovirus or adenovirus. Sexually transmitted proctocolitis can cause plasma-cell-rich inflammation. Gastrointestinal histoplasmosis is more likely to cause diffuse histiocyte infiltration rather than the expected granuloma formation. In some cases, ancillary tests are useful, but equivocal results can cause diagnostic dilemmas. Conclusion Given the range with which colonic infectious disorders can manifest, pathologists should be aware of the typical features of infectious colitis, as well as findings beyond the classic morphologies.
Collapse
|
3
|
Webb JA, Fabreau G, Spackman E, Vaughan S, McBrien K. The cost-effectiveness of schistosomiasis screening and treatment among recently resettled refugees to Canada: an economic evaluation. CMAJ Open 2021; 9:E125-E133. [PMID: 33622765 PMCID: PMC8034375 DOI: 10.9778/cmajo.20190057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Many refugees and asylum seekers from countries where schistosomiasis is endemic are infected with the Schistosoma parasite when they arrive in Canada. We assessed, from a systemic perspective, which of the following management strategies by health care providers is cost-effective: testing for schistosomiasis and treating if the individual is infected, treating presumptively or waiting for symptoms to emerge. METHODS We constructed a decision-tree model to examine the cost-effectiveness of 3 management strategies: watchful waiting, screening and treatment, and presumptive treatment. We obtained data for the model from the literature and other sources, to predict deaths and chronic complications caused by schistosomiasis, as well as costs and net monetary benefit. RESULTS Presumptive treatment was cost-saving if the prevalence of schistosomiasis in the target population was greater than 2.1%. In our baseline analysis, presumptive treatment was associated with an increase of 0.156 quality-adjusted life years and a cost saving of $405 per person, compared with watchful waiting. It was also more effective and less costly than screening and treatment. INTERPRETATION Among recently resettled refugees and asylum claimants in Canada, from countries where schistosomiasis is endemic, presumptive treatment was predicted to be less costly and more effective than watchful waiting or screening and treatment. Our results support a revision of the current Canadian recommendations.
Collapse
Affiliation(s)
- John A Webb
- South Zone Medical Affairs, Alberta Health Services (Webb); Department of Community Health Sciences (Fabreau, Spackman, McBrien), O'Brien Institute for Public Health (Fabreau, Spackman, McBrien), Department of Medicine (Fabreau, Vaughan), Division of Infectious Diseases (Vaughan) and Department of Family Medicine (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Gabriel Fabreau
- South Zone Medical Affairs, Alberta Health Services (Webb); Department of Community Health Sciences (Fabreau, Spackman, McBrien), O'Brien Institute for Public Health (Fabreau, Spackman, McBrien), Department of Medicine (Fabreau, Vaughan), Division of Infectious Diseases (Vaughan) and Department of Family Medicine (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Eldon Spackman
- South Zone Medical Affairs, Alberta Health Services (Webb); Department of Community Health Sciences (Fabreau, Spackman, McBrien), O'Brien Institute for Public Health (Fabreau, Spackman, McBrien), Department of Medicine (Fabreau, Vaughan), Division of Infectious Diseases (Vaughan) and Department of Family Medicine (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Stephen Vaughan
- South Zone Medical Affairs, Alberta Health Services (Webb); Department of Community Health Sciences (Fabreau, Spackman, McBrien), O'Brien Institute for Public Health (Fabreau, Spackman, McBrien), Department of Medicine (Fabreau, Vaughan), Division of Infectious Diseases (Vaughan) and Department of Family Medicine (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta
| | - Kerry McBrien
- South Zone Medical Affairs, Alberta Health Services (Webb); Department of Community Health Sciences (Fabreau, Spackman, McBrien), O'Brien Institute for Public Health (Fabreau, Spackman, McBrien), Department of Medicine (Fabreau, Vaughan), Division of Infectious Diseases (Vaughan) and Department of Family Medicine (McBrien), Cumming School of Medicine, University of Calgary, Calgary, Alta
| |
Collapse
|
4
|
Hauptmann S, Gabler W, Tappe D. Histopathological and molecular diagnosis of orofacial schistosomiasis with an odontogenic cyst: An unusual case. HUMAN PATHOLOGY: CASE REPORTS 2020. [DOI: 10.1016/j.ehpc.2020.200456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
5
|
Giorgio S, Gallo-Francisco PH, Roque GAS, Flóro E Silva M. Granulomas in parasitic diseases: the good and the bad. Parasitol Res 2020; 119:3165-3180. [PMID: 32789534 DOI: 10.1007/s00436-020-06841-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/02/2020] [Indexed: 12/12/2022]
Abstract
Parasitic diseases affect more than one billion people worldwide, and most of them are chronic conditions in which the treatment and prevention are difficult. The appearance of granulomas, defined as organized and compact structures of macrophages and other immune cells, during various parasitic diseases is frequent, since these structures will only form when individual immune cells do not control the invading agent. Th2-typering various parasitic diseases are frequent, since these structures will only form when individual immune cells do not control the invading agent. The characterization of granulomas in different parasitic diseases, as well as recent findings in this field, is discussed in this review, in order to understand the significance of the granuloma and its modulation in the host-parasite interaction and in the immune, pathological, and parasitological aspects of this interaction. The parasitic granulomatous diseases granulomatous amebic encephalitis, toxoplasmosis, leishmaniasis, neurocysticercosis, and schistosomiasis mansoni are discussed as well as the mechanistic and dynamical aspects of the infectious granulomas.
