Shedding of feline lungworm larvae and their infectivity to snail intermediate hosts after anthelmintic treatment

Aelurostrongylus abstrusus and Troglostrongylus brevior are snail-transmitted helminths causing respiratory diseases in infected cats. The shedding of feline lungworm L1s and their infectivity to the snail intermediate host, after administration of anthelminthic products to cats, are poorly documented. To assess the efficacy of 8.3% fipronil, 10% (S)-methoprene, 0.4% eprinomectin and 8.3% praziquantel (i.e. eprinomectin formulation) and 10% imidacloprid/1% moxidectin (i.e. moxidectin formulation) against these nematodes and to determine the number of days post-treatment until viable L1s are released in the faeces, 384 animals were screened by faecal examination. Of the 54 positive animals (i.e., 14.1%; 7.3% A. abstrusus, 6.2% T. brevior and 0.5% coinfected), 36 were randomly allocated to four groups. Groups A and B were composed of cats positive for T. brevior and treated with the eprinomectin and with the moxidectin formulations, respectively, whereas cats in groups C and D were positive to A. abstrusus and treated with the eprinomectin and the moxidectin formulations, respectively. Prior to and every day after treatment, faecal samples were analysed by the Baermann technique and the number of larvae per gram of faeces determined, and again four weeks after treatment, to assess the efficacy of a single administration of the products. In addition, to evaluate the pre- and post-treatment infectivity of L1s to snail intermediate hosts, one/two snails per cat were infected with 100 L1s collected from the faeces of enrolled animals and then digested 28 days p.i. Based on L1s faecal counts, the efficacy of the eprinomectin and the moxidectin formulations at 28 days was 100% for both A. abstrusus and T. brevior, with a mean number of days of 7.9 ± 1.2 in group A, 7.8 ± 1.9 in B, 6.9 ± 1.6 in C and 8.9 ± 2.0 in D to become negative. Following the artificial digestion, active L3s of T. brevior and A. abstrusus were found in 160 (87.4%) experimentally infected snails. The results of this study demonstrate that a single administration of the two formulations is effective in the treatment of A. abstrusus and T. brevior infections and that during the post-treatment period live L1s are shed for up to 8.9 ± 2.0 days. L1s of both lungworm species released in the faeces after drug administration are still able to reach the infective larval stage in the infected snails. Hence, preventative measures after the treatment of infected animals should include keeping cats indoors and disposal of their faeces for approximately 10 days to avoid environmental contamination and infection of gastropod intermediate hosts.

Helminth and respiratory mite lesions in Pinnipeds from Punta San Juan, Peru

The tissues and parasites collected from Peruvian fur seals (Arctocephalus australis) and South American sea lions (Otaria byronia) found dead at Punta San Juan, Peru were examined. The respiratory mite, Orthohalarachne attenuata infected 3 out of 32 examined fur seals and 3 out of 8 examined sea lions, however caused moderate to severe lymphohistiocytic pharyngitis only in fur seals. Hookworms, Uncinaria sp, infected 6 of the 32 examined fur seals causing variable degrees of hemorrhagic and eosinophilic enteritis. This parasite caused the death of 2 of these pups. In fur seals and sea lions, Corynosoma australe and Contracaecum osculatum were not associated with significant tissue alterations in the intestine and stomach respectively. Respiratory mites and hookworms have the potential to cause disease and mortality among fur seals, while parasitic infections do not impact significatively the health of sea lions at Punta San Juan, Peru.

Heartworm-associated respiratory disease (HARD) induced by immature adult Dirofilaria immitis in cats

BACKGROUND

A controlled, blind research study was conducted to define the initial inflammatory response and lung damage associated with the death of immature adult Dirofilaria immitis in cats as compared with cats developing adult heartworm infections and cats on preventive medication.

METHODS

Three groups of cats were utilized, 10 per group. All cats were infected with 100 third-stage (L3) larvae by subcutaneous injection. Group A cats were treated topically with selamectin (Revolution®; Zoetis) per label directions at 28 days post infection (PI) and once monthly for 8 months. Group B cats were treated orally with ivermectin (Ivomec®; Merial) at 150 μg/kg at 70 days PI, then every 2 weeks for 5 months. Group C cats were untreated PI. At baseline (Day 0) and on Days 70, 110, 168, and 240 PI, peripheral blood, serum, bronchial lavage, and thoracic radiographic images were collected on all cats. Upon completion of the study (Day 245), cats were euthanized and necropsies were conducted.

RESULTS

Results were analyzed statistically between groups by ANOVA and by paired sample T testing for changes within the group over time. The selamectin-treated cats (Group A) did not develop radiographically evident changes throughout the study and were free of adult heartworms or worm fragments at necropsy. The heartworm life cycle was abbreviated with oral doses of ivermectin (Group B), shown by the absence of adult heartworms or worm fragments at necropsy. The early stage of immature adult worm in Group B cats, however, did induce severe pulmonary airway, interstitial, and arterial lung lesions, revealing that the abbreviated infection is a significant cause of respiratory pathology in cats. Cats in Groups B and C could not be differentiated based on radiographic changes, serologic antibody titers, complete blood count, or bronchoalveolar lavage cytology at any time point throughout the study. Eighty percent of cats in Group A and 100% of cats in Groups B and C became heartworm antibody positive at some time point post infection.

CONCLUSIONS

The clinical implications of this study are that cats that become infected with immature adult heartworms may not develop fully mature heartworms and are only transiently heartworm antibody positive, but do develop Heartworm-Associated Respiratory Disease (HARD).

