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Biomedical subjects

P Prociv

Publications and source records attributed to P Prociv.

At least 19 recordsLinked to original sources
PubMed1992

Successful treatment of disseminated strongyloidiasis.

OBJECTIVE: To report the successful treatment of Strongyloides stercoralis hyperinfection, which is usually lethal but in this case was diagnosed in its early stages. CLINICAL FEATURES: A 44-year-old woman, who had spent much of her life in Fiji and India, was treated with a high dose of prednisolone for rheumatoid arthritis complicated by gold lung. The onset of abdominal symptoms, an exacerbation of respiratory symptoms, and a persistent high eosinophil count and serum IgE level, led to the detection of numerous Strongyloides larvae in her faeces and sputum. INTERVENTION AND OUTCOME: She was treated with thiabendazole for five days, then mebendazole for one month, and the dose of prednisolone was reduced. Clinical symptoms and signs improved within days and after one week parasites could not be found in her faeces. After six months, enzyme-linked immunosorbent assay for Strongyloides infection gave a reading which was 40% of the initial level but still in the positive range. CONCLUSION: Steroid therapy in individuals with chronic, subclinical strongyloidiasis predisposes to the insidious development of hyperinfection syndrome, which has a high mortality rate. If detected early, this complication can be treated effectively. It can be prevented by actively seeking Strongyloides infection, by faecal microscopy and culture techniques and by serological tests, in high-risk individuals, such as immigrants from endemic areas.

Adult↗
PubMed1992

Human ectopic fascioliasis in Australia: first case reports.

OBJECTIVE: To describe the manifestations of two cases of migratory ectopic fascioliasis diagnosed in Australia, including the first report of lymphatic infection. PRESENTATION: Both patients presented with acute, superficial swellings. In the first, a 46-year-old woman, the lump was found to be a cervical lymph node containing a mature Fasciola hepatica which had released eggs into surrounding tissues. The second patient was a 34-year-old male abattoir worker, in whom the subcutaneous lesion resembled an infected sebaceous cyst and contained an immature fluke. FINDINGS: Both lesions were resected and diagnosed histologically. Fasciola eggs were not found in the faeces of either patient. Blood eosinophilia was not detected in either case. A serological test for fascioliasis was carried out in the second case and the result was positive. In both cases, infection was probably acquired in Australia, although neither patient had eaten watercress. OUTCOME: Neither patient was specifically treated with anthelminthic agents, and neither suffered further complications. CONCLUSION: Migratory fascioliasis occurs in Australia. It can present as superficial or deep focal lesions, not necessarily in association with peripheral blood eosinophilia or Fasciola eggs in faeces. Serological tests may be helpful in diagnosing such cases.

Adult↗
PubMed1992

Isosporiasis in the aboriginal population of Queensland.

OBJECTIVE: To report on the endemicity of Isospora belli in Queensland. DESIGN: A 10-year retrospective survey of data from routine parasitological surveillance of Queensland Aboriginal communities, by microscopic examination of preserved faecal specimens. SETTING: The Aboriginal Health Programme of the Queensland Department of Health and Medical Services. POPULATION: Children under 15 years of age from all the Aboriginal communities of Queensland. RESULTS: Oocysts of I. belli were detected in 33 (0.2%) of a total of 17,642 faecal samples examined. CONCLUSION: Isosporiasis is endemic in the Queensland Aboriginal population. It is likely to be more common than indicated, because the infection is difficult to diagnose, and the techniques used to identify the organism were not particularly sensitive. It is predicted that isosporiasis will be recognised with increasing frequency as a cause of diarrhoea in Aboriginal and white Australians who develop AIDS.

Adolescent↗
PubMed1992

A genetic comparison of human and wildlife isolates of Echinococcus granulosus in Queensland: public health implications.

OBJECTIVE: To test the hypothesis that the hydatid parasite infecting macropods and dingoes in Queensland is a sylvatic strain of Echinococcus granulosus, distinct from the domestic strain which produces cysts in sheep and humans. DESIGN: Molecular biological techniques were used to compare DNA isolated from hydatid cysts from humans, local macropods and sheep from New South Wales and the United Kingdom, as well as from adult tapeworms in dingoes. SETTING: The human cysts were surgically resected from two patients seen with hydatidosis in Brisbane teaching hospitals over a one-year period. Neither patient had had previous contact with sheep farms. Macropods and dingoes were shot randomly in the localities where the patients presumably acquired their infections. Sheep liver cysts were obtained from abattoirs. METHODOLOGY: Studies comprised extraction of DNA from cysts, digestion by a series of restriction endonucleases, slab gel electrophoresis. Southern blotting and then hybridisation with defined DNA probes. Polymerase chain reaction, in combination with direct DNA sequencing, was used to compare DNA from cysts and adult worms from dingoes. RESULTS: The restriction fragment length polymorphism (RFLP) patterns of DNA from all cysts and a defined mitochondrial DNA sequence from all sources were indistinguishable. This finding is significant as both techniques can clearly distinguish between genetically distinct, well characterised strains of E. granulosus. CONCLUSIONS: Hydatid cysts are prevalent in some macropod populations and adult worms are common in dingoes. Since there are relatively few sheep-rearing areas in Queensland, contact with wild animals may be the main source of human hydatid infection in this State. The strain of E. granulosus in both patients was genetically indistinguishable from that found in macropods, dingoes and sheep from New South Wales and the United Kingdom. This strongly suggests that the domestic strain of E. granulosus, or a form very close genetically, freely infects Australian wildlife, and argues against the existence of a distinct sylvatic strain. The implications for public health are considerable.

