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Fan X, Chen T, Yang H, Gao Y, Chen Y. Encephalomyelomeningitis Caused by Balamuthia mandrillaris: A Case Report and Literature Review. Infect Drug Resist 2023; 16:727-733. [PMID: 36756612 PMCID: PMC9901442 DOI: 10.2147/idr.s400692] [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: 12/16/2022] [Accepted: 01/21/2023] [Indexed: 02/05/2023] Open
Abstract
Central nervous system infection by Balamuthia mandrillaris is a rare and severe condition, which has a fatality rate of approximately 95% and often evades timely diagnosis due to its rarity and non-specific clinical manifestations. Here, we report a case of encephalomyelomeningitis caused by B. mandrillaris in a male who presented with transient coma, nausea, and vomiting when working in a garbage dump. Initial magnetic resonance imaging (MRI) of the brain showed normal signals. Despite receiving steroids as well as antibacterial and antiviral treatment, he developed urinary and fecal dysfunction, inability to walk, and deterioration of consciousness. Both brain and spinal cord MRI revealed abnormal findings, and next-generation sequencing of the cerebrospinal fluid showed the presence of B. mandrillaris. A combination of fluconazole and albendazole was administered; however, the patient deteriorated gradually and died 30 days after the onset. We suggest the unbiased metagenomic sequencing of the affected tissues/CSF in patients with CNS infections that are difficult to diagnose or treat, and multiple tests at different stages of the disease may be required.
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Affiliation(s)
- XueMei Fan
- Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - TianWen Chen
- Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - Hui Yang
- Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China
| | - Yue Gao
- Department of General Practice, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China,Yue Gao, Tel +86 13706511908; +86 531-56006851, Email
| | - Yan Chen
- Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China,Correspondence: Yan Chen, Department of Neurology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, No. 261, Huan Sha Road, Shangcheng District, Hangzhou, People’s Republic of China, Tel +86 15397086693; +86 531-56006952, Email
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2
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Alvarez P, Torres-Cabala C, Gotuzzo E, Bravo F. Cutaneous balamuthiasis: A clinicopathological study. JAAD Int 2022; 6:51-58. [PMID: 35059659 PMCID: PMC8760460 DOI: 10.1016/j.jdin.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Methods Results Conclusion
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Affiliation(s)
- Patricia Alvarez
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Correspondence to: Patricia Alvarez, MD, Patologia cutánea, Av. Angamos Oeste 896, Miraflores Lima, Peru.
| | - Carlos Torres-Cabala
- Departments of Pathology and Dermatology, The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Eduardo Gotuzzo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Nacional Cayetano Heredia, Lima, Peru
| | - Francisco Bravo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
- Departamento de Patología, Hospital Cayetano Heredia, Lima, Peru
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3
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Hu J, Zhang Y, Yu Y, Yu H, Guo S, Shi D, He J, Hu C, Yang J, Fang X, Xiao Y. Encephalomyelitis Caused by Balamuthia mandrillaris in a Woman With Breast Cancer: A Case Report and Review of the Literature. Front Immunol 2022; 12:768065. [PMID: 35069540 PMCID: PMC8766823 DOI: 10.3389/fimmu.2021.768065] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
Balamuthia mandrillaris is one cause of a rare and severe brain infection called granulomatous amoebic encephalitis (GAE), which has a mortality rate of >90%. Diagnosis of Balamuthia GAE is difficult because symptoms are non-specific. Here, we report a case of Balamuthia amoebic encephalomyelitis (encephalitis and myelitis) in a woman with breast cancer. She sustained trauma near a garbage dump 2 years ago and subsequently developed a skin lesion with a Mycobacterium abscessus infection. She experienced dizziness, lethargy, nausea and vomiting, inability to walk, and deterioration of consciousness. Next-generation sequencing of cerebrospinal fluid (CSF) samples revealed B. mandrillaris, and MRI of both brain and spinal cord showed abnormal signals. T-cell receptor (TCR) sequencing of the CSF identified the Top1 TCR. A combination of amphotericin B, flucytosine, fluconazole, sulfamethoxazole, trimethoprim, clarithromycin, pentamidine, and miltefosine was administrated, but she deteriorated gradually and died on day 27 post-admission.
