Fatal Algaemia in Patient with Chronic Lymphocytic Leukemia

Total Page:16

File Type:pdf, Size:1020Kb

Fatal Algaemia in Patient with Chronic Lymphocytic Leukemia LETTERS References Fatal Algaemia in eramide. Voriconazole (400 mg/day) was used from day 17 to day 27. On 1. Chang WH. Current status of tsutsuga- Patient with Chronic mushi disease in Korea. J Korean Med day 21, Cryptosporidium parvum was Sci. 1995;10:227–38. Lymphocytic detected on parasitologic stool exami- 2. Cook GC, Warrell DA, Bryceson AD. Leukemia nation. Symptoms persisted on day Royal Society of Tropical Medicine and 26, with strong asthenia and deteriora- Hygiene meeting at Manson House, Lon- don, 17 October 1996. Debate: tropical To the Editor: Prototheca spe- tion of general state. At that time, the 9 medicine as a formal discipline is dead and cies are achlorophyllic lower algae, leukocyte count was 178 × 10 /L with should be buried. Trans R Soc Trop Med ubiquitous in nature, which can cause 3.56 × 109/L polymorphonuclear neu- Hyg. 1997;91:372–4, discussion 374–5. human infections, particularly in im- trophils and 172 × 109/L lymphocytes. DOI: 10.1016/S0035-9203(97)90244-3 3. Watt G, Parola P. Scrub typhus and tropi- munocompromised patients (1). Hu- Three peripheral blood samples were cal rickettsioses. Curr Opin Infect Dis. man protothecosis is mostly caused by cultured for detection of bacteria and 2003;16:429–36. DOI: 10.1097/00001432- P. wickerhamii and P. zopfii. Although fungi. On day 27, septic shock devel- 200310000-00009 such infections are infrequent, they oped in the patient. A blood culture 4. Ogawa M, Hagiwara T, Kishimoto T, Shiga S, Yoshida Y, Furuya Y, et al. Scrub can manifest themselves clinically showed an Escherichia coli strain sus- typhus in Japan: epidemiology and clini- as cutaneous lesions, olecranon bur- ceptible to piperacillin-tazobactam, cal features of cases reported in 1998. Am sitis, and, even more rarely, as dis- aminoglycosides, and quinolones. J Trop Med Hyg. 2002;67:162–5. seminated or systemic infections (1). Amikacin was added to the treatment 5. Lee YS, Wang PH, Tseng SJ, Ko CF, Teng HJ. Epidemiology of scrub typhus in east- These infections occur in severely regimen. Nonetheless, the patient died ern Taiwan, 2000–2004. Jpn J Infect Dis. immunocompromised patients, such on day 28. 2006;59:235–8. as persons with AIDS, or patients un- Two blood cultures for bacteria 6. Cao M, Guo H, Tang T, Wang C, Li X, dergoing extensive treatment, such as in aerobic vials grew the day of the Pan X, et al. Spring scrub typhus, People’s Republic of China. Emerg Infect Dis. cancer treatment or organ transplanta- patient’s death, but tests of blood cul- 2006;12:1463–5. tion (1–4). We describe a fatal case of tures for fungus remained negative. 7. Seong SY, Choi MS, Kim IS. Orientia P. wickerhamii algaemia in a patient After Gram staining, gram-positive tsutsugamushi infection: overview and with chronic lymphocytic leukemia. spherical unicellular organisms were immune responses. Microbes Infect. 2001;3:11–21. DOI: 10.1016/S1286-4579 In July 2007, a 79-year-old man, observed (Figure). After 48 hours of (00)01352-6 who had been monitored since 1993 incubation, creamy, yeast-like colo- 8. Okada N. Tsutsugamushi disease found for stage C chronic lymphocytic leuke- nies grew on chocolate agar (bio- in the northern districts of Awaji Island— mia (5), was hospitalized July 13–20 Mérieux, Marcy l’Etoile, France), but epidemiological study of the outbreak sea- son temperature [in Japanese]. Kansen- for a depressive syndrome with fever, not on Sabouraud agar containing gen- shogaku Zasshi. 