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Aggarwal A, Gupta M, Gabriel J, Walker D. Metastatic neuroendocrine tumor masquerading as liver abscesses. Clin Case Rep 2020; 8:2530-2535. [PMID: 33363773 PMCID: PMC7752639 DOI: 10.1002/ccr3.3224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/16/2020] [Indexed: 11/12/2022] Open
Abstract
Fever and deranged transaminases with liver mass(es) on imaging mandates further evaluation of the mass(es) and should be followed radiologically and clinically. In the absence of a definitive diagnosis, repeat biopsy should be done.
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Affiliation(s)
- Abhimanyu Aggarwal
- Division of Infectious DiseasesDepartment of MedicineBaystate Medical Center‐University of Massachusetts Medical SchoolSpringfieldMassachusettsUSA
| | | | - Joseph Gabriel
- Division of Medical OncologyBaystate Medical Center‐University of Massachusetts Medical SchoolSpringfieldMassachusettsUSA
| | - Durane Walker
- Division of Infectious DiseasesDepartment of MedicineBaystate Medical Center‐University of Massachusetts Medical SchoolSpringfieldMassachusettsUSA
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Janczar S, Bulas M, Walenciak J, Baranska D, Ussowicz M, Młynarski W, Zalewska-Szewczyk B. Pulmonary Exacerbation of Undiagnosed Toxocariasis in Intensively-Treated High-Risk Neuroblastoma Patients. CHILDREN-BASEL 2020; 7:children7100169. [PMID: 33028049 PMCID: PMC7600921 DOI: 10.3390/children7100169] [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] [Received: 09/01/2020] [Revised: 09/26/2020] [Accepted: 10/03/2020] [Indexed: 11/16/2022]
Abstract
Toxocariasis is one of the most common zoonoses, with high seroprevalence in apparently healthy individuals. Neuroblastoma is an aggressive childhood cancer. The cure rates are improving due to dose-dense chemotherapy, progress in surgical practice, myeloablative therapy with autologous stem cell transplantation, and recently, anti-GD2 immunotherapy. This is associated with a burden of complications, some of which are relatively specific for neuroblastoma treatment. Based on previous reports of Toxocara canis infection in high-risk neuroblastoma patients and cases of pulmonary exacerbation from our center in this disease, we propose that toxocariasis is a specific complication of intensive pediatric cancer treatment and advocate for active surveillance.
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Affiliation(s)
- Szymon Janczar
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Sporna 36/50 St., 91-738 Lodz, Poland; (M.B.); (J.W.); (W.M.); (B.Z.-S.)
- Correspondence:
| | - Monika Bulas
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Sporna 36/50 St., 91-738 Lodz, Poland; (M.B.); (J.W.); (W.M.); (B.Z.-S.)
| | - Justyna Walenciak
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Sporna 36/50 St., 91-738 Lodz, Poland; (M.B.); (J.W.); (W.M.); (B.Z.-S.)
| | - Dobromila Baranska
- Department of Diagnostic Imaging, Polish Mother’s Memorial Hospital Research Institute, 91-738 Lodz, Poland;
| | - Marek Ussowicz
- Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Wojciech Młynarski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Sporna 36/50 St., 91-738 Lodz, Poland; (M.B.); (J.W.); (W.M.); (B.Z.-S.)
| | - Beata Zalewska-Szewczyk
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Sporna 36/50 St., 91-738 Lodz, Poland; (M.B.); (J.W.); (W.M.); (B.Z.-S.)
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3
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Dewair A, Bessat M. Molecular and microscopic detection of natural and experimental infections of Toxocara vitulorum in bovine milk. PLoS One 2020; 15:e0233453. [PMID: 32433671 PMCID: PMC7239449 DOI: 10.1371/journal.pone.0233453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 05/05/2020] [Indexed: 02/02/2023] Open
Abstract
Toxocara vitulorum is an Ascarid nematode infecting the small intestine of buffalo and cattle particularly neonate calves, with the postnatal route through milk is the main infection source. However, little is known about shedding rates and the optimum detection methods of T. vitulorum larvae in the milk of the infected bovine hosts. In this study, we aimed to evaluate the use of two methods, microscopy and PCR, and their detection limits both under the experimental and natural infection situations. In doing this, T. vitulorum eggs extracted from naturally occurring adult female worms were successfully subjected to experimental embryonation, and larvae were implemented in experimental infection of milk in ascending infection doses of 0, 1, 5, 10, 20, 50 larvae/2-ml milk samples. With the except of negative control, microscopy-based examination detected larvae in all samples, albeit with means, ranges, and the total number of larvae were detected in exponential rates relative to larvae densities in milk samples. PCR technique corresponded well to microscopy in detecting genomic DNA of T. vitulorum larvae in all milk samples down to a single larva/sample. On the other hand, and by applying the same methodology approach on 50 naturally-occurring bovine colostrum/milk samples, 13 (26%) and 20 (40%) samples were tested positive for T. vitulorum infection by microscopy and the PCR-based detection, respectively. Of these, 11 out of 26 buffalo samples (42.30%) and 2 out of 24 cow samples (8.33%) were tested positive by microscopy, while 16 (61.54%) and 3 (12.50%) of buffalo and cow samples were tested positive by PCR, respectively. By applying the Agreement Coefficient, substantial agreement (0.77) between molecular and microscopy detection was detected from all tested samples. In conclusion, larvae of T. vitulorum were unequivocally detected by microscopy and molecular methods in milk samples both under the experimental and natural field situations. Nevertheless, slightly higher rates by PCR than microscopy were obtained when detecting naturally-infected milk samples. To the best of our knowledge, this is the first in situ detection of larvae of T. vitulorum in the milk of the naturally infected animals.