The progression of heartworm associated respiratory disease (HARD) in SPF cats 18 months after Dirofilaria immitis infection

BACKGROUND

Heartworm-associated respiratory disease (HARD) in cats is induced by the arrival and death of immature adult Dirofilaria immitis in the pulmonary system and is indistinguishable from mature adult heartworm infection.

METHODS

A controlled, blind research study investigated the long-term (18 months post infection, PI) consequences of the inflammatory response associated with the death of immature adult heartworms in cats. Three groups of cats, 10 per group, were infected with 100 third-stage (L3) larvae by subcutaneous injection. Group A cats were treated with selamectin (Revolution®; Zoetis) per label directions at 28 days PI and once monthly for 17 months. Group B cats were treated orally with ivermectin (Ivomec®; Merial) at 150 μg/kg) at 70 days PI, then every 2 weeks for 15 months. Group C cats were untreated PI. At baseline (Day 0) and on Days 70, 110, 168, 240, 309, 380, and 505 PI, peripheral blood, serum, bronchial lavage, and thoracic radiographic images were collected.

RESULTS

The selamectin-treated cats (Group A) and ivermectin-treated cats (Group B) were free of heartworms or heartworm fragments at necropsy. All cats became heartworm antibody positive at some time point in the study except for one cat in Group A. Only cats in Group C (all with adult heartworms) were heartworm antigen positive. The heartworm antibody titer for Group B was highest on Days 110 to 168 and then decreased over time and 50% were serologically antibody negative on Day 240. Eosinophilic bronchoalveolar lavage (BAL) cytology and peripheral eosinophilia were most pronounced on Day 110 in all cats. Randomly distributed myofibrocytes in the lungs of some Group A cats suggest that precardiac larval stages were affecting the lungs. Radiographs in Group B cats demonstrated partial resolution of the initial HARD reaction but chronic myofibrocyte proliferation was histologically evident 18 months after infection.

CONCLUSION

HARD was induced by immature adult worm infection with progressive improvement starting 6 to 8 months after infection but histologic lesions were evident in some cats 18 months after infection. The serologic antibody assay was negative in 50% of cats at 8 months and 100% of cats at 18 months post infection. Abnormal radiographic lung patterns continued in a subset of Group B cats for months after heartworm antibody serology and BAL cytology returned to normal.

Trichomonas vaginalis: paradigm of a successful sexually transmitted organism

Trichomonas vaginalis (TV) is one of the most successful protozoan pathogens and one of the most common sexually transmitted organism in females, yet it is also one of the most poorly investigated. By producing a wide array of glycosidases and cysteine proteinase enzymes, the organism can easily adapt to the environment, harvesting host proteins and DNA for metabolism. With the ability to cause lesions, vaginitis and acute inflammatory disease of the genital mucosa, TV acts as a potential catalyst in the acquisition of secondary infections including human immunodeficiency virus (HIV) and human papillomavirus (HPV), the organism responsible for the pathogenesis of cervical cancer. Treatment of TV infection is relatively easy and could dramatically reduce the transmission of HIV in areas where TV is endemic.

Effects of different inoculation routes on the parasitic sites of Cryptosporidium baileyi infection in chickens

Cryptosporidiosis is prevalent in domesticated, caged, and wild birds. Cryptosporidium baileyi, an ascendant species of avian Cryptosporidium, is an important pathogen. It causes respiratory disease in chickens, especially chickens younger than 50 days. In this study, SEM, histological, semi-quantitative PCR, and nested PCR techniques were used to explore the impact of different inoculation routes on sites of C. baileyi infection in chickens. Results showed that inoculation with sporozoites or oocysts via the rectum was an effective means of causing infection. This may provide an important reference for the development of the transfection system of C. baileyi in chickens. Numerous endogenous stages of C. baileyi were observed in the bursas of Fabricius (BF) and cloacas of chickens inoculated with sporozoites or oocysts via the rectum, but no parasite was seen in the tracheas of any of these chickens. In chickens infected with oocysts via the crop, the number of parasites in the BF was approximately 23-fold more than in the trachea. All blood samples collected after inoculation were negative for C. baileyi. These data show that C. baileyi was not transferred by blood circulation between the BF and respiratory tract. Different routes of inoculation were here found to distinctly affect sites of parasitism in chickens. These findings may facilitate further understanding of the biology of C. baileyi and efforts to control avian cryptosporidiosis.

[Nematode infections of the respiratory tract in dogs in Germany]

Recent studies have shown that the risk of lungworm infection may have increased in dogs in Germany in recent years. Analysis of the fecal examination of dogs has shown that Angiostrongylus vasorum, Crenosoma vulpis and Eucoleus aerophilus are endemic in Germany. Infections with A. vasorum were diagnosed in 223 of the examined dogs. A total of 102 A. vasorum-positive dogs were located in Baden-Wuerttemberg, 65 in North Rhine-Westphalia, 27 in Saarland, 15 in Bavaria, 7 in Rhineland-Palatinate, 5 in Hessen and 2 in Brandenburg. A total of 170 dogs were infected with C. vulpis, 54 of which came from North Rhine-Westphalia, 40 from Baden-Wuerttemberg, 30 from Bavaria, 17 from Rhineland-Palatinate, 17 from Saarland, 9 from Hessen and 1 each from Lower Saxony, Berlin and Mecklenburg-Western Pomerania. Infections with E. aerophilus were detected in 83 dogs, of which 23 lived in Baden-Wuerttemberg, 20 in North Rhine-Westphalia, 17 in Bavaria, 11 in Rhineland-Palatinate, 7 in Hessen, 4 in Saarland and 1 in Mecklenburg-Western Pomerania. Lungworm infections in dogs appear to be well established in Germany. The aim of the study presented was to assess the main facts, occurrence, geographical distribution, clinical signs, diagnosis and therapy of lungworm infections in dogs.