2003;77:60–7. asthenia, and weight loss (3 kg over 2 tamicin and chloramphenicol (Becton months). Blood and urinary cultures Dickinson). Microscopy and the API Address for correspondence: Jin-Su Choi, on admission were sterile. The patient 20C AUX system (bioMérieux) iden- Department of Preventive Medicine, Chonnam was hospitalized again on July 30 for tified P. wickerhamii. National University College of Medicine, 5 fever (39°C), anorexia, and diarrhea, Sequencing the 18S rDNA with Hakdong, Donggu, Gwangju, South Korea; with ≈7 stools per day. He had lost 10 the primers Pw18SF 5′-TCAAAAA email: [email protected] kg in 2 weeks. Blood cultures for bac- GTCCCGGCTAATCTCGTGC-3′ teria (in BD Bactec Plus Aerobic/F and and Pw18SR 5′-CGCTTTCGTGCCT Letters BD Bactec Lytic Anaerobic/F vials; CAATGTCAGTGTT-3′ confirmed the Letters commenting on recent articles as Becton Dickinson, Le Pont de Claix, identification. The sequence of the well as letters reporting cases, outbreaks, France) and fungi (BD Bactec Mycosis amplified product was compared with or original research are welcome. Letters IC/F; Becton Dickinson) and stool cul- sequences published in the database commenting on articles should contain no more than 300 words and 5 references; tures for bacteria were negative. Blood of the National Center for Biotech- they are more likely to be published if cultures were incubated in a Bactec nology Information (Bethesda, MD, submitted within 4 weeks of the origi- 9240 instrument (Becton Dickinson). USA). The most likely identification, nal article’s publication. Letters report- Aspergillus fumigatus was found in a according to BLAST analysis (www. ing cases, outbreaks, or original research bronchoalveolar lavage specimen, but ncbi.nlm.nih.gov/blast/Blast.cgi), was should contain no more than 800 words and 10 references. They may have 1 no Aspergillus galactomannan antigen P. wickerhamii. Figure or Table and should not be divided was detected in blood. In vitro susceptibility tests were into sections. All letters should contain The patient was treated with performed by the Etest method (AB material not previously published and in- piperacillin-tazobactam, ciprofloxa- Biodisk, Solna, Sweden), on RPMI clude a word count. cin, acyclovir, voriconazole, and lop- agar. P. wickerhamii was found to be Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 15, No. 7, July 2009 1129 LETTERS Authors affiliations: Centre Hospitalier Ré- gional Universitaire de Tours, Tours, France (P. Lanotte, G. Baty, D. Senecal, C. Darti- geas, E. Bailly, T.H. Duong, J. Chandenier, A. Goudeau); and Université François Rabelais, Tours (P. Lanotte, G. Baty, T.H. Duong, J. Chandenier, A. Goudeau) References 1. Lass-Flörl C, Mayr A. Human prototheco- sis. Clin Microbiol Rev. 2007;20:230–42. DOI: 10.1128/CMR.00032-06 2. Torres HA, Bodey JP, Tarrand JJ, Kontoy- iannis DP. Protothecosis in patients with Figure. Gram-positive spherical unicellular organisms in a blood culture from a 79-year-old cancer: case series and literature review. man with chronic lymphocytic leukemia. Magnification ×1,000. A color version of this figure Clin Microbiol Infect. 2003;9:786–92. is available online (www.cdc.gov/EID/content/15/7/1129-F.htm). DOI: 10.1046/j.1469-0691.2003.00600.x 3. Lass-Flörl C, Fille M, Gunsilius E, Gastl G, Nachbaur D. Disseminated infection susceptible to amphotericin B and bacteria, viruses, or yeasts which with Prototheca zopfii after unrelated posaconazole, with MICs of 0.047 cause co-infections (1), as in this stem cell transplantation for leukemia. J μg/mL and 0.012 μg/mL, respec- case, in which the alga was associ- Clin Microbiol. 2004;42:4907–8. DOI: tively. By contrast, it was resistant ated with E. coli. This association is 10.1128/JCM.42.10.4907-4908.2004 4. Narita M, Muder RR, Cacciarelli TV, to fluconazole (MIC>256 μg/mL), probably the result of disseminated Singh N. Protothecosis after liver trans- voriconazole (MIC>32 μg/mL), and protothecosis in severely immuno- plantation. Liver Transpl. 2008;14:1211–5. caspofungin (MIC>32 μg/mL). It was compromised patients, and the alga DOI: 10.1002/lt.21565 also susceptible to gentamicin (MIC = may cross digestive or cutaneous 5. Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, Goasguen J, et al. 0.25 μg/mL) but resistant to amikacin barriers. Reasons for septic shock or A new prognostic classification of chronic (MIC>24 μg/mL). death are unclear for most associa- lymphocytic leukemia derived from a However, the patient died before tions of pathogens (2,4). Prototheca multivariate survival analysis. Cancer. the algae were detected in the blood spp. are found in various reservoirs, 1981;48:198–206. DOI: 10.1002/1097- 0142(19810701)48:1<198::AID- culture vials. In this case, antifungal including the environment, animals, CR2820480131>3.0.CO;2-V treatment based on voriconazole use and food (1). In the case described 6. Sheikh-Ahmad M, Goldstein S, Potas- was empiric and ineffective. Some here, the infection may have originat- man I. Prototheca wickerhamii hand authors have described a successful ed from a contaminated well used to infection successfully treated by itracon- azole and voriconazole. J Travel Med. treatment on localized protothecosis obtain water for the patient’s kitchen 2006;13:321–3. DOI: 10.1111/j.1708- with voriconazole (6). Amphotericin garden. However, we were unable to 8305.2006.00062.x B currently seems to be most effective test this hypothesis. 7. Khoury JA, Dubberke ER, Devine SM. agent, although the best treatment re- Disseminated protothecosis is Fatal case of protothecosis in a hematopoi- etic stem cell transplant récipient after in- mains a matter of debate (1,4,7). Al- currently rare but, due to the algae’s fliximab treatment for graft-versus-host though in vitro susceptibility test re- ubiquitous nature, increasing use of disease. Blood. 2004;104:3414–5. DOI: sults are not necessarily well correlated immunosuppressive therapy, and in- 10.1182/blood-2004-07-2720 with results obtained in vivo, the low creasing incidence of hematologic ma- 8. Tortorano AM, Prigitano A, Dho Gio- vanna, Piccinini R, Dapra V, Viviani MA. MIC of posaconazole reported here lignancy, Prototheca spp. may emerge In vitro activity of conventional antifun- may be of interest in clinical practice as opportunistic pathogens.
Recommended publications
  • Intestinal Protothecosis in a Young Bengal Cat
    Open Journal of Veterinary Medicine, 2021, 11, 157-164 https://www.scirp.org/journal/ojvm ISSN Online: 2165-3364 ISSN Print: 2165-3356 Intestinal Protothecosis in a Young Bengal Cat Sara Manfredini1, Luca Formaggini1, Michele Marino2, Luigi Venco1* 1Clinica Veterinaria Lago Maggiore, Dormelletto (NO), Italy 2Laboratorio Analisi Veterinarie La Vallonea, Passirana di Rho (MI), Italy How to cite this paper: Manfredini, S., Abstract Formaggini, L., Marino, M. and Venco, L. (2021) Intestinal Protothecosis in a Young Background: Intestinal protothecosis is an uncommon and insidious mycotic Bengal Cat. Open Journal of Veterinary disease. Only one human case and a few rare cases in dogs have been reported. Medicine, 11, 157-164. To the authors’ knowledge, intestinal protothecosis has never been reported https://doi.org/10.4236/ojvm.2021.115011 in cats. Case description: This paper describes a case of intestinal prototheco- Received: March 19, 2021 sis in a nine-month-old male, Bengal cat. The cat presented because of onset Accepted: May 15, 2021 of haemorrhagic diarrhoea. Investigations allowed diagnosis of intestinal pro- Published: May 18, 2021 tothecosis, confirmed by PCR test on faeces. Treatment with itraconazole did Copyright © 2021 by author(s) and not improve the clinical signs. Treatment with nystatin was prescribed and Scientific Research Publishing Inc. caused improvement in the clinical signs and decreased number of pathogens This work is licensed under the Creative seen on faecal cytology. PCR on faecal samples was negative two months after Commons Attribution International License (CC BY 4.0). treatment, with complete resolution of symptoms. Conclusion: Infection with http://creativecommons.org/licenses/by/4.0/ Prototheca should be part of the list of differential diagnoses for diarrhoea in Open Access cats.
