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PubMed1991

Tetracyclines, chloramphenicol, erythromycin, clindamycin, and metronidazole.

The tetracyclines are effective in the treatment of Chlamydia, Mycoplasma pneumoniae, and rickettsial infections and also can be used for gonococcal infections in patients unable to tolerate penicillin. These drugs may cause gastrointestinal irritation, diarrhea, phototoxic dermatitis, and vestibular damage, and fatal reactions due to hepatotoxicity have occurred in pregnant women. Chloramphenicol has a broad spectrum of bacteriostatic activity, but its association with suppression of the bone marrow and aplastic anemia has relegated it to a historical role. Erythromycin is the drug of choice for the treatment of infections caused by M. pneumoniae, Legionella species, group A beta-hemolytic streptococci, and Streptococcus pneumoniae. The frequency of serious adverse effects associated with the use of erythromycin is low; dose-related epigastric distress may occur. Clindamycin is bactericidal to most nonenterococcal gram-positive aerobic bacteria and many anaerobic microorganisms. Although historically it was a frequent cause of antibiotic-associated diarrhea and colitis, clindamycin is considered an excellent alternative to beta-lactam antibiotics for treatment of many staphylococcal infections, and it has therapeutic utility in anaerobic infections and in several protozoan infections in immunosuppressed patients. Metronidazole is efficacious for treating nonpulmonary anaerobic infections, various parasitic infections (trichomoniasis, amebiasis, and giardiasis), nonspecific vaginitis, and Clostridium difficile-mediated colitis. With use of metronidazole, mild side effects such as epigastric discomfort, diarrhea, reversible neutropenia, and allergic-type cutaneous reactions may occur.

Chloramphenicol↗
PubMed1993

Parasites of the arctic fox (Alopex lagopus) in Iceland.

Forty-four of 50 arctic foxes (Alopex lagopus) in Iceland harbored 15 species of intestinal parasites, including Protozoa: Eimeria sp. or Isospora sp. (in 4%); Trematoda: Cryptocotyle lingua (24%), Plagiorchis elegans (4%), Brachylaemus sp. (12%), Tristriata sp. (10%), and Spelotrema sp. (8%); Cestoda: Mesocestoides canislagopodis (72%), Schistocephalus solidus (2%), and Diphyllobothrium dendriticum (4%); Nematoda: Toxascaris leonina (50%), Toxocara canis (2%), Uncinaria stenocephala (4%), and eggs of the lung worm Capillaria aerophila (6%); and Acanthocephala: Polymorphus meyeri (8%) and Corynosoma hadweni (2%). Only four of the species previously had been recorded in Iceland. Eleven species are new records in Iceland and six appear to be new host records. Two additional nematodes, Stegophorus stercorarii and Syphacia sp., probably were ingested accidentally with the prey. Foxes from coastal habitats harbored 14 parasitic species while only five species were found in foxes from inland habitats. Arctic foxes from coastal habitats generally had higher helminth burdens and harbored more parasitic species per fox than foxes from inland habitats.

Acanthocephala↗
PubMed1982

The pathoparasitology of the alimentary tract and pancreas of nonhuman primates: a review.

A review of the literature concerning the gross and histologic lesions associated with protozoal and metazoal parasitism in the alimentary tract and pancreas of nonhuman primates is presented. In addition, the natural history, morphology, life cycle, methods for diagnosis, and potential for zoonotic disease are reviewed briefly for each parasite discussed. The parasite species reviewed in detail are those most common or most likely to produce lesions in the alimentary tract and pancreas of the nonhuman primate host. All parasites, both pathogenic and nonpathogenic, in each major group (protozoa: flagellates, sarcodines, sporozoans, neosporans, and ciliates; and metazoa: trematodes, cestodes, nematodes, acanthocephalans, and pentastomids) that have been reported in the nonhuman primate alimentary tract and pancreas are presented in tables.

Amebiasis↗
PubMed1977

Cerebral nematodiasis in captive nutria.

Of 35 nutria (Myocaster coypus) at a city zoo, 20 died or were killed because of a progressive central nervous system disease. On the basis of histopathologic findings, a diagnosis of cerebral nematodiasis complicated by nosematosis was made. The only significant management change prior to illness was the feeding of poplar tree branches from a lowland area inhabited by skunks and raccoons. Neurologic disturbances gradually ceased within 2 months after control measures were initiated and the practice of provided poplar branches as a source of roughage was discontinued.

Animals↗
PubMed1996

Pathology of microsporidiosis: emerging parasitic infections in patients with acquired immunodeficiency syndrome.