[Toxocariasis respiratory manifestations in cases hospitalized in the Paediatric Diseases Clinic of Iaşi, between 2005-2008]

The authors present the results of retrospective epidemiological, clinical and laboratory diagnosis on toxocariasis cases hospitalized in the Pediatric Diseases Clinic of Iaşi, between January 2005-June 2008.

MATERIAL AND METHOD

The study included a number of 228 children.

RESULTS

Respiratory manifestations were present in 184 children: 105 boys (46.05%) and 79 girls (34.64%), with a slight advance of the rural environment (44.29%). The age distribution highlighted a predominance of 1-5 years of age (65.76%). Respiratory manifestations were fever, coughing, wheezing, asthma, infections of respiratory pathways, pneumonia. The distribution of toxocariasis in children patients in Moldavia, Romania, highlighted a predominance in Iaşi. The children with respiratory manifestations had hypereosinophilia associated with hyperleucocytosis. All the patients were serologically confirmed with toxocariasis. The children responded well to treatment with albendazole.

Pulmonary Superinfection by Trichomonads in the Course of Acute Respiratory Distress Syndrome

The finding of trichomonads in bronchoalveolar lavage fluid (BALF) samples from an acute respiratory distress syndrome (ARDS) patient, never previously reported, incited us to search for these parasites retrospectively in the BALF of patients with ARDS or related pathologies. Eighty-four consecutive BALF samples have been reviewed. Results were compared with data from clinical files of patients included in this study. Detection and identification of trichomonads were based on cytologic characteristics. Subsequently, immunocytochemistry and in situ hybridization were performed in the last case of the series. Our results were as follows: (1) Trichomonads were detected in 25/84 BALFs (20/77 patients). Among the patients testing positive, 17 suffered from ARDS, about 30% of the ARDS patients included in the study. (2) Trichomonads were detected more frequently at a late ARDS stage. (3) No correlation was found between trichomonad detection and other data. (4) Within the group of trichomonad-infected ARDS patients, density of infection correlated with higher mortality. The late detection of these microorganisms in the course of ARDS suggested that trichomonad development is a secondary event. As BALFs obtained early in the course of ARDS were also included in the study, trichomonad incidence could be underestimated. The significance of trichomonad lung colonization in ARDS and its potential pathogenic role are unclear. Nevertheless, the question of an active role of trichomonads in the extension of alveolar lesions or in the limitation of recovery is clearly raised.

Cryptosporidium hominis infection of the human respiratory tract

Cryptosporidium oocysts, observed in a natural sputum sample of a patient with HIV, were further studied by using DNA markers to determine the species of the parasite. C. hominis was identified as the species infecting the patient’s respiratory tract, a finding that strengthens evidence regarding this pathogen’s role in human disease.

Nonatopic asthma is associated with helminth infections and bronchiolitis in poor children

Asthma is common in urban centres in Latin America, but atopic asthma may not be the main phenotype among children. Helminth infections are highly prevalent in poor populations, and it was hypothesised that they attenuate allergic asthma, whereas other factors are related to the expression of a nonatopic wheeze/asthma phenotype. A total of 1,982 children from Southern Brazil with a mean+/-sd age of 10.1+/-0.76 yrs completed asthma questionnaires, and 1,011 were evaluated for intestinal parasites and atopy using skin-prick tests (SPTs). Wheeze in the previous 12 months was reported by 25.6%, and 9.3% showed current asthma; 13% were SPT-positive and 19.1% were positive for any helminths. Most children with either wheeze or asthma were SPT-negative; however, severe wheeze was more prevalent among the atopic minority. Helminth infections were inversely associated with positive SPT results. Bronchiolitis before the age of 2 yrs was the major independent risk factor for asthma at age 10 yrs; high-load Ascaris infection, a family history of asthma and positive SPT results were also asthma risk factors. Most asthma and wheeze are of the nonatopic phenotype, suggesting that some helminths may exert an attenuating effect on the expression of the atopic portion of the disease, whereas viral bronchiolitis predisposes more specifically to recurrent airway symptoms.

Serratospiculosis in a New Zealand Falcon (Falco novaeseelandiae)

CASE HISTORY

An adult New Zealand falcon was presented with metacarpal fractures in the left wing.

CLINICAL FINDINGS

In addition to the fractures, radiographs revealed an area of opacity in the air sacs. A few days after hospitalisation and initiation of treatment of the fractures, the bird developed signs of respiratory disease; the area of opacity was found to have increased in size and density. Treatment with antibiotics and nebulisation was commenced; the bird initially responded but respiratory signs subsequently worsened and the bird died. At necropsy, air sacculitis and bronchopneumonia were associated with numerous nematodes in the air sacs, which were morphologically consistent with Serratospiculum guttatum.

DIAGNOSIS

Serratospiculosis

CLINICAL RELEVANCE

The discovery of this parasite and the associated disease for the first time in New Zealand indicates that it should be considered in the differential diagnosis of respiratory disease in falcons and possibly other raptors in New Zealand.

