DOCSLIB.ORG

Dientamoeba Fragilis: Plaints Come to Light

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Dientamoeba Fragilis: Plaints Come to Light Analysis Dientamoeba fragilis: plaints come to light. The organism has a median age of 41 years for all patients been isolated from patients with clinical submitting samples (mean 40.8 yr), an emerging role in disease in countries around the world, which suggests that sample bias does including an Australian study reporting not account for the observation of dif- intestinal disease that all of 60 patients with confirmed D. ferences in the incidence of this para- fragilis infection were symptomatic.3 site in younger people. irst described in 1918 by Jepps Moreover, treatment with drugs known Specimens from patients 11–15 years and Dobell, Dientamoeba fragi- to have parasiticidal activity in vitro has of age had relatively high rates of posi- F lis is a binucleated, unflagellated led to prompt and dramatic clinical im- tive reports (boys 10.3%, girls 9.6%). protozoan related to the trichomon- provement in the majority of reported Those from young men aged 16–20 ads,1 readily identified in stool speci- cases.1,2 In some cases, patients with years had the highest rate: 11.5% (95% mens by means of routine iron-hema- prior misdiagnoses of irritable bowel confidence interval [CI] 4%–19%). The toxylin stains. First observed in 7 syndrome (IBS) or chronic diarrhea positivity rate of specimens from young patients, of whom 6 had diarrhea or have been found to be infected with the women aged 16–20 years, on the other dysentery, the parasite was dubiously parasite and cured with antiparasitic hand, was much lower (1.1%, 95% CI classified as a nonpathogen based on agents.1 Such observations indicate a 0.3%–1.9%; p < 0.01), in contrast with its source of nutrition: its voracious ap- need not only for appropriate investiga- reports from other countries1,2 where a petite is for the commensal bacteria of tion but also treatment of patients who female predilection has been sugges- the gut rather than the tissues of its have symptoms of irritable bowel syn- ted. Furthermore, 45.9% of positive re- host.1 For decades, the organism was drome before a reputedly incurable con- sults applied to specimens from female thrown into the grab-bag of human dition is diagnosed. As a result of these patients, who furnished 58.3% of the commensal protozoa with the likes of and other observations, many countries specimens submitted (p = 0.03). Adults Entamoeba coli and Endolimax nana. have finally recognized D. fragilis as a over 20 years of age had the lowest inci- Questions about the nonpathogenicity true gastrointestinal pathogen.1 dence rates (0.6–2.0%); the rates in 5 of this protozoan have emerged, how- The prevalence of D. fragilis would children under 10 were intermediate 6 2 0 ever, and there can now be little doubt surprise most clinicians. A review of (1.3%–5.7%). Incidence rates showed 6 0 . 1–3 j a of its role in gastrointestinal disease. stool-examination reports at the Cad- no seasonal variation over a 5-year pe- m c / Only recently has the evidence sup- ham Provincial Laboratory in Winnipeg, riod (data not shown), which contrasts 3 0 5 1 porting D. fragilis as a cause of diar- which handles 80%–90% of stool ex- sharply with the summer–fall seasonal- . 0 1 : rhea, abdominal pain, cramping and aminations for parasites done in Mani- ity of pathogens traditionally associated I O D a plethora of vague abdominal com- toba, revealed that the incidence of this with contaminated water (e.g., G. lam- parasite was second only to Blastocystis blia/intestinalis, C. parvum). Blastocystis hominis hominis and far in excess of more com- The mode of transmission of D. fra- monly incriminated parasites such as gilis remains a mystery, perhaps be- Dientamoeba fragilis Giardia lamblia/intestinalis, Enta- cause its acknowledgement as a patho- moeba histolytica/dispar and