OBJECTIVE: Microsporidiosis is a group of rapidly emerging protozoan infections that have thus far been reported predominantly from severely immunosuppressed persons with the acquired immunodeficiency syndrome (AIDS). The four genera that have been identified in AIDS patients (Enterocytozoon, Encephalitozoon, Septata, and Pleistophora) are an increasingly common source of both localized and disseminated infections. However, the clinical and pathologic features of these agents are being described with such rapidity that many pathologists are unaware of the histologic, immunologic, and molecular methods for diagnosing these infections. This article summarizes the clinical and morphologic spectrum of the microsporidian species that infect patients with AIDS. Additionally, the role of ultrastructural, immunologic, tissue culture, and molecular techniques for the diagnosis of microsporidian infections are discussed. DATA SOURCES: Clinical and pathologic findings were obtained from patients with AIDS who were evaluated for microsporidian infections at the Grady Memorial Hospital in Atlanta. Selected laboratory studies were performed at the Division of Parasitic Diseases of the Centers for Disease Control and Prevention and at the Department of Physiology at Morehouse University. Additionally, some cases were sent for consultation to the Infectious Disease Pathology service at Emory University. These data were combined with the published studies of microsporidian infection from the medical literature. DATA SYNTHESIS: The pathologic appearance of microsporidian infections in each major organ system (ocular, respiratory, genitourinary, gastrointestinal) is illustrated using routine and special histochemistry and immunofluorescence. The differential diagnostic features of the four genera of microsporidia infecting AIDS patients are illustrated using transmission and scanning electron micrographs from biopsy, autopsy, and tissue culture materials. Cytologic evaluation of body tissues is emphasized as a sensitive method for microsporidian diagnosis. CONCLUSIONS: Microsporidian infections can be expected to remain an increasingly important cause of morbidity and mortality in patients with AIDS. It is important that pathologists and microbiologists become acquainted with the clinicopathologic spectrum of these emerging protozoal infections, ensuring timely diagnosis and subsequent treatment.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Management of HIV and AIDS in the African context.

The initial response to the African HIV epidemic was to concentrate on the prevention of new infections. There is now an urgent need to address the health care requirements of large numbers of already infected individuals. The spectrum of disease in the African setting is dominated by tuberculosis, bacterial and protozoan infections. In much of Africa, health services are overwhelmed by the care of terminally ill AIDS patients. In the absence of specific HIV therapy, health care resources are being increasingly utilised, but with little survival benefit for the individual. Resources available for treating patients vary considerably between the richer and poorer countries of the continent. Primary prevention of opportunistic infections and maternal child transmission are at present affordable and cost-effective interventions. Whilst antiretroviral therapies may presently be unaffordable in much of Africa, they represent a modality that can have a major effect on HIV survival. The challenge is to improve the health and longevity of HIV-infected individuals with the rational use of the limited health resources available in Africa today.

AIDS-Related Opportunistic Infections↗
PubMed2001

Endemic infectious diseases and biological warfare during the Gulf War: a decade of analysis and final concerns.

Infectious diseases were one of the first health threats confronted by Coalition troops deployed to the Arabian desert in August 1990. On the basis of experiences in World War II, the major endemic infectious disease risks were thought to be sandfly fever, cutaneous leishmaniasis, diarrheal disease, and malaria. Although there was active surveillance, no case of sandfly fever and few other endemic infectious diseases were identified among over 500,000 U.S., British, and Canadian ground troops. In addition, there was no diagnosis of biological warfare (BW) exposure, and BW agents were not detected in clinical, environmental, or veterinary samples. The most common infectious disease problems were those associated with crowding (acute upper respiratory infections) and reduced levels of sanitation (travelers-type diarrhea). Only one endemic infectious disease has been confirmed as causing chronic health problems: visceral Leishmania tropica infection (viscerotropic leishmaniasis). However, this protozoan infection was diagnosed in only 12 U.S. veterans, and no new cases have been identified during the last 8 years. Infectious diseases were not a serious problem for Gulf War troops because of extensive preventive medicine efforts and favorable weather and geographic factors. Moreover, it is unlikely that an endemic infectious disease or a BW agent could cause chronic health problems and remain undetected over a 10-year period.

Biological Warfare↗
PubMed1976

[Polyarteritis nodosa: general aspects and occurrence in domestic animals, particularly in association with nosematosis in blue foxex (author's transl)].