Collapse
Affiliation(s)
- Selma Giorgio
- Department of Animal Biology, Biology Institute, State University of Campinas, Campinas, 13083-865, Brazil.
| | | | | | - Marina Flóro E Silva
- Department of Animal Biology, Biology Institute, State University of Campinas, Campinas, 13083-865, Brazil
| |
Collapse
|
6
|
Marchese V, Beltrame A, Angheben A, Marocco S, Gaeta GB, Bisoffi Z. The impact of schistosomiasis co-infection in the presentation of viral hepatitis B in migrants: An observational study in non-endemic area. Travel Med Infect Dis 2019; 35:101467. [PMID: 31449881 DOI: 10.1016/j.tmaid.2019.101467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 06/30/2019] [Accepted: 08/22/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND In Europe, the prevalence rates of schistosomiasis and HBV infection in migrants from sub-Saharan Africa are high. The co-infection schistosomiasis-HBV has been scarcely studied. METHODS This is a retrospective study assessing differences in clinical presentation, laboratory and ultrasound findings in a cohort of migrants admitted at the Department of Infectious - Tropical Diseases and Microbiology IRCCS Sacro Cuore Don Calabria Hospital of Negrar (Northeast Italy) with schistosomiasis, HBV infection or both. RESULTS Of the 227 migrants, 175 (77.1%) with a diagnosis of schistosomiasis were classified as SCHISTO group, 35 (15.4%) with schistosomiasis and hepatitis B were classified as SCHISTO/HBV group, and 17 (7.5%) patients with a diagnosis of HBV infection were classified as HBV group. S. mansoni was found in 47 patients, classified in MANSONI (38/175, 21.7%) or MANSONI/HBV (9/35, 25.7%) group depending on HBsAg status. Mean transaminases and APRI index values were higher in SCHISTO/HBV compared to SCHISTO group (p < 0.01). AST differed between MANSONI/HBV and MANSONI group (p = 0.038). No differences were found between SCHISTO/HBV and HBV group. Eosinophil count and total IgE differed only between MANSONI/HBV and HBV group (p = 0,049). CONCLUSIONS Schistosomiasis seems not to increase the liver damage in people with HBV infection. Conversely, finding elevated transaminases in patients with schistosomiasis should alert for presence of HBV.
Collapse
Affiliation(s)
- Valentina Marchese
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy; University Department of Infectious and Tropical Diseases & WHO Collaborating Centre for TB/HIV and TB Elimination, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Anna Beltrame
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy.
| | - Andrea Angheben
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy
| | - Stefania Marocco
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy
| | - Giovanni Battista Gaeta
- Chair of Infectious Diseases, Campania University "Luigi Vanvitelli", Policlinico Via Pansini 5, 8031, Naples, Italy
| | - Zeno Bisoffi
- Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar, Italy; Department of Diagnostics and Public Health, University of Verona, Piazzale L.A. Scuro, 37134, Verona, Italy
| |
Collapse
|
7
|
Agrusa A, Di Buono G, Buscemi S, Canfora I, Randisi B, Bonventre G, Gulotta L, Maienza E, Sorce V, Romano G, Gulotta G. Systemic schistosomiasis and large bowel perforation: An unexpected surgical urgency. Report of a case and literature review. Clin Case Rep 2019; 7:968-972. [PMID: 31110726 PMCID: PMC6509925 DOI: 10.1002/ccr3.2138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 03/10/2019] [Accepted: 03/12/2019] [Indexed: 12/28/2022] Open
Abstract
In the presence of suggestive clinical picture (high eosinophil count and multiple CT scan granuloma-like lesions), schistosomiasis should be taken into account in case of suspected bowel perforation even if common risk factors are not identified through anamnesis.
Collapse
Affiliation(s)
- Antonino Agrusa
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| | - Giuseppe Di Buono
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| | - Salvatore Buscemi
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| | - Ilaria Canfora
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| | - Brenda Randisi
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| | - Giulia Bonventre
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| | - Leonardo Gulotta
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| | - Elisa Maienza
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| | - Vincenzo Sorce
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| | - Giorgio Romano
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| | - Gaspare Gulotta
- Section of General and Urgent Surgery, Department of Surgical, Oncological and Oral SciencesUniversity of PalermoPalermoItaly
| |
Collapse
|
8
|
Guler R, Mpotje T, Ozturk M, Nono JK, Parihar SP, Chia JE, Abdel Aziz N, Hlaka L, Kumar S, Roy S, Penn-Nicholson A, Hanekom WA, Zak DE, Scriba TJ, Suzuki H, Brombacher F. Batf2 differentially regulates tissue immunopathology in Type 1 and Type 2 diseases. Mucosal Immunol 2019; 12:390-402. [PMID: 30542107 PMCID: PMC7051910 DOI: 10.1038/s41385-018-0108-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 10/04/2018] [Accepted: 10/07/2018] [Indexed: 02/04/2023]
Abstract
Basic leucine zipper transcription factor 2 (Batf2) activation is detrimental in Type 1-controlled infectious diseases, demonstrated during infection with Mycobacterium tuberculosis (Mtb) and Listeria monocytogenes Lm. In Batf2-deficient mice (Batf2-/-), infected with Mtb or Lm, mice survived and displayed reduced tissue pathology compared to infected control mice. Indeed, pulmonary inflammatory macrophage recruitment, pro-inflammatory cytokines and immune effectors were also decreased during tuberculosis. This explains that batf2 mRNA predictive early biomarker found in active TB patients is increased in peripheral blood. Similarly, Lm infection in human macrophages and mouse spleen and liver also increased Batf2 expression. In striking contrast, Type 2-controlled schistosomiasis exacerbates during infected Batf2-/- mice with increased intestinal fibro-granulomatous inflammation, pro-fibrotic immune cells, and elevated cytokine production leading to wasting disease and early death. Together, these data strongly indicate that Batf2 differentially regulates Type 1 and Type 2 immunity in infectious diseases.