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Affiliation(s)
- Juan Hu
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yiqi Zhang
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yongwei Yu
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Huili Yu
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Siruo Guo
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ding Shi
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianqin He
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chi Hu
- Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiqi Yang
- Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueling Fang
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yonghong Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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4
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Khan AS, Al‐Awadi A, Willis FB, Pujalte GGA. Cutaneous larva migrans in the city. Clin Case Rep 2020; 8:3162-3163. [PMID: 33363899 PMCID: PMC7752308 DOI: 10.1002/ccr3.3262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 07/04/2020] [Accepted: 07/29/2020] [Indexed: 11/08/2022] Open
Abstract
Cutaneous larva migrans is typically reported in tropical and subtropical regions of the world. However, cutaneous larva migrans cases are spreading and should now be recognized even in urban, nontropical settings.
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Affiliation(s)
- Aruna S. Khan
- Department of Family MedicineMayo ClinicJacksonvilleFlorida
- Florida State UniversityTallahasseeFlorida
| | - Ahmad Al‐Awadi
- Department of Family MedicineMayo ClinicJacksonvilleFlorida
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Costa CA, Lopes RM, Ferraz LS, Esteves GN, Di Iorio JF, Souza AA, de Oliveira IM, Manarin F, Judice WA, Stefani HA, Rodrigues T. Cytotoxicity of 4-substituted quinoline derivatives: Anticancer and antileishmanial potential. Bioorg Med Chem 2020; 28:115511. [DOI: 10.1016/j.bmc.2020.115511] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/08/2020] [Accepted: 04/14/2020] [Indexed: 12/11/2022]
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Cartography and Epidemiological Study of Leishmaniasis Disease in Sefrou Province (2007-2010), Central North of Morocco. Interdiscip Perspect Infect Dis 2020; 2020:1867651. [PMID: 32377182 PMCID: PMC7180398 DOI: 10.1155/2020/1867651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/01/2020] [Accepted: 03/25/2020] [Indexed: 11/21/2022] Open
Abstract
Increasing cases of leishmaniasis disease have been reported during recent years in Sefrou Province, Central North of Morocco. This study presents the epidemiological profile of the provincial population, aims at analyzing the epidemiological profile, and in particular, spatiotemporal follow-up of all cases of leishmaniasis. It is a retrospective analysis of leishmaniasis cases recorded between 2007 and 2010. The data were analyzed by SPSS software (version 20). Over a four-year period, from 2007 to 2010, there were 62 cases of leishmaniasis, 93.12% of cases of cutaneous leishmaniasis and 6.87% of visceral leishmaniasis. The case number of leishmaniasis in the Province of Sefrou varies between 0.165% and 0.0018%. For each type of leishmaniasis, the female sex was the most affected compared to the male sex. This difference cannot be considered statistically significant (χ2 = 0.083, p value = 0.77). For cutaneous leishmaniasis, all age groups were affected with a large percentage: patients aged 0–9 years with 63.11% followed by the age group [10–19] with 24.18%. Visceral leishmaniasis mainly has affected the infant population [0–9] with 83.33%. We have not observed any association between the age classes and the leishmaniasis type (χ2 = 6.20, p value = 0.4). From a spatial point of view, the majority of cases of leishmaniasis was reported in El Menzel region (67 cases) followed by Sefrou (64 cases) and Tazouta (38 cases). There is a statistically significant relationship between the type of leishmaniasis and the studied regions (χ2 = 52; p value <0.001). The study of the epidemiological profile of leishmaniasis cases may be useful in enlightening health authorities to develop screening, treatment, and control strategies to reduce the incidence rate of the disease. Other research studies can be conducted to the dynamics of the vectors of sandflies and their ecology.
