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Esteban JG, Muñoz-Antolí C, Toledo R, Ash LR. Diagnosis of Human Trematode Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1454:541-582. [PMID: 39008275 DOI: 10.1007/978-3-031-60121-7_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Digenetic trematodes form a major group of human parasites, affecting a large number of humans, especially in endemic foci. Over 100 species have been reported infecting humans, including blood, lung, liver and intestinal parasites. Traditionally, trematode infections have been diagnosed by parasitological methods based on the detection and the identification of eggs in different clinical samples. However, this is complicated due to the morphological similarity between eggs of different trematode species and other factors such as lack of sensitivity or ectopic locations of the parasites. Moreover, the problem is currently aggravated by migratory flows, international travel, international trade of foods and changes in alimentary habits. Although efforts have been made for the development of immunological and molecular techniques, the detection of eggs through parasitological techniques remains as the gold standard for the diagnosis of trematodiases. In the present chapter, we review the current status of knowledge on diagnostic techniques used when examining feces, urine, and sputum and also analyze the most relevant characteristics used to identify eggs with a quick key for the identification of eggs.
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Affiliation(s)
- J Guillermo Esteban
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain.
| | - Carla Muñoz-Antolí
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Rafael Toledo
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Lawrence R Ash
- Infectious & Tropical Diseases, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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Xu XT, Wang BH, Wang Q, Guo YJ, Zhang YN, Chen XL, Fang YF, Wang K, Guo WH, Wen ZZ. Idiopathic hypereosinophilic syndrome with hepatic sinusoidal obstruction syndrome: A case report and literature review. World J Gastrointest Surg 2023; 15:1532-1541. [PMID: 37555104 PMCID: PMC10405125 DOI: 10.4240/wjgs.v15.i7.1532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/17/2023] [Accepted: 05/17/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Hypereosinophilic syndrome (HES) is classified as primary, secondary or idiopathic. Idiopathic HES (IHES) has a variable clinical presentation and may involve multiple organs causing severe damage. Hepatic sinusoidal obstruction syndrome (HSOS) is characterized by damage to the endothelial cells of the hepatic sinusoids of the hepatic venules, with occlusion of the hepatic venules, and hepatocyte necrosis. We report a case of IHES with HSOS of uncertain etiology. CASE SUMMARY A 70-year-old male patient was admitted to our hospital with pruritus and a rash on the extremities for > 5 mo. He had previously undergone antiallergic treatment and herbal therapy in the local hospital, but the symptoms recurred. Relevant examinations were completed after admission. Bone marrow aspiration biopsy showed a significantly higher percentage of eosinophils (23%) with approximately normal morphology. Ultrasound-guided hepatic aspiration biopsy indicated HSOS. Contrast-enhanced computed tomography (CT) of the upper abdomen showed hepatic venule congestion with hydrothorax and ascites. The patient was initially diagnosed with IHES and hepatic venule occlusion. Prednisone, low molecular weight heparin and ursodeoxycholic acid were given for treatment, followed by discontinuation of low molecular weight heparin due to ecchymosis. Routine blood tests, biochemical tests, and imaging such as enhanced CT of the upper abdomen and pelvis were reviewed regularly. CONCLUSION Hypereosinophilia may play a facilitating role in the occurrence and development of HSOS.