Collapse
Affiliation(s)
- Reto Guler
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDepartment of Pathology, University of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aWellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Diseases and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Thabo Mpotje
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDepartment of Pathology, University of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Mumin Ozturk
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDepartment of Pathology, University of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Justin K. Nono
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDepartment of Pathology, University of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa ,0000 0004 0595 6917grid.500526.4The Medical Research Centre, Institute of Medical Research and Medicinal Plant Studies (IMPM), Ministry of Scientific Research and Innovation, Yaoundé, Cameroon
| | - Suraj P. Parihar
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDepartment of Pathology, University of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aWellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Diseases and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDivision of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Julius Ebua Chia
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDepartment of Pathology, University of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Nada Abdel Aziz
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDepartment of Pathology, University of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa ,0000 0004 0639 9286grid.7776.1Department of Chemistry, Faculty of Science, Cairo University, Cairo, Egypt
| | - Lerato Hlaka
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDepartment of Pathology, University of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Santosh Kumar
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDepartment of Pathology, University of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| | - Sugata Roy
- RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, 230-0045 Japan
| | - Adam Penn-Nicholson
- 0000 0004 1937 1151grid.7836.aSouth African Tuberculosis Vaccine Initiative, Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, 7925 South Africa
| | - Willem A. Hanekom
- 0000 0004 1937 1151grid.7836.aSouth African Tuberculosis Vaccine Initiative, Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, 7925 South Africa
| | - Daniel E. Zak
- 0000 0004 0463 2611grid.53964.3dThe Center for Infectious Disease Research, Seattle, WA 98109 USA
| | - Thomas J. Scriba
- 0000 0004 1937 1151grid.7836.aSouth African Tuberculosis Vaccine Initiative, Division of Immunology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, 7925 South Africa
| | - Harukazu Suzuki
- RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, 230-0045 Japan
| | - Frank Brombacher
- International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town Component, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aDepartment of Pathology, University of Cape Town, Institute of Infectious Diseases and Molecular Medicine (IDM), Division of Immunology and South African Medical Research Council (SAMRC) Immunology of Infectious Diseases, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa ,0000 0004 1937 1151grid.7836.aWellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Diseases and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town, 7925 South Africa
| |
Collapse
|
9
|
Maezawa K, Furushima-Shimogawara R, Yasukawa A, Ohta N, Iwanaga S. Real-time observation of pathophysiological processes during murine experimental Schistosoma japonicum infection using high-resolution ultrasound imaging. Trop Med Health 2018; 46:1. [PMID: 29317853 PMCID: PMC5755264 DOI: 10.1186/s41182-017-0082-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 12/19/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Hepatosplenic lesion formation is one of the typical clinical symptoms of schistosomiasis japonica. Although it is established that circum-oval granuloma formation mediated by T lymphocytes is the key event triggering the formation of hepatic lesions, the time-course kinetics of disease progression remains to be fully elucidated. METHODS The real-time process of the pathophysiology of schistosomiasis japonica from the early to late clinical phase was non-invasively observed in a murine experimental infection model using high-resolution ultrasonography. Together with clinical parameters, including body weight and the levels of serum markers of hepatic damage or fibrosis, ultrasonography was used to assess changes in the liver parenchyma and diameter of the portal vein and portal blood flow velocity. In parallel, parasitological parameters were observed, including egg number in the feces and maturation of parasites. RESULTS Abnormal high-echo spot patterns in the liver parenchyma, reflecting hepatic fibrosis in ultrasonography, appeared in the liver at 4 weeks post-infection and the pattern became more enlarged and severe over time. This finding was concordant with parasite maturation and initial egg excretion. The serum M2BPGi level markedly increased from 8 weeks post-infection, suggesting sharp deterioration of hepatic fibrosis. At the same time, the diameter of the portal vein, reflecting portal hypertension, became enlarged and reached the peak level at 8 weeks post-infection. Ascites were apparent around the spleen at 9 weeks post-infection, and dilatation of the splenic vein was noted at 10 weeks post-infection. Live adult worms seemed to be detected in the portal vein at 4 weeks post-infection by ultrasonography. CONCLUSIONS We obtained real-time imaging of the development of hepatosplenic lesions of schistosomiasis japonica in mice. The time-course kinetics of the onset, development, and modulation of each symptom was uncovered. These results are expected to provide new clues for understanding the pathophysiology of human schistosomiasis japonica.
