Persistent febrile hepatomegaly with eosinophilia due to hepatic capillariasis in Central China

Rats and their helminth parasites: Potential zoonosis threats of land use change in the northeastern sub-watersheds of Mount Makiling, Laguna, Philippines

The continuous challenges of land use change have brought potential threats to biodiversity and the spread of zoonotic diseases. In this study, synanthropic rodents and their helminth parasites were used as sentinels to assess the potential impact of land use on zoonosis. Rats were collected in different ecosystems, namely agricultural, agroforest, and residential areas in the northeastern sub-watersheds of Mount Makiling, Laguna, Philippines. Three (3) species of rats were captured, namely, Rattus tanezumi, Rattus norvegicus, and Rattus exulans. Of the total 180 rats collected, 92.7 % were found infected with helminth parasites, namely Hymenolepis diminuta, Hymenolepis nana, Taenia pisiformis, and Strobilocercus fasciolaris (cestodes); Angiostrongylus cantonensis, Nippostrongylus brasiliensis, Strongyloides ratti, Capillaria hepatica, Trichuris muris, and Rictularia sp. (nematodes); and Echinostoma ilocanum (trematode). Of these 11 species, nine (9) were considered zoonotic. This study provides important information on the helminth parasites of rats in the northeastern sub-watersheds of Mount Makiling and the potential threat of zoonotic transmission due to increasing land use change and urbanization in the area. Moreover, urbanization can provide favorable eco-epidemiological conditions for rodent-borne pathogens, such as parasites, that are seriously threatening agricultural settings and human settlements in these areas.

Molecular characterization of a Trichinella spiralis elastase-1 and its potential as a diagnostic antigen for trichinellosis

BACKGROUND

Trichinella spiralis muscle larval (ML) excretion/secretion (ES) antigen is the most widely used diagnostic antigen of trichinellosis, but preparation of ES antigen requires collecting worms from infected animals, and detection of specific IgG against ML ES antigen may result in a false negative at the early stage of infection. The aim of the study was to characterize T. spiralis elastase-1 (TsEla) and to evaluate its potential as diagnostic antigen for trichinellosis.

METHODS

The complete cDNA sequences of the TsEla gene were cloned and expressed, and recombinant (rTsEla) was purified. TsEla transcription and expression in different T. spiralis life-cycle stages was investigated by qPCR and western blotting, and its location in the nematodes was evaluated using an immunofluorescence assay (IFA). The antigenicity of rTsEla was investigated by western blotting analysis and ELISA. Anti-Trichinella IgG, IgM and IgE of experimentally infected mice and specific IgG antibodies of trichinellosis patients were assayed by rTsEla-ELISA and ES-ELISA.

RESULTS

The results of the qPCR and western blotting showed that TsEla was expressed in various T. spiralis life stages. Natural TsEla was detected in the soluble proteins and ES proteins of different life stages. IFA revealed that TsEla was identified in the whole nematodes of various stages, especially in the cuticle, stichosome and genital primordium of the parasite. Serum anti-Trichinella IgM, IgG and IgE in infected mice was first detected by rTsEla-ELISA at 6, 10 and 12 days post-infection (dpi), and reached 100% at 8, 14 and 14 dpi, respectively. When rTsEla-ELISA and ES-ELISA were used to detect anti-Trichinella IgG in sera of trichinellosis patients, the sensitivity was 97.37% (37/38) and 89.74% (34/38) (P > 0.05), and the specificity was 99.10% (220/222) and 98.20% (218/222), respectively (P > 0.05). The rTsEla cross-reacted with only one serum sample out of 20 samples from paragonimiasis patients and 7 samples from clonorchiasis patients.

CONCLUSIONS

rTsEla is valuable to early diagnosis of trichinellosis and could be an alternative diagnostic antigen to the ML ES antigens.

Clinical and laboratory characterizations of hepatic capillariasis

Hepatic capillariasis is a rare and neglected parasitic disease caused by infection with Capillaria hepatica in human liver. The disease is not well described and the information for the disease's clinical manifestation, laboratory findings and disease management strategy is not well reported. The limited information for this neglected infection often results in the delay of diagnosis or misdiagnosed to other diseases, therefore the real prevalence or severity of the infection may be underestimated. More case report with systemic analysis and features summary of this disease is needed to better understand the serious zoonotic disease. This study included systemic analysis of 16 patients infected with hepatic capillariasis in China between 2011-2017, including clinical manifestations, laboratory/radiative image findings and treatment results. Clinical manifestation included sustained fever (56.25%), respiratory disorder (37.5%), abdominal pain (37.5%), diarrhea (25%), leukocytosis (93.75%) and eosinophilia (100%). No egg was detected in feces of all patients. Over 60% patients showed elevated level of hepatic enzymes and proteins related to liver fibrosis in sera. Ultrasound and MRI examinations displayed scattered parasitic granuloma leisure in affected liver. Liver biopsy revealed parasite eggs, necrotized parasitic granulomas and septal fibrosis. Treatment with albendazole combined with corticoids for several treatment courses cured all patients with capillariasis. The difficulty of diagnosis, apparent damage of liver functions and potential fibrosis make the disease's prevalence and severity underestimated.

Capillaria hepatica (Calodium hepaticum) infection in a horse: a case report

Background

Capillaria hepatica is a zoonotic parasite in humans and animals and has a worldwide distribution. However, infections in mammals apart from rodents, which are natural hosts of the parasite, have rarely been reported. This report describes the first known case of C. hepatica infection in a horse in Japan.

Case presentation

A 3-year-old filly without clinical signs was presented at a slaughterhouse in Japan. Gross examination revealed white to tan nodules 0.5 to 1.5 cm in diameter in the parenchyma of the liver. Histologically, the nodules had mature fibrous capsules and consisted of multifocal to coalescing granulomatous inflammations with numerous nematode eggs. The eggs were barrel shaped with an opercular plug on each end and double-layered shells; these findings are consistent with the features of C. hepatica eggs.

Conclusions

To our knowledge, this is the first case of C. hepatica infection in a horse in Japan. The pathological findings confirmed the presence of this pathogen in this part of the world, and they highlight the importance of this nematode in the differential diagnosis of hepatic granulomatous lesions in horses.

Intracranial inflammatory granuloma caused by toxoplasmosis

Toxoplasmosis is a serous parasitic zoonosis caused by the protozoan Toxoplasma gondii worldwide. Human beings acquire the disease by eating infected meat containing T. gondii cysts, by ingesting water or vegetables contaminated with oocysts shed in the feces of an infected cat, and by transmission from mother to fetus. Cerebral toxoplasmosis is one of the most serious complications in immunocompromised individuals such as HIV-infected patients, with a high mortality rate, whereas the incidence of cerebral toxoplasmosis is extremely rare in immunocompetent persons. Due to the low incidence and the high rate of misdiagnosis, cerebral toxoplasmosis was occasionally described in sporadic cases. (1) Furthermore, the diagnosis of cerebral toxoplasmosis is rather difficult because the clinical manifestations are non-specific and are not sufficiently characteristic for a definite diagnosis. It mimics several other infectious diseases or primary central nervous system (CNS) tumor. (2) In the present study, we reported an exceedingly rare cerebral toxoplasmosis with obvious space-occupying lesion occurring in the left temporal lobe of an immunocompetent adult patient. To our knowledge, this is the first report of successful treatment of acquired cerebral toxoplasmosis in China.