[Fecal examination of Shami goats from Damascus with respiratory syndrome]

This study was carried out in order to determine the prevalence of helminth species and their relation to the respiratory syndrome in Damascus goats bred in Hatay, Turkey. Fecal samples obtained from 130 Shami goats with respiratory signs including coughing, growling respiration and mucopurulent discharge were examined using the Fulleborne's salt saturated flotation, Benedek sedimentation and Baerman Wetzel methods. Helminth invasions were commonly observed in the goats. Of these goats, 68.46% were found to be infected by various helminth species. Besides this, 30% of the goats were infected with Eimeria species. The percentage of lung nematodes causing respiratory syndrome in goats was found to be 18.46. In conclusion, the goats with respiratory syndrome should also be examined for lung nematodes.

[Check list of the helminths in the respiratory system of domesticated animals in Turkey]

Helminths of the respiratory system make up an important part of the parasitic diseases found in domestic animals. Therefore, many studies have been carried out on these helminths in Turkey. In this article, a check list and the prevalence rates of helminths of respiratory system found in domestic animals in Turkey has been given.

Tetratrichomonads from the oral cavity and respiratory tract of humans

To clarify the taxonomy of trichomonads associated with human respiratory diseases, we examined a collection of axenic trichomonad strains isolated from the oral cavity and bronchi of patients from pulmonary diseases clinics in Tallin, Estonia. The oral and bronchial strains were compared mutually as well as with a reference strain of Trichomonas tenax, a common inhabitant of the human oral cavity, and other trichomonad species from humans and animals. Unexpectedly, the morphological studies, as well as DNA sequencing of ITS1-5.8S rRNA-ITS2 regions revealed that the Estonian strains belong to the genus Tetratrichomonas, with a high similarity to the avian species Tetratrichomonas gallinarum. None of the strains belonged to Trichomonas tenax. DNA fingerprinting using the RAPD method separated Estonian strains into 2 distinct groups: 'bronchial' consisting of 5 and 2 strains isolated from bronchi and 'oral' cavity, respectively, and oral consisting of 3 oral strains. Consistent differences between 'bronchial' and 'oral' groups were confirmed by analysis of ITS1-5.8S rRNA-ITS2 sequences. Our results have revealed novel trichomonad species of the human oral cavity and bronchi.

Haemonchus contortus egg excretion and female length reduction in sheep previously infected with Oestrus ovis (Diptera: Oestridae) larvae

Mixed parasitic infection of animals is a common phenomenon in nature. The existence of one species often positively or negatively influences the survival of the other. Our experimental study was started with the objectives to demonstrate the interaction of Haemonchus contortus and Oestrus ovis in relation to cellular and humoral immune responses in sheep. Twenty-two sheep of Tarasconnais breed (France) were divided into four groups (O, OH, H and C) of five or six animals. Group O and OH received 5 weekly consecutive inoculations with O. ovis L1 larvae (total = 82 L1) in the first phase of the experiment between days 0 and 28. On the second phase, groups OH and H received 5000 L3 of H. contortus on day 48 while group C served as our control throughout the experimental period. Parasitological, haematological, serological and histopathological examinations were made according to standard procedures and all animals were slaughtered at day 95. There was no significant variation in the number and degree of development of O. ovis larvae between the two infected groups. Furthermore, in tissues examined in the upper respiratory tract (nasal septum, turbinate, ethmoide and sinus), group O and OH has responded similarly on the basis of cellular inflammatory responses (blood and tissue eosinophils, mast cells and globule leucocytes (GL)) and serum antibody responses against the nasal bots. This may indicate that the presence of H. contortus in the abomasa of group OH had no marked influence over the development of O. ovis larvae in the upper respiratory tract. On the other hand, we have observed a significantly lower H. contortus female worm length, fecal egg count (FEC) and in utero egg count in animals harbouring the nasal bot (OH) than in the mono-infected group (H). This was significantly associated with higher blood eosinophilia, higher packed cell volume (PCV) and increased number of tissue eosinophils and globule leucocytes. We conclude that, the establishment of O. ovis larvae in the upper respiratory tract has initiated higher inflammatory cellular activity in group OH there by influencing the development and fecundity of H. contortus in the abomasum.

Examination of the migration of first instar larvæ of the parasite Œstrus ovis (Linne 1761) [Diptera: Œstridæ] in the upper respiratory tract of artificially infected lambs and daily measurements of the kinetics of blood eosinophilia and mucosal inflammatory response associated with repeated infection

Twelve lambs were divided into two groups: Group C control, non-infected, and Group O infected once a week for 5 weeks with OEstrus ovis L1 through the same nostril. The first objective of this experiment was to check whether larvae moving through a given nostril remain in the same side nasal cavity or might to spread in both nasal cavities. It has been observed that larvae invade and spread through the entire nasal cavities. The only possible passage way between both sides is via the choanae and velum palatinum. The second objective was to follow the kinetics of blood eosinophilia. A primary peak in eosinophil numbers was noted 4 days following infection, with a higher peak following the second infection. After that, no major changes were seen. Nevertheless, the numbers of eosinophils were always higher than in control animals until the end of the follow-up. The third objective of the study was an enumeration of reactive cells (mast cells, globule leucocytes, and eosinophils) in the mucosae of the upper and lower respiratory tract after necropsy of the animals of the two groups. As observed in previous experiments, there was a large accumulation of these cells in mucosae of the upper respiratory tract. It was also worth noting a significant accumulation of eosinophils in the tissues of the trachea, bronchae and lungs even though OE. ovis was not present there. This "distant" eosinophilic reaction may have important consequences on patho-physiology of other parasites living in these locations: eosinophils have the potential to kill them even though these cells are not activated by their specific antigens.