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Affiliation(s)
- Amira Dewair
- Department of Parasitology, Faculty of Veterinary Medicine, Alexandria University, Alexandria, Egypt
| | - Mohamed Bessat
- Department of Parasitology, Faculty of Veterinary Medicine, Alexandria University, Alexandria, Egypt
- * E-mail:
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Wu T, Bowman DD. Visceral larval migrans of Toxocara canis and Toxocara cati in non-canid and non-felid hosts. ADVANCES IN PARASITOLOGY 2020; 109:63-88. [PMID: 32381221 DOI: 10.1016/bs.apar.2020.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Toxocara canis and Toxocara cati are considered the most ubiquitous gastrointestinal helminths in domesticated canids and felids. Ascarid eggs passed in the faeces of canids and felids in a suitable environment may remain infective for years and are capable of infecting not only canids and felids, but a large range of other vertebrate paratenic hosts, including man. Infection with Toxocara species also occurs following the ingestion of paratenic hosts containing infective larvae. As infective larvae are incapable of completing their lifecycle in these hosts, they instead travel to different parts of the body, sometimes inducing inflammatory responses, and in some cases remaining entrapped in the body for years. Migration routes depend on the host species; however, nearly all organs may be affected with varying quantities of larval burdens.
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Affiliation(s)
- Timothy Wu
- Department of Biomedical Sciences, Section of Anatomic Pathology, College of Veterinary Medicine, Cornell University, Ithaca, NY, United states
| | - Dwight D Bowman
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States.
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Kim HG, Yang JW, Hong SC, Lee YJ, Ju YT, Jeong CY, Lee JK, Kwag SJ. Toxocara canis Mimicking a Metastatic Omental Mass from Sigmoid Colon Cancer: A Case Report. Ann Coloproctol 2018; 34:160-163. [PMID: 29991206 PMCID: PMC6046541 DOI: 10.3393/ac.2017.12.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/20/2017] [Indexed: 12/21/2022] Open
Abstract
Toxocara canis is an important roundworm of canids and a fearsome animal parasite of humans. Human infections can lead to syndromes called visceral larva migrans (VLM), ocular larva migrans, neurotoxocariasis, and covert toxocariasis. VLM is most commonly diagnosed in children younger than 8 years of age, but adult cases are relatively frequent among those infected by ingesting the raw tissue of paratenic hosts in East Asia. This research reports the case of a 59-year-old man with sigmoid colon cancer, who visited our institution for surgery. An intraperitoneal mass was found on preoperative computed tomography, and it was thought to be a metastatic mass from sigmoid colon cancer. A postoperative histologic examination and serum test showed eosinophilic granuloma due to toxocariasis. Diagnosis of VLM is often difficult and highly suspicious in adults. Researchers suggest, although rarely, that VLM be included in the differential diagnosis as a cause of intraperitoneal tumors.
