The distribution pattern of Halicephalobus gingivalis in a horse is suggestive of a haematogenous spread of the nematode

The first molecular isolation of Halicephalobus gingivalis from horses in Iran

BACKGROUND

Parasitic infections pose significant threats to humans' and animals' well-being worldwide. Among these parasites, Halicephalobus spp., a genus of nematodes, has gained attention due to its ability to cause severe infections in various animal species, including horses.

OBJECTIVE

This study aimed to determine the prevalence of Halicephalobus spp., specifically focusing on Halicephalobus gingivalis in horses.

MATERIALS AND METHODS

In July 2022, a cross-sectional study was conducted in northern Iran to determine the prevalence of Halicephalobus spp. Using standard coprological techniques, 141 fecal samples from randomly selected horses were analyzed for GI helminth eggs. The Halicephalobus spp. eggs present in faeces were identified by molecular methods. Polymerase Chain Reaction (PCR) was used to amplify the partial 5' variable region (~ 390 base pairs) of 18 S DNA using SSUA_F and SSU22_R primers. Furthermore, the PCR products obtained were sequenced, and phylogenetic analysis was performed using available sequences from GenBank.

RESULTS

Microscopic examination of 141 fresh faecal samples revealed 5 fecal samples were infected with small ellipsoidal nematode eggs ranging between 40 and 50 × 50-60 μm. This study's PCR amplicons showed ~ 390 bp bands on 2.0% agarose gel. A partial sequence of 18 S DNA (363 bp) was obtained herein (GenBank accession no. OQ843456).

CONCLUSION

Overall, using molecular tools represents a significant step forward in diagnosing and managing the Halicephalobus gingivalis infections in horses.

First Swedish case of fatal equine parasitic encephalitis by Halicephalobus gingivalis

BACKGROUND

Halicephalobus gingivalis is a nematode with zoonotic potential which can cause fatal opportunistic infections in various mammals. The parasite has never been diagnosed in Sweden, in any species, prior to the presented case.

CASE PRESENTATION

An imported 21-year-old Icelandic mare developed severe neurological signs. The horse was eventually euthanized and submitted for post-mortem examination where severe lesions in the kidneys were noted. Histopathology revealed the presence of H. gingivalis in both kidneys and the brain. Phylogenetic analysis of the parasite determined it to belong to Lineage 1.

CONCLUSIONS

With the occurrence of H. gingivalis in Sweden, the disease should be added to the list of differential diagnoses in cases with acute onset of neurological disease in both horses and other mammals including humans.

Disseminated Halicephalobus gingivalis infection in a horse

A 19-y-old American Saddlebred gelding was evaluated for epiphora of the right eye and generalized cachexia. Initial examination revealed anterior uveitis without ulceration, for which treatment was initiated. Despite the initial response to treatment, the signs progressively worsened to blindness. Histologic examination of the enucleated eye revealed granulomatous panuveitis and optic neuritis with intralesional nematode larvae identified as Halicephalobus gingivalis. Over time and despite anthelmintic treatment, blindness developed in the left eye along with neurologic signs, and the horse was euthanized. Disseminated halicephalobosis was diagnosed on postmortem examination, involving the heart, spleen, kidneys, oral cavity, tongue, left eye, lungs, CNS, adrenal glands, liver, and lymph nodes. Splenic involvement has not been reported previously, to our knowledge. Halicephalobosis is a sporadic parasitic disease that affects equids mostly and for which prognosis is poor despite aggressive systemic anthelmintic treatment. Parasitic granulomatous disease should be included as a differential diagnosis in equids with ocular or neurologic disease.

First case of fatal equine meningoencephalitis caused by Halicephalobus gingivalis in Mexico

Aberrant nematode larval migration in the CNS of horses is rare but frequently fatal; one of the main etiological agents involved in this illness is Halicephalobus gingivalis. This soil nematode has been associated with several fatal equine meningoencephalitis reports worldwide; however, it had never been diagnosed in horses of Mexico. A 10 year-old Andalusian horse presented dysphagia, fever, weakness, prostration and ataxia; the patient expired during the medical attention. Post mortem examination was performed and no gross alterations were found. Histopathology revealed meningoencephalitis, vasculitis and intralesional adult nematodes, larvae and eggs compatible with Halicephalobus spp. A polymerase chain reaction (PCR) for the nuclear large subunit ribosomal RNA gene (LSU rDNA) of nematodes was performed from formalin-fixed and paraffin wax-embedded sections of brain. Posterior nucleotide sequence analysis of the amplified fragment identified the agent as H. gingivalis. To our knowledge, this is the first confirmed report of Halicephalobiasis in Mexico.

Parasitic and zoonotic meningoencephalitis in humans and equids: Current knowledge and the role of Halicephalobus gingivalis

Halicephalobus gingivalis is a saprophytic nematode parasite that causes a rare form of fatal meningoencephalomyelitis in equids, humans, and ruminants. This nematode has neurotropic activity, but has also been found in the kidney, liver, lungs, optic nerves and even heart of its host. Despite the zoonotic potential and severity of the disease, the epidemiology, pathogenesis, life cycle, and risk factors are poorly understood. Cases have been reported from several countries in Europe countries and North America but none is recorded in Africa except Egypt. This review looks at the historical overview, morphology, diagnosis, treatment and summary of reported cases in humans and equids. We recommend the parasitic helminthic infection in the differential list of meningoencephalitis involving humans and animals worldwide despite its rareness.