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Affiliation(s)
- Xu-Tao Xu
- Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Bing-Hong Wang
- Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Qiang Wang
- Department of Hepatopancreatobiliary Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Yang-Jie Guo
- Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Yu-Ning Zhang
- Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Xiao-Li Chen
- Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Yan-Fei Fang
- Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Kan Wang
- Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Wen-Hao Guo
- Department of Pathology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Zhen-Zhen Wen
- Department of Gastroenterology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, Zhejiang Province, China
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Pylephlebitis: A Systematic Review on Etiology, Diagnosis, and Treatment of Infective Portal Vein Thrombosis. Diagnostics (Basel) 2023; 13:diagnostics13030429. [PMID: 36766534 PMCID: PMC9914785 DOI: 10.3390/diagnostics13030429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/20/2022] [Accepted: 01/21/2023] [Indexed: 01/27/2023] Open
Abstract
Pylephlebitis, defined as infective thrombophlebitis of the portal vein, is a rare condition with an incidence of 0.37-2.7 cases per 100,000 person-years, which can virtually complicate any intra-abdominal or pelvic infections that develop within areas drained by the portal venous circulation. The current systematic review aimed to investigate the etiology behind pylephlebitis in terms of pathogens involved and causative infective processes, and to report the most common symptoms at clinical presentation. We included 220 individuals derived from published cases between 1971 and 2022. Of these, 155 (70.5%) were male with a median age of 50 years. There were 27 (12.3%) patients under 18 years of age, 6 (2.7%) individuals younger than one year, and the youngest reported case was only 20 days old. The most frequently reported symptoms on admission were fever (75.5%) and abdominal pain (66.4%), with diverticulitis (26.5%) and acute appendicitis (22%) being the two most common causes. Pylephlebitis was caused by a single pathogen in 94 (42.8%) cases and polymicrobial in 60 (27.2%) cases. However, the responsible pathogen was not identified or not reported in 30% of the included patients. The most frequently isolated bacteria were Escherichia coli (25%), Bacteroides spp. (17%), and Streptococcus spp. (15%). The treatment of pylephlebitis consists initially of broad-spectrum antibiotics that should be tailored upon bacterial identification and continued for at least four to six weeks after symptom presentation. There is no recommendation for prescribing anticoagulants to all patients with pylephlebitis. However, they should be administered in patients with thrombosis progression on repeat imaging or persistent fever despite proper antibiotic therapy to increase the rates of thrombus resolution or decrease the overall mortality, which is approximately 14%.
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Suppurative Thrombosis of the Portal Vein (Pylephlebits): A Systematic Review of Literature. J Clin Med 2022; 11:jcm11174992. [PMID: 36078922 PMCID: PMC9456472 DOI: 10.3390/jcm11174992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/24/2022] Open
Abstract
Suppurative portal vein thrombosis (pylephlebitis) is an uncommon condition usually associated with an intra-abdominal infection or inflammatory process. In this study, we aimed to synthesize data on previously published cases according to the PRISMA guidelines. A total of 103 patients were included. Patients were more commonly male (71.8%) and had a mean age of 49 years. The most common infection associated with pylephlebitis was diverticulitis (n = 29, 28.2%), and Escherichia coli was the most isolated pathogen (n = 21, 20.4%). Blood cultures were positive in 64 cases (62.1%). The most common site of thrombosis was the main portal vein (PV) in 59 patients (57.3%), followed by the superior mesenteric vein (SMV) in 40 patients (38.8%) and the right branch of the PV in 30 patients (29.1%). Sepsis developed in 60 patients (58.3%). The mortality rate in our review was 8.7%, and independent risk factors for mortality were the presence of pertinent comorbidities (OR 5.5, p = 0.02), positive blood cultures (OR 2.2, p = 0.02), and sepsis (OR 17.2, p = 0.049).
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Liver Abscess due to Fasciola hepatica: A Case Report of the North of Iran. Case Rep Infect Dis 2022; 2022:4399061. [PMID: 35795082 PMCID: PMC9252842 DOI: 10.1155/2022/4399061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/10/2022] [Indexed: 11/18/2022] Open
Abstract
One of the rare manifestations of fascioliasis is liver abscess. In this paper, we report the case of a 38-year-old woman with a liver abscess caused by Fasciola hepatica (F. hepatica). The patient was referred to the clinic with recurrent fever, right upper quadrant (RUQ) pain, and a large abscess in her liver. Despite the consumption of an antibiotic drug, she still had symptoms. The symptoms began to disappear upon starting the consumption of triclabendazole (TCBZ). Fascioliasis can manifest itself with unusual symptoms that provide no specific clue for its diagnosis. Therefore, it is important to consider F. hepatica in the differential diagnosis of liver abscess, especially in endemic regions.
