Parasite-Induced Th2 Polarization—An Unusual Cause of Paediatric Hepatic Abscess

Liver abscess (LA) is a serious infectious disease, but is relatively rare in the paediatric population, especially in developed countries. Mostly, hepatic abscesses are pyogenic, caused by Staphylococcus aureus, while in extremely rare cases can be caused by parasites, such as Ascaris lumbricoides. Antimicrobial therapy and percutaneous drainage are the treatments of choice, lowering the mortality caused by this infection. We report a case of a 3-year-old girl admitted to the hospital for abdominal pain and a low-grade fever, with abdominal ultrasonography revealing a hepatic lesion. Initial laboratory tests showed moderate anaemia, thrombocytosis, eosinophilia, high inflammatory markers, and normal liver function. A computed tomography scan revealed two liver abscesses located subdiaphragmatically, and a high immunoglobulin E (IgE) value (22,300 U/mL). After excluding other possible etiologies, the patient was tested for parasitic infections. IgE for Ascaris lumbricoides came slightly higher. In addition to empirical antibiotic treatment, the patient received albendazole and made an uneventful recovery, with the full remission of the abscesses and without the need for drainage. In certain cases, parasites such as Ascaris lumbricoides are capable of inducing a T helper 2 (Th2) dominated immune response, predisposing the host to eosinophilia, hyperIgE, and increased susceptibility to bacterial infections. Early diagnosis and treatment in these cases may lead to less invasive therapy options in order to obtain a full recovery. To the best of our knowledge, this is the only reported case in the literature of a paediatric patient with parasite-induced liver abscesses, with extremely high IgE values, minimal symptomatology, that made a fast, full recovery without the need of drainage.

Download Full-text

Infections and the liver

Emergencies in Gastroenterology and Hepatology ◽

10.1093/med/9780199231362.003.0017 ◽

2013 ◽

pp. 273-289

Author(s):

Daniel Marks ◽

Marcus Harbord

Keyword(s):

Liver Disease ◽

Bacterial Infections ◽

Parasitic Infections ◽

Liver Abscesses

Infections and the liver Liver abscesses Bacterial infections Parasitic infections The liver in sepsis The liver may be involved in direct infection or as part of a systemic illness. This chapter considers both processes. The viral hepatitides are covered in Chapter 14, and liver disease in HIV-infected patients in ...

Download Full-text

Partial hepatectomy for treatment of multiple liver abscess in a calf: a case report

BMC Veterinary Research ◽

10.1186/s12917-021-02750-y ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Reiichiro Sato ◽

Kazutaka Yamada ◽

Taiki Yokoyama ◽

Koki Tanimoto ◽

Shoko Takeuchi ◽

...

Keyword(s):

Case Report ◽

Partial Hepatectomy ◽

Liver Abscess ◽

Bacterial Infections ◽

Umbilical Vein ◽

Abdominal Cavity ◽

Left Liver Lobe ◽

Vessel Sealing ◽

Liver Abscesses ◽

Sealing Device

Abstract Background Umbilical vein bacterial infections may cause liver abscesses during bacterial ascent. A single liver abscess can be surgically treated by marsupialization, but a risk of recurrence or non-healing remains. Moreover, there is no effective treatment for multiple abscesses. Case presentation A 17-day-old Holstein female calf exhibited reduced general condition, swelling and drainage of the umbilicus, and pressure sores in the area of the carpus, resulting in reluctance to stand up. The umbilicus showed pain at palpation; deep abdominal palpation indicated a swollen umbilical vein coursing from the umbilicus toward the liver. Ultrasonography confirmed a swollen umbilical vein with pus accumulation and multiple abscesses in the liver. Contrast-enhanced computed tomography (CT) examination confirmed that the swollen umbilical vein with fluid continued to the liver, and multiple unenhanced lesions, most likely abscesses, were confirmed in the liver. Partial hepatectomy was performed to remove as many abscesses as possible. For the resection, a vessel sealing device (LigaSureTM) was used to excise a part of the left liver lobe. As we could not remove all the abscesses in the liver during the operation, cefazolin sodium (5 mg/kg) was administered for 14 days after surgery. Post-operatively, blood accumulation was observed in the abdominal cavity, but no signs of peritonitis were found. The calf returned to the farm on day 38 after surgery. Follow-up information was obtained after 1 year, and complications were not reported. Conclusions To our knowledge, this is the first report of partial hepatectomy using a vessel sealing device for a calf with multiple liver abscesses. This case report suggests that the combination of partial hepatectomy and long-term administration of antibacterial drugs may restore the health of calves with multiple liver abscesses.