Collapse
Affiliation(s)
- Katsumi Maezawa
- Department of Environmental Parasitology, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113–8519 Japan
| | - Rieko Furushima-Shimogawara
- Department of Environmental Parasitology, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113–8519 Japan
| | - Akio Yasukawa
- Nishiogi Veterinary Medical Hospital, 4-9-2 Nishiogikita, Suginami-ku, Tokyo, 167–0042 Japan
| | - Nobuo Ohta
- Department of Environmental Parasitology, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113–8519 Japan
- Depertment of Clinical Nutrition, Faculty of Health Science, Suzuka University of Medical Science, 1001-1, Kishioka-cyo, Suzuka-shi, Mie 510-0293 Japan
| | - Shiro Iwanaga
- Department of Environmental Parasitology, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113–8519 Japan
| |
Collapse
|
10
|
Theilmann L, Abdel Samie A. A Patient with a Solitary Lump in the Sigmoid Colon. Gastroenterology 2016; 150:e11-2. [PMID: 26627330 DOI: 10.1053/j.gastro.2015.05.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Accepted: 05/27/2015] [Indexed: 12/02/2022]
Affiliation(s)
- Lorenz Theilmann
- Department of Gastroenterology, HELIOS Hospital, Pforzheim, Germany
| | | |
Collapse
|
11
|
Shaish H, Gilet A, Gerard P. 'It's all foreign to me': how to decipher gastrointestinal intraluminal foreign bodies. ABDOMINAL IMAGING 2015; 40:2173-2192. [PMID: 25952573 DOI: 10.1007/s00261-015-0434-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In evaluating the gastrointestinal tract, whether in the emergency room setting, the inpatient setting or the outpatient setting, the radiologist may encounter a myriad of intraluminal radio-opaque, non-anatomic entities. It is the radiologist's role to distinguish between true foreign bodies and medical paraphernalia. Further, the later must be evaluated for proper positioning vs. improper, potentially detrimental positioning. While many foreign bodies from the community may be distinctly familiar to the radiologist, the large variety of medical tools in existence may not be. Furthermore, many medical devices are designed to transiently traverse, or interact with the gastrointestinal tract, requiring the radiologist to become familiar with their natural history. We explore a select group of common and uncommon intraluminal foreign bodies and will divide them into medical paraphernalia that are properly positioned; medical paraphernalia that are in abnormal locations and miscellaneous foreign bodies from the community. For each medical tool, we will discuss its development and medical utility, natural history as it relates to the gastrointestinal tract, optimal positioning as assessed radiologically, malpositioning, and subsequent complications. A small selection of unusual foreign bodies from the community will be presented. Finally, a selection of medical conditions which produce symptoms due to acquired intraluminal objects will be reviewed.
Collapse
Affiliation(s)
- Hiram Shaish
- Department of Radiology, Westchester Medical Center, 100 Woods Rd., Valhalla, NY, 10595, USA.
| | - Anthony Gilet
- Department of Radiology, Westchester Medical Center, 100 Woods Rd., Valhalla, NY, 10595, USA
| | - Perry Gerard
- Department of Radiology, Westchester Medical Center, 100 Woods Rd., Valhalla, NY, 10595, USA
| |
Collapse
|
12
|
Ali MA, Arnold CA, Singhi AD, Voltaggio L. Clues to uncommon and easily overlooked infectious diagnoses affecting the GI tract and distinction from their clinicopathologic mimics. Gastrointest Endosc 2014; 80:689-706. [PMID: 25070906 DOI: 10.1016/j.gie.2014.04.065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Accepted: 04/29/2014] [Indexed: 02/07/2023]
Affiliation(s)
- M Aamir Ali
- Department of Gastroenterology, George Washington University Hospital, Washington, District of Columbia, USA
| | | | - Aatur D Singhi
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lysandra Voltaggio
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| |
Collapse
|
13
|
Olveda DU, Olveda RM, McManus DP, Cai P, Chau TNP, Lam AK, Li Y, Harn DA, Vinluan ML, Ross AGP. The chronic enteropathogenic disease schistosomiasis. Int J Infect Dis 2014; 28:193-203. [PMID: 25250908 DOI: 10.1016/j.ijid.2014.07.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 06/26/2014] [Accepted: 07/16/2014] [Indexed: 02/08/2023] Open
Abstract
Schistosomiasis is a chronic enteropathogenic disease caused by blood flukes of the genus Schistosoma. The disease afflicts approximately 240 million individuals globally, causing approximately 70 million disability-adjusted life years lost. Chronic infections with morbidity and mortality occur as a result of granuloma formation in the intestine, liver, or in the case of Schistosoma haematobium, the bladder. Various methods are utilized to diagnose and evaluate liver fibrosis due to schistosomiasis. Liver biopsy is still considered the gold standard, but it is invasive. Diagnostic imaging has proven to be an invaluable method in assessing hepatic morbidity in the hospital setting, but has practical limitations in the field. The potential of non-invasive biological markers, serum antibodies, cytokines, and circulating host microRNAs to diagnose hepatic fibrosis is presently undergoing evaluation. This review provides an update on the recent advances made with respect to gastrointestinal disease associated with chronic schistosomiasis.
Collapse
Affiliation(s)
- David U Olveda
- Department of Medical Sciences, Griffith Health Institute, Gold Coast, Australia
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Manila, The Philippines
| | - Donald P McManus
- Department of Molecular Parasitology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Pengfei Cai
- Department of Molecular Parasitology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Thao N P Chau
- Department of Public Health, Flinders University, Adelaide, Australia
| | - Alfred K Lam
- Department of Medical Sciences, Griffith Health Institute, Gold Coast, Australia
| | - Yuesheng Li
- Department of Molecular Parasitology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Donald A Harn
- Department of Infectious Diseases, University of Georgia, Georgia, USA
| | - Marilyn L Vinluan
- Department of Health, Research Institute for Tropical Medicine, Manila, The Philippines
| | - Allen G P Ross
- Department of Medical Sciences, Griffith Health Institute, Gold Coast, Australia.
| |
Collapse
|
14
|
Van-Lume DSDM, Albuquerque MDFPMD, Souza AID, Domingues ALC, Lopes EPDA, Morais CNLD, Montenegro SML. Association between Schistosomiasis mansoni and hepatitis C: systematic review. Rev Saude Publica 2014; 47:414-24. [PMID: 24037369 DOI: 10.1590/s0034-910.2013047004247] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 07/15/2012] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To perform a systematic review of the prevalence of the HCV/ S. mansoni co-infection and associated factors in Schistosoma mansoni -infected populations. METHODS The bibliographic search was carried out using the Medline, Lilacs, SciELO, Cochrane Library and Ibecs databases. The criteria for the studies' selection and the extraction data were based on systematic review methods. Forty five studies were found, with nine being excluded in a first screening. Thirteen articles were used for data extraction. RESULTS The HCV infection rates in schistosomiasis populations range from 1% in Ethiopia to 50% in Egypt. Several studies had poorly defined methodologies, even in areas characterized by an association between hepatitis C and schistosomiasis, such as Brazil and Egypt, which meant conclusions were inconsistent. HCV infection rates in schistosomotic populations were heterogeneous and risk factors for acquiring the virus varied widely. CONCLUSIONS Despite the limitations, this review may help to identify regions with higher rates of hepatitis C and schistosomiasis association. However, more studies are necessary for the development of public health policies on prevention and control of both diseases.