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Hartuis S, Lavergne RA, Nourrisson C, Verweij J, Desoubeaux G, Lussac-Sorton F, Lemoine JP, Cateau E, Jeddi F, Poirier P, Le Pape P, Morio F. The Novodiag ® Stool parasites assay, an innovative high-plex technique for fast detection of protozoa, helminths and microsporidia in stool samples: a retrospective and prospective study. Parasite 2022; 29:27. [PMID: 35550028 PMCID: PMC9102957 DOI: 10.1051/parasite/2022026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/25/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We provide the first evaluation of the CE-IVD marked Novodiag® stool parasites assay (NVD), allowing rapid and high-plex detection of 26 distinct targets, encompassing protozoans, helminths and microsporidia in stool samples. METHODS A total of 254 samples (n = 205 patients) were prospectively processed by the NVD and our routine procedure (RP). Performances of the NVD were compared with RP. Samples only positive by the NVD assay were investigated by external PCR assays. Sensitivity and specificity (Se/Sp) and time from sample receipt to results were determined for each method. The NVD was also evaluated against 77 additional samples positive for a wide range of parasites. RESULTS Overall positivity rate was 16.9% for RP compared with 34% using the NVD assay, and 164 samples (66%) were negative by both methods. Only 30 positive samples (12%) showed full concordance between RP and NVD. Fifty-three discordant samples were sent for external investigations. Except for Giardia intestinalis and Trichuris spp., higher Se was observed for the NVD assay for Blastocystis spp. (100% vs. 63%), Dientamoeba fragilis (100% vs. 0%), Schistosoma spp. (100% vs. 17%), and Enterobius vermicularis (100% vs. 67%) but roughly similar to RP for the remaining parasites tested. False-positive results were identified for Blastocystis spp., G. intestinalis, and Trichuris spp. using the NVD assay. The NVD mostly provides a diagnosis on the day of sample receipt compared with a mean of three days with RP. CONCLUSIONS Besides some limitations, the NVD is a new diagnostic strategy allowing rapid and high-plex detection of gastrointestinal parasites from unpreserved stools.
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Affiliation(s)
- Sophie Hartuis
- Nantes Université, CHU de Nantes, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR1155 44000 Nantes France
| | - Rose-Anne Lavergne
- Nantes Université, CHU de Nantes, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR1155 44000 Nantes France
| | - Céline Nourrisson
- Laboratoire de Parasitologie–Mycologie, Centre de Biologie, CHU Gabriel Montpied 58 rue Montalembert 63000 Clermont-Ferrand France
| | - Jaco Verweij
- Elisabeth-TweeSteden Hospital, Microvida Laboratory for Medical Microbiology and Immunology PO Box 90151 5000 Tilburg The Netherlands
| | - Guillaume Desoubeaux
- Service de Parasitologie – Mycologie – Médecine Tropicale, CHRU de Tours 2 Boulevard Tonnellé 37000 Tours France
| | - Florian Lussac-Sorton
- Laboratoire de Parasitologie–Mycologie PTMI – Groupe Hospitalier Pellegrin Place Amélie Raba Léon 33076 Bordeaux France
| | | | - Estelle Cateau
- Laboratoire de Parasitologie et Mycologie Médicales, CHU La Miletrie BP 577 86021 Poitiers Cedex France
| | - Fakhri Jeddi
- Nantes Université, CHU de Nantes, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR1155 44000 Nantes France
| | - Philippe Poirier
- Laboratoire de Parasitologie–Mycologie, Centre de Biologie, CHU Gabriel Montpied 58 rue Montalembert 63000 Clermont-Ferrand France
| | - Patrice Le Pape
- Nantes Université, CHU de Nantes, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR1155 44000 Nantes France
| | - Florent Morio
- Nantes Université, CHU de Nantes, Cibles et Médicaments des Infections et de l’Immunité, IICiMed, UR1155 44000 Nantes France
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Torrús-Tendero D, Ramos-Rincón JM, Salvador F, Oliveira I, Llenas-García J, Arsuaga M, Crespillo-Andújar C, Pérez-Molina JA. Imported fascioliasis in Spain: Report of 12 cases from the +REDIVI collaborative network (2009–2019). Travel Med Infect Dis 2022; 47:102286. [DOI: 10.1016/j.tmaid.2022.102286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 01/10/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
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Carnevale S, Malandrini JB, Pantano ML, Sawicki M, Kamenetzky L, Soria CC, Velásquez JN. Use of the PCR in a Combined Methodological Approach for the Study of Human Fascioliasis in an Endemic Area. Acta Parasitol 2021; 66:455-460. [PMID: 33113104 DOI: 10.1007/s11686-020-00302-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/13/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE Fascioliasis is a worldwide distributed trematodiasis considered a neglected disease. Diagnosis in humans has been traditionally based on parasitological and immunological techniques. Recently we reported the use of the PCR in stool samples for the individual diagnosis. The purpose of this study was to evaluate human fascioliasis by a combination of diagnostic methods in an area where the disease is highly endemic in animals. METHODS We studied all the inhabitants (N = 240) of Tatón village, Argentina, by Fasciola hepatica rproCL1-ELISA. Among them, we continued the study with 13 cases that had at least two positive serological tests, who performed a questionnaire, physical examination, abdominal ultrasonography, and collection of blood and faeces. Blood/serum samples were used for Fh rproCL1-ELISA and liver function tests. Faeces were used for parasitological analysis and PCR of a repetitive fragment of Fasciola sp. RESULTS Among the 13 patients, 9 presented symptoms of biliary colic. All patients repeated positive serology. F. hepatica eggs were not detected. PCR was positive in 11 cases. CONCLUSION This is the first report employing an approach based on the combination of methods for the evaluation of human fascioliasis in an endemic area, which includes molecular tools with a high value in detecting low infections.