Differences in susceptibility of the European eel (Anguilla anguilla) and the Japanese eel (Anguilla japonica) to the swim-bladder nematode Anguillicola crassus

The swim-bladder nematode Anguillicola crassus originates from the Far East where it is a parasite of the Japanese eel (Anguilla japonica). After A. crassus was introduced to Europe, it became a predominant parasite of the European eel (Anguilla anguilla). A study performed with experimentally infected eels (98 days, 23 degrees C) revealed significant differences in the susceptibility of the two eel species to this parasite. The recovery rate of 30 administered infective A. crassus larvae (L3) from A. japonica was less than half of that from A. anguilla (33.2% and 13.8%, respectively). Almost 60% of the worms recovered from A. japonica were found as dead, encapsulated and necrotic larvae in the swimbladder wall. In contrast, no dead larvae were found in A. anguilla. Additionally, the development of the worms was shown to be significantly slower in A. japonica compared with A. anguilla. The lower survival rate of the worms, together with their slower development, resulted in a significantly lower adult worm burden (11 and 428 mg wet weight, respectively) and in a decreased reproductive success in A. japonica compared with A. anguilla. These results demonstrate that the original host, A. japonica, possesses more effective defence mechanisms against A. crassus than does the non-adapted host, A. anguilla.

Concurrent parasitic infections of sheep: depression of Trichostrongylus colubriformis populations by a subsequent infection with Oestrus ovis

Concurrent infections of sheep with Oestrus ovis and trichostrongyles of the digestive tract are common in the field. Previous results have shown that a previous infection with O. ovis adversely affects worm populations of either Trichostrongylus colubriformis or Haemonchus contortus. However, no information was available to determine the influence of the succession of infections on the expression of interactions between these parasites located in remote anatomical sites. In order to investigate the role of these modulating factors, an experimental study was conducted on four groups of naïve sheep, examining the consequences of a delayed infection with O. ovis on a pre-existing population of T. colubriformis. group T was infected four times with 4000 T. colubriformis larvae on days 0, 14, 28 and 42 of experiment; group O received multiple infections with O. ovis first instar larvae on days 42, 49, 56, 70 and 77; sheep from group TO received both infections and animals from group C remained as uninfected controls. Faecal egg counts and eosinophilia were measured weekly throughout the study. At necropsy (day 91), the mucosal cellular responses in the nasal cavities (septum, turbinates, ethmoid and sinus) and in the digestive tract (stomach and small intestine) from all animals were analysed from histological sections. Infection of the digestive tract with nematodes did not modify the biology of Oestrus populations, as measured by the number and weight of larvae. In contrast, infections with O. ovis after T. colubriformis infection was related to significant reductions (P < 0.01) in nematode egg excretion and worm burdens. These changes were associated with significant modifications in populations of mast cells, globule leucocytes and eosinophils in the respiratory and digestive tracts. These results indicate that an antagonistic interaction exists between the populations of O. ovis in the nasal cavities and T. colubriformis in the small intestine but that the order of succession of infections with the two parasites is not a major modulating factor for expression of interactions. They also confirm that parasitic infection in one particular anatomical site induces "at distance" inflammatory reactions of the whole mucosal system.

[Analysis of possible causes of recurrent respiratory tract infections in children from Lodz, Poland]

Recurrent respiratory tract infections are responsible for about 85% of all diseases in childhood. Early diagnosis helps to prevent infections and start the appropriate treatment, what in turn prevents lungs from irreversible damage. The aim of this study was the analysis of possible causes of recurrent respiratory tract infections in children in Lodz region. We analyzed cases of 6335 children with recurrent respiratory tract infections, age 3 months to 17 years, referred to the clinic in our hospital by family doctors from 2000 to 2002. Among all children, 41.5% were diagnosed with allergy, 26.9% of patients had persistent Mycoplasma pneumoniae and 1.4% Bordetella pertussis infection. Very disturbing was the fact of very late cystic fibrosis diagnose at the age of 7,11 and 16. Congenital immune disorders were diagnosed late in five children at the age of 6,7,8,9,11, what delayed appropriate therapy and early prevention of infections.

Pulmonary localization of Enterocytozoon bieneusi in an AIDS patient: case report and review

Enterocytozoon bieneusi is an agent of intestinal microsporidiosis leading to malabsorption syndrome and diarrhea in AIDS patients. Respiratory tract microsporidiosis due to Encephalitozoon spp. has been reported. To date, however, only two cases of pulmonary involvement of E. bieneusi have been documented for patients with intestinal microsporidiosis. We report here another pulmonary localization of E. bieneusi in a human immunodeficiency virus-infected patient. Clinical features of these three cases are reviewed. E. bieneusi can colonize the respiratory tract but could be considered a simple carriage associated with an intestinal infection.

Myxobolus cycloides on the swimbladder of chub Leuciscus cephalus: a controlled, host-specific localisation

Of 150 wild stock chub, Leuciscus cephalus L. captured in Lower Austrian watercourses, 112 revealed disc like plasmodia of Myxobolus cycloides Gurley, 1893 on the caudal chamber of the swim bladder. Other cyprinid species from the same waters lacked M. cycloides or other myxosporeans in this specific localisation. In chub, the intensity of infection (number of discs on the swim bladder) showed a logarithmic, age-dependent increase. The plasmodia of M. cycloides were situated in the connective tissue--mainly along blood vessels--and exhibited a delicate envelope of host tissue, thus forming a characteristic myxosporean cyst. Occasionally single trophozoites seemed to merge. A general process of fibroblast proliferation leading to encapsulation and degradation of the parasite was observed. This process was initiated by the formation of small multiple encapsulations within the spore containing trophozoid, before thickening of the outer cyst wall occurred. The general non-inflammatory course of the M. cycloides infection, and the obvious good health of the investigated chub suggest that this myxosporean in its host specific localisation cannot be regarded as a serious pathogen--on the contrary: parasite multiplication and degradation seemed to occur in a well-defined equilibrium controlled by the host fish.