Collapse
|
15
|
Elbaz T, Esmat G. Hepatic and intestinal schistosomiasis: review. J Adv Res 2013; 4:445-52. [PMID: 25685451 PMCID: PMC4293886 DOI: 10.1016/j.jare.2012.12.001] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 12/05/2012] [Accepted: 12/07/2012] [Indexed: 02/07/2023] Open
Abstract
Schistosomiasis is an endemic disease in Egypt caused by the trematode Schistosoma which has different species. Hepatic schistosomiasis represents the best known form of chronic disease with a wide range of clinical manifestations. The pathogenesis of schistosomiasis is related to the host cellular immune response. This leads to granuloma formation and neo angiogenesis with subsequent periportal fibrosis manifested as portal hypertension, splenomegaly and esophageal varices. Intestinal schistosomiasis is another well identified form of chronic schistosomal affection. Egg deposition and granuloma formation eventually leads to acute then chronic schistosomal colitis and is commonly associated with polyp formation. It frequently presents as abdominal pain, diarrhea, tenesmus and anal pain. Definite diagnosis of schistosomiasis disease depends on microscopy and egg identification. Marked progress regarding serologic diagnosis occurred with development of recent PCR techniques that can confirm schistosomal affection at any stage. Many antischistosomal drugs have been described for treatment, praziquantel being the most safe and efficient drug. Still ongoing studies try to develop effective vaccines with identification of many target antigens. Preventive programs are highly needed to control the disease morbidity and to break the cycle of transmission.
Collapse
Affiliation(s)
- Tamer Elbaz
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | - Gamal Esmat
- Endemic Medicine Department, Faculty of Medicine, Cairo University, Egypt
| |
Collapse
|
16
|
Almadi MA, Aljebreen AM, Sanai FM, Marcus V, Almeghaiseeb ES, Ghosh S. New insights into gastrointestinal and hepatic granulomatous disorders. Nat Rev Gastroenterol Hepatol 2011; 8:455-66. [PMID: 21818145 DOI: 10.1038/nrgastro.2011.115] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Numerous diseases that involve the gastrointestinal tract reveal the presence of granulomas on histological analysis. Granulomatous diseases can be either primary or secondary to environmental factors. Granulomas are dynamic structures composed of organized collections of activated macrophages, including epithelioid and multinucleated giant cells, surrounded by lymphocytes. The formation of granulomas is usually in response to antigenic stimulation and is orchestrated through cytokines, immune cells and host genetics. In this Review, the pathogenesis and etiologies of granulomas of the gastrointestinal tract and liver are discussed, as are the available diagnostic tools to help differentiate their various underlying etiologies. In addition, the role of granulomas in harboring latent tuberculosis is reviewed. The effects of tumor necrosis factor antagonists and interferon-α on the development of granulomas are also discussed.
Collapse
Affiliation(s)
- Majid A Almadi
- Department of Medicine, Gastroenterology Division, King Khalid University Hospital, King Saud University, PO Box 231494, Riyadh 11321, Saudi Arabia.
| | | | | | | | | | | |
Collapse
|
17
|
Li Y, Chen D, Ross AG, Burke ML, Yu X, Li RS, Zhou J, McManus DP. Severe hepatosplenic schistosomiasis: clinicopathologic study of 102 cases undergoing splenectomy. Hum Pathol 2010; 42:111-9. [PMID: 20970162 DOI: 10.1016/j.humpath.2010.05.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Revised: 05/19/2010] [Accepted: 05/20/2010] [Indexed: 10/18/2022]
Abstract
We present the preoperative findings of 102 patients who underwent successful splenectomy for advanced schistosomiasis japonica. All patients were symptomatic for schistosomiasis and had splenomegaly greater than or equal to II according to the Hackett criteria. Before surgery, all patients underwent clinical examination including full blood count; fibrinogen and serum protein levels; liver function tests; and serology for hepatitis B, C, and D. Ultrasound examination of the liver and spleen and liver histology for evidence of pathology were also undertaken. Ninety patients had a treatment history for schistosomiasis. Fifty-six patients were seropositive for hepatitis B virus antibody, and 6 patients were seropositive for hepatitis C virus antibody. Immunohistochemical testing of the liver samples confirmed that 45 patients were positive for hepatitis B virus surface antigen, thereby indicating active infection. A total of 66.7% of patients had fibrosis stages II to III by ultrasound; and 76.5% of patients had portal vein inner diameter greater than 12 mm, indicating portal vein hypertension. A total of 83.2% of patients showed various stages of esophageal varicosis via x-ray, and 81.4% had fibrotic stages III to IV by liver biopsy. Coinfection with hepatitis B virus accelerated the development of liver fibrosis. There was moderate concordance between the fibrosis assessed by ultrasonography and histopathology, indicating that ultrasound underestimates the true pathology. Combined assessment is needed to improve the diagnosis of clinical hepatic fibrosis.