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Affiliation(s)
- Han-Gil Kim
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jung-Wook Yang
- Department of Pathology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Soon-Chan Hong
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Joon Lee
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young-Tae Ju
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Chi-Young Jeong
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jin-Kwon Lee
- Department of General Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Seung-Jin Kwag
- Department of General Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
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Jang EY, Choi MS, Gwak GY, Koh KC, Paik SW, Lee JH, Paik YH, Yoo BC. Enhanced resolution of eosinophilic liver abscess associated with toxocariasis by albendazole treatment. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2017; 65:222-8. [PMID: 25896156 DOI: 10.4166/kjg.2015.65.4.222] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND/AIMS Visceral larva migrans, caused by Toxocara canis and Toxocara cati, has emerged as a significant cause of eosinophilic liver abscess (ELA). Differentiation of ELA associated with toxocariasis (ELA-T) from metastasis or primary liver malignancy is sometimes difficult. However, the role of albendazole treatment remains uncertain in this condition. The aim of this study was to evaluate whether albendazole can enhance the radiologic resolution of ELA-T. METHODS We retrospectively reviewed the medical records of the patients diagnosed with ELA-T at our institution between January 2008 and December 2011. ELA-T was diagnosed based on the imaging findings on computed tomography or magnetic resonance imaging and the presence of positive serum IgG antibody for Toxocara canis. Among a total of 163 patients, 32 patients received albendazole (albendazole group) and 131 did not (control group). Baseline characteristics and fate of liver nodules were compared between the two groups. RESULTS Baseline characteristics (age, sex, number and maximal size of lesions, eosinophil count) were similar between the two groups. Median duration for achieving radiologic resolution in the albendazole group was significantly shorter than in the control group (207 days [range 186-228] vs. 302 days [range 224-380], p=0.023). In Cox regression analysis of the cumulative rates of radiologic resolution, the hazard ratio for albendazole treatment was 1.99 (95% confidence interval, 1.22-3.23). CONCLUSIONS Radiologic resolution of ELA-T can be accelerated with albendazole treatment. Hence, inconvenience associated with long-term follow-up and unnecessary worries among patients can be eliminated with albendazole treatment.
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Affiliation(s)
- Eun Young Jang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon Seok Choi
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Geum Youn Gwak
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang Cheol Koh
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Woon Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Hyeok Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Han Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Chul Yoo
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Jorge D, Strady C, Guy B, Deslée G, Lebargy F, Dury S. [Multiple pulmonary opacities revealing toxocariasis]. REVUE DE PNEUMOLOGIE CLINIQUE 2016; 72:273-276. [PMID: 27368139 DOI: 10.1016/j.pneumo.2016.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 03/04/2016] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Toxocariasis is a parasitosis which complicates the accidental infestation of the humans by larvae of a roundworms belonging of the genus Toxocara. In adults, the discovery is often incidental during a hypereosinophilia check-up. Clinical signs are not specific and depend on affected organs. CASE REPORT We report the case of a 53-year-old-woman who has consulted for a recent cough, after spontaneous resolution of abdominal pain. The laboratory examination isolated an hypereosinophilia and the liver sonography showed two hypoechogenic nodules. The CT-scan found bilateral lung nodules with ground glass halo. Broncho-alveolar lavage identified an eosinophilic alveolitis. Positive serologic results for toxocariasis and western blot results allowed to conclude to the diagnosis of pulmonary and hepatic toxocariasis. CONCLUSION Although rare, pulmonary toxocariasis should be suspect in any lung eosinophilia, especially if the patient has never traveled.
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Affiliation(s)
- D Jorge
- Service des maladies respiratoires, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51 092 Reims cedex, France
| | - C Strady
- Groupe Courlancy, Cabinet d'infectiologie, Clinique Saint-André, 51100 Reims, France
| | - B Guy
- Groupe Courlancy, Cabinet de pneumologie, Clinique Saint-André, 51100 Reims, France
| | - G Deslée
- Service des maladies respiratoires, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51 092 Reims cedex, France; Unité 903, Inserm, 51100 Reims, France
| | - F Lebargy
- Service des maladies respiratoires, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51 092 Reims cedex, France; EA 4683, université de médecine et de pharmacie, 51100 Reims, France
| | - S Dury
- Service des maladies respiratoires, hôpital Maison-Blanche, CHU de Reims, 45, rue Cognacq-Jay, 51 092 Reims cedex, France; EA 4683, université de médecine et de pharmacie, 51100 Reims, France.
