Effect of Brugia pahangi co-infection with Plasmodium berghei ANKA in gerbils (Meriones unguiculatus)

Helminth-host-environment interactions: Looking down from the tip of the iceberg

In 1978, the theory behind helminth parasites having the potential to regulate the abundance of their host populations was formalized based on the understanding that those helminth macroparasites that reduce survival or fecundity of the infected host population would be among the forces limiting unregulated host population growth. Now, 45 years later, a phenomenal breadth of factors that directly or indirectly affect the host-helminth interaction has emerged. Based largely on publications from the past 5 years, this review explores the host-helminth interaction from three lenses: the perspective of the helminth, the host, and the environment. What biotic and abiotic as well as social and intrinsic host factors affect helminths? What are the negative, and positive, implications for host populations and communities? What are the larger-scale implications of the host-helminth dynamic on the environment, and what evidence do we have that human-induced environmental change will modify this dynamic? The overwhelming message is that context is everything. Our understanding of second-, third-, and fourth-level interactions is extremely limited, and we are far from drawing generalizations about the myriad of microbe-helminth-host interactions.Yet the intricate, co-evolved balance and complexity of these interactions may provide a level of resilience in the face of global environmental change. Hopefully, this albeit limited compilation of recent research will spark new interdisciplinary studies, and application of the One Health approach to all helminth systems will generate new and testable conceptual frameworks that encompass our understanding of the host-helminth-environment triad.

Spleen nodules in Loa loa infection: re-emerging knowledge and future perspectives

Loiasis, the infection with the vector-borne filarial nematode Loa loa, is widely distributed in central and west Africa. Long considered a rather benign infection, recently loiasis with high microfilarial burden was associated with increased mortality risk. Eyeworm and Calabar swelling are pathognomonic signs of the infection, but other atypical, non-specific manifestations can also occur. For instance, splenic nodules have been seldom reported. In this Grand Round, we report two cases of loiasis in migrants who presented with spleen nodules, which could be followed up over time (up to 27 months) with multiple imaging techniques until their resolution. We comment on the clinical implications of these observations, including differential diagnosis with similar imaging findings, and critically review the evidence of spleen involvement in loiasis and other filarial infections.