    [Show full text]
  • The Non-Photosynthetic Algae Helicosporidium Spp.: Emergence of a Novel Group of Insect Pathogens
    Insects 2013, 4, 375-391; doi:10.3390/insects4030375 OPEN ACCESS insects ISSN 2075-4450 www.mdpi.com/journal/insects/ Review The Non-Photosynthetic Algae Helicosporidium spp.: Emergence of a Novel Group of Insect Pathogens Aurélien Tartar Division of Math, Science, and Technology, Nova Southeastern University, 3301 College Avenue, Fort Lauderdale, FL 33314, USA; E-Mail: [email protected]; Tel.: +1-954-262-8148; Fax: +1-954-262-3931 Received: 30 May 2013; in revised form: 4 July 2013 / Accepted: 8 July 2013 / Published: 17 July 2013 Abstract: Since the original description of Helicosporidium parasiticum in 1921, members of the genus Helicosporidium have been reported to infect a wide variety of invertebrates, but their characterization has remained dependent on occasional reports of infection. Recently, several new Helicosporidium isolates have been successfully maintained in axenic cultures. The ability to produce large quantity of biological material has led to very significant advances in the understanding of Helicosporidium biology and its interactions with insect hosts. In particular, the unique infectious process has been well documented; the highly characteristic cyst and its included filamentous cell have been shown to play a central role during host infection and have been the focus of detailed morphological and developmental studies. In addition, phylogenetic analyses inferred from a multitude of molecular sequences have demonstrated that Helicosporidium are highly specialized non-photosynthetic algae (Chlorophyta: Trebouxiophyceae), and represent the first described entomopathogenic algae. This review provides an overview of (i) the morphology of Helicosporidium cell types, (ii) the Helicosporidium life cycle, including the entire infectious sequence and its impact on insect hosts, (iii) the phylogenetic analyses that have prompted the taxonomic classification of Helicosporidium as green algae, and (iv) the documented host range for this novel group of entomopathogens.
    [Show full text]
  • A First Insight Into the Genome of Prototheca Wickerhamii, a Major
    Bakuła et al. BMC Genomics (2021) 22:168 https://doi.org/10.1186/s12864-021-07491-8 RESEARCH ARTICLE Open Access A first insight into the genome of Prototheca wickerhamii, a major causative agent of human protothecosis Zofia Bakuła1, Paweł Siedlecki2,3, Robert Gromadka4, Jan Gawor4, Agnieszka Gromadka3, Jan J. Pomorski5, Hanna Panagiotopoulou5 and Tomasz Jagielski1* Abstract Background: Colourless microalgae of the Prototheca genus are the only known plants that have consistently been implicated in a range of clinically relevant opportunistic infections in both animals and humans. The Prototheca algae are emerging pathogens, whose incidence has increased importantly over the past two decades. Prototheca wickerhamii is a major human pathogen, responsible for at least 115 cases worldwide. Although the algae are receiving more attention nowadays, there is still a substantial knowledge gap regarding their biology, and pathogenicity in particular. Here we report, for the first time, the complete nuclear genome, organelle genomes, and transcriptome of the P. wickerhamii type strain ATCC 16529. Results: The assembled genome size was of 16.7 Mbp, making it the smallest and most compact genome sequenced so far among the protothecans. Key features of the genome included a high overall GC content (64.5%), a high number (6081) and proportion (45.9%) of protein-coding genes, and a low repetitive sequence content (2.2%). The vast majority (90.6%) of the predicted genes were confirmed with the corresponding transcripts upon RNA-sequencing analysis. Most (93.2%) of the genes had their putative function assigned when searched against the InterProScan database. A fourth (23.3%) of the genes were annotated with an enzymatic activity possibly associated with the adaptation to the human host environment.