Download Full-text

LINC-42. EPIDEMIOLOGICAL OVERVIEW OF CHILDHOOD CNS TUMORS IN THE NEUROSURGICAL UNIT IN YEREVAN, ARMENIA

Neuro-Oncology ◽

10.1093/neuonc/noaa222.475 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii386-iii386

Author(s):

Nune Karapetyan ◽

Samvel Danielyan ◽

Gevorg Tamamyan ◽

Armen Tananyan ◽

Liana Safaryan ◽

...

Keyword(s):

Medical Center ◽

Survival Rates ◽

Developed Countries ◽

Cns Tumors ◽

Malignant Neoplasms ◽

Low Grade ◽

Embryonal Tumors ◽

Low Grade Gliomas ◽

Neurosurgical Treatment

Abstract BACKGROUND Central nervous system (CNS) tumors are the second most common malignant neoplasms among children worldwide. The current paper aims to analyze the situation in pediatric neuro-oncology in Armenia from the neurosurgical perspective. METHODS We have collected data of pediatric patients with CNS tumors treated in the Neurosurgery department of “Surb Astvasamayr” Medical Center from 01.01.2010 till 01.12.2019. Incidence by gender, age at diagnosis, and histopathology results were calculated. Survival rates were calculated based on the follow-up results performed until 30.12.2019. RESULTS Hospital-based data showed that during the previous 10 years 47 patients with CNS tumors received neurosurgical treatment in the unit, among them 66% were females. 38.3%, 31.9% and 29.8% of diagnosed patients were aged 0–4, 5–9, and 10–18 respectively. In 41 cases, the disease was not disseminated at diagnosis. The most common observed malignancies were low-grade gliomas (21.3%) and embryonal tumors (19.1%), followed by high-grade gliomas (14.9%) and ependymal tumors (8.5%). Follow-up information only for 33 patients is available. From them, 14 are dead and 19 alive. Survival rates in most common groups were 62.5%, 80%, 50%, and 50% respectively. The median follow-up time was 18 months (range 1–113 months). CONCLUSION Similar to the data reported in the literature, low-grade gliomas, and embryonal tumors are the most frequent pediatric CNS tumors in Armenia. On the other hand, the pediatric CNS tumor survival rates are lower compared to those reported in developed countries.

Download Full-text

In VitroAntistaphylococcal Effects ofEmbelia schimperiExtracts and Their Component Embelin with Oxacillin and Tetracycline

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/175983 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 4

Author(s):

Johana Rondevaldova ◽

Olga Leuner ◽

Alemtshay Teka ◽

Ermias Lulekal ◽

Jaroslav Havlik ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Medicinal Plants ◽

Bacterial Infections ◽

Inhibitory Concentration ◽

Developed Countries ◽

Positive Interactions ◽

Fractional Inhibitory Concentration ◽

Broth Microdilution ◽

Microdilution Method ◽

Broth Microdilution Method

Bacterial infections are in less-developed countries traditionally treated by remedies prepared from medicinal plants.Embelia schimperi(Vatke) is a plant used as a taenicide or disinfectant in Ethiopia, very often taken mixed with another plant species. In the present study, we examined two extracts prepared from seeds and twigs with leaves ofE. schimperiand its main present secondary metabolite embelin for their antibacterial combinatory effect with oxacillin and tetracycline against sensitive and resistantStaphylococcus aureusstrains. Minimum inhibitory concentrations were determined through the broth microdilution method, whereas the combinatory effect was evaluated through fractional inhibitory concentration sum (ΣFIC) indices. Results show many positive interactions and synergy occurring in embelin and oxacillin combinations against 4 out of 9 strains (ΣFIC 0.203–0.477) and for embelin and tetracycline combination against 3 out of 9 strains (ΣFIC 0.400–0.496). Moreover, the resistance to oxacillin has been overcome in 2 strains and to tetracycline in 3 strains. According to our knowledge, this is the first study showing antimicrobial combinatory effect ofE. schimperias well as of embelin. These findings can be used for the further research targeted on the development of new antistaphylococcal agents.

Download Full-text

INTESTINAL PARASITE INFECTIONS

The Professional Medical Journal ◽

10.29309/tpmj/18.4691 ◽

2018 ◽

Vol 25 (10) ◽

pp. 1464-1468

Author(s):

Imdad Ali Ansari ◽

Jawed Akhtar Samo ◽

Mohammad Aslam Soomro

Keyword(s):