Crypto- gen is so recent. The organism has Giardia lamblia/intestinalis sporidium parvum. Coinfection with B. never been found to have a cyst stage, Entamoeba histolytica/dispar hominis and D. fragilis was also com- deemed necessary for efficient feco-oral 1–3 Cryptosporidium parvum mon (Fig. 1). transmission. Moreover, direct trans- Entamoeba vermicularis To examine the epidemiology of D. mission via trophozoite forms was fragilis infection in Manitoba, we re- deemed unlikely when, in keeping with Dientamoeba latum viewed the examination results for all a longstanding practice among early Ascaris lumbricoides fecal specimens submitted over a 12- parasitologists of self-experimentation, B. hominis—D. fragilis coinfection month period (Feb. 2005 through Jan. Dobell swallowed a culture containing 2006) to the Cadham Provincial Labo- millions of trophozoites.1 Not only did 0 100 200 300 400 ratory for ova and parasites: a total of he remain asymptomatic, but for 10 No. of specimens positive for parasites 11 100 specimens from 6363 patients years he examined his own stool speci- (mean 1.74 specimens per patient). The mens and never observed the parasite. Fig. 1: Nonrepeat occurrence of the 8 parasite was found predominantly in Because of its morphological, bio- most common intestinal parasites di- specimens from young adults: 50% of logical and genetic similarities to pro- agnosed via stool examination at Cad- people found to have dientamoebiasis tozoan parasites of nonhuman animals ham Provincial Laboratory, Winnipeg, Man., over a 1-year period. in Manitoba were younger than 24 that are known to use the eggs of para- (mean 28.7) years. This contrasts with sitic worms as vectors, it was speculated CMAJ • August 29, 2006 • 175(5) | 468 © 2006 CMA Media Inc. or its licensors Analysis infections with Enterobius and Dienta- found in all patients with gastrointesti- Table 1: Treatments that have moeba, but appropriate testing (sticky nal complaints. Furthermore, people exterminated * Dientamoeba fragilis tape or paddle) for Enterobius eggs was who have symptoms of IBS should be Agent Dose, mg† Duration, d not performed consistently. Lastly, PCR evaluated for the presence of this and of nucleic acid extract of Enterobius other parasites. Where required, treat- Iodoquinol 650 20 eggs did not identify Dientameoba ment should be provided before a diag- Doxycycline, DNA in coinfected individuals.4 As it nosis of IBS is given. 100 10 twice a day stands, although the mode of transmis- Metronidazole 500 10 sion remains unknown, it seems fair to Philippe R. Lagacé-Wiens Department of Medical Microbiology Paromomycin, query the role of Enterobius in the 8–12 7 mg/kg body wt transmission of Dientamoeba. and Infectious Diseases University of Manitoba Secnidazole, Several drugs are thought to have 2000 1 Paul G. VanCaeseele single dose paraciticidal activity against D. fragilis. Unfortunately, in vitro testing is in- Department of Medical Microbiology Note: wt = weight. accurate and cannot reliably predict and Infectious Diseases *Adapted from references 1, 2 and 5–9. University of Manitoba †Administered by mouth: 3 times per day, unless treatment outcomes because Dienta- Cadham Provincial Laboratory otherwise indicated. moeba requires xenic media (media Cliff Koschik containing bacteria for the parasite to Cadham Provincial Laboratory that D. fragilis may also be transmitted feed on). Furthermore, no large-scale Winnipeg, Man. that way.1 Early studies pointed toward randomized control trials have been the pinworm, Enterobius vermicularis, done. Many agents have, however, led This article has been peer reviewed. as a potential vector: coinfection with to the eradication of D. fragilis from D. fragilis and E. vermicularis initially stools and resolution of symptoms as Competing interests: None declared. appeared to be far more common than documented in case reports (Table expected; amoeboid bodies resembling 1).1,2,5–9 The most commonly employed D. fragilis have been described in the and best studied treatments currently REFERENCES 1,8 1. Johnson EH, Windsor JJ, Clark CG. Emerging from eggs of E. vermicularis; and the parasi- are iodoquinol and doxycycline. This obscurity: biological, clinical, and diagnostic as- tologist Ockert (again, in the tradition regimen was studied in a small case pects of Dientamoeba fragilis. Clin Microbiol Rev of self-experimentation) successfully series of 21 people with IBS-like symp- 2004;17:553-70. 