scholarly journals Fatal Multiorgan Failure Syndrome in a Strongyloides-HTLV-1 Coinfected Patient, after Treatment with Ivermectin

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Emmanuelle Guérin ◽  
Paule Poirier ◽  
Marine Nervo ◽  
Christophe Le Terrier
Keyword(s):  
Multiorgan Failure ◽  
Severe Disease ◽  
Intestinal Bacteria ◽  
Strongyloides Stercoralis ◽  
T Lymphotropic Virus ◽  
E Coli ◽  
Multiple Organs ◽  
Disseminated Strongyloidiasis ◽  
Characteristic Features ◽  
Coinfected Patient

Because of its characteristic features of autoinfection, the parasitic nematode Strongyloides stercoralis can infect patients for years. An acceleration of its autoinfective cycle can be triggered by human T-lymphotropic virus-1 (HTLV-1) infection, mainly by the deviation of the protective Th2- to Th1-type immune response and can lead to severe disease by dissemination of Strongyloides stercoralis larvae carrying intestinal bacteria to multiple organs. Meningitis caused by enteric Gram-negative bacteria is a potentially fatal complication of disseminated strongyloidiasis. Herein, we present the case of a Strongyloides-HTLV-1 coinfected patient, admitted for E. coli meningitis. One day after initiation of ivermectin, the patient developed significant S. stercoralis dissemination, complicated by multiorgan failure syndrome, and died from neurological failure. While the initial clinical scenario of our case has already been well described in the literature, its course after antihelminthic treatment initiation remains unclear and needs to be discussed.

scholarly journals E. coliMeningitis Presenting in a Patient with DisseminatedStrongyloides stercoralis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Juliana B. Gomez ◽  
Yvan Maque ◽  
Manuel A. Moquillaza ◽  
William E. Anicama
Keyword(s):  
Gastrointestinal Symptoms ◽  
Abdominal Distension ◽  
Strongyloides Stercoralis ◽  
The Body ◽  
Case Presentation ◽  
E Coli ◽  
History Of ◽  
Disseminated Strongyloidiasis ◽  
Proper Diagnosis ◽  
Cerebrospinal Fluid Culture

Introduction. SpontaneousEscherichia colimeningitis is an infrequent condition in adults and is associated with some predisposing factors, including severeStrongyloides stercoralis(SS) infections.Case Presentation. A 43-year-old Hispanic man, with history of travelling to the jungle regions of Peru and Brazil two decades ago, and who received prednisone due to Bell’s palsy for three weeks before admission, presented to the Emergency Department with diarrhea, fever, and hematochezia. A week after admission he developed drowsiness, meningeal signs, abdominal distension, and constipation. A cerebrospinal fluid culture showed extended spectrumβ-lactamase producingE. coli. A colonoscopy was performed and showed pancolitis. Three days after the procedure the patient became unstable and developed peritoneal signs. He underwent a laparotomy, which ended up in a total colectomy and partial proctectomy due to toxic megacolon. Three days later the patient died in the intensive care unit due to septic shock. Autopsy was performed and microscopic examination revealed the presence of multipleStrongyloideslarvae throughout the body.Conclusion.Strongyloides stercoralisinfection should be excluded in adults with spontaneousE. colimeningitis, especially, if gastrointestinal symptoms and history of travelling to an endemic area are present. Even with a proper diagnosis and management, disseminated strongyloidiasis has a poor prognosis.

Oxidative burst and phagocytic activity of phagocytes in canine parvoviral enteritis

2021 ◽  
pp. 104063872110255
Author(s):  
Kelly du Preez ◽  
Yolandi Rautenbach ◽  
Emma H. Hooijberg ◽  
Amelia Goddard
Keyword(s):  
Oxidative Burst ◽  
Phagocytic Activity ◽  
Severe Disease ◽  
Burst Activity ◽  
E Coli ◽  
Reactive Protein ◽  
Oxidative Burst Activity ◽  
Healthy Control ◽  
Complete Blood Counts ◽  
Serum Crp