Intestinal Parasite ◽

Intestinal Parasites ◽

Clinical Manifestations ◽

Developed Countries ◽

Parasitic Infections ◽

Hymenolepis Nana ◽

Cross Sectional ◽

Multi Centre Study ◽

Climate Conditions ◽

Parasite Infections

Background: Worldwide, intestinal parasitic infections are major causeof human mortality and morbidity especially among developing countries wherein publichealth standards are not much better like developed countries. Intestinal parasiticinfections are linked with poor sanitation, lack of safe drinking water, inadequate dietaryand cultural habits and climate conditions. Objective: To assess the frequency, riskfactors and clinical manifestations related to intestinal parasite infections in patients withgastrointestinal disorders. Study Design: Cross-sectional multi-centre study. Setting:Department of Medicines, Chandka Medical College Larkana and Civil Hospital, KhairpurMirs. Period: 1st January 2017 to 31st December 2017. Method: 260 patients, the patientswith gastrointestinal disorders presenting one or more symptoms (e.g. diarrhea, dysentery,abdominal pain, nausea and vomiting, cramping and constipation) were included.Results: Frequency of intestinal parasites was 32.3%. The most common parasites wereEntamoeba histolytica (10.4%), Giardia lamblia (8.5%) and Hymenolepis nana (6.9%). Age,education, monthly income and contact with animal were significantly associated withintestinal parasite infections. Concerning symptoms, the presence of intestinal parasitesinfection was significantly associated with diarrhea and dysentery. Conclusion: Studyconcluded that most prevalent parasites were Entamoeba histolytica, Giardia lambliaand Hymenolepis nana. Significant association was found in age, education and monthlyincome.

Download Full-text

Neopterin as a marker of inflammation

Diagnostyka Laboratoryjna ◽

10.5604/01.3001.0004.1550 ◽

2015 ◽

Vol 51 (2) ◽

pp. 153-156

Author(s):

Magdalena Bartold ◽

Joanna Matowicka-Karna

Keyword(s):

Blood Serum ◽

Human Body ◽

Bacterial Infections ◽

Viral Infections ◽

Immunological Response ◽

Body Fluids ◽

Parasitic Infections ◽

Specific Marker ◽

Neopterin Concentration ◽

Living Bacteria

Neopterin is a non-specific marker of immunological response of human body of cellular type. It belongs to the chemical group known as pteridines. Neopterin has been widely associated with inter alia viral infections, bacterial infections (by intracellular living bacteria), parasitic infections, skin burns or autoimmune diseases. Neopterin is a very important parameter diagnostically not only in diagnosis and monitoring of treatment but also a reliable indicator of macrophages’ activity. Most frequently neopterin concentration is measured in body fluids like blood, serum or urine, but it may be used as an indicator in other body fluids.

Download Full-text

Assessment of symptoms on patients with urinary tract infections and adherence to medications

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i3.4776 ◽

2021 ◽

Vol 12 (3) ◽

pp. 1740-1744

Author(s):

Eva Lorel Kouassi ◽

Abdul Wahid Ishaque ◽

Amulya P. Shetty ◽

Rimpa Devi ◽

Sheethal Kuriakose ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Bacterial Infections ◽

Developed Countries ◽

P Value ◽

Strong Positive Correlation ◽

Early Assessment ◽

Tract Infections ◽

Outpatient Settings ◽

The Impact

Although urinary tract infections (UTIs) are considered to be the most common bacterial infections worldwide, their assessment remains a big clinical challenge, because they are not reportable diseases in developed countries like United States and any other parts of the world including India. This situation is further complicated by the fact that accurate diagnosis depends on both the presence of symptoms and a positive urine culture, although in most outpatient settings this diagnosis is made without the benefit of culture. Our study aimed to appraise the impact of urinary tract infections symptoms on selected patients and comprehend their adherence to medications despite the challenges of antimicrobial susceptibility and resistance observed. One hundred and twenty patients with confirmed cases of urinary tract infections were recruited for the study. The mean age of females and males patients was found to be 59.86±2.37and 52.27±3 years respectively. Pertinent descriptive and inferential statistics were performed. Spearman correlation test revealed a strong positive correlation between overall UTIs’ symptoms and their impact on patients at baseline (0.84) and at follow up (0.799) with p value =0.5. On the other hand the majority of patients were found to be adherent to the medications after discharge. The current study revealed that Urinary tract infections if left untreated can negatively impact the lives of patients suffering from it and hinder their adherence to medications. Consequently, accurate and early assessment of UTIs’ symptoms in clinics and hospitals becomes a necessity.

Download Full-text

Case report of congenital asplenia presenting with Haemophilus influenzae type a (Hia) sepsis: an emerging pediatric infection in Minnesota

BMC Infectious Diseases ◽

10.1186/s12879-019-4572-4 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Tiffany Albrecht ◽

Kristina Poss ◽

Satja Issaranggoon Na Ayuthaya ◽

Lori Triden ◽

Katherine L. Schleiss ◽

...

Keyword(s):