    [Show full text]
  • INFECTIOUS DISEASES of ETHIOPIA Infectious Diseases of Ethiopia - 2011 Edition
    INFECTIOUS DISEASES OF ETHIOPIA Infectious Diseases of Ethiopia - 2011 edition Infectious Diseases of Ethiopia - 2011 edition Stephen Berger, MD Copyright © 2011 by GIDEON Informatics, Inc. All rights reserved. Published by GIDEON Informatics, Inc, Los Angeles, California, USA. www.gideononline.com Cover design by GIDEON Informatics, Inc No part of this book may be reproduced or transmitted in any form or by any means without written permission from the publisher. Contact GIDEON Informatics at [email protected]. ISBN-13: 978-1-61755-068-3 ISBN-10: 1-61755-068-X Visit http://www.gideononline.com/ebooks/ for the up to date list of GIDEON ebooks. DISCLAIMER: Publisher assumes no liability to patients with respect to the actions of physicians, health care facilities and other users, and is not responsible for any injury, death or damage resulting from the use, misuse or interpretation of information obtained through this book. Therapeutic options listed are limited to published studies and reviews. Therapy should not be undertaken without a thorough assessment of the indications, contraindications and side effects of any prospective drug or intervention. Furthermore, the data for the book are largely derived from incidence and prevalence statistics whose accuracy will vary widely for individual diseases and countries. Changes in endemicity, incidence, and drugs of choice may occur. The list of drugs, infectious diseases and even country names will vary with time. Scope of Content: Disease designations may reflect a specific pathogen (ie, Adenovirus infection), generic pathology (Pneumonia – bacterial) or etiologic grouping(Coltiviruses – Old world). Such classification reflects the clinical approach to disease allocation in the Infectious Diseases Module of the GIDEON web application.
    [Show full text]
  • Protothecosis and Chlorellosis in Sheep and Goats: a Review
    VDIXXX10.1177/1040638720978781Protothecosis and chlorellosis in sheep and goatsRiet-Correa et al. 978781review-article2020 Review Journal of Veterinary Diagnostic Investigation 1 –5 Protothecosis and chlorellosis in sheep © 2020 The Author(s) Article reuse guidelines: sagepub.com/journals-permissions and goats: a review DOI:https://doi.org/10.1177/1040638720978781 10.1177/1040638720978781 jvdi.sagepub.com Franklin Riet-Correa,1 Priscila Maria Silva do Carmo, Francisco A. Uzal Abstract. Protothecosis and chlorellosis are sporadic algal diseases that can affect small ruminants. In goats, protothecosis is primarily associated with lesions in the nose and should be included in the differential diagnosis of causes of rhinitis. In sheep, chlorellosis causes typical green granulomatous lesions in various organs. Outbreaks of chlorellosis have been reported in sheep consuming stagnant water, grass from sewage-contaminated areas, and pastures watered by irrigation canals or by effluents from poultry-processing plants. Prototheca and Chlorella are widespread in the environment, and environmental and climatic changes promoted by anthropogenic activities may have increased the frequency of diseases produced by them. The diagnosis of these diseases must be based on gross, microscopic, and ultrastructural lesions, coupled with detection of the agent by immunohistochemical-, molecular-, and/or culture-based methods. Key words: chlorellosis; goats; protothecosis; sheep. Introduction pathogenic for animals and humans.1,2,12,26 Genotype 2 is involved more frequently than genotype 1 in protothecosis of Prototheca spp. (achlorophyllous algae) and Chlorella spp. animals and human.1,2,12,16,26 Since 2008, 2 more species have (chlorophyll-containing algae) are ubiquitous algae that been recognized as pathogens: P. blaschkeae was isolated reproduce asexually by internal septation (endosporulation) from the mammary gland of cows with mastitis,16 and P.