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Yang Y, Hu X, Min L, Dong X, Guan Y. Balamuthia mandrillaris-Related Primary Amoebic Encephalitis in China Diagnosed by Next Generation Sequencing and a Review of the Literature. Lab Med 2020; 51:e20-e26. [PMID: 31711180 DOI: 10.1093/labmed/lmz079] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Encephalitis is caused by infection, immune mediated diseases, or primary inflammatory diseases. Of all the causative infectious pathogens, 90% are viruses or bacteria. Granulomatous amoebic encephalitis (GAE), caused by Balamuthia mandrillaris, is a rare but life-threatening disease. Diagnosis and therapy are frequently delayed due to the lack of specific clinical manifestations. METHOD A healthy 2 year old Chinese male patient initially presented with a nearly 2 month history of irregular fever. We present this case of granulomatous amoebic encephalitis caused by B. mandrillaris. Next generation sequencing of the patient's cerebrospinal fluid (CSF) was performed to identify an infectious agent. RESULT The results of next generation sequencing of the CSF showed that most of the mapped reads belonged to Balamuthia mandrillaris. CONCLUSION Next generation sequencing (NGS) is an unbiased and rapid diagnostic tool. The NGS method can be used for the rapid identification of causative pathogens. The NGS method should be widely applied in clinical practice and help clinicians provide direction for the diagnosis of diseases, especially for rare and difficult cases.
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Affiliation(s)
- Yinan Yang
- Department of Pediatrics, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xiaobin Hu
- School of Public Health, Lanzhou University, Cheng Guan District, Lanzhou, Gansu, China
| | - Li Min
- Department of Pediatrics, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Xiangyu Dong
- Department of Pediatrics, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Yuanlin Guan
- Chief Information Officer, Hugobiotech MicrobeCode Biotechnology Co. Ltd., Xi'an, Shaanxi, China
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Ogueta I, Navajas-Galimany L, Concha-Rogazy M, Álvarez-Véliz S, Vera-Kellet C, Gonzalez-Bombardiere S, Wortsman X. Very High- and High-Frequency Ultrasound Features of Cutaneous Larva Migrans. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:3349-3358. [PMID: 31106871 DOI: 10.1002/jum.15023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 04/28/2019] [Indexed: 06/09/2023]
Abstract
Cutaneous larva migrans is a common infestation among travelers. Although the diagnosis may be suspected clinically, cases can show atypical presentations. We present the ultrasound features of 4 cases at 18 and 70 MHz. Small linear hyperechoic and hyper-refringent subepidermal and intrafollicular structures suggestive of fragments of larvae, hypoechoic dermal and hypodermal tunnels that match with dilatation of lymphatic ducts, and inflammatory dermal and hypodermal ultrasound signs can support the diagnosis. This work suggests that larvae can penetrate the cutaneous basement membrane through the ostia of the hair follicles and potentially disseminate through the dermal and hypodermal lymphatic network.