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Laroia ST, Rastogi A, Bihari C, Bhadoria AS, Sarin SK. Hepatic visceral larva migrans, a resilient entity on imaging: Experience from a tertiary liver center. Trop Parasitol 2016; 6:56-68. [PMID: 26998435 PMCID: PMC4778184 DOI: 10.4103/2229-5070.175100] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Hepatic visceral larva migrans (VLM) is an uncommon parasitic manifestation seen in the liver. It presents as coalescing, conglomerated, or solitary abscess cavities in the liver on imaging. We conducted a retrospective clinico-radiological analysis of 24 patients with biopsy proven VLM who were reviewed and followed up at our tertiary liver institute over a period of 4 years. MATERIALS AND METHODS The study was performed to correlate the radiological features and imaging response to therapy for hepatic VLM. The disease course, imaging findings, progressive, absolute eosinophil counts (AEC), hydatid serology, and the extent of radiological regression of the liver lesions, on follow-up were analyzed. RESULTS Imaging showed a diagnostic accuracy of 42%. Hydatid serology was positive in 46% patients before starting treatment. The median pretreatment AEC of 507 showed a significant posttreatment AEC decline to median value of 117. The Wilcoxon signed ranks test showed significant decline in the AEC (P < 0.001). Radiological regression was present in all lesions. However, patients showed residual abscesses on imaging, up to 2 years on follow-up. CONCLUSION This study reveals that AEC has a significant predictive value in diagnosis and as a marker for disease regression. Complete radiological resolution of hepatic lesions does not correlate with total clinical remission. This finding warrants the need for further studies to look into the role of prolonged medical therapy or surgery as an alternate to current therapy module in cases of hepatic visceral larva abscesses.
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Affiliation(s)
| | - Archana Rastogi
- Department of Hepato Pathology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Chhagan Bihari
- Department of Hepato Pathology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ajeet Singh Bhadoria
- Department of Community Medicine and Public Health, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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Gordon CA, McManus DP, Jones MK, Gray DJ, Gobert GN. The Increase of Exotic Zoonotic Helminth Infections: The Impact of Urbanization, Climate Change and Globalization. ADVANCES IN PARASITOLOGY 2016; 91:311-97. [PMID: 27015952 DOI: 10.1016/bs.apar.2015.12.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Zoonotic parasitic diseases are increasingly impacting human populations due to the effects of globalization, urbanization and climate change. Here we review the recent literature on the most important helminth zoonoses, including reports of incidence and prevalence. We discuss those helminth diseases which are increasing in endemic areas and consider their geographical spread into new regions within the framework of globalization, urbanization and climate change to determine the effect these variables are having on disease incidence, transmission and the associated challenges presented for public health initiatives, including control and elimination.
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Affiliation(s)
- Catherine A Gordon
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Malcolm K Jones
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; School of Veterinary Science, University of Queensland, Brisbane, QLD, Australia
| | - Darren J Gray
- Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Geoffrey N Gobert
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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The role of inflammation in gastric cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 816:235-57. [PMID: 24818726 DOI: 10.1007/978-3-0348-0837-8_10] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Gastric cancer, despite its declining incidence rate, is still the second cause of cancer-related death worldwide, killing 750,000 people each year and remaining the second common type of cancer. The best examples of inflammation-associated cancer in human beings may be gastric cancer. Understanding the molecular mechanism of the inflammation in gastric carcinogenesis is important for developing new strategies against gastric cancer.
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Aituov B, Duisembekova A, Bulenova A, Alibek K. Pathogen-driven gastrointestinal cancers: Time for a change in treatment paradigm? Infect Agent Cancer 2012; 7:18. [PMID: 22873119 PMCID: PMC3508868 DOI: 10.1186/1750-9378-7-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 07/27/2012] [Indexed: 02/06/2023] Open
Abstract
The regulation of cancerous tumor development is converged upon by multiple pathways and factors. Besides environmental factors, gastrointestinal (GI) tract cancer can be caused by chronic inflammation, which is generally induced by bacteria, viruses, and parasites. The role of these inducers in cancer development, cell differentiation and transformation, cell cycle deregulation, and in the expression of tumor-associated genes cannot be ignored. Although Helicobacter pylori activates many oncogenic pathways, particularly those in gastric and colorectal cancers, the role of viruses in tumor development is also significant. Viruses possess significant oncogenic potential to interfere with normal cell cycle control and genome stability, stimulating the growth of deregulated cells. An increasing amount of recent data also implies the association of GI cancers with bacterial colonization and viruses. This review focuses on host-cell interactions that facilitate primary mechanisms of tumorigenesis and provides new insights into novel GI cancer treatments.
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Affiliation(s)
- Bauyrzhan Aituov
- Nazarbayev University, 53 Kabanbay Batyr Avenue, Astana 010000, Kazakhstan
| | - Assem Duisembekova
- Nazarbayev University, 53 Kabanbay Batyr Avenue, Astana 010000, Kazakhstan
| | - Assel Bulenova
- Nazarbayev University, 53 Kabanbay Batyr Avenue, Astana 010000, Kazakhstan
| | - Kenneth Alibek
- Nazarbayev University, 53 Kabanbay Batyr Avenue, Astana 010000, Kazakhstan
- Republican Scientific Center for Emergency Care, 3 Kerey and Zhanibek Khan Street, Astana 010000, Kazakhstan
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