Adult↗
PubMed1992

Strongyloidiasis in North Queensland: re-emergence of a forgotten risk group?

OBJECTIVE: To describe the clinical presentation, diagnosis and management of strongyloidiasis in northern Queensland, and to identify predisposing factors for this infection. DESIGN: A five-year retrospective study of medical records of all cases diagnosed in a regional hospital microbiology laboratory, with follow-up by interview where possible. SETTING: The Townsville General Hospital. PATIENTS: A total of 14 cases of strongyloidiasis were identified, with patients ranging in age from 7 months to 59 years. RESULTS: Infected patients included nine Aborigines and two Vietnamese refugees, both high-risk groups. Of three Caucasians diagnosed, one was a war veteran, but the other two did not have significant travel histories; all three had lived or worked under insanitary conditions. In only one case was strongyloidiasis suspected; in most, it was diagnosed because of diarrhoea or blood eosinophilia which could not be related to the presenting illness. Thiabendazole treatment was effective in most cases. CONCLUSION: In northern Australia, strongyloidiasis can be acquired locally by Caucasians who live in unhygienic circumstances. It should be suspected in any person with unexplained abdominal pain, diarrhoea, cutaneous symptoms or blood eosinophilia, and the laboratory must be informed of the provisional diagnosis.

Adolescent↗
PubMed1990

Eosinophilic enteritis presenting as surgical emergencies: a report of six cases.

Eosinophilic enteritis is now commonly diagnosed in northern Queensland, and cases have been seen elsewhere. The patients present with acute abdominal symptoms, which may mimic appendicitis, and many cases are managed by surgery. To facilitate the diagnosis of this unusual syndrome, six surgically treated cases are reported here. Blood eosinophilia may be a helpful diagnostic feature, but in some cases it does not develop until after the acute abdominal episode. Most cases resolve satisfactorily with conservative management.

Abdomen, Acute↗
PubMed1990

Human eosinophilic enteritis caused by dog hookworm Ancylostoma caninum.

An epidemic of eosinophilic enteritis (93 cases) has occurred in Townsville, northern Queensland, Australia. A hookworm was found attached to a resected, inflamed ileal segment from 1 patient but the species could not be identified. An adult hookworm of species Ancylostoma caninum was recovered at colonoscopy from the terminal ileum of a later patient. All of 38 patients interviewed in an epidemiological survey described behaviour which could have exposed them to infective larvae of this widespread dog parasite.

Adolescent↗
PubMed1990

First record of human acanthocephalan infections in Australia.

Two cases of asymptomatic acanthocephalan infections in infants are described. We believe this is the first report from Australia of infection with these parasites in humans. Their clinical, epidemiological and biological significance is discussed.

Acanthocephala↗
PubMed1990

Observations on the morphology of Toxocara pteropodis eggs.

Fertile eggs of Toxocara pteropodis, passed in the faeces of juvenile flying-foxes, were ovoid to spheroid in shape with a diameter range of 80-110 microns. The shell was often seen to comprise 4 layers: a fine inner lipid layer, a thicker clear chitinous layer, an equally thick outer vitelline layer and a pitted outermost, proteinaceous uterine layer of variable thickness. Infertile eggs were less uniform in shape and generally did not have well-defined shell layers, the formation of which is triggered by sperm penetration of the oocyte. The eggs of this species are bulkier than those of related ascaridoids, apparently because of a thicker external coat which, while not providing mechanical strength, is thought to protect against desiccation. Scanning electron microscopical findings suggest that the outer layer is not applied directly by uterine cells, but forms by the gradual deposition of secretions in the uterine lumen, regardless of whether the oocyte has been fertilized.

Animals↗
PubMed1990

Aberrant migration by Toxocara pteropodis in flying-foxes--two case reports.

Adults of the large nematode, Toxocara pteropodis, have not previously been reported from extra-intestinal sites in their hosts, juvenile flying-foxes (fruit-bats of the genus Pteropus). In one captive bat which died unexpectedly, a nematode was found coiled within the gall bladder and common bile duct; in another a nematode was in the esophagus and protruded into the laryngopharynx. Like other ascaridoids, this species is capable of aberrant migration.

Animals↗