Evaluation of the acarofauna of the domiciliary ecosystem in Juiz de Fora, State of Minas Gerais, Brazil

From August 1999 to January 2000, samples of house dust were collected from 160 domiciles in the city of Juiz de Fora, State of Minas Gerais, Brazil. In 36 of these domiciles kitchen samples were obtained. Prevalence rate was 77.5%, varying according to the geographical sector. There were found 2,278 specimens of mites, with 1,530 (67.2%) in the adult stage and 748 (32.8%) in immature forms. The main species found were Dermatophagoides pteronyssinus, D. farinae, Euroglyphus maynei, Blomia tropicalis and Tyrophagus putrescentiae. In a minor incidence we found Lepidoglyphus destructor, Suidasia pontificiae, Chortoglyphus arcuatus, Cheyletus malaccensis, C. fortis, Ker bakeri, Cheletonella vespertilionis, C. caucasica and others. C. vespertilionis and C. caucasica were identified for the first time in the domiciliary ecosystem and in Brazil. The abundance rate and the infestation intensity were analyzed. There was a varied correlation between climatic conditions and positive domiciles and number of mites. The difference between the number of positive domiciles in the urban area and in the expanding urban area was significant and so was the difference between samples from the domiciles compared to those from the kitchens.

Exotic pulmonary infections

Pulmonary infections are the commonest type of illnesses seen in everyday practice. Although most infections are caused by a few familiar pathogens, an increase in global travel has led to the occurrence of rare and exotic diseases that often do not manifest until after the traveller returns home. Previously innocuous organisms may also be the cause of exotic infections in patients undergoing transplantation, or very aggressive immunosupression. Such treatment regimes may reactivate quiescent organisms acquired years previously, for example melioidosis and strongyloides stercoralis. In most developed countries there is also an increasing incidence of zoonotic infections, with a number of these presenting with mainly pulmonary symptoms. A carefully taken history of recent travel, exposure to wild or domestic animals or the presence of immunosuppression, is extremely helpful in identifying problematic infections that fall into the realm of the exotic. This review discusses some of the respiratory infections in each of these groups with an emphasis on imported infections.

Amphibian respiratory diseases

This article describes the diseases that commonly affect the lungs, gills, and nasal passages of frogs, toads, and salamanders. Although these organs often are affected by systemic infections, only diseases that are limited to the respiratory system are discussed. Gills of aquatic amphibians commonly are affected by poor water quality, infestations by protozoa or trematodes, or infections by water molds. Nematodes in the genus Rhabias are significant pulmonary pathogens in frogs and toads. The nasal passages of frogs, toads, and salamanders may be parasitized by Bufolucilia fly larvae.

Respiratory nematodiases in raptors in Quebec

This is a retrospective study on wild raptors submitted to the Université de Montréal (Quebec, Canada) from 1989 to 1996. Cyathostoma spp. (Nematoda: Syngamidae) adults and/or eggs were found in air sacs, lungs, bronchi, and trachea of 12 raptors (Falconiformes and Strigiformes) from Quebec, Canada, belonging to eight different species, five of which are first host records for this parasite: barred owl (Strix varia), snowy owl (Nyctea scandiaca), northern harrier (Circus cyaneus), northern goshawk (Accipiter gentilis), and broad-winged hawk (Buteo platypterus). The infection was considered fatal in four birds, while no significant clinical signs were observed in the other cases. Major pathologic changes included diffuse pyogranulomatous air sacculitis, pneumonia, and bronchitis. A few unidentified larval nematodes embedded in a granuloma were found in the lungs of an additional Coopers' hawk (Accipiter cooperii); they were not considered clinically significant. A dead nematode, surrounded by necrotic inflammatory cells, was found in the air sac of a northern goshawk. The presence of nematodes in air sacs or lungs should be considered in wild raptors demonstrating respiratory problems.

Broiler industry strategies for control of respiratory and enteric diseases

The commercial broiler industry is a modern day agricultural success due to popular consumer demand, healthy flocks, and least cost production. Preventive medicine is the key for economical control of disease in integrated broiler companies, and includes quarantine-eradication, controlled-exposure, and preventive feed medication. Respiratory and enteric diseases present a continuing, potential threat for economic loss. Most exotic and egg-transmitted poultry diseases have been controlled by reduction or eradication policies. Endemic diseases are controlled by mass vaccination and preventive feed medication. Improvements in genetics, housing, equipment, and disease surveillance has allowed continued improvements in disease prevention. Attention to detail and management of risk is crucial to industry success. With fast industry growth and market maturity of the broiler industry, new challenges have risen. These challenges include increased poultry house density, increasing economic pressures, changing industry attitudes, and increased governmental regulations that will strain the continued success of today's control strategies.

Turkey industry strategies for control of respiratory and enteric diseases

Current strategies to control respiratory and enteric diseases of turkeys involve sanitation and biosecurity practices to prevent the introduction of infectious agents. In addition, proper husbandry and management practice reduce stress and help maintain a competent immune system. Industry-wide monitoring programs are used in conjunction with isolation, depopulation, and orderly marketing to eliminate pathogens that cause serious economic loss. Vaccines are available and utilized against some pathogens. Effective drug treatment is available and used for some diseases but is most commonly used to control secondary disease losses when treatment is not available for the primary disease.