2. Norberg A, Nord CE, Evengard B. Dientamoeba infected himself and 2 other adult vol- toms and concomitant infection with fragilis — a protozoal infection which may cause unteers by ingesting E. vermicularis D. fragilis who were treated with iodo- severe bowel distress. Clin Microbiol Infect 2003; 9:65-8. eggs taken from a child coinfected quinol and doxycycline: the symptoms 3. Stark D, Beebe N, Marriott D, et al. Prospective with D. fragilis.1 resolved in 14 of the patients (67%), in study of the prevalence, genotyping, and clinical relevance of Dientamoeba fragilis infections in an Despite these observations, many whom the organism was eradicated. In Australian population. J Clin Microbiol 2005;43: have questioned a role for pinworms in a more recent study of secnidazole 2718-23. 9 4. Menghi CI, Makiya R, Gatta CL, et al. Dientamoeba transmission, frequently citing the pau- treatment, a single dose eradicated fragilis: molecular biology techniques for the eluci- city of well-controlled epidemiological the parasite in 34 of 35 patients (97%, dation of its mode of transmission. Parasitol Lati- experiments.1 In one study, Stark and 95% CI 92%–100%) and resolved clini- noam 2005;60:25-31. 5. Dardick KR. Tetracycline treatment of Dientamoe- 3 colleagues performed appropriate pin- cal symptoms in 27 cases (77%, 95% ba fragilis. Conn Med 1983;47:69-70. worm testing in conjunction with mi- CI 63%–91%). 6. Spencer MJ, Garcia LS, Chapin MR. Dientamoeba fragilis: an intestinal pathogen in children? Am J croscopic stool examination and found Intestinal parasites, particularly Dis Child 1979;133:390-3.
Load more

Recommended publications
  • Traveler's Diarrhea
    Traveler’s Diarrhea JOHNNIE YATES, M.D., CIWEC Clinic Travel Medicine Center, Kathmandu, Nepal Acute diarrhea affects millions of persons who travel to developing countries each year. Food and water contaminated with fecal matter are the main sources of infection. Bacteria such as enterotoxigenic Escherichia coli, enteroaggregative E. coli, Campylobacter, Salmonella, and Shigella are common causes of traveler’s diarrhea. Parasites and viruses are less common etiologies. Travel destination is the most significant risk factor for traveler’s diarrhea. The efficacy of pretravel counseling and dietary precautions in reducing the incidence of diarrhea is unproven. Empiric treatment of traveler’s diarrhea with antibiotics and loperamide is effective and often limits symptoms to one day. Rifaximin, a recently approved antibiotic, can be used for the treatment of traveler’s diarrhea in regions where noninvasive E. coli is the predominant pathogen. In areas where invasive organisms such as Campylobacter and Shigella are common, fluoroquinolones remain the drug of choice. Azithromycin is recommended in areas with qui- nolone-resistant Campylobacter and for the treatment of children and pregnant women. (Am Fam Physician 2005;71:2095-100, 2107-8. Copyright© 2005 American Academy of Family Physicians.) ILLUSTRATION BY SCOTT BODELL ▲ Patient Information: cute diarrhea is the most com- mised and those with lowered gastric acidity A handout on traveler’s mon illness among travelers. Up (e.g., patients taking histamine H block- diarrhea, written by the 2 author of this article, is to 55 percent of persons who ers or proton pump inhibitors) are more provided on page 2107. travel from developed countries susceptible to traveler’s diarrhea.
