Veterinary Parasitology 173 (2010) 358–361

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Veterinary Parasitology

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Short communication Fatal infections in a captive Pithecia irrorata (primate) by Porocephalus sp. ()

W.L.A. Pereira a,∗, R.N.M. Benigno a,1, K.S.M. Silva b,2 a Instituto da Saúde e Produc¸ ão (ISPA), da Universidade Federal Rural da Amazônia (UFRA), Caixa P.O. box 917, CEP 66.077-530, Belém, Pará, Brazil b Centro Nacional de Primatas/SVS/MS, Rod. Br 316, km 07, s/n, CEP 67030-000, Ananindeua, Pará, Brazil article info abstract

Article history: This work presents a case of sudden death of a non-human adult male primate, which Received 25 May 2009 belongs to the National Primate Center (CENP – Ananindeua – Pará – Brazil). The specimen Received in revised form 7 July 2010 was necropsied, and the anatomicopathologic exam showed a great collection of clotted Accepted 22 July 2010 blood in the right thoracic cavity, forming a mold. The aorta revealed an extensive lesion in its intima with a disruption area in its tissue. In the lungs, three encapsulated para- Keywords: sites were observed in subpleural location, specifically in the diaphragmatic, right apical Neotropical primates and accessory lobes, measuring 05 mm diameter, which revealed a C-form by transparency Pentastomida Sudden death analysis, characteristic of the nymphal stage of Pentastomida. Two cysts were dissected Histopathologic description and the parasites demonstrated structural and morphometric patterns compatible with the nymph of Porocephalus. Histologically, encapsulated parasites were observed in the lungs, with inflammatory reaction in the underlying parenchyma, presence of exudate composed of fibrin, macrophages, detaching the eosinophils and presenting no granulomatous reac- tion. The aortic adventitial tissue presented development of granulation tissue, deposit of fibroid material in its margins, prevalence of eosinophils and free blood. The macroscopic and microscopic alterations in the aorta, as well as the presence of nymphs of Pentastomida in the lungs are data that base the hypothesis that the aortic lesion was responsible for the fatal picture of internal hemorrhage, and this picture was due to the migratory process of Pentastomida. © 2010 Elsevier B.V. All rights reserved.

1. Introduction of . Their data indicated that it belongs to a modified group of , probably related to the Pentastomida is an aberrant group of zoonotic endopar- brachiura. asites of vertebrates, with a questionable systematic Adult Pentastomids are found in the respiratory tract of position, since they present similarities to several tax- carnivorous , usually of the Ophidia where imma- onomic groups, with around 130 species, according to ture stages (larvae and nymphs) are found in a variety Almeida and Christoffersen (1999). Recently, Lavrov et al. of animals, mostly in mammals, has been found even in (2004) performed a study to solve the group’s genetic posi- dog (Self, 1972; Brookins et al., 2009). These immature tion, determining the sequence of the mitochondrial DNA stages are found encysted in tissues of their intermediary host, and are associated with an identifiable clinical syn- drome. The majority of nymph infections were identified ∗ in necropsy or incidentally during thoracic or abdominal Corresponding author. Tel.: +55 91 3210 5136; fax: +55 91 32650304. surgeries (Lok and Kirkpatrick, 1987). E-mail addresses: [email protected] (W.L.A. Pereira), [email protected] (K.S.M. Silva). In humans, Pentastomes may be located in the viscera, 1 Tel.: +55 91 3210 5136. acquired through ingestion of larvated eggs. On which case 2 Tel.: +55 91 3213 0400. the person behaves like and intermediate host. Or they may