Attempts to analyse Anguillicola crassus infection and the humoral host response in eels (Anguilla anguilla) of Lake Balaton, Hungary

Since the introduction of Anguillicola crassus into Europe, anguillicolosis has been a considerable problem in several countries. From 1991, periodical eel mortality occurred in Lake Balaton, Hungary. However, eels with a worm burden of 20 to 50 parasites did not show severe swimbladder lesions, which observation cast doubts on the primary aetiological role of the parasite in the eel kill. In order to study the pathology of the infection, from the spring of 1996 until October of the same year, 51 eels were collected from two regions of Lake Balaton and examined for swimbladder changes. To detect humoral antibodies, an enzyme-linked immunosorbent assay (ELISA) was performed, using cuticular-oesophageal worm antigen. The results of the test show the applicability of the method. However, no direct correlation was found between antibody levels or the intensity of infection and the swimbladder lesions. The low level of specific antibodies and the increasing severity of swimbladder changes in the autumn suggest that parasite-induced immunity is insufficient to prevent reinfection.

Identification of Enterocytozoon bieneusi spores in respiratory samples from an AIDS patient with a 2-year history of intestinal microsporidiosis

Enterocytozoon bieneusi, a microsporidian parasite, has been recognized since 1985 as an agent of intestinal microsporidiosis leading to malabsorption syndrome, diarrhea, and weight loss in AIDS patients. Recently, however, we have identified E. bieneusi spores in the sputum, bronchoalveolar lavage, and stool samples of an AIDS patient with a 2-year history of intestinal microsporidiosis. The spores were characterized by Weber's chromotrope-based staining, immunofluorescence tests, and PCR. No microsporidia were detected in urine samples by the same techniques. PCR was performed with DNAs purified from specimens with E. bieneusi-, Encephalitozoon cuniculi-, Encephalitozoon hellem-, and Encephalitozoon (Septata) intestinalis-specific primers. Treatment with albendazole and loperamide resulted in an improvement of intestinal symptoms, without eradication of the parasite. To our knowledge, this is the second report of the identification of E. bieneusi spores in respiratory and enteric samples obtained from an AIDS patient. Although no pulmonary pathology could be established in either of these cases, it is now clear that E. bieneusi is capable of colonizing the respiratory tract and it is suggested that investigators should be aware of the possibility of finding E. bieneusi spores in respiratory secretions.

Respiratory cryptosporidiosis: case series and review of the literature

Five case of intestinal cryptosporidiosis with pulmonary involvement in patients with AIDS are reported. The diagnosis was based on the recognition of acid-fast oocysts in sputum or aspirated bronchial material and stool specimens. Coughing and excess secretions were present in all cases. Four patients had other associated pulmonary pathogens: two Mycobacterium tuberculosis, one Mycobacterium fortuitum and one Cytomegalovirus + Pneumocystis carinii; all of them had a previous (three cases) or simultaneous (one case) diagnosis of intestinal cryptosporidiosis, presenting with diarrhoea and vomiting. In the fifth patient Cryptosporidium was the only pulmonary pathogen found in a bronchial aspirate, and the onset of diarrhoea was 1 month after respiratory detection. Fifty-seven cases of respiratory cryptosporidiosis have been reported since 1980. In 17 of them, no other pathogen was found. Diarrhoea was present in 77% of the patients, cough in 77%, dyspnea in 58%, expectoration in 54%, fever in 45%, thoracic pain in 33%.

High prevalence of Cryptosporidium in young children with prolonged diarrhea

A prospective study was done to identify Cryptosporidium in the stools of young children, aged 2 months to 3 years, admitted to hospital. Of a total of 387 stool samples from 387 individuals, 131 stool specimens forming the control group were from children with non-diarrheal, respiratory tract infections, 200 and 56 stool samples were from children with acute diarrhea and prolonged diarrhea, respectively. No Cryptosporidium was discovered in the control group. Only 1 sample positive for Cryptosporidium was found in the group with acute diarrhea, whereas 4 samples of Cryptosporidium were found in the group with prolonged diarrhea. The prevalence of Cryptosporidium in the group with prolonged diarrhea was significantly higher than the other two groups (p < 0.05). In those children with prolonged diarrhea, Cryptosporidium should always be included in the differential diagnosis.

Disseminated Strongyloides stercoralis infection

A case of disseminated S stercoralis is an immunosuppressed patient manifested with diarrhea, a rash, and progressive respiratory insufficiency. The parasites were eradicated with thiabendazole despite continued steroid therapy, and the patient survived the hospitalization. The characteristics of S stercoralis allow it to be harbored within a host for prolonged periods of time, only to disseminate once cell-mediated immunity is suppressed. A diagnosis of strongyloidiasis should be considered in an immunocompromised patient with a petechial rash. Prompt diagnosis and initiation of thiabendazole therapy provides the greatest opportunity for patient survival. Secondary bacterial infections should be aggressively sought. Mortality from disseminated strongyloidiasis approaches 80%.

[Infectious respiratory complications of AIDS]

Respiratory infections are particularly frequent in HIV infection. They depend upon the degree of immunodeficiency, the geographical region and a possible prophylaxis. Bronchopneumopathies caused by pyogenic organisms (notably pneumococci) appear when the number of T4 lymphocytes is little reduced. Pulmonary tuberculosis, particularly frequent in Africans and Haitians, occurs in patients with moderate immunodeficiency (T4 between 200 and 300/mm3). HIV infections modify the epidemiology of tuberculosis in Africa, but also in the USA and probably in Europe. Despite a well-established prophylaxis, pneumocystosis, which develops when the number of T4 cells falls below 200/mm3, is the opportunistic pathology which in most cases points to AIDS in the USA and in France. Atypical mycobacterial infections (Mycobacterium avium complex) and CMV infections occur at a late stage of the disease in patients with severe immunodeficiency. Noticeable advances have recently been made in the treatment of these complications.