Canine parvoviral enteritis (CPE) is a severe disease characterized by systemic inflammation and immunosuppression. The function of circulating phagocytes (neutrophils and monocytes) in affected dogs has not been fully investigated. We characterized the functional capacity of canine phagocytes in CPE by determining their oxidative burst and phagocytic activities using flow cytometry. Blood was collected from 28 dogs with CPE and 11 healthy, age-matched, control dogs. Oxidative burst activity was assessed by stimulating phagocytes with opsonized Escherichia coli or phorbol 12-myristate 13-acetate (PMA) and measuring the percentage of phagocytes producing reactive oxygen species and the magnitude of this production. Phagocytosis was measured by incubating phagocytes with opsonized E. coli and measuring the percentage of phagocytes containing E. coli and the number of bacteria per cell. Complete blood counts and serum C-reactive protein (CRP) concentrations were also determined. Serum CRP concentration was negatively and positively correlated with segmented and band neutrophil concentrations, respectively. Overall, no differences in phagocyte function were found between dogs with CPE and healthy control dogs. However, infected dogs with neutropenia or circulating band neutrophils had decreased PMA-stimulated oxidative burst activity compared to healthy controls. Additionally, CPE dogs with neutropenia or circulating band neutrophils had decreased PMA- and E. coli–stimulated oxidative burst activity and decreased phagocytosis of E. coli compared to CPE dogs without neutropenia or band neutrophils. We conclude that phagocytes have decreased oxidative burst and phagocytic activity in neutropenic CPE dogs and in CPE dogs with circulating band neutrophils.

From strongyloidiasis to disseminated mucormycosis: the story of an HTLV-1-infected migrant

2020 ◽  
Author(s):  
Brice Autier ◽  
Adélaïde Chesnay ◽  
Claire Mayence ◽  
Stéphanie Houcke ◽  
Hélène Guégan ◽  
...  
Keyword(s):  
Immune Deficiency ◽  
Strongyloides Stercoralis ◽  
The Body ◽  
Life Threatening ◽  
Disseminated Strongyloidiasis ◽  
Disseminated Mucormycosis

Strongyloidiasis manifestations range from asymptomatic cases to the life-threatening disseminated strongyloidiasis in case of immune deficiency: larvae migrate throughout the body, disseminating germs from the digestive flora to various organs. Here, we described a case of disseminated mucormycosis consecutive to Strongyloides stercoralis hyperinfestation in a Surinamese migrant infected with HTLV-1.

scholarly journals A case of fatal disseminated strongyloidiasis accompanied with intestinal obstruction

2019 ◽  
Vol 2019 (10) ◽  
Author(s):  
Peyman Heydarian ◽  
Iraj Mobedi ◽  
Mohamad Ali Mohaghegh ◽  
Abozar Hosseini ◽  
Fatemeh Goudarzvand Chegini ◽  
...  
Keyword(s):  
Intestinal Obstruction ◽  
Signs And Symptoms ◽  
Strongyloides Stercoralis ◽  
Final Diagnosis ◽  
High Humidity ◽  
Important Message ◽  
Disseminated Strongyloidiasis ◽  
Endemic Areas

Abstract Strongyloides stercoralis is an endemic parasite in some regions including the tropical and subtropical areas with high humidity. Most infections are asymptomatic with nonspecific signs and symptoms, making the final diagnosis complicated. Here, we report a patient referred to our hospital with signs consistent with sepsis, intestine obstruction, which finally died with the diagnosis of strongyloidiasis. The patient was from northern parts of Iran which are considered as endemic areas for S. stercoralis. In conclusion, there is an important message in this history, i.e. physicians should be aware of specific and non-specific signs of strongyloidiasis especially in people living in endemic areas to make an accurate final diagnosis by proper clinical and paraclinical examinations.

scholarly journals Pathobiology of A/Chicken/Hong Kong/220/97 (H5N1) Avian Influenza Virus in Seven Gallinaceous Species