    [Show full text]
  • Amoebic Dysentery
    University of Nebraska Medical Center DigitalCommons@UNMC MD Theses Special Collections 5-1-1934 Amoebic dysentery H. C. Dix University of Nebraska Medical Center This manuscript is historical in nature and may not reflect current medical research and practice. Search PubMed for current research. Follow this and additional works at: https://digitalcommons.unmc.edu/mdtheses Part of the Medical Education Commons Recommended Citation Dix, H. C., "Amoebic dysentery" (1934). MD Theses. 320. https://digitalcommons.unmc.edu/mdtheses/320 This Thesis is brought to you for free and open access by the Special Collections at DigitalCommons@UNMC. It has been accepted for inclusion in MD Theses by an authorized administrator of DigitalCommons@UNMC. For more information, please contact [email protected]. A MOE B leD Y SEN T E R Y By H. c. Dix University of Nebraska College of Medicine Omaha, N~braska April 1934 Preface This paper is presented to the University of Nebraska College of MediCine to fulfill the senior requirements. The subject of amoebic dysentery wa,s chosen due to the interest aroused from the previous epidemic, which started in Chicago la,st summer (1933). This disea,se has previously been considered as a tropical disease, B.nd was rarely seen and recognized in the temperate zone. Except in indl vidu8,ls who had been in the tropics previously. In reviewing the literature, I find that amoebio dysentery may be seen in any part of the world, and from surveys made, the incidence is five in every hun- dred which harbor the Entamoeba histolytlca, it being the only pathogeniC amoeba of the human gastro-intes­ tinal tract.
    [Show full text]
  • Dientamoeba Fragilis – the Most Common Intestinal Protozoan in the Helsinki Metropolitan Area, Finland, 2007 to 2017
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Helsingin yliopiston digitaalinen arkisto Research Dientamoeba fragilis – the most common intestinal protozoan in the Helsinki Metropolitan Area, Finland, 2007 to 2017 Jukka-Pekka Pietilä1, Taru Meri2, Heli Siikamäki1, Elisabet Tyyni3, Anne-Marie Kerttula3, Laura Pakarinen1, T Sakari Jokiranta4,5, Anu Kantele1,6 1. Inflammation Center, Infectious Diseases, Helsinki University Hospital and Helsinki University, Helsinki, Finland 2. Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland 3. Division of Clinical Microbiology, Helsinki University Hospital, HUSLAB, Helsinki, Finland 4. Medicum, University of Helsinki, Finland 5. SYNLAB Finland, Helsinki, Finland 6. Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Finland Correspondence: Anu Kantele ([email protected]) Citation style for this article: Pietilä Jukka-Pekka, Meri Taru, Siikamäki Heli, Tyyni Elisabet, Kerttula Anne-Marie, Pakarinen Laura, Jokiranta T Sakari, Kantele Anu. Dientamoeba fragilis – the most common intestinal protozoan in the Helsinki Metropolitan Area, Finland, 2007 to 2017. Euro Surveill. 2019;24(29):pii=1800546. https://doi.org/10.2807/1560- 7917.ES.2019.24.29.1800546 Article submitted on 08 Oct 2018 / accepted on 12 Apr 2019 / published on 18 Jul 2019 Background: Despite the global distribution of of Dientamoeba-like structures in formalin-fixed sam- the intestinal protozoan Dientamoeba fragilis, its ples, an approach applicable also in resource-poor clinical picture remains unclear. This results from settings. Symptoms of dientamoebiasis differ slightly underdiagnosis: microscopic screening methods from those of giardiasis; patients with distressing either lack sensitivity (wet preparation) or fail to symptoms require treatment.
