Baylisascaris procyonis Roundworm Infection in Child with Autism Spectrum Disorder, Washington, USA, 2022

We describe a case of Baylisascaris procyonis roundworm infection in a child in Washington, USA, with autism spectrum disorder. Environmental assessment confirmed nearby raccoon habitation and B. procyonis eggs. B. procyonis infections should be considered a potential cause of human eosinophilic meningitis, particularly among young children and persons with developmental delays.

Cutaneous larva migrans: A case report diagnosed using teledermatology

Teledermatology is a branch of dermatology that transmits medical data over several miles using telecommunications technologies. It involves the diagnosis of skin lesions using digital photographs and related patient data, and it can be especially helpful for patients in remote areas who might not have convenient access to dermatologists. Cutaneous larva migrans (CLM) is a zoonotic parasitic disease found in tropical and subtropical areas that are sunny and hot; however, cases of allocated resources have been disclosed in Saudi Arabia. There is little information about the frequency of CLM as a work-related illness among employees who are exposed to potentially polluted soil or have close contact with pets. In this paper, we present an ancestral case of CLM in Saudi Arabia, explaining the hazards of CLM infection. CLM may pose a challenge for physicians in non-endemic areas regarding assessment, therapeutic interventions, and protection, especially at work. The holistic strategy to CLM assessment, which includes the participation of numerous science competencies (e.g., veterinarians, dermatologists, and occupational physicians), may contribute to a better understanding of the expansion of human CLM and related risk factors, lowering the chance of infection.

North Italy: Welcome to the Tropics!

We describe a case of cutaneous Larva Migrans in an 8-year-old Caucasian girl. The lesion appeared ten days after a bath in the river in a valley in the north-east of Piedmont. The patient was successfully treated with Albendazole 400 mg daily for 5 days. Autochthonous cases are rare, particularly in northern Italy. Probably the high temperatures and the high degree of humidity favored by the climate changes to which Europe is subjected are favorable to the development of larvae. The diagnosis of cutaneous Larva Migrans should, therefore, be considered also in individuals who have not traveled in geographic areas at risk for the climate.

Baylisascaris Potosis Larvae in Mice of Different Strains and Infectivity of Tissue Larvae

Migration of Baylisascaris potosis larvae in different mouse strains were compared, and infectivity of the persisting larvae in mice tissues were investigated. Five strains of mice, BALB/c, C57BL/6, AKR, B10.BR, and ICR were inoculated with 1,000 B. potosis eggs/mouse, and necropsied at week 13 post inoculation (PI). The other uninfected ICR mice (secondary host) were inoculated with 43 larvae/ mouse recovered from mice at week 13 PI with eggs, and necropsied at day 21 PI. Larvae in organs or tissues were counted at necropsy. One AKR mouse showed torticollis and circling at day 56 PI. At necropsy at week 13 PI, larvae were recovered from all mice. A mean total larvae recovered were 124.1 (n=40). Majority of larvae were found in the carcass (mean 113.9) and some in the viscera (mean 9.9). Zero to 1 larva were found in the brain or eyes of some mice. There were no differences among the mouse strains in the number of larvae, except in the viscera; more larvae were seen in BALB/c or ICR than in B10.BR mice. No larvae were found in the secondary host mice. Present study demonstrated that B. potosis larvae migrate well in the carcass of any strains of mice, however, the tissue larvae did not infect the secondary host. Results of our present study suggest that B. potosis larvae is less aggressive for the nervous tissue migration than that of B. procyonis larvae which is commonly known to migrate in central nervous system of mammals and birds.

A Baylisascaris Outbreak in Fox Squirrels (Sciurus niger) and Subsequent Detection of Francisella tularensis in Kansas, USA

Thorough epidemiologic investigations of wildlife mortality events are often challenging, in part because of the dynamic variables involved. In May 2011, six fox squirrels (Sciurus niger) in Clinton State Park, Kansas, US were euthanized after exhibiting clinical signs of neurologic disease. Postmortem examination of two squirrels revealed that these individuals died of Baylisascaris larva migrans, which resulted in meningoencephalitis and variable pneumonia and myocarditis. Fecal flotation of raccoon (Procyon lotor) feces collected in the area revealed Baylisascaris sp. ova, presumably Baylisascaris procyonis, in one of nine samples. Additional fox squirrel carcasses were submitted for diagnostic evaluation from eastern Kansas for 1 yr following the Baylisascaris sp. outbreak. This monitoring unexpectedly resulted in the detection of Francisella tularensis, the zoonotic pathogen that causes tularemia, in two fox squirrels. The increased attention to fox squirrel mortalities prompted by the outbreak of Baylisascaris sp. larva migrans revealed cases of tularemia that may not have been otherwise detected. Although F. tularensis is endemic in Kansas, the current distribution and prevalence of B. procyonis in raccoons and other hosts in Kansas are poorly understood. This yearlong mortality investigation illustrated the importance of wildlife health monitoring as a means of assessing public health risks, especially during unusual wildlife mortality events.