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Affiliation(s)
- Silvana Carnevale
- Departamento de Parasitología, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Dr. Carlos G. Malbrán", Avenida Vélez Sarsfield 563,, CP 1281, Ciudad de Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad de Buenos Aires, Argentina
| | - Jorge Bruno Malandrini
- Facultad de Ciencias de la Salud, Universidad Nacional de Catamarca, Maestro Quiroga 1ra. Cuadra, CP 4700, San Fernando del Valle de Catamarca, Catamarca, Argentina
| | - María Laura Pantano
- Departamento de Parasitología, Instituto Nacional de Enfermedades Infecciosas, ANLIS "Dr. Carlos G. Malbrán", Avenida Vélez Sarsfield 563,, CP 1281, Ciudad de Buenos Aires, Argentina
| | - Mirna Sawicki
- Hospital de Infecciosas "Dr. Francisco Javier Muñiz". Uspallata 2272, CP 1282, Ciudad de Buenos Aires, Argentina
| | - Laura Kamenetzky
- Instituto de Microbiología y Parasitología Médica (IMPaM), UBA-CONICET, Paraguay 2155 piso 13, CP 1121, Ciudad de Buenos Aires, Argentina
| | - Claudia Cecilia Soria
- Facultad de Ciencias de la Salud, Universidad Nacional de Catamarca, Maestro Quiroga 1ra. Cuadra, CP 4700, San Fernando del Valle de Catamarca, Catamarca, Argentina
| | - Jorge Néstor Velásquez
- Hospital de Infecciosas "Dr. Francisco Javier Muñiz". Uspallata 2272, CP 1282, Ciudad de Buenos Aires, Argentina.
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Marcos L, Maco V, Terashima A. Triclabendazole for the treatment of human fascioliasis and the threat of treatment failures. Expert Rev Anti Infect Ther 2020; 19:817-823. [PMID: 33267701 DOI: 10.1080/14787210.2021.1858798] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The only drug effective against the infection caused by Fasciola hepatica or F. gigantica is triclabendazole (TCBZ), recommended by the WHO and recently approved by the FDA. Here, we describe the evolution of TCBZ regimens and the emergence of TCBZ failure to Fasciola infection. AREAS COVERED The present review focuses on the evidence of TCBZ for the treatment of fascioliasis. For acute fascioliasis, there is a lack of studies to measure the presence of eggs of Fasciola in stool samples on the follow-up after initial TCBZ treatment. For chronic fascioliasis, WHO recommends a single oral dose of TCBZ 10 mg/kg whereas CDC recommends two doses of TCBZ 10 mg/kg 12 h apart. Incremental number of treatment failures have been documented worldwide. There are currently no therapeutic alternatives for the treatment of fascioliasis in humans. EXPERT OPINION Most cases of human fascioliasis are successfully treated with TCBZ, but some continue excreting eggs in the stools despite 1-2 standard of care regimens of TCBZ. A precise regimen is unclear for those patients who fail the initial treatment with TCBZ. Further clinical trials are needed to address the possible TCBZ emerging resistance.
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Affiliation(s)
- Luis Marcos
- Division of Infectious Diseases, Department of Medicine, Stony Brook University, Stony Brook, NY, USA.,Department of Microbiology and Immunology, Stony Brook University, Stony Brook, NY, USA
| | - Vicente Maco
- Laboratorio De Parasitologia, Instituto De Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Angelica Terashima
- Laboratorio De Parasitologia, Instituto De Medicina Tropical Alexander Von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.,Departamento De Enfermedades Infecciosas, Tropicales Y Dermatologicas, Hospital Cayetano Heredia, Lima, Peru
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