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Affiliation(s)
- Isabel Ogueta
- Departments of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lucas Navajas-Galimany
- Departments of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcela Concha-Rogazy
- Departments of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sergio Álvarez-Véliz
- Departments of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristián Vera-Kellet
- Departments of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Ximena Wortsman
- Departments of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
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9
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Complex Investigation of a Pediatric Haematological Case: Haemophagocytic Syndrome Associated with Visceral Leishmaniasis and Epstein⁻Barr (EBV) Co-Infection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122672. [PMID: 30486459 PMCID: PMC6313770 DOI: 10.3390/ijerph15122672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/19/2018] [Accepted: 11/21/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Visceral leishmaniasis (VL) is an anthropozoonosis caused by an intracellular parasite belonging to the genus Leishmania. In the Mediterranean region, L. donovani and L. infantum are responsible for VL and dogs are the main reservoir. Haemophagocytic lymphohistiocytosis (HLH) represents a complication of VL and consists of unrestrained activation and proliferation of lymphocytes and macrophages, leading to uncontrolled immune activation. Haemophagocytic lymphohistiocytosis may also develop during viral infection, and Epstein⁻Barr virus (EBV) infection is one of the main HLH causes. Macrophage haemophagocytosis in the bone marrow aspirate is pathognomonic. CASE PRESENTATION The case involves a 19-month-old male infant presenting with a high persistent fever with a fluctuating pattern, pancytopaenia, hepatosplenomegaly, and a high triglyceride level. Initial investigations showed an EBV infection. Considering the persistent signs and symptoms, bone marrow aspiration was performed and confirmed the suspicion of HLH. In addition, the presence of Leishmania infection was shown. The patient was treated with liposomal amphotericin B and had complete resolution of his symptoms. CONCLUSION Diagnosis of VL represents a demanding challenge in endemic and non-endemic areas. Our case demonstrates that leishmaniasis should always be considered in the differential diagnosis in patients presenting with hepatosplenomegaly and cytopaenia with a persistent fever, even in cases of infectious mononucleosis. Moreover, the execution of bone marrow aspiration should not be delayed in order to diagnose and treat at an early stage the potential occurrence of VL, especially if complicated with HLH.
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Abamor EŞ. A New Approach To The Treatment of Leıshmaniasis: Quercetin-Loaded Polycaprolactone Nanoparticles. JOURNAL OF THE TURKISH CHEMICAL SOCIETY, SECTION A: CHEMISTRY 2018. [DOI: 10.18596/jotcsa.417831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abstract
Leishmaniasis is caused by an intracellular parasite transmitted to humans by the bite of a sand fly. It is endemic in Asia, Africa, the Americas, and the Mediterranean region. Worldwide, 1.5 to 2 million new cases occur each year, 350 million are at risk of acquiring the disease, and leishmaniasis causes 70,000 deaths per year. Clinical features depend on the species of
Leishmania involved and the immune response of the host. Manifestations range from the localized cutaneous to the visceral form with potentially fatal outcomes. Many drugs are used in its treatment, but the only effective treatment is achieved with current pentavalent antimonials.
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Affiliation(s)
- Edoardo Torres-Guerrero
- Sección de Micología, Hospital "Manuel Gea González" Secretaría de Salud, Calz. de Tlalpan 4800, Ciudad de México 14080, Mexico
| | | | - Julieta Ruiz-Esmenjaud
- Sección de Micología, Hospital "Manuel Gea González" Secretaría de Salud, Calz. de Tlalpan 4800, Ciudad de México 14080, Mexico
| | - Roberto Arenas
- Sección de Micología, Hospital "Manuel Gea González" Secretaría de Salud, Calz. de Tlalpan 4800, Ciudad de México 14080, Mexico
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Cáceres L, Suarez JA, Jackman C, Galbster A, Miranda R, Murgas I, Pascale J, Sosa N, Rodriguez-Morales AJ. Dermatitis Due to Paederus Colombinus: Report of an Epidemic Outbreak of 68 Cases in the Province of Darien, Panama. Cureus 2017; 9:e1158. [PMID: 28507830 PMCID: PMC5429145 DOI: 10.7759/cureus.1158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Contact dermatitis due to Paederus is a particular form of accident by animal contact. It is characterized by the sudden onset of erythematous and vesicular lesions with burning sensation on exposed areas of the body. The aim of this study was to describe the epidemiological and clinical findings of an outbreak of Paederus dermatitis in Panama. Methods Clinical and epidemiological findings of an outbreak of contact dermatitis caused by Paederus sp. in the province of Darien in eastern Panama is reported. After reviewing the clinical records, a clinical-epidemiological questionnaire was developed and used in 20 communities where reported cases were found. We captured and collected the specimens for species characterization for three consecutive days using three different methods of capture. Results During May-July, 2014, 68 cases of Paederus irritant contact dermatitis occurred in 20 communities of the Darien. Fifty-three percent were females. The age group of zero to five years had the highest number of cases, 15 (22%). The most common clinical presentation was the classical linear dermatitis (58%); 42% of the subjects had mirror image lesions, multiple vesicular-pustular lesions, and crust lesions. Symptoms were most commonly reported as a burning sensation (65%), followed by pruritus in 60%, pain (25%), and fever (nine percent). A total of 81 specimens of Paederus were collected, 68% in peridomiciliary areas. Conclusions This Paederus sp. dermatitis report represents one of the largest outbreak described in Latin America and the diagnosis could be confused with others skin diseases like pyodermitis or other contact dermatitis.