Collapse
Affiliation(s)
- Yuesheng Li
- Hunan Institute of Parasitic Diseases, World Health Organization Collaborating Centre for Research and Control on Schistosomiasis on Lake Region, Yueyang, Hunan Province 414000, The People's Republic of China
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Kansagra A, Nagaria N, Ahlawat S. Asymptomatic colon adenoma associated with Schistosoma mansoni. Dig Liver Dis 2010; 42:526-7. [PMID: 19948430 DOI: 10.1016/j.dld.2009.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Accepted: 10/28/2009] [Indexed: 12/11/2022]
|
19
|
Esquistosomiasis intestinal. GASTROENTEROLOGIA Y HEPATOLOGIA 2009; 32:131-2. [DOI: 10.1016/j.gastrohep.2008.09.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Accepted: 09/01/2008] [Indexed: 11/15/2022]
|
20
|
Cook GC. Tropical Gastroenterological Problems. MANSON'S TROPICAL DISEASES 2009. [PMCID: PMC7310931 DOI: 10.1016/b978-1-4160-4470-3.50014-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
21
|
|
22
|
Reimert CM, Tukahebwa EM, Kabatereine NB, Dunne DW, Vennervald BJ. Assessment of Schistosoma mansoni induced intestinal inflammation by means of eosinophil cationic protein, eosinophil protein X and myeloperoxidase before and after treatment with praziquantel. Acta Trop 2008; 105:253-9. [PMID: 18177822 DOI: 10.1016/j.actatropica.2007.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 11/20/2007] [Accepted: 11/21/2007] [Indexed: 12/12/2022]
Abstract
Faecal concentrations of eosinophil cationic protein (ECP), eosinophil protein X (EPX) and myeloperoxidase (MPO) were measured in extracts of stool samples obtained from a cohort of people (n=182) living in Bugoigo, a fishing community on the Eastern shore of Lake Albert, Buliisa District, in North Western Uganda where Schistosoma mansoni is endemic. Samples were collected before treatment and 5, 15, 20 and 52 weeks after treatment with praziquantel. Significantly increased levels of faecal ECP and EPX were found in S. mansoni infected individuals (n=155) compared to the levels found in stools from non-infected (n=27) (median values ECP: 11.3 microg/g vs. 5.9 microg/g, P=0.005, and EPX: 413.5 ng/g vs. 232.2 ng/g, P=0.045). An increased level of MPO was also found among the infected individuals compared to the non-infected 11.6 mu/g vs. 5.3 mu/g, P=0.07). Significant but weak correlations were found between faecal egg counts and faecal concentrations of ECP and EPX. Treatment with praziquantel induced a significant decline in both ECP and EPX, but only a non-significant reduction in faecal MPO. Following reinfection and despite of very low infection intensities, the protein levels increased significantly reaching the pre-treatment level (ECP and EPX) or levels significantly higher than the pre-treatment levels (MPO). This response pattern may imply a rebound effect during reinfection following treatment and resolution of immune regulatory immunosuppressive mechanisms in function during the chronic infection.
Collapse
|
23
|
Abstract
Parasitic infections are a major worldwide health problem, and they account for millions of infections and deaths each year. Most of the infections as well as the morbidity and mortality from these diseases occur in the developing world in rural regions. However, these diseases have become more common in Western countries and in big cities over the past 25 years. These changing disease patterns can be attributed to emigration from the third world to developed countries and migration of rural populations to the big cities in developing nations. These parasitic infections have protean manifestations and consequences. The medical problems range from chronic asymptomatic carrier to fulminant infections and even death. Several factors such as the host immune status, the infecting organism, and the availability of treatment all play key roles in the outcomes of parasitic colitides. The two major classes of parasites causing these infections are the helminthes (ascariasis, strongyloidiasis, enterobiasis, trichuriasis, and schistosomiasis) and the protozoa (Isospora, Cryptosporidium, Cyclospora, Trypanosoma cruzi, Giardia lamblia, and Balantidium coli). This article summarizes the salient features of each parasite with respect to epidemiology, transmission, pathogenesis, clinical features, diagnosis, and treatment. The vast majority of these infections have a self-limited clinical course or are easily treated with medical management, and surgery is rarely needed.
Collapse
Affiliation(s)
- Joel E Goldberg
- Division of General and Gastrointestinal Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| |
Collapse
|
24
|
Hillaire S, Cazals D, Valla D. Les maladies vasculaires du foie en dehors des atteintes des gros vaisseaux. ACTA ACUST UNITED AC 2006; 30:1155-61. [PMID: 17075470 DOI: 10.1016/s0399-8320(06)73494-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
MESH Headings
- Amyloidosis/diagnosis
- Amyloidosis/pathology
- Autoimmune Diseases/diagnosis
- Autoimmune Diseases/pathology
- Biopsy
- Humans
- Hyperplasia
- Hypertension, Portal/diagnosis
- Hypertension, Portal/etiology
- Hypertension, Portal/pathology
- Hypertension, Portal/therapy
- Liver/blood supply
- Liver/pathology
- Liver Circulation
- Liver Cirrhosis, Biliary/diagnosis
- Liver Cirrhosis, Biliary/pathology
- Liver Diseases/congenital
- Liver Diseases/diagnosis
- Liver Diseases/pathology
- Liver Diseases/physiopathology
- Liver Diseases, Parasitic/diagnosis
- Liver Diseases, Parasitic/pathology
- Microcirculation
- Sarcoidosis/diagnosis
- Sarcoidosis/pathology
- Schistosomiasis/diagnosis
- Schistosomiasis/pathology
- Tuberculosis, Hepatic/diagnosis
- Tuberculosis, Hepatic/pathology
- Venules/pathology
Collapse
Affiliation(s)
- Sophie Hillaire
- Réseau Val de Seine, Hôpital Foch, Suresnes Hôpital Beaujon, Clichy
| | | | | |
Collapse
|
25
|
Strickland GT. Liver disease in Egypt: hepatitis C superseded schistosomiasis as a result of iatrogenic and biological factors. Hepatology 2006; 43:915-22. [PMID: 16628669 DOI: 10.1002/hep.21173] [Citation(s) in RCA: 186] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In Egypt, schistosomiasis was traditionally the most important public health problem and infection with Schistosoma mansoni the major cause of liver disease. From the 1950s until the 1980s, the Egyptian Ministry of Health (MOH) undertook large control campaigns using intravenous tartar emetic, the standard treatment for schistosomiasis, as community-wide therapy. This commendable effort to control a major health problem unfortunately established a very large reservoir of hepatitis C virus (HCV) in the country. By the mid-1980s, the effective oral drug, praziquantel, replaced tartar emetic a s treatment f o r schistosomiasis in the entire country. This both reduced schistosomal transmission and disease and interrupted the "occult" HCV epidemic. It was evident when diagnostic serology became available in the 1990s that HCV had replaced schistosomiasis as the predominant cause of chronic liver disease. Epidemiological studies reported a high prevalence and incidence of HCV, particutarly within families in rural areas endemic for schistosomiasis. Clinical studies showed 70% to 90% of patients with chronic hepatitis, cirrhosis, or hepatocellular carcinoma had HCV infections. Co-infections with schistosomiasis caused more severe liver disease than infection with HCV alone. Schistosomiasis was reported to cause an imbalance in HCV-specific T-cell responses leading to increased viral load, a higher probability of HCV chronicity, and more rapid progression of complications in co-infected persons. As complications of HCV usually occur after 20 years of infection, the peak impact of the Egyptian outbreak has not yet occurred. Efforts have been initiated by the Egyptian MOH to prevent new infections and complications of HCV in the estimated 6 million infected persons.