0304-4017/$ – see front matter © 2010 Elsevier B.V. All rights reserved. doi:10.1016/j.vetpar.2010.07.010 W.L.A. Pereira et al. / Veterinary Parasitology 173 (2010) 358–361 359 reside in the nasopharynx following acquisition of nymphs with inclusion in CENP’s Laboratory of Histopathology, sec- of Linguatula serrrata. tioned at 5 ␮, and stained by Hematoxylin-Eosin. In the latter, the disease behaves as an aberrant definite The remaining two samples were dissected to remove host (Ma et al., 2002). The disease is often associated with the specimens and these were processed in the Labora- the Pentastomida of the genus Armillifer, and the majority tory of Veterinarian Parasitology of the Institute of Health of cases in the last 20 years have been reported in China and Animal Production – Laboratório de Parasitologia Vet- (Cum et al., 2005). erinária do Instituto da Saúde e Produc¸ ão Animal –ofthe The cases in non-human primates are usually related Universidade Federal Rural da Amazônia, according to to parasitism of the genera Armillifer and Porocephalus in the methodology for Copepoda crustaceans suggested by animals of the Old World, and of the genus Porocephalus in Amato et al. (1991). animals of the New World (Cosgrove et al., 1970). This case reports the occurrence of pentastomiasis in a neotropical 3. Results primate of the species Pithecia irrorata, vulgarly known as Parauacu. This neotropical primate lives in groups of 2 to 3.1. Necroscopic findings 8 individuals in an area approximately 25 hectares in vari- ous types of forests distributed geographically throughout The dead body presented a good muscular and adipose the states of Amazonas, Rondônia and Mato Grosso, in the conformation. The organs in the abdominopelvic cavity south of the Amazon River, west of the rivers Tapajós and revealed normality, except for the liver, which was char- Juruema up to the Juruá River, and south of the Guaporé acterized by atrophy and its surface seemed like orange River. They eat leaves, fruits, seeds, flowers and insects rind, especially on its visceral face. While opening the tho- (CENP, 2005). racic cavity, the presence of a great collection of clotted The objective of this work is to describe and discuss blood was observed in the right side, forming a mold of the the necropsy findings and consequences of the infection by cavity. Pentastomida in Pithecia irrorata specimens, from Brazil’s The lungs were slightly hyperemic, with habitual cadav- National Primate Center – Centro Nacional de Primatas eric spasm. Three cystic formations were observed in (CENP). subpleural location, in the diaphragmatic, right side fill- ing the available space and accessory lobes, measuring 2. Materials and Methods about 05 mm in diameter. They revealed a C-form by transparency analysis (Fig. 1), and were still alive after dis- In the years 2003 and 2004, the Pathology Section of section. CENP necropsied 131 primates of different species, and one The analysis of the aorta showed an extensive lesion in case of sudden death in an adult male neotropical primate the intima with a perforation area, what caused hemotho- of the species P. irrorata, from CENP’s external exhibition rax and the death of the animal. cage, was reported. The animal was found in the morning and sent to be necropsied. During the anatomicopatholog- 3.2. Identification of parasites ical exam, parasitic cystic lesions were noticed, and one was extracted for histopathological analysis. The sample Morphologically, the two parasites dissected were was fixed in 10% buffered formalin, and was processed whitish, vermiform, presented a C-form, and were thickly

Fig. 1. Lung after fixation, presenting a formation of parasitic cyst in the accessory lobe. 360 W.L.A. Pereira et al. / Veterinary Parasitology 173 (2010) 358–361

Fig. 2. Sample of Pentastomida extracted from the cystic formation. clavate (Fig. 2). They revealed characteristics of a nymph- fibrinous infiltration and an inflammatory reaction of the stage Pentastomida, with an average of 36 rings and subjacent pulmonary parenchyma, an exudate composed an average size was 6.3 mm by 1.4 mm of length and of fibrin, macrophages and detached eosinophils, with no width, respectively. The analysis of the anterior extrem- granulomatous reaction (Fig. 3). In the subpleura and in the ity revealed the presence of two pairs of hooks around the superficial parenchyma, we observed encapsulated para- mouth, with compatible characteristics with those referred sites which presented with characteristics of nymphs of by Self (1972) for the genus Porocephalus. Pentastomida. Noticeable alterations were observed in the aorta, 3.3. Histopathologic description which presented an extensive inflammatory reaction in its subaortic mediastinal connective tissue, with plasmatic The result of the histological analysis of the lung showed fibrinous infiltration and presence of inflammatory cells, chronic interstitial pneumopathy and emphysemic (com- predominantly eosinophils and free blood. We could also pensatory) areas. In segments of pleura we observed observe the development of granulation tissue and severe