A survey of polyarteritis nodosa in domestic animals is presented, including a description of the patho-morphological lesions and a discussion on the causal factors. This vascular disease occurs in domestic animals in association with both viral infections (infectious plasmacytosis in mink), bacterial infections (erysipelas in swine), and protozoan infections (nosematosis in blue foxes). The conclusion is drawn that the observations in domestic animals support the view that immunological disturbances are involved as pathogenetic mechanisms. Nosematosis is dealt with in more detail; the infecting agent (fig. 1), Nosema cuniculi (Encephalitozoon cuniculi), is a widespread mamalian parasite, which causes cerebral and renal lesions in blue foxes of the same type as in animals of other species. In addition, the vascular system throughout the body is affected, resulting in patho-morphological alterations corresponding to classical polyarteritis nodosa (Fig. 2). In the early stages of involvement, masses of parasitic organisms are regularly found within the walls of affected arteries (Fig. 3). This disease is frequently lethal, and always accompanied by elevated values of gamma globulins. Both the hypergammaglobulinemia and the tissue lesions, seem at times, at least in part, to be reversible.

Animals↗
PubMed1994

Prevalence of intestinal parasites in rural areas of district Shahjahanpur, Uttar Pradesh.

A stool survey was carried out in some of the villages of Dadraul and Bhawal Khera PHC's of district Shahjahanpur (Uttar Pradesh). Out of 381 individuals examined 111 (29.2 per cent) were found positive for one or the other intestinal parasite. Ascaris lumbricoides superseded all the parasites by showing a positivity of 17.85 percent. Other parasites found were Hookworm, Hymenolepis nana, Tapeworm, Trichuris trichiura, Enterobius vermicularis, Entamoeba histolytica, E. coli and Giardia lamblia. Parasitic load was slightly higher in females (33.59 per cent) than males (28.18 per cent). The highest positivity was encountered in the age groups between 6 to 14 years. This high prevalence of intestinal parasites may be due to the lack of awareness about personal cleanliness and hygiene and illiteracy among rural women. Majority of them had helminthic infections. It is concluded that in rural areas of district Shahjahanpur intestinal helminthic infections are more prevalent that protozoan infections.

Adolescent↗
PubMed2003

Lack of basophilia in human parasitic infections.

While basophilia is often found in animal models of parasitic infection, it has not yet been established whether it occurs in parasite-infected humans. We investigated the relationship between basophilia and parasitic infections in humans by reviewing charts from 668 patients with confirmed parasitic infection (472 with only helminths, 146 with only protozoa, and 50 with both helminth and protozoan infections) and from 50 patients without parasitic infections. Basophilia (> 290 cells/mm3 ) occurred in only four of the 668 parasite-infected patients (0.6%), and there were no statistically significant differences in the percentages of patients with basophilia or in the absolute basophil counts among either the helminth-infected, protozoa-infected, or uninfected populations. Analysis with regard to relative basophil levels revealed that basophils constituted more than 3% of the peripheral white blood cell population in only four patients. Thus, basophilia occurs only rarely in human parasitic infections and is consequently not a useful clinical marker in the evaluation of suspected parasitic disease.

Adolescent↗
PubMed2004

Mast cell-dependent control of Giardia lamblia infections in mice.

Mast cells are important for protective immunity to intestinal helminth infections and as mediators of allergic disease. Their role in protozoan infections is less well described. We have therefore analyzed mast cell responses and parasite control in mice infected with the protozoan Giardia lamblia. We also measured immunoglobulin A (IgA) responses to the parasite, as IgA can have a protective role in this model. c-kit w/wv mice failed to make parasite-specific IgA, mount a mast cell response, or eliminate the infection. Anti-c-kit-treated C57BL/6 mice had normal IgA responses, lacked mast cell responses, had reduced interleukin-6 (IL-6) mRNA in the small intestine, and failed to control the infection within 10 days. IL-9-deficient mice had a significant but reduced mast cell response and still controlled the infection within 2 weeks. Interestingly, IL-6-deficient mice had enhanced mast cell responses yet failed to rapidly control the infection. However, prevention of mast cell responses in IL-6-deficient mice by anti-c-kit treatment did not lead to parasite elimination. Both IL-6- and IL-9-deficient mice had normal IgA production. IL-6-deficient mice had significant serum levels of mast cell mediators, histamine and mast cell protease 1, following infection. Together, these results show that mast cells are important for the rapid control of Giardia infections in mice. Furthermore, they show that IL-6 is not necessary for these mast cell responses. Instead, they suggest that mast cell production of IL-6 appears to be important for control of this infection.

Animals↗