    [Show full text]
  • Ulcerative Post-Dysenteric Colitis
    Gut: first published as 10.1136/gut.7.5.438 on 1 October 1966. Downloaded from Gut, 1966, 7, 438 Ulcerative post-dysenteric colitis S. J. POWELL AND A. J. WILMOT From the Amoebiasis Research Unit' and the Department ofMedicine, University ofNatal, Durban, South Africa EDITORIAL COMMENT Better treatment is resulting in more severe cases of amoebic colitis surviving and these patients may have severe residual damage to the bowel resulting in ulcerative post-dysenteric colitis. This is considered to be a distinct entity. The term 'post-dysenteric colonic irritability' was thousand patients who attend this hospital annually introduced by Sir Arthur Hurst (1943) to describe with acute amoebic dysentery complications are persistent irritability of the bowel following an acute common and we have had the opportunity to study attack of bacillary or amoebic dysentery. The early them (Wilmot, 1962). It is from this material that we symptoms were attributed to a non-specific chronic have based the following report of ulcerative post- colitis occurring after the specific infection had died dysenteric colitis in 33 African patients observed in out, but in the later stages were thought to be due to recent years. 'functional irritability' of the colon. Stewart (1950) found that post-dysenteric colitis was more common- CLINICAL FINDINGS ly a sequel to acute amoebic dysentery and was able All patients presented initially with severe amoebic to recognize two forms in his patients: 1 Those with dysentery, sigmoidoscopic examination showing a mild symptoms and no colonic ulceration, which he congested, oedematous mucosa with extensive rectal named 'functional post-dysenteric colitis', and (2) ulcers the surfaces of which were covered by sloughs http://gut.bmj.com/ Those with colonic ulceration and more severe and exudate.
    [Show full text]
  • Remarks on Pelvic Peritonitis and Pelvic Cellulitis, with Illustrative Cases
    Article IV.- Remarks on Pelvic Peritonitis and Pelvic Cellulitis, with Illustrative Cases. By Lauchlan Aitken, M.D. Rather moie than a year ago there appeared from the pen of a well- known of this a gynecologist city very able monograph on the two forms of pelvic inflammation whose names head this article; and it cannot have escaped the recollection of the reader that Dr M. Dun- can, adopting the nomenclature first proposed by Yirchow, has used on his different terms title-page1 than those older appellations I still to retain. Under these propose ^ circumstances I feel at to compelled least to attempt justify my preference for the original names: and I trust to be able to show that are they preferable to, and less con- others that fusing than, any have as yet been proposed, even though we cannot consider them absolutely perfect. 1 Treatise on A Practical Perimetritis and Parametritis (Edin. 1869). 1870.] DR LAUCI1LAN AITKEN ON PELVIC FERITONITIS, ETC. 889 Passing over, then, such terms as 'periuterine cellulitis or phleg- mons periuterins as bad compounds ; others, as inflammation of the broad ligaments, as too limited in meaning ; and others, again, as engorgement periutdrin, as only indicating one of the stages of the affection,?I shall endeavour as succinctly as possible to state my reasons for preferring the older names to those proposed by Virchow. ls?. The two Greek prepositions, peri and para, are employed somewhat arbitrarily to indicate inflammatory processes which are essentially distinct. I say arbitrarily, because I am not aware that para has been generally employed in the form of a compound to ex- press inflammation of the cellular tissue elsewhere.1 By those who remember that the cellular tissue not only separates the serous membrane from the uterus at that part where the cervix and body of the organ meet, but is even abundant there,2 perimetritis might readily be taken to indicate one of the varieties, though indeed not a in for which very common one, of pelvic cellulitis?a variety, fact, the term perimetric cellulitis has been proposed.