Collapse
Affiliation(s)
- G Thomas Strickland
- Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.
| |
Collapse
|
26
|
Hoare M, Gelson WTH, Davies SE, Curran M, Alexander GJM. Hepatic and intestinal schistosomiasis after orthotopic liver transplant. Liver Transpl 2005; 11:1603-7. [PMID: 16315308 DOI: 10.1002/lt.20622] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Schistosomiasis affects 200 to 250 million people worldwide. Hepatic schistosomiasis is a well-recognized cause of chronic liver disease and portal hypertension. There are no previous reports of schistosomiasis post liver transplantation. We report on 2 cases of schistosomiasis in liver transplant recipients--a case of gastric schistosomiasis and a case of hepatic schistosomiasis. A discussion of the pathology of schistosomal infection and a rationale for screening potential liver transplant recipients from endemic areas follows.
Collapse
Affiliation(s)
- Matthew Hoare
- Department of Hepatology, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK
| | | | | | | | | |
Collapse
|
27
|
Ferraz AAB, Campos JM, Júnior JGCDA, De Albuquerque AC, Ferraz EM. Gut Bacterial Translocation and Postoperative Infections: A Prospective Study in Schistosomotic Patients. Surg Infect (Larchmt) 2005; 6:197-201. [PMID: 16128626 DOI: 10.1089/sur.2005.6.197] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Bacterial translocation (BT) across the intact intestinal mucosal barrier has been postulated as a source of sepsis in susceptible patients, including those with cirrhosis and portal hypertension. This condition has not been studied in hepatosplenic schistosomiasis, wherein portal hypertension and the presence of an immune deficiency state associated with the parasitic disease could predispose to BT into mesenteric lymph nodes (MLN). A study was conducted to determine the prevalence of aerobic bacteria in MLN (bacterial translocation) of patients with hepatosplenic schistosomiasis, and establish a possible association with postoperative infections. METHODS In a series of 51 patients submitted to surgical treatment of schistosomotic portal hypertension with splenectomy and gastric devascularization, MLN were obtained from each patient at the beginning (MLN1) and at the end (MLN2) of the surgical procedure, and sent for bacteriological analysis. Prospective patient evaluation during the postoperative period correlated positive MLN cultures with infectious complications. RESULTS The prevalence of aerobic bacteria was 17.6% at MLN1 and 27.5% at MLN2, however, this difference was non-significant (p = 0.24). Bacterial translocation to all MLN was 22.5%. Escherichia coli was the most frequent organism (26.1%, 6/23). The overall incidence of postoperative infections was 19.6% (10/51), with a significant association with the presence of positive cultures of MLN (p = 0.043). CONCLUSIONS The findings of this study suggest that the presence of aerobic bacteria on MLN as a consequence of BT may play a role in the development of postoperative infectious complications, particularly in schistosomotic patients.
Collapse
|
28
|
Escoín C, Torrús D, Merino de Lucas E, Teruel del Valle A. [Patient native of Ghana with diarrhea and proctalgia]. Enferm Infecc Microbiol Clin 2005; 23:321-2. [PMID: 15899182 DOI: 10.1157/13074972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Corina Escoín
- Servicio de Medicina Interna, Hospital General Universitario de Alicante, Maestro Alonso 109, 03010 Alicante, Spain.
| | | | | | | |
Collapse
|
29
|
Abstract
Schistosomiasis is an important disease in many parts of the world and has affected the course of human history many times over. The parasitic infection is acquired during contact with infected water. A chronic inflammatory response to schistosome eggs, mediated by both cellular and humoral mechanisms, is the root of the pathology seen in schistosomiasis. Hepatosplenic disease results in intrahepatic presinusoidal portal hypertension. The resultant esophageal and gastric varices are an important cause of morbidity and mortality. Standard treatment guidelines for managing varices can be applied to patients with schistosomiasis. Coinfection with viral hepatitis results in liver disease that progresses more rapidly and is more difficult to treat. Intestinal schistosomiasis may be confused with other disease states and can be an important cause of morbidity, especially in heavily infected patients. Diagnosis relies on demonstration of schistosome eggs in feces or tissue. Praziquantel is the treatment of choice. The development of a vaccine for schistosomiasis is an important goal in the attempt to control this disease.