    [Show full text]
  • Disseminated Prototheca Wickerhamii Infection with Arthritis and Tenosynovitis JOAN S
    Case Report Disseminated Prototheca wickerhamii Infection with Arthritis and Tenosynovitis JOAN S. PASCUAL, LUCIA L. BALOS, and ALAN N. BAER ABSTRACT. Achloric algae of the Prototheca species are a rare cause of infection in humans. These infections are usually localized to the skin, olecranon bursae, and tendon sheaths of the hands and wrists. Our patient with acquired immunodeficiency syndrome and a chronic Prototheca wickerhamii skin infec- tion of the hand developed tenosynovitis and arthritis of his ankle in the setting of a documented algemia. This is the first reported case of protothecal arthritis and tenosynovitis resulting from hematogenous dissemination. The reported musculoskeletal manifestations of protothecal infections are reviewed. (J Rheumatol 2004;31:1861–5) Key Indexing Terms: PROTOTHECA ALGAE TENOSYNOVITIS INFECTIOUS ARTHRITIS ACQUIRED IMMUNODEFICIENCY SYNDROME Prototheca are achloric algae that can be a rare cause of tous inflammation with ovoid basophilic bodies both in and around histio- infection in humans. Infections are generally localized to cytes (Figure 1). A culture grew P. wickerhamii. Oral itraconazole was resumed. Within 3 weeks of this biopsy, the patient inadvertently stepped exposed skin of the face and distal extremities, olecranon in a hole and forcibly dorsiflexed his left ankle; swelling of the ankle bursae, and tendon sheaths of the hands and wrists. They persisted for over 2 months, prompting an intraarticular injection of dexam- occur in both immunocompetent and immunocompromised ethasone. Five months prior to hospitalization, the patient developed hosts. Systemic protothecosis with visceral and meningeal several subcutaneous nodules in his left lower extremity, despite ongoing involvement occurs rarely in immunocompromised individ- itraconazole therapy.
    [Show full text]
  • Infectious Diseases of the Philippines
    INFECTIOUS DISEASES OF THE PHILIPPINES Stephen Berger, MD Infectious Diseases of the Philippines - 2013 edition Infectious Diseases of the Philippines - 2013 edition Stephen Berger, MD Copyright © 2013 by GIDEON Informatics, Inc. All rights reserved. Published by GIDEON Informatics, Inc, Los Angeles, California, USA. www.gideononline.com Cover design by GIDEON Informatics, Inc No part of this book may be reproduced or transmitted in any form or by any means without written permission from the publisher. Contact GIDEON Informatics at [email protected]. ISBN-13: 978-1-61755-582-4 ISBN-10: 1-61755-582-7 Visit http://www.gideononline.com/ebooks/ for the up to date list of GIDEON ebooks. DISCLAIMER: Publisher assumes no liability to patients with respect to the actions of physicians, health care facilities and other users, and is not responsible for any injury, death or damage resulting from the use, misuse or interpretation of information obtained through this book. Therapeutic options listed are limited to published studies and reviews. Therapy should not be undertaken without a thorough assessment of the indications, contraindications and side effects of any prospective drug or intervention. Furthermore, the data for the book are largely derived from incidence and prevalence statistics whose accuracy will vary widely for individual diseases and countries. Changes in endemicity, incidence, and drugs of choice may occur. The list of drugs, infectious diseases and even country names will vary with time. Scope of Content: Disease designations may reflect a specific pathogen (ie, Adenovirus infection), generic pathology (Pneumonia - bacterial) or etiologic grouping (Coltiviruses - Old world). Such classification reflects the clinical approach to disease allocation in the Infectious Diseases Module of the GIDEON web application.