    [Show full text]
  • Original Article Dientamoeba Fragilis Diagnosis by Fecal Screening
    Original Article Dientamoeba fragilis diagnosis by fecal screening: relative effectiveness of traditional techniques and molecular methods Negin Hamidi1, Ahmad Reza Meamar1, Lameh Akhlaghi1, Zahra Rampisheh2,3, Elham Razmjou1 1 Department of Medical Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 2 Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran 3 Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Abstract Introduction: Dientamoeba fragilis, an intestinal trichomonad, occurs in humans with and without gastrointestinal symptoms. Its presence was investigated in individuals referred to Milad Hospital, Tehran. Methodology: In a cross-sectional study, three time-separated fecal samples were collected from 200 participants from March through June 2011. Specimens were examined using traditional techniques for detecting D. fragilis and other gastrointestinal parasites: direct smear, culture, formalin-ether concentration, and iron-hematoxylin staining. The presence of D. fragilis was determined using PCR assays targeting 5.8S rRNA or small subunit ribosomal RNA. Results: Dientamoeba fragilis, Blastocystis sp., Giardia lamblia, Entamoeba coli, and Iodamoeba butschlii were detected by one or more traditional and molecular methods, with an overall prevalence of 56.5%. Dientamoeba was not detected by direct smear or formalin-ether concentration but was identified in 1% and 5% of cases by culture and iron-hematoxylin staining, respectively. PCR amplification of SSU rRNA and 5.8S rRNA genes diagnosed D. fragilis in 6% and 13.5%, respectively. Prevalence of D. fragilis was unrelated to participant gender, age, or gastrointestinal symptoms. Conclusions: This is the first report of molecular assays to screen for D.
    [Show full text]
  • 6 Chronic Abdominal Pain in Children
    6 Chronic Abdominal Pain in Children Chronic Abdominal Pain in Children in Children Pain Abdominal Chronic Chronische buikpijn bij kinderen Carolien Gijsbers Carolien Gijsbers Carolien Chronic Abdominal Pain in Children Chronische buikpijn bij kinderen Carolien Gijsbers Promotiereeks HagaZiekenhuis Het HagaZiekenhuis van Den Haag is trots op medewerkers die fundamentele bijdragen leveren aan de wetenschap en stimuleert hen daartoe. Om die reden biedt het HagaZiekenhuis promovendi de mogelijkheid hun dissertatie te publiceren in een speciale Haga uitgave, die onderdeel is van de promotiereeks van het HagaZiekenhuis. Daarnaast kunnen promovendi in het wetenschaps­­magazine HagaScoop van het ziekenhuis aan het woord komen over hun promotieonderzoek. Chronic Abdominal Pain in Children Chronische buikpijn bij kinderen © Carolien Gijsbers 2012 Den Haag ISBN: 978-90-9027270-2 Vormgeving en opmaak De VormCompagnie, Houten Druk DR&DV Media Services, Amsterdam Printing and distribution of this thesis is supported by HagaZiekenhuis. All rights reserved. Subject to the exceptions provided for by law, no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form by any means, electronic, mechanical, photocopying, recording or otherwise, without the written consent of the author. Chronic Abdominal Pain in Children Chronische buikpijn bij kinderen Carolien Gijsbers Proefschrift ter verkrijging van de graad van doctor aan de Erasmus Universiteit Rotterdam op gezag van de rector magnificus Prof.dr. H.G. Schmidt en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op donderdag 20 december 2012 om 15.30 uur door Carolina Francesca Maria Gijsbers geboren te Zierikzee Promotiecommisie Promotor: Prof.dr. H.A.
    [Show full text]
  • Molecular Characterization of Enterotoxigenic Escherichia Coli
    iolog ter y & c P a a B r f a o s i l t o a l n o r Yameen et al., J Bacteriol Parasitol 2018, 9:3 g u y o J Bacteriology and Parasitology DOI: 10.4172/2155-9597.1000339 ISSN: 2155-9597 Research Article Open Access Molecular Characterization of Enterotoxigenic Escherichia coli: Effect on Intestinal Nitric Oxide in Diarrheal Disease Muhammad Arfat Yameen1, Ebuka Elijah David2*, Humphrey Chukwuemeka Nzelibe3, Muhammad Nasir Shuaibu3, Rabiu Abdussalam Magaji4, Amakaeze Jude Odugu5 and Ogamdi Sunday Onwe6 1Department of Pharmacy, COMSATS Institute of Information Technology, Abbottabad, Pakistan 2Department of Biochemistry, Federal University, Ndufu-Alike, Ikwo, Ebonyi State, Nigeria 3Department of Biochemistry, Ahmadu Bello University, Zaria, Kaduna State, Nigeria 4Department of Human Physiology, Ahmadu Bello University, Zaria, Kaduna State, Nigeria 5Medical Laboratory, Ahmadu Bello University, Teaching Hospital, Zaria, Kaduna State, Nigeria 6Laboratory Service Unit, Federal Teaching Hospital, Abakiliki, Ebonyi State, Nigeria *Corresponding author: Ebuka Elijah David, Department of Biochemistry, Federal University, Ndufu-Alike, Ikwo, Ebonyi State, Nigeria, Tel: +2348033188823; E-mail: [email protected] Received date: May 01, 2018; Accepted date: May 25, 2018; Published date: May 30, 2018 Copyright: ©2018 Yameen MA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract This study was aimed to investigate the effect of enterotoxigenic E. coli (ETEC)-induced diarrhea on fecal nitric oxide (NO) and intestinal inducible nitric oxide synthase (iNOS) expression in rats.