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Affiliation(s)
- Lorenzo Cáceres
- Entomology Section, Instituto Conmemorativo Gorgas De Estudios De La Salud, Panama City, Panama
| | - Jose A Suarez
- Clinical Research Department, Instituto Conmemorativo Gorgas De Estudios De La Salud, Panama City, Panama
| | | | - Amanda Galbster
- Clinical Research Department, Instituto Conmemorativo Gorgas De Estudios De La Salud, Panama City, Panama
| | - Roberto Miranda
- Entomology Section, Instituto Conmemorativo Gorgas De Estudios De La Salud, Panama City, Panama
| | - Ingrid Murgas
- Entomology Section, Instituto Conmemorativo Gorgas De Estudios De La Salud, Panama City, Panama
| | - Juan Pascale
- Clinical Research Department, Instituto Conmemorativo Gorgas De Estudios De La Salud, Panama City, Panama
| | - Nestor Sosa
- Clinical Research Department, Instituto Conmemorativo Gorgas De Estudios De La Salud, Panama City, Panama
| | - Alfonso J Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica De Pereira, Pereira, Risaralda, Colombia
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Farnon EC, Kokko KE, Budge PJ, Mbaeyi C, Lutterloh EC, Qvarnstrom Y, da Silva AJ, Shieh WJ, Roy SL, Paddock CD, Sriram R, Zaki SR, Visvesvara GS, Kuehnert MJ. Transmission ofBalamuthia mandrillarisby Organ Transplantation. Clin Infect Dis 2016; 63:878-888. [DOI: 10.1093/cid/ciw422] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/14/2016] [Indexed: 11/13/2022] Open
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14
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Lupi O, Downing C, Lee M, Pino L, Bravo F, Giglio P, Sethi A, Klaus S, Sangueza OP, Fuller C, Mendoza N, Ladizinski B, Woc-Colburn L, Tyring SK. Mucocutaneous manifestations of helminth infections: Nematodes. J Am Acad Dermatol 2016; 73:929-44; quiz 945-6. [PMID: 26568337 DOI: 10.1016/j.jaad.2014.11.034] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 11/06/2014] [Accepted: 11/17/2014] [Indexed: 11/30/2022]
Abstract
In the 21st century, despite increased globalization through international travel for business, medical volunteerism, pleasure, and immigration/refugees into the United States, there is little published in the dermatology literature regarding the cutaneous manifestations of helminth infections. Approximately 17% of travelers seek medical care because of cutaneous disorders, many related to infectious etiologies. This review will focus on the cutaneous manifestations of helminth infections and is divided into 2 parts: part I focuses on nematode infections, and part II focuses on trematode and cestode infections. This review highlights the clinical manifestations, transmission, diagnosis, and treatment of helminth infections. Nematodes are roundworms that cause diseases with cutaneous manifestations, such as cutaneous larval migrans, onchocerciasis, filariasis, gnathostomiasis, loiasis, dracunculiasis, strongyloidiasis, ascariasis, streptocerciasis, dirofilariasis, and trichinosis. Tremadotes, also known as flukes, cause schistosomiasis, paragonimiasis, and fascioliasis. Cestodes (tapeworms) are flat, hermaphroditic parasites that cause diseases such as sparganosis, cysticercosis, and echinococcus.