    [Show full text]
  • INFECTIOUS DISEASES of HAITI Free
    INFECTIOUS DISEASES OF HAITI Free. Promotional use only - not for resale. Infectious Diseases of Haiti - 2010 edition Infectious Diseases of Haiti - 2010 edition Copyright © 2010 by GIDEON Informatics, Inc. All rights reserved. Published by GIDEON Informatics, Inc, Los Angeles, California, USA. www.gideononline.com Cover design by GIDEON Informatics, Inc No part of this book may be reproduced or transmitted in any form or by any means without written permission from the publisher. Contact GIDEON Informatics at [email protected]. ISBN-13: 978-1-61755-090-4 ISBN-10: 1-61755-090-6 Visit http://www.gideononline.com/ebooks/ for the up to date list of GIDEON ebooks. DISCLAIMER: Publisher assumes no liability to patients with respect to the actions of physicians, health care facilities and other users, and is not responsible for any injury, death or damage resulting from the use, misuse or interpretation of information obtained through this book. Therapeutic options listed are limited to published studies and reviews. Therapy should not be undertaken without a thorough assessment of the indications, contraindications and side effects of any prospective drug or intervention. Furthermore, the data for the book are largely derived from incidence and prevalence statistics whose accuracy will vary widely for individual diseases and countries. Changes in endemicity, incidence, and drugs of choice may occur. The list of drugs, infectious diseases and even country names will vary with time. © 2010 GIDEON Informatics, Inc. www.gideononline.com All Rights Reserved. Page 2 of 314 Free. Promotional use only - not for resale. Infectious Diseases of Haiti - 2010 edition Introduction: The GIDEON e-book series Infectious Diseases of Haiti is one in a series of GIDEON ebooks which summarize the status of individual infectious diseases, in every country of the world.
    [Show full text]
  • Parasites in Liver & Biliary Tree
    Parasites in Liver & Biliary tree Luis S. Marsano, MD Professor of Medicine Division of Gastroenterology, Hepatology and Nutrition University of Louisville & Louisville VAMC 2011 Parasites in Liver & Biliary Tree Hepatic Biliary Tree • Protozoa • Protozoa – E. histolytica – Cryptosporidiasis – Malaria – Microsporidiasis – Babesiosis – Isosporidiasis – African Trypanosomiasis – Protothecosis – S. American Trypanosomiasis • Trematodes – Visceral Leishmaniasis – Fascioliasis – Toxoplasmosis – Clonorchiasis • Cestodes – Opistorchiasis – Echynococcosis • Nematodes • Trematodes – Ascariasis – Schistosomiasis • Nematodes – Toxocariasis – Hepatic Capillariasis – Strongyloidiasis – Filariasis Parasites in the Liver Entamoeba histolytica • Organism: E. histolytica is a Protozoa Sarcodina that infects 1‐ 5% of world population and causes 100000 deaths/y. – (E. dispar & E. moshkovskii are morphologically identical but only commensal; PCR or ELISA in stool needed to differentiate). • Distribution: worldwide; more in tropics and areas with poor sanitation. • Location: colonic lumen; may invade crypts and capillaries. More in cecum, ascending, and sigmoid. • Forms: trophozoites (20 mcm) or cysts (10‐20 mcm). Erytrophagocytosis is diagnostic for E. histolytica trophozoite. • Virulence: may increase with immunosuppressant drugs, malnutrition, burns, pregnancy and puerperium. Entamoeba histolytica • Clinical forms: – I) asymptomatic; – II) symptomatic: • A. Intestinal: – a) Dysenteric, – b) Nondysenteric colitis. • B. Extraintestinal: – a) Hepatic: i) acute
    [Show full text]
  • Red Algal Parasites: Models for a Life History Evolution That Leaves Photosynthesis Behind Again and Again
    Prospects & Overviews Review essays Red algal parasites: Models for a life history evolution that leaves photosynthesis behind again and again Nicolas A. Blouinà and Christopher E. Lane Many of the most virulent and problematic eukaryotic Introduction pathogens have evolved from photosynthetic ancestors, such as apicomplexans, which are responsible for a Parasitology is one of the oldest fields of medical research and continues to be an essential area of study on organisms wide range of diseases including malaria and toxoplas- that kill millions annually, either directly or through mosis. The primary barrier to understanding the early agricultural loss. In the early genomics era, parasites were stages of evolution of these parasites has been the diffi- some of the initial eukaryotes to have their genomes culty in finding parasites with closely related free-living sequenced. The combination of medical interest and small lineages with which to make comparisons. Parasites genome size (due to genome compaction [1]) has resulted found throughout the florideophyte red algal lineage, in a relatively large number of sequenced genomes from these taxa. The range of relationships that exist between however, provide a unique and powerful model to inves- parasites and comparative free-living taxa, however, compli- tigate the genetic origins of a parasitic lifestyle. This is cates understanding the evolution of eukaryotic parasitism. because they share a recent common ancestor with an In some cases (such as apicomplexans, which cause extant free-living red algal species and parasitism has malaria, cryptosporidiosis and toxoplasmosis, among other independently arisen over 100 times within this group. diseases) entire lineages appear to have a common parasitic ancestor [2].