2001 ◽  
Vol 38 (2) ◽  
pp. 149-164 ◽  
Author(s):  
L. E. L. Perkins ◽  
D. E. Swayne
Keyword(s):  
Hong Kong ◽  
Avian Influenza ◽  
Pulmonary Edema ◽  
Multiorgan Failure ◽  
Clinical Manifestations ◽  
Highly Pathogenic ◽  
H5n1 Avian Influenza Virus ◽  
Multiple Organs ◽  
H5n1 Avian Influenza ◽  
Virus Localization

Direct bird-to-human transmission, with the production of severe respiratory disease and human mortality, is unique to the Hong Kong-origin H5N1 highly pathogenic avian influenza (HPAI) virus, which was originally isolated from a disease outbreak in chickens. The pathobiology of the A/chicken/Hong Kong/ 220/97 (H5N1) (HK/220) HPAI virus was investigated in chickens, turkeys, Japanese and Bobwhite quail, guinea fowl, pheasants, and partridges, where it produced 75-100% mortality within 10 days. Depression, mucoid diarrhea, and neurologic dysfunction were common clinical manifestations of disease. Grossly, the most severe and consistent lesions included splenomegaly, pulmonary edema and congestion, and hemorrhages in enteric lymphoid areas, on serosal surfaces, and in skeletal muscle. Histologic lesions were observed in multiple organs and were characterized by exudation, hemorrhage, necrosis, inflammation, or a combination of these features. The lung, heart, brain, spleen, and adrenal glands were the most consistently affected, and viral antigen was most often detected by immunohistochemistry in the parenchyma of these organs. The pathogenesis of infection with the HK/220 HPAI virus in these species was twofold. Early mortality occurring at 1-2 days postinoculation (DPI) corresponded to severe pulmonary edema and congestion and virus localization within the vascular endothelium. Mortality occurring after 2 DPI was related to systemic biochemical imbalance, multiorgan failure, or a combination of these factors. The pathobiologic features were analogous to those experimentally induced with other HPAI viruses in domestic poultry.

scholarly journals Prevalence of intestinal parasitic infection in five farms in Holambra, São Paulo, Brazil

1995 ◽  
Vol 37 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Jun Kobayashi ◽  
Hideo Hasegawa ◽  
Archimedes A. Forli ◽  
Nancy F. Nishimura ◽  
Ademar Yamanaka ◽  
...  
Keyword(s):  
Parasitic Infection ◽  
Strongyloides Stercoralis ◽  
Sao Paulo ◽  
São Paulo ◽  
Infection Rates ◽  
Blastocystis Hominis ◽  
Culture Methods ◽  
E Coli ◽  
Parasitological Survey ◽  
Protozoan Species

A parasitological survey was carried out on 222 inhabitants of five farms in Holambra, located 30 km north of Campinas, São Paulo, Brazil, on October 1992. Approximately 70% of the inhabitants were found to be infected with at least one species of intestinal parasite. The positive rates of 6 helminths and 7 protozoan species detected are as follows: 5.4% Ascaris lumbricoides; 8.6% Trichuris trichiura; 19.8% Necator americanus; 10.4% Strongyloides stercoralis; 14% Enterobius vermicularis; 0.9% Hymenolepis nana; 3.2% Entamoeba histolytica; 2.7% E. hartmanni; 9.9% E. coli; 14.0% Endolimax nana; 2.3% Iodamoeba butschlii; 10.4% Giardia lamblia; 37.8% Blastocystis hominis. The positive rates of helminth infection were generaly higher in the younger-group under 16 years-old than those in the elder group aged 16 or more, whereas the infection rates of protozoan species were higher in the elder group. The infection rate of Strongyloides was found to be 10.4% by a newly developed sensitive method (an agarplate culture methods).

scholarly journals The landscape of circulating platelet aggregates in COVID-19

2021 ◽  
Author(s):  
Yuqi Zhou ◽  
Masako Nishikawa ◽  
Hiroshi Kanno ◽  
Tinghui Xiao ◽  
Takuma Suzuki ◽  
...  
Keyword(s):  
Large Scale ◽  
Multiorgan Failure ◽  
Young Patients ◽  
Clinical Feature ◽  
Platelet Activity ◽  
Multiple Organs ◽  
Characteristic Clinical Feature ◽  
Circulating Platelet Aggregates ◽  
Platelet Aggregates ◽  
D Dimer