Cryptosporidiosis in children in Gaza

A prospective survey of children admitted with gastro-enteritis to the Nasser Children's Hospital, Gaza revealed that 19% were excreting cryptosporidium, a significantly (p less than 0.001) greater percentage than that (7%) observed in children admitted for other reasons. Detection of cryptosporidium decreased when the change from hot dry to colder wetter weather occurred. Although Salmonella spp were isolated more frequently than cryptosporidium in children with diarrhoea (20% of cases), there was no statistically significant association between excretion of Salmonella spp and gastro-enteritis. A follow-up study of a cohort of the children with cryptosporidiosis indicated that over three-quarters were dehydrated and all were below their expected weight-for-age. There was a statistically significant association between cryptosporidium gastro-enteritis and evidence of respiratory tract infection.

Symptoms and transmission of intestinal cryptosporidiosis

Cryptosporidium spp are a cause of diarrhoea in toddlers. Symptoms and routes of transmission were investigated in a prospective case-control study in the city and surroundings of Basel, Switzerland. Twenty one (4.6%) out of 455 children with diarrhoea who attended paediatric and general practices from June to September 1988 were positive for cryptosporidium. The mothers of each case, of two controls with diarrhoea of another origin, and of two healthy controls were interviewed with a standardised questionnaire. In comparison with controls with diarrhoea of another origin, respiratory symptoms were significantly more frequent in children with cryptosporidiosis: eight of 19 (42%) compared with five of 38 (13%). In comparison with healthy controls, preceding contact with a person suffering from diarrhoea was associated with the greatest relative risk for cryptosporidiosis, followed by travel in a Mediterranean country. Transient cryptosporidial infection of the respiratory tract may be common in immunocompetent children. In the area investigated person to person transmission may account for most cases.

Respiratory cryptosporidiosis in chickens

In order to better characterize spontaneous respiratory cryptosporidiosis in chickens, a retrospective examination of histopathology reports from the Georgia Poultry Laboratories for an 18-mo period (4/1/86 to 9/30/87) was made; 12 cases were found. Collected data were analyzed and certain epidemiologic and histologic features were identified. Eleven of the 12 cases involved broiler type chickens. The ages of chickens with respiratory cryptosporidiosis were evenly distributed between 17 and 52 days of age. The infected birds were always clinically ill. Viruses or bacteria or both often accompanied respiratory Cryptosporidium sp. infections. Histologic lesions (including those of ciliary-adherent bacteria) are described. As the inflammatory response in infected organs became progressively nonpurulent (lymphocytes and plasma cells predominate), numbers of Cryptosporidium diminished. Cytologic preparations were useful for making diagnoses of respiratory cryptosporidiosis in chickens. Identification of epidemiologic features of respiratory cryptosporidiosis, and improved ability to make accurate and prompt diagnoses of Cryptosporidium sp. infection, are vital for a more complete understanding of the impact of this disease on poultry health.

Parasites of the respiratory tract

The author discusses the parasites that infect the nasal passages, trachea, bronchi, and lung parenchyma of dogs and cats. The clinical signs, diagnosis, epidemiology, treatment, and control of infection are also considered.

[The nature of an inflammatory reaction as dependent on the etiology of infection and some peculiarities of the macroorganism]

The paper summarizes long-term studies on infectious pathology. On the example of the involvements of respiratory organs, the intestinal tract, and the central nervous system caused by viruses, bacteria, mycoplasma, fungi, and Protozoa, differences in the structural changes of the internal organs due to particular properties of the causative agents are analysed. These changes have been shown to be the greatest when the causative agents belong to different types and classes. The influence of host factors, first of all the immune status, on the course of infectious diseases is discussed. Changes occurring in the macro- and microorganism in the course of the infectious disease are considered. Not only local but also systemic defence mechanisms have been shown to be disturbed during infection which facilitates the occurrence of diseases of other etiologies and leads to increased incidence of combined infections.

Respiratory cryptosporidiosis in a peacock chick

Respiratory cryptosporidiosis was diagnosed in a 2-week-old peacock chick, whose symptoms were a gurgling respiration, coughing and sneezing, and a serous oculonasal discharge. Light microscopy detected cryptosporidial-like organisms attached to the surface of conjunctival, nasal-sinus, and tracheal-epithelial cells, and electron microscopy demonstrated stages typical of cryptosporidial trophozoites, schizonts, and oocysts. About 30 other in-contact peacock chicks also developed the same clinical symptoms, and all died despite treatment with oxytetracycline HCl at 200 ppm in the drinking water.

Recovery of soil Amebas from the nasal passages of children during the dusty harmattan period in Zaria

Following a fatal case of primary amebic meningoencephalitis during the dusty harmattan period in an 8-month-old child in whose case Naegleria fowleri was recovered both from the cerebrospinal fluid and from material from the nose in absence of a history of swimming, it was hypothesized that dust during the harmattan might harbor amebic cysts, which may be inhaled by human beings and cause infection. A preliminary survey was thus carried out to examine the nasal passages of children for the presence of soil amebas during the harmattan. In all, 50 children were evaluated for the presence of soil amebas. Positive cultures for the soil amebas were obtained from 12 children (24%). Four species of amebas were isolated singly or in combination with other species. Pathogenic Naegleria fowleri, proved pathogenic for mice, were cultured from specimens from two children.