Gnathostomiasis Acquired by Visitors to the Okavango Delta, Botswana

Gnathostomiasis is a zoonotic nematode parasite disease, most commonly acquired by eating raw or undercooked fish. Although the disease is well known in parts of Asia and Central and South America, relatively few cases have been reported from Africa. Raw fish consumed in the Okavango River delta area of Botswana, and in nearby western Zambia, has previously produced laboratory-proven gnathostomiasis in tourists. The purpose of this communication is to record additional cases of the infection acquired in the Okavango delta, and to alert visitors to the inadvisability of eating raw freshwater fish in the southern African region.

Very High- and High-Frequency Ultrasound Features of Cutaneous Larva Migrans

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.

Immune response to chronic Toxocara canis infection in a mice model

AIMS

The zoonotic nematode Toxocara canis causes larva migrans syndrome that induces an immune response characterized by the production of antibodies and eosinophilia. A Th2 polarization has been associated with the infection, but there are still details of the cellular and humoral immune response that need to be described. Thus, the aim of this study was to describe the systemic host immune response to T canis chronic infection in a mouse model.

METHODS AND RESULTS

BALB/c mice were inoculated once with 500 T canis embryonated eggs, per os. After 49 days, the amounts of larval found in brain and muscle tissues were statistically two and four times higher, respectively, than the amounts found in lung, liver, kidney or heart tissues. Splenic proportions of F4/80⁺ cells, as well as B, cytotoxic T and CD4⁺ Foxp3⁺ lymphocytes, were statistically higher (P ≤ .05, P ≤ .01, P ≤ .001 and P ≤ .001, respectively) as compared with control mice. In lymph nodes, some of these proportions changed, with the exception of F4/80⁺ cells. IgG1 levels in infected mice sera were increased. IL-4, IL-10 and VEGF levels were statistically higher in spleen (P ≤ .05, all) and sera (P ≤ .01, P ≤ .05 and P ≤ .05, respectively) in the infected mice. Also, in infected animals, IL-5 serum levels were increased (P ≤ .01).

CONCLUSION

These results suggest that T canis chronic infection in BALB/c mice results in a type 2 response with an incipient regulatory response.

Morphological and Molecular Characterization of Toxocara tanuki (Nematoda: Ascaridae) from Korean Raccoon Dog, Nyctereutes procyonoides koreensis

Present study was performed to describe the morphological and molecular characterization of Toxocara tanuki (Nematoda: Ascaridae) from Korean raccoon dog, Nyctereutes procyonoides koreensis, naturally infected in the Republic of Korea (Korea). Juvenile and adult worms of T. tanuki were recovered in 5 out of 10 raccoon dogs examined and the larval worms were detected in 15 out of 20 muscle samples (75%). Small lateral alae were observed on the cranial end of the body in male and female adults and 2 long spicules (3.0–3.5 mm) were characteristically observed in the posterior end of males. In SEM observation, 18 pairs of proximal precloacal, a precloacal median, a postcloacal median and 5 pairs of postcloacal papillae were uniquely revealed in the posterior portion of males, but the proximal papillae were not shown in the lateral ends of females. Molecular analysis on the 18S rRNA partial DNA sequences was revealed the same finding in both samples, adult worms and muscle larvae, which are closely related to T. tanuki. In conclusion, it was confirmed for the first time that T. tanuki is indigenously distributed, the Korean raccoon dog is acted as the natural definitive host of this nematode in Korea and the morphological characteristics of T. tanuki were shown in specific structure for single postcloacal median papilla in male.

Cavitary myiasis and its management

Myiasis is a parasitic disease of humans and vertebrates, caused by fly larvae feeding on the host's necrotic or living tissue. Myiasis is classified into cutaneous and cavitary myiasis. Cavitary myiasis is rare and occurs more frequently in tropical and subtropical regions of Africa and America associated with low economic status and poor hygiene. This article reviews current literature, provides general descriptions, and discusses life cycles of each species. It also gives diagnosis, treatment techniques and descriptions of each type of illness that result from interaction / infestation.

Baylisascaris procyonis Roundworm Seroprevalence among Wildlife Rehabilitators, United States and Canada, 2012-2015

Baylisascaris procyonis roundworms can cause potentially fatal neural larva migrans in many species, including humans. However, the clinical spectrum of baylisascariasis is not completely understood. We tested 347 asymptomatic adult wildlife rehabilitators for B. procyonis antibodies; 24 were positive, suggesting that subclinical baylisascariasis is occurring among this population.