Collapse
Affiliation(s)
- T W Schafer
- Clinical Investigation Department (KCA), Naval Medical Center, San Diego, 34800 Bob Wilson Drive, Suite 5, San Diego, CA 92134-1005, USA
| | | |
Collapse
|
30
|
Aquino RT, Chieffi PP, Catunda SM, Araújo MF, Ribeiro MC, Taddeo EF, Rolim EG. Hepatitis B and C virus markers among patients with hepatosplenic mansonic schistosomiasis. Rev Inst Med Trop Sao Paulo 2000; 42:313-20. [PMID: 11136517 DOI: 10.1590/s0036-46652000000600003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To evaluate the frequency and the consequences of the co-infection of hepatitis B and C viruses in patients with hepatosplenic schistosomiasis (HSS). METHODS B and C serologic markers, exposure to risk factors, biochemical assays, upper gastrointestinal endoscopies, and abdominal ultrasonograms were evaluated in 101 patients with HSS from 1994 to 1997. Whenever possible, PCR was tested and histopathological studies were reviewed. RESULTS At least one HBV virus marker was found in 15.8%, and anti-HCV was detected in 12.9% of the subjects. The seropositive subjects tended to be older than the seronegative ones. A history of blood transfusion was significantly related to the presence of anti-HCV. Three (18.75%) out of 16 subjects exposed to B virus were HBsAg positive. Eleven (84.6%) out of thirteen patients who were anti-HCV positive demonstrated viral activity. Patients with ongoing viral infection presented a higher average level of liver aminotransferases, a higher frequency of cell decompensation and a higher rate of chronic hepatitis. Portal hypertension parameters were not influenced by viral exposure. CONCLUSIONS The rate of hepatitis B and C viruses serologic markers observed in the patients with HSS was higher than the control group. The co-infection was responsible for a higher frequency of cell decompensation.
Collapse
Affiliation(s)
- R T Aquino
- Faculdade de Ciências Médicas, Santa Casa de São Paulo, São Paulo, SP, 01277-900, Brasil
| | | | | | | | | | | | | |
Collapse
|
31
|
Bogers J, Moreels T, De Man J, Vrolix G, Jacobs W, Pelckmans P, van Marck E. Schistosoma mansoni infection causing diffuse enteric inflammation and damage of the enteric nervous system in the mouse small intestine. Neurogastroenterol Motil 2000; 12:431-40. [PMID: 11012943 DOI: 10.1046/j.1365-2982.2000.00219.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Schistosomiasis mansoni is a major health problem, mainly occurring in developing countries. A large proportion of infected individuals suffers from motility-related gastrointestinal problems. In the present study, the diffuse inflammatory response in the small bowel wall, as compared to the egg-induced granulomatous inflammation, was investigated. For this purpose, OF1 mice infected with Schistosoma mansoni 8-16 weeks prior to the experiment, and uninfected control mice were studied. The ileum showed both a diffuse mucosal inflammation as well as a granulomatous reaction. The diffuse mucosal inflammation caused an increase in the thickness of the mucosa, with blunting of the villi. A significant, transient increase of thickness of the muscularis propria after 12 weeks of infection was noted. There was an infection-related mast cell infiltrate in the muscularis propria, consisting of formalin fixation-insensitive connective tissue mast cells. Ganglionitis of the myenteric plexus was noted. Rarely, ganglia of the myenteric plexus contained apoptotic cells. A general pharmacological set of experiments showed a significant increase in intestinal contractility, both to exogenously administered, as well as to endogenously released neurotransmitters. Our results demonstrate that S. mansoni infection in the mouse ileum leads to diffuse specific enteric inflammation that is associated with an enhanced response to contractile agents.
Collapse
Affiliation(s)
- J Bogers
- Laboratory of Pathology, University of Antwerp (UIA), Universiteitsplein 1, B-2610 Antwerp (Wilrijk), Belgium
| | | | | | | | | | | | | |
Collapse
|
32
|
Abstract
Schistosomiasis is a major, worldwide cause of morbidity and mortality. Disease from the organism Schistosoma mansoni results from egg deposition in the liver, intestines, and other organs and is associated with an intense, granulomatous response from the human host. Clinical manifestations range from mild to severe intestinal forms, and hepatosplenic schistosomiasis, which is associated with hepatic fibrosis, portal hypertension, esophageal varices, and splenomegaly. This article presents information about the epidemiology, immunopathogenesis and clinical aspects of the disease, the relationship between hepatic schistosomiasis and viral infections, diagnosis, therapy, and control strategies for schistosomiasis.
Collapse
Affiliation(s)
- I Bica
- Department of Medicine, New England Medical Center, Boston, Massachusetts, USA
| | | | | |
Collapse
|
33
|
Abstract
Parasitic infections of the gastrointestinal tract are a major cause of morbidity and mortality worldwide. Increased international travel means that gastroenterologists are now more likely to care for patients with parasitic diseases. This article reviews various aspects of the more common intestinal parasites and their infections, including epidemiology, life cycle, pathogenesis, clinical manifestations, diagnosis, and treatment.
Collapse
Affiliation(s)
- C M Noyer
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA
| | | |
Collapse
|
34
|
Sood R, Green MR, McKeever PA, Johnstone JM. Meckel's diverticulitis associated with Schistosoma mansoni. J Pediatr Gastroenterol Nutr 1999; 28:336-7. [PMID: 10067741 DOI: 10.1097/00005176-199903000-00025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- R Sood
- Children's Hospital, Leicester Royal Infirmary, United Kingdom
| | | | | | | |
Collapse
|