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Affiliation(s)
- Omar Lupi
- Federal University of the State of Rio de Janeiro and Policlinica Geral do Rio de Janeiro, Rio de Janerio, Brazil
| | - Christopher Downing
- Department of Dermatology, University of Texas Health Science Center, Houston, Texas.
| | - Michael Lee
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Livia Pino
- Federal University of the State of Rio de Janeiro and Policlinica Geral do Rio de Janeiro, Rio de Janerio, Brazil
| | - Francisco Bravo
- Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Aisha Sethi
- Section of Infectious Diseases and Global Health, Department of Dermatology, University of Chicago, Chicago, Illinois
| | - Sidney Klaus
- Department of Dermatology, Dartmouth School of Medicine, Hanover, New Hampshire
| | - Omar P Sangueza
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina; Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Claire Fuller
- International Foundation for Dermatology and Consultant, Chelsea and Westminster Hospital, London, United Kingdom
| | - Natalia Mendoza
- Department of Dermatology, University of Texas Health Science Center, Houston, Texas
| | - Barry Ladizinski
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Laila Woc-Colburn
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas
| | - Stephen K Tyring
- Center for Clinical Studies, Houston, Texas; Department of Dermatology, University of Texas Health Science Center, Houston, Texas
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15
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Maco V, Bravo L, Marcos LA. Recurrent abdominal panniculitis in a Peruvian man. Int J Dermatol 2015; 55:1057-9. [PMID: 26536475 DOI: 10.1111/ijd.13107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 05/19/2015] [Accepted: 06/09/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Vicente Maco
- Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano, Heredia, Lima, Peru.
| | - Leny Bravo
- Private University San Juan Bautista, School of Medicine, Chorrillos, Lima, Peru
| | - Luis A Marcos
- Institute of Tropical Medicine Alexander von Humboldt, Universidad Peruana Cayetano, Heredia, Lima, Peru
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First Draft Genome Sequence of Balamuthia mandrillaris, the Causative Agent of Amoebic Encephalitis. GENOME ANNOUNCEMENTS 2015; 3:3/5/e01013-15. [PMID: 26404594 PMCID: PMC4582570 DOI: 10.1128/genomea.01013-15] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The free-living amoeba Balamuthia mandrillaris is a rare but highly lethal agent of amoebic encephalitis in humans and many other mammalian species. Here, we announce the first draft genome sequence of the original 1990 isolate cultured from the brain of a deceased mandrill baboon.
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HTLV-1-associated infective dermatitis demonstrates low frequency of FOXP3-positive T-regulatory lymphocytes. J Dermatol Sci 2015; 77:150-5. [PMID: 25676425 DOI: 10.1016/j.jdermsci.2015.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 01/08/2015] [Accepted: 01/14/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Human T-lymphotropic virus (HTLV)-1-associated infective dermatitis (ID) is a rare severe chronic eczema, considered as a harbinger for the development of cutaneous adult T-cell leukemia/lymphoma (ATLL) and/or HTLV-1-associated myelopathy (HAM)/tropical spastic paraparesis (TSP). The pathogenesis of ID remains unclear. High numbers of peripheral blood CD4+ CD25+ FoxP3+ regulatory T cells (Tregs) have been reported in ATLL and HAM/TSP. OBJECTIVE To investigate the status of Tregs, unknown to date, and the histopathological features of ID. METHODS We studied 16 skin biopsies from 15 Peruvian adults and children with ID by immunohistochemistry. RESULTS Histopathological patterns were seborrheic dermatitis-like and lichenoid. Intraepidermal lymphocytes were conspicuous. The infiltrate was composed of a CD3+ T cell infiltrate with a predominance of CD8+ over CD4+ cells. CD4+ CD25+ FoxP3+ Tregs were rare and their numbers were significantly lower than those reported in other inflammatory dermatoses. CONCLUSION Tregs have an essential role in maintaining immune homeostasis of skin. Treg dysregulation ends in severe clinical manifestations. The clinical presentation of ID, with lesions resembling those seen in patients with atopic dermatitis and with mutations in the FoxP3 gene, is in agreement with a common Treg-deficient skin environment in these disorders, possibly secondary to HTLV-1 infection.