    [Show full text]
  • Clinical Appendix for Parasitic Diseases Seventh Edition
    Clincal Appendix for the Seventh Edition Parasitic Diseases Despommier Griffin Gwadz Hotez Knirsch Parasites Without Borders, Inc. NY Dickson D. Despommier, Daniel O. Griffin, Robert W. Gwadz, Peter J. Hotez, Charles A. Knirsch Clinical Appendix for Parasitic Diseases Seventh Edition see full text of Parasitic Diseases Seventh Edition for references Parasites Without Borders, Inc. NY The organization and numbering of the sections of the clinical appendix is based on the full text of the seventh edition of Parasitic Diseases. Dickson D. Despommier, Ph.D. Professor Emeritus of Public Health (Parasitology) and Microbiology, The Joseph L. Mailman School of Public Health, Columbia University in the City of New York 10032, Adjunct Professor, Fordham University Daniel O. Griffin, M.D., Ph.D. CTropMed® ISTM CTH© Department of Medicine-Division of Infectious Diseases, Department of Biochemistry and Molecular Biophysics, Columbia University Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center New York, New York, NY 10032, ProHealth Care, Plainview, NY 11803. Robert W. Gwadz, Ph.D. Captain USPHS (ret), Visiting Professor, Collegium Medicum, The Jagiellonian University, Krakow, Poland, Fellow of the Hebrew University of Jerusalem, Fellow of the Ain Shams University, Cairo, Egypt, Chevalier of the Nation, Republic of Mali Peter J. Hotez, M.D., Ph.D., FASTMH, FAAP, Dean, National School of Tropical Medicine, Professor, Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, Texas Children’s Hospital Endowed Chair of Tropical Pediatrics, Co-Director, Texas Children’s Hospital Center for Vaccine Development, Baker Institute Fellow in Disease and Poverty, Rice University, University Professor, Baylor University, former United States Science Envoy Charles A.