    [Show full text]
  • MOLECULAR EVOLUTION of the PARASITIC GREEN ALGA, HELICOSPORIDIUM SP. by AUDREY PATRICIA DE KONING B.Sc., the University of North
    MOLECULAR EVOLUTION OF THE PARASITIC GREEN ALGA, HELICOSPORIDIUM SP. by AUDREY PATRICIA DE KONING B.Sc., The University of Northern British Columbia, 1999 M.Sc., The University of British Columbia, 2002 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE STUDIES (Genetics) THE UNIVERSITY OF BRITISH COLUMBIA AUGUST 2006 Audrey Patricia de Koning, 2006 ii Abstract Helicosporidia are single-celled obligate endoparasites of invertebrates. They have a unique morphology and infection strategy, which make them unlike any other eukaryote. Molecular data were produced to clarify their phylogenetic relationship and to examine the evolution of their cryptic plastid. Phylogenetic analyses of 69 ribosomal proteins identified from an expressed sequence tag (EST) library showed that Helicosporidia are derived green algae and more specifically, are related to the trebouxiophyte algae. An obligate parasitic lifestyle is rare among plant and algal groups, and because Helicosporidium possesses no pigments and no chloroplast-like structure has been identified, photosynthetic ability has presumably been lost in this organism. I sought to examine the role that a relict plastid might play in Helicosporidium. I identified ESTs of 20 putatively plastid-targeted enzymes that are involved in a wide variety of metabolic pathways. As expected, no components of photosynthesis were found, but components of other metabolic pathways including sulfur metabolism and fatty acid, isoprenoid and heme biosynthesis suggest that Helicosporidium retains its plastid for these functions. The complete plastid genome of this species of Helicosporidium was sequenced and revealed only four protein-coding genes not involved in transcription or translation, with two of these confirming the metabolic functions suggested by the nuclear-encoded, plastid-targeted genes identified from the ESTs.
    [Show full text]
  • Bilateral Choroiditis from Prototheca Wickerhamii Algaemia
    nal stalk, or retina.2,3 It is a neoplasm traction folds, but no evidence of in- chemical characteristics. Ophthalmology. 1988; 95:1565-1575. of childhood that usually becomes traretinal involvement was present. 8. Orellana J, Moura RA, Font RL, Boniuk M, Mur- clinically symptomatic during the first Our patient had an unusual mass phy D. Medulloepithelioma diagnosed by ul- decade of life (mean age, 5 years).1 that disclosed extensive seeding of trasound and vitreous aspirate: electron mi- croscopic observations. Ophthalmology. 1983; However, there are well-docu- tumor cells along the internal lim- 90:1531-1539. mented cases in which the tumor had iting membrane of the retina with 9. Shields JA, Eagle RC Jr, Shields CL, Potter PD. Congenital neoplasms of the nonpigmented cili- become symptomatic in adult- foci of intraretinal involvement. In ary epithelium (medulloepithelioma). 4,5 hood. The most frequent clinical addition, seedings of tumor cells Ophthalmology. 1996;103:1998-2006. signs are leukocoria; notching or sub- were present along the anterior seg- 10. Shields JA, Eagle RC Jr, Shields CL, Singh AD, Robitaille J. Pigmented medulloepithelioma of luxation of the lens; cataract; and a ment structures, surrounding the the ciliary body. Arch Ophthalmol. 2002;120: mass in the iris, ciliary body, or an- remnants of the anterior lens cap- 207-210. terior chamber. Almost all tumors are sule. We believe it is quite unlikely unilateral. There is no predilection of that the pattern of spread of the tu- this tumor for race, sex, and lateral- mor to the retinal surface and onto ity.6 It also has a strong tendency to the lens capsule is related to the prior Bilateral Choroiditis From induce secondary glaucoma due to cyclectomy specimen.
    [Show full text]