Fig. 3. Pulmonary parenchyma: plasm and fibrinous exudate (1), macrophages (2) and eosinophils (3), Hematoxylin-eosin fixation, zoom ×400. W.L.A. Pereira et al. / Veterinary Parasitology 173 (2010) 358–361 361 lesion with rupture of the aortic wall, followed by intense (1991) and Pan et al. (2005) in human infections by the mural hemorrhage. Pentastomida Armillifer either. The presence of granulation tissue with predominance 4. Discussion of eosinophils in the aorta is characteristic of a chronic par- asitic lesion. This fact, together with the gross alteration The genus Porocephalus comprise the species P. cro- and the presence of Pentastomida in the lungs, base the tali, P. clavatus, P. stilessi and P. subuliffer, which displayed hypothesis that the aortic lesion, responsible for the inter- complex cycle, with the presence of rodents, herbivores, nal hemorrhage and the sudden death, was an effect of the carnivores and primates as intermediary hosts. They get Pentastomida’s migratory process. infected by ingesting larvated eggs passed by ophidians, generating, after the migratory process, encysted nymphs Acknowledgements in the peritoneal cavity, liver, spleen, kidneys, lungs and ganglions (Martinez et al., 2000; Tropical Medicine Central This work as carried out at the National Primate Center Resource, 2005). (CENP-SVS/MS). We would like to thank Mr. Osvaldo Leal Cases of pentastomiasis in several species of animals dos Santos Filho (CENP) for the preparation of the histology have been reported. They include snakes (Martinez et al., samples. 2000), fish (Boyce et al., 1987), humans in China (Pan et al., 2005), in Canada (Guardian et al., 1991), and other coun- References tries. In non-humans primates, Heuschele (1961) reported infection in the omentum, mesentery, liver, spleen and Almeida, W.D., Christoffersen, M.L., 1999. A cladistic approach to relation- ships in Pentastomida. J. Parasitol. 85, 695–704. pleura cavity in Cercopithecus hamlyni; Fox et al. (1972) Amato, J.F.R., Boeger, W.A., Amato, S.B., 1991. Protocolos para laboratório verified infection in the cerebral cortex of Saimiri sciureus; – coleta e procedimento de parasitos do pescado. Imprensa Univer- and Lok and Kirkpatrick (1987) reported infection in the sitária – UFRRJ, Rio de Janeiro, 81 pp. Auricchio, P., 1995. Primatas do Brasil. Parma, São Paulo, 168 pp. omentum, mesentery and lungs of the species Macaca fas- Boyce, W.M., Kazacos, E.A., Kazacos, K.R., Engelhardt, J.A., 1987. Pathology cicularis and Cebus capucinus. Moreover, Cosgrove et al. of Pentastomid infections (Sebekia mississippiensis) in fish. J. Wildl. Dis. (1970) observed that 29% of their primates were infected 23 (4), 689–692. with Porocephalus clavatus primarily in the lungs. Brookins, M.D., Wellehan, J.F.X., Roberts, J.F., Allison, K., Curran, S.S., Chil- dress, A.L., Greiner, E.C., 2009. Massive visceral Pentastomiasis caused Regarding the infection by Porocephalus in our case, by Porocephalus crotali in a dog. Vet. Pathol. 46, 460–463. the possibility of the animal having acquired the infec- Cosgrove, G.E., Nelson, B.M., Self, J.T., 1970. The pathology of pentastomid tion by ingestion of food contaminated with eggs of the infection in primates. Lab. Anim. Sci. 20, 354–360. Cum, P.C., Feng, T.H., Hua, Q.M., Xing, X.Q., 2005. Heavy infection Pentastomida must be considered. However, it was not with Armillifer moniliformis: a case report. Chin. Med. J. 118 (3), possible to determine the interrelationship with the def- 262–264. inite hosts, which are generally ophidians (Cosgrove et al., Durden, L.A., Sly, D.L., Buck, A.T., 1985. Parasitic of bushbabies (Galago Senegalensis and G. Crassicaudatus) recently imported to the 1970; Martinez et al., 2000). It is also important to highlight U.S.A. Lab. Primate Newslett. 24, 4. the fact that this species does not have the habit of eating Fox, J.G., Diaz, J.R., Barth, R.A., 1972. Nymphal Porochephalus Clavatus in snakes, but other primates do, such as the Callitrichidae the brain of a Squirrel monkey Saimiri sciureus. Am. Assoc. Lab. Anim. Sci. 22 (6), 908–910. (Auricchio, 1995). Guardian, S.N., Sepp, H., Scholten, T., Morava-Protzner, I., 1991. Pentasto- Durden et al. (1985) reported that the eggs of Pentas- miasis in Canada. Arch. Pathol. Lab. Med. 115 (5), 515–517. tomida released with the ophidian’s nasal secretions can Heuschele, W.P., 1961. Internal parasitism of monkeys with the Pentasto- mid, Armillifer armillatus. JAVMA 139 (8), 911–912. be fixed to the vegetation, and that vertebrate animals, Lavrov, V.L., Brown, W.M., Boore, J.L., 2004. Phylogenetic position of the notably mammals, can ingest those eggs during forage then Pentastomida and (pan) relationships. Proc. R. Soc. Lond. act like intermediary hosts. Hypothetically, this was not Ser. B: Biol. Sci. 271, 537–544. the case, since the foods offered to the animals are hygien- Lok, J.B., Kirkpatrick, C.E., 1987. Pentastomiasis in captive monkeys. Lab. Anim. Sci. 37 (4), 494–496. ically manipulated and treated. Furthermore, considering Ma, K.C., Qui, M.H., Rong, Y.L., 2002. Pathological differentiation of sus- that our monkey was housed in a outdoor exhibit, we can- pected cases of pentastomiasis in China. Trop. Med. Int. Health 7 (2), not rule out the possibility of indirect contamination of the 166–177. Martinez, F.A., Troiano, J.C., Anasco, L.G., Fescina, N., Jará, D.N., 2000. food by arthropods, which are mechanical vectors of eggs Infestacíon por ninfas de pentastómidos del gênero Porocephalus of the parasite. (Humboldt, 1811) en Hydrodinastes gigas (OPHIDIA-COLUBRIDAE). Histologically, it was observed that the parasites were Analecta Veterinária 20 (1), 39–42. Pan, C., Tang, H., Qiu, M., Xiong, Q., 2005. 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