Fatal Halicephalobus gingivalis infection in horses from Central America

Halicephalobus gingivalis is a free-living nematode that causes an opportunistic infection in animals and humans. Two fatal cases of encephalitis and nephritis caused by H. gingivalis in equines from Costa Rica and Honduras are reported. Case 1: a 6-year-old Arabian stallion, from Costa Rica, presented severe neurological signs and was treated with systemic anti-inflammatory drugs and antibiotics. Because there was no improvement, it was euthanatized. Grossly, both kidneys showed large white nodules, ranging from 0.10 to 2.50cm. Histopathologically, both kidneys showed similar changes consisting of multiple necrotic foci with longitudinal and transversal sections of nematode larvae. In the brain, there were several foci with similar parasites, surrounded by lymphocytes and gitter cells. Case 2: an 8-year-old Spanish stallion from Honduras it was reported as depressed and would not eat or drink water. The animal was treated with antibiotics and analgesics, without response and died spontaneously three days after the onset of clinical signs. Only pieces of kidney were sent for histopathological examination and showed findings similar to those described in case 1. These findings are similar with cases already reported expanding the knowledge about the geographical distribution of H. gingivalis in horses.

Isolation and molecular characterisation of Halicephalobus gingivalis in the brain of a horse in Piedmont, Italy

Background

A fatal case of meningoencephalitis was reported in a 13-year-old Koninklijk Warmbloed Paard Nederland stallion, suspected of West Nile virus (WNV) infection, in the Piedmont region of Italy. Clinical signs included right head tilt and circling, depression alternated with excitability, fever and lateral strabismus. Combined treatment consisting of dimethylsulfoxide, dexamethasone, sulphonamides and sedative was administered, but because of the poor conditions the horse was euthanatized and submitted for necropsy.

Results

At post-mortem examination no skin lesions were observed, all organs appeared normal on gross evaluation and only head and blood samples were further investigated. Neuropathological findings consisted of granulomatous meningoencephalitis and larvae and adult females of Halicephalobus gingivalis were isolated and identified from the digested brain. Frozen brain was submitted to PCR amplification and 220 bp multiple sequence alignment was analysed by Bayesian phylogenetic analysis.

Conclusions

Phylogenetic inference revealed that the isolate belongs to H. gingivalis Lineage 3. WN surveillance can help to deepen our knowledge of horse neurological disorders investigating their causes and incidence. Moreover, it can help to understand the geographic distribution of the H. gingivalis, to unravel epidemiological information, and to estimate risk for humans.

An outbreak of bovine meningoencephalomyelitis with identification of Halicephalobus gingivalis

Halicephalobus gingivalis is an opportunistic parasite which is known to cause fatal meningoencephalomyelitis primarily in equines but sporadically also in humans. In April 2014, laboratory examination of the head of a young dairy calf, euthanized due to severe central nervous system symptoms, revealed the presence of granulomatous to necrotizing encephalitis and myriads of nematodes in the brain lesion. Morphologically the parasites were identified as H. gingivalis. The diagnosis was confirmed by molecular analysis of the large subunit (LSU) rRNA and the small subunit (SSU) rRNA genes, revealing genetic variations of 0.5-4.4% and 0.7-8.6%, respectively, between the H. gingivalis isolated from the Danish calf and published isolates, collected worldwide from free-living and parasitic stages of the nematode. Clinical symptoms and histological changes indicated infection with H. gingivalis from another three calves in the herd. This is the first scientific publication of H. gingivalis induced meningoencephalomyelitis in ruminants. As ante mortem diagnosis is a major challenge, the infection may easily remain undiagnosed in cattle.

First report of fatal systemic Halicephalobus gingivalis infection in two Lipizzaner horses from Romania: clinical, pathological, and molecular characterization

Halicephalobus gingivalis (H. gingivalis) causes a rare and fatal infection in horses and humans. Despite the zoonotic potential and severity of the disease, the epidemiology and pathogenesis of halicephalobiasis are still poorly understood. Several European cases of equine halicephalobiasis have been documented; however, in South-Eastern European countries, including Romania, equine neurohelminthiasis caused by H. gingivalis has not been previously described. Two Lipizzaner horses with a clinical history of progressive neurological signs were referred to the Pathology Department of the Cluj-Napoca (Romania) for necropsy. Both horses died with severe neurological signs. Gross examination and cytological, histological, and molecular analyses were performed. The stallions came from two different breeding farms. No history of traveling outside Romania was recorded. At necropsy, granulomatous and necrotizing lesions were observed in the kidneys, lymph nodes, brain, retroperitoneal adipose tissue, and lungs, indicating a systemic infection. Parasitological and histopathological analyses evidenced larval and adult forms of rhabditiform nematodes consistent with Halicephalobus species. Parasites were observed in both lymph and blood vessels of different organs and were also identified in urine samples. A subunit of the large-subunit ribosomal RNA gene (LSU rDNA) of H. gingivalis (673 bp) was amplified from lesions in both horses.To the authors' knowledge, this is the first report of equine systemic H. gingivalis infection in Romania and in South-Eastern Europe. Our findings provide new insights into the geographic distribution of specific genetic lineages of H. gingivalis, while also raising public health awareness, as the parasite is zoonotic.

Fatal Human Meningoencephalitis due to Halicephalobus Nematodes, Germany

Infections with Halicephalobus nematodes, causative agents of severe meningoencephalitis in horses, have rarely been reported in humans. In this study, the clinical, serological, cytokine, and histopathological findings of a rapidly progressive and eventually fatal meningoencephalitis in a previously healthy human are described. The helminth was finally diagnosed by specific polymerase chain reactions from post mortem tissue.