A characteristic clinical feature of COVID-19 is the frequent occurrence of thrombotic events. Furthermore, many cases of multiorgan failure are thrombotic in nature. Since the outbreak of COVID-19, D-dimer testing has been used extensively to evaluate COVID-19-associated thrombosis, but does not provide a complete view of the disease because it probes blood coagulation, but not platelet activity. Due to this limitation, D-dimer testing fails to account for thrombotic events which occur despite low D-dimer levels, such as sudden stroke in young patients and autopsy-identified widespread microthrombi in multiple organs. Here we report the landscape of circulating platelet aggregates in COVID-19 obtained by large-scale single-cell image-based profiling and temporal monitoring of the blood of COVID-19 patients (n = 110). Surprisingly, our analysis shows the anomalous presence of excessive platelet aggregates in nearly 90% of all COVID-19 patients, including those who were not clinically diagnosed with thrombosis and those with low D-dimer levels (less than 1 ug/mL). Additionally, results indicate a strong link between the concentration of platelet aggregates and the severity and mortality of COVID-19. Finally, high-dimensional analysis and comparison with other diseases reveal that COVID-19 behaves as a product of thrombosis (localized) and infectious diseases (systemic), as a cause of systemic thrombosis.

scholarly journals Seasonal prevalence and characterization of Shiga toxin-producing Escherichia coli on pork carcasses at three steps of the harvest process at two commercial processing plants in the US

2020 ◽  
Author(s):  
Ivan Nastasijevic ◽  
John W. Schmidt ◽  
Marija Boskovic ◽  
Milica Glisic ◽  
Norasak Kalchayanand ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Foodborne Pathogens ◽  
Shiga Toxin ◽  
Severe Disease ◽  
Control Point ◽  
Plate Count ◽  
Seasonal Effect ◽  
E Coli ◽  
Significant Control ◽  
Pork Products

ABSTRACTShiga toxin (stx) -producing Escherichia coli (STEC) are foodborne pathogens that have a significant impact on public health, with those possessing the attachment factor intimin (eae) referred to as enterohemorrhagic E. coli (EHEC) associated with life threatening illnesses. Cattle and beef are considered typical sources of STEC, but their presence in pork products is a growing concern. Therefore, carcasses (n=1536) at two U.S. pork processors were sampled once per season at three stages of harvest (post-stunning skins; post-scald carcasses; chilled carcasses) then examined using PCR for stx and eae, aerobic plate count (APC) and Enterobacteriaceae counts (EBC). Skins, post-scald, and chilled carcasses had prevalence of stx (85.3, 17.5, and 5.4%, respectively), with 82.3, 7.8, and 1.7% respectively, having stx and eae present. All stx positive samples were subjected to culture isolation that resulted in 368 STEC and 46 EHEC isolates. The most frequently identified STEC were serogroup O121, O8, and O91(63, 6.7, and 6.0% of total STEC, respectively). The most frequently isolated EHEC was serotype O157:H7 (63% of total EHEC). Results showed that scalding significantly reduced (P < 0.05) carcass APC and EBC by 3.00 and 2.50 log10 CFU/100 cm2 respectively. A seasonal effect was observed with STEC prevalence lower (P < 0.05) in winter. The data from this study shows significant (P < 0.05) reduction in the incidence of STEC (stx) from 85.3% to 5.4% and of EHEC (stx+eae) from 82.3% to 1.7% within slaughter-to-chilling continuum, respectively, and that potential EHEC can be confirmed present throughout using culture isolation.IMPORTANCESeven serogroups of Shiga toxin-producing Escherichia coli (STEC) are responsible for most (>75%) cases of severe illnesses caused by STEC and are considered adulterants of beef. However, some STEC outbreaks have been attributed to pork products although the same E. coli are not considered adulterants in pork because little is known of their prevalence along the pork chain. The significance of the work presented here is that it identifies disease causing STEC, enterohemorrhagic E. coli (EHEC), demonstrating that these same organisms are a food safety hazard in pork as well as beef. The results show that most STEC isolated from pork are not likely to cause severe disease in humans and that processes used in pork harvest, such as scalding, offer a significant control point to reduce contamination. The results will assist the pork processing industry and regulatory agencies to optimize interventions to improve the safety of pork products.