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Kiderlen AF, Radam E, Laube U, Martínez AJ. Resistance to Intranasal Infection with Balamuthia mandrillaris
Amebae is T-Cell Dependent. J Eukaryot Microbiol 2014; 62:26-33. [DOI: 10.1111/jeu.12189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 08/19/2014] [Accepted: 08/30/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Albrecht F. Kiderlen
- Division for Mycotic, Parasitic and Mycobacterial Infections; Robert Koch Institute; Nordufer 20 13353 Berlin Germany
| | - Elke Radam
- Division for Mycotic, Parasitic and Mycobacterial Infections; Robert Koch Institute; Nordufer 20 13353 Berlin Germany
| | - Ulrike Laube
- Division for Mycotic, Parasitic and Mycobacterial Infections; Robert Koch Institute; Nordufer 20 13353 Berlin Germany
| | - A. Julio Martínez
- Department of Pathology; Presbyterian Hospital and University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania 15231 USA
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Doroud D, Rafati S. Leishmaniasis: focus on the design of nanoparticulate vaccine delivery systems. Expert Rev Vaccines 2014; 11:69-86. [DOI: 10.1586/erv.11.166] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Cockerell C, Mihm MC, Hall BJ, Chisholm C, Jessup C, Merola M. Parasitic Infections and Bite Reactions. Dermatopathology (Basel) 2014. [DOI: 10.1007/978-1-4471-5448-8_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Diagnosis of infections caused by pathogenic free-living amoebae. Interdiscip Perspect Infect Dis 2009; 2009:251406. [PMID: 19657454 PMCID: PMC2719787 DOI: 10.1155/2009/251406] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Accepted: 06/05/2009] [Indexed: 11/23/2022] Open
Abstract
Naegleria fowleri, Acanthamoeba spp., Balamuthia mandrillaris, and Sappinia sp. are pathogenic free-living amoebae. N. fowleri causes Primary Amoebic Meningoencephalitis, a rapidly fatal disease of the central nervous system, while Acanthamoeba spp. and B. mandrillaris cause chronic granulomatous encephalitis. Acanthamoeba spp. also can cause cutaneous lesions and Amoebic Keratitis, a sight-threatening infection of the cornea that is associated with contact lens use or corneal trauma. Sappinia pedata has been identified as the cause of a nonlethal case of amoebic encephalitis. In view of the potential health consequences due to infection with these amoebae, rapid diagnosis is critical for early treatment. Microscopic examination and culture of biopsy specimens, cerebral spinal fluid (CSF), and corneal scrapings have been used in the clinical laboratory. For amoebic keratitis, confocal microscopy has been used to successfully identify amoebae in corneal tissue. More recently, conventional and real-time PCR assays have been developed that are sensitive and specific for the amoebae. In addition, multiplex PCR assays are available for the rapid identification of these pathogens in biopsy tissue, CSF, and corneal specimens.
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Abstract
All dermatologists worldwide should have at least passing familiarity with various tropical maladies that generate cutaneous manifestions. In addition to the standard infectious ailments associated with tropical environs, the authors have described herein five "emerging" illnesses that are gaining increasing attention for their capacity to cause human disease in those immigrating from, or traveling to, the tropical and subtropical world.
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Affiliation(s)
- Whitney A High
- Dermatology and Pathology, University of Colorado Health Sciences Center, P.O. Box 6510, Mail Stop F703, Aurora, CO 80045-0510, USA.