    [Show full text]
  • The Global View of Campylobacteriosis
    FOOD SAFETY THE GLOBAL VIEW OF CAMPYLOBACTERIOSIS REPORT OF AN EXPERT CONSULTATION UTRECHT, NETHERLANDS, 9-11 JULY 2012 THE GLOBAL VIEW OF CAMPYLOBACTERIOSIS IN COLLABORATION WITH Food and Agriculture of the United Nations THE GLOBAL VIEW OF CAMPYLOBACTERIOSIS REPORT OF EXPERT CONSULTATION UTRECHT, NETHERLANDS, 9-11 JULY 2012 IN COLLABORATION WITH Food and Agriculture of the United Nations The global view of campylobacteriosis: report of an expert consultation, Utrecht, Netherlands, 9-11 July 2012. 1. Campylobacter. 2. Campylobacter infections – epidemiology. 3. Campylobacter infections – prevention and control. 4. Cost of illness I.World Health Organization. II.Food and Agriculture Organization of the United Nations. III.World Organisation for Animal Health. ISBN 978 92 4 156460 1 _____________________________________________________ (NLM classification: WF 220) © World Health Organization 2013 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO web site (www.who.int/about/licensing/copyright_form/en/index. html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
    [Show full text]
  • Unusual Presentation of Shigellosis: Acute Perforated Appendicitis And
    Case Report 45 Unusual Presentation of Shigellosis: Acute Perforated Appendicitis and Peritonitis Gülsüm İclal Bayhan1, Gönül Tanır1, Haşim Ata Maden2, Şengül Özkan3 1Pediatric Infection Clinic, Dr. Sami Ulus Gynecology, Child Care and Treatment Training and Research Hospital, Ankara, Turkey 2Department of Pediatric Surgery, Dr. Sami Ulus Gynecology, Child Care and Treatment Training and Research Hospital, Ankara, Turkey 3Microbiology Clinic. Dr. Sami Ulus Gynecology, Child Care and Treatment Training and Research Hospital, Ankara, Turkey Abstract Shigella spp. is one of the most common agents that cause bacterial diarrhea and dysentery in developing coun- tries. Clinical presentation of shigellosis may vary over a wide spectrum from mild diarrhea to severe dysentery. We report the case of 5.5-year-old previously healthy boy, who presented to our clinic with abdominal pain, vomiting, and constipation. On examination, we noticed abdominal tenderness with guarding at the right lower quadrant. With the diagnosis of acute appendicitis, open appendectomy was performed. Exploration of the abdominal cavity revealed perforated appendicitis and generalized peritonitis. Shigella sonnei was isolated from the peritoneal fluid culture. The patient completely recovered without any complications. Surgical complications, including appendicitis, could have developed during shigellosis. There are few reported cases of perforated appendicitis associated with Shigella. Prompt surgical intervention can be beneficial to prevent morbidity and mortality if it is performed early in the course of the disease. (J Pediatr Inf 2015; 9: 45-8) Keywords: Shigella spp., acute appendicitis, peritonitis, surgical complication Introduction intestinal and extra-intestinal complications. There are few reported cases of perforated Shigella spp., a group of Gram-negative, appendicitis complicated with peritonitis due to Received: 04.10.2013 Accepted: 03.02.2014 small, non-motile, non-spore forming, and rod- Shigella spp.
    [Show full text]
  • Bacillary Dysentery
    Bacillary dysentery by Sudhir Chandra Pal uring the first half of 1984, a infectious dose. It requires only 10 to drome and leukaemoid reactions were severe epidemic of bacillary 100 shigella bacteria to produce dys­ also reported. dysentery swept through the entery, whereas one million to ten Similar epidemics due to the districts of West Bengal and a few million germs may need to be swal­ multiple-drug-resistant S. shigae have other eastern Indian States, affecting lowed to cause cholera. also occurred in Somalia (1976), three over 350,000 people and leaving By 1920, dysentery due to the most villages in South India (1976), Sri about 3,500, mostly children, dead. It virulent variety, the Shiga bacillus, Lanka (1978-80), Central Africa was like a nightmare as the disease had almost disappeared from Europe (1980-82), Eastern India, Nepal, Bhu­ stubbornly refused to respond to con­ and North America. However, it con­ tan and the Maldives (1984) and Bur­ ventional treatment, and its galloping tinued to be reported from the de­ ma (1984-85). The pattern was more spread could not be contained by all veloping countries in the form of local­ or less the same everywhere. The available public health measures. ised outbreaks. During the late sixties, disease spread with terrific speed in People became confused and panicky, Shiga's bacillus reappeared with a big spite of all available public health not knowing what to do. bang as the main culprit of a series of measures, attacking over 10 per cent Bacillary dysentery, characterised devastating epidemics of dysentery of the population and killing between by frequent passage of blood and in a number of countries in Latin two and 10 per cent even of the mucus in the stools accompanied by America, Asia and Africa.
    [Show full text]