Prevalence, seasonality and severity of disease caused by pathogenic Escherichia coli in children with diarrhoea in Bolivia

2013 ◽  
Vol 62 (11) ◽  
pp. 1697-1706 ◽  
Author(s):  
Lucia Gonzales ◽  
Enrique Joffre ◽  
Rosario Rivera ◽  
Åsa Sjöling ◽  
Ann-Mari Svennerholm ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Severe Disease ◽  
Severe Diarrhoea ◽  
E Coli ◽  
Number Of Children ◽  
Severity Of Disease ◽  
Positive Stool ◽  
Pathogenic Escherichia Coli ◽  
Stool Samples

The prevalence of infection caused by different categories of diarrhoeagenic E. coli (DEC) strains, including enteroaggregative (EAEC), enteropathogenic (EPEC), enterotoxigenic (ETEC), enteroinvasive (EIEC) and enterohaemorrhagic (EHEC) E. coli, in children who suffered from diarrhoea (n = 3943) or did not have diarrhoea (n = 1026) were analysed in two areas in Bolivia over a period of 4 years. We also analysed the seasonality of DEC infections and severity of diarrhoea in children with DEC infection and compared antibiotic resistance in DEC strains isolated from children with and without diarrhoea. Stool samples were analysed for the presence of DEC by culturing followed by PCR. The most prevalent DEC categories in samples from the children were: EAEC (11.2 %); ETEC (6.6 %); EPEC (5.8 %); and EIEC and EHEC (<1 %). DEC strains were isolated significantly more often from diarrhoea cases (21.6 %) than from controls (17.6 %; P = 0.002). The number of children with diarrhoea associated with EAEC, EPEC and ETEC infections peaked in the Bolivian winter (April–September), although the proportion of DEC-positive stool samples was higher during the warm rainy season (October–March). High levels of antibiotic resistance were detected among the DEC strains. In particular, resistance to tetracycline and sulfamethoxazole–trimethoprim was significantly higher in strains isolated from individuals with diarrhoea than in samples from controls. The severity of disease in children infected with EAEC, EPEC and ETEC varied from mild to severe diarrhoea, although disease severity did not differ significantly between the different DEC categories. ETEC, EPEC and EAEC are commonly found in Bolivia and may cause severe disease in children.

Restrictive cardiomyopathy

ESC CardioMed ◽  
2018 ◽  
pp. 1485-1490
Author(s):  
Jens Mogensen
Keyword(s):  
Randomized Clinical Trials ◽  
Systolic Function ◽  
Severe Disease ◽  
Significant Proportion ◽  
Gene Mutations ◽  
Restrictive Cardiomyopathy ◽  
Multiple Organs ◽  
Normal Wall ◽  
Sarcomeric Gene ◽  
The Individual

Restrictive cardiomyopathy (RCM) is an uncommon myocardial disease, characterized by impaired filling of the ventricles in the presence of normal wall thickness and systolic function. Most patients have both left- and right-sided heart failure which are often accompanied by severe symptoms. Enlargement of both atria is usually present and thromboembolic events are common. The prognosis is generally poor and a significant proportion of patients require a cardiac transplantation. RCM may appear in the context of diseases involving multiple organs or it may be confined to the heart. In addition, the condition appears in both familial and non-familial forms. The majority of familial forms are caused by sarcomeric gene mutations, which are also frequently identified in hypertrophic, dilated, and non-compaction cardiomyopathy. This implies that familial evaluation should be considered whenever an individual is diagnosed with RCM. In non-familial RCM, the most frequent aetiology is amyloidosis due to haematological diseases or senile forms. There are no randomized clinical trials of therapy in patients with symptomatic RCM. Diuretics remain the cornerstone of treatment and require careful titration since RCM patients are very sensitive to hypovolaemia. Since the condition is very rare with a severe disease expression and poor prognosis, it is recommended that RCM patients should be followed in expert centres in order to optimize management of the individual patient.

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