Rapid development of migratory, linear, and serpiginous lesions in association with immunosuppression

A 78-year-old Bulgarian woman presented to the National Institutes of Health (NIH) with a diagnosis of poorly differentiated metastatic carcinoma of unknown origin. The prior month she had been seen at a hospital in Bulgaria for weight loss and a right inguinal mass. NIH pathology review confirmed a poorly differentiated carcinoma with extensive necrosis suggesting squamous cell carcinoma. She was enrolled in a treatment trial at NIH with metastatic disease invading the lungs and lymph nodes (mediastinum, abdomen, and pelvis) and a chemotherapy regimen was started of gemcitabine, carboplatin, and lenalidomide with dexamethasone as an antiemetic. The patient returned on day 8, and a rash of 2 days duration was noted. Immediately before arriving at the dermatology clinic, she developed altered mental status with aphasia and was admitted for neurologic observation. The altered mental status resolved and evaluation revealed only small-vessel ischemia. The patient was also experiencing diarrhea and was found to have elevated transaminases (4- to 7-fold over normal). Chemotherapy was held because of the transaminase abnormalities and altered mental status. The following day, the patient was seen by dermatology for a progressive asymptomatic eruption.

A case report of cutaneous larva migrans

Cutaneous larva migrans (CLM) is a helminthic infection most commonly found in tropical and subtropical geographic areas. However, with the ease and increase of foreign travel by many around the world, CLM is no longer confined to these areas. CLM is an erythematous, serpiginous, cutaneous eruption caused by accidental percutaneous penetration and subsequent migration of larvae. Here, we present a case diagnosed as CLM and treated with Albendazole.

Raccoon roundworm eggs near homes and risk for larva migrans disease, California communities

The raccoon roundworm, Baylisascaris procyonis, is increasingly recognized as a cause of serious or fatal larva migrans disease in humans and animals. We assessed the potential for infection in three northern California communities by determining the density and distribution of raccoon latrines, where transmission primarily occurs, and the prevalence of eggs at private residences. We collected fecal samples from 215 latrines and found that 44%-53% of the latrines contained B. procyonis eggs and that 16%-32% contained infective eggs. Among the properties surveyed, 28%-49% harbored at least one latrine that was positive for B. procyonis eggs. The latrine densities in these communities were higher than any previously reported. The presence of B. procyonis eggs in raccoon latrines was common, widespread, and closely associated with human habitation. Where raccoon densities are high, education of the public and removal of raccoons may be necessary.

Baylisascaris procyonis: an emerging helminthic zoonosis

Baylisascaris procyonis, a roundworm infection of raccoons, is emerging as an important helminthic zoonosis, principally affecting young children. Raccoons have increasingly become peridomestic animals living in close proximity to human residences. When B. procyonis eggs are ingested by a host other than a raccoon, migration of larvae through tissue, termed larval migrans, ensues. This larval infection can invade the brain and eye, causing severe disease and death. The prevalence of B. procyonis infection in raccoons is often high, and infected animals can shed enormous numbers of eggs in their feces. These eggs can survive in the environment for extended periods of time, and the infectious dose of B. procyonis is relatively low. Therefore, the risk for human exposure and infection may be greater than is currently recognized.

Two imported cases of cutaneous larva migrans

Cutaneous larva migrans (CLM) is a rare serpiginous cutaneous eruption caused by accidental penetration and migration in the skin with infective larvae of nematode that normally do not have the human as their host. Although CLM has a worldwide distribution, the infection is most frequent in warmer climates. More recently, they have been increasingly imported from the tropics or subtropics by travelers. We experienced two patients who had pruritic serpiginous linear eruption in their skin for a few weeks after traveling to the endemic areas (Brazil and Thailand, respectively). After the treatment with albendazole, the skin lesions resolved with post-inflammatory hyperpigmentation. We report herein two cases of cutaneous larva migrans successfully treated with albendazole.

Cerebral Manifestations of Ascaris lumbricoides

Humans are the definitive host for the nematode, round-worm Ascaris lumbricoides, which generally produces only mild systemic symptoms. The authors report two cases of intestinal A. lumbricoides with concurrent cerebral manifestations. A 53-year-old Syrian woman with intestinal A. lumbricoides presented with a generalized seizure and a cerebral lesion that worsened for several days and then resolved after treatment with mebendazole. Magnetic resonance imaging revealed a 2-cm lesion in the right mesial temporal lobe. The lesion was hypointense to brain on T₁-weighted images and hyperintense on T₂-weighted images. There was a small focus of central enhancement. The second patient, a 2-year-old girl, died of a brain abscess with six organisms, including Neisseria mucosa, Eikenella corrodens, and microaerophillic streptococcus. The hypothesis that A. lumbricoides served as a vector for these bacterial pathogens, as well as potential alternative roles of A. lumbricoides in causing a polymicrobial bacterial abscess, are discussed. These cases suggest that specific treatment strategies including antihelminthic therapy or abscess resection may be successful in patients with cerebral lesions and concomitant intestinal A. lumbricoides.