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Kiderlen AF, Laube U, Radam E, Tata PS. Oral infection of immunocompetent and immunodeficient mice with Balamuthia mandrillaris amebae. Parasitol Res 2006; 100:775-82. [PMID: 17111178 DOI: 10.1007/s00436-006-0334-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Accepted: 09/01/2006] [Indexed: 11/25/2022]
Abstract
Balamuthia mandrillaris is an opportunistic agent of lethal granulomatous amebic encephalitis (GAE). In mice, we have shown that intranasally instilled B. mandrillaris amebae infect the brain via the olfactory nerve pathway. In this study, we raised the question whether this ameba might also reach the brain after an oral/gastrointestinal infection. Immunocompetent (WT) and immunodeficient (RAG) mice received B. mandrillaris amebae by gavage into the esophagus. Mice of both groups became ill and some died (WT 20%, RAG 40%) within 42 days. All orally infected mice revealed B. mandrillaris amebae in the central nervous system. Outwardly intact amebae and/or specific antigen were found widely distributed in various organs and the stool. The data indicate that oral infection with B. mandrillaris leading to GAE is possible. Exit from the gastrointestinal tract and dissemination remains unresolved. Though stool cultures were negative, transmission of this highly pathogenic ameba via stool cannot be ruled out.
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Affiliation(s)
- Albrecht F Kiderlen
- Cellular Immunology Unit, Robert Koch-Institut, Nordufer 20, 13353, Berlin, Germany.
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Markosian M, Hyde RM. Oligonucleotides and polyribonucleotides: a review of antiviral activity. Antivir Chem Chemother 2005; 16:91-102. [PMID: 15889532 DOI: 10.1177/095632020501600202] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Current antiviral therapies are insufficient for treating emerging, re-emerging and established viral diseases. In an effort to find new therapeutics, oligo- and polyribonucleotides are being studied for their antiviral capabilities. Studies have shown that uniquely modified single- and double-stranded nucleic acid constructs are effective in inhibiting viral proliferation by various mechanisms. This review gives a brief history and highlights the development of oligo- and polyribonucleotides as antiviral agents primarily in the fields of interferon induction, mRNA complementation and reverse transcriptase inhibition.
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Weitzel T, Mühlberger N, Jelinek T, Schunk M, Ehrhardt S, Bogdan C, Arasteh K, Schneider T, Kern WV, Fätkenheuer G, Boecken G, Zoller T, Probst M, Peters M, Weinke T, Gfrörer S, Klinker H, Holthoff-Stich ML. Imported leishmaniasis in Germany 2001–2004: data of the SIMPID surveillance network. Eur J Clin Microbiol Infect Dis 2005; 24:471-6. [PMID: 15997368 DOI: 10.1007/s10096-005-1363-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Leishmaniasis is a rare, non-notifiable disease in Germany. Epidemiological and clinical data, therefore, are scarce. Most infections seen in Germany are contracted outside the country. The German surveillance network for imported infectious diseases (Surveillance Importierter Infektionen in Deutschland, or SIPMID) recorded 42 cases of imported leishmaniasis (16 visceral, 23 cutaneous, and 3 mucocutaneous) from January 2001 to June 2004. Although most infections were acquired in European Mediterranean countries, the risk of infection was highest for travelers to Latin America. HIV coinfection was observed significantly more often in patients with visceral leishmaniasis than in patients with cutaneous/mucocutaneous leishmaniasis (31 vs. 4%, p=0.02). The median time to a definitive diagnosis was 85 days in cases of visceral leishmaniasis and 61 days in cases of cutaneous/mucocutaneous leishmaniasis, reflecting the unfamiliarity of German physicians with leishmanial infections. Visceral leishmaniasis was treated most frequently with amphotericin B, whereas cutaneous/mucocutaneous leishmaniasis was treated with a variety of local and systemic therapies. The findings presented here should serve to increase awareness as well as improve clinical management of leishmaniasis in Germany.
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Affiliation(s)
- T Weitzel
- Institut für Tropenmedizin, Spandauer Damm 130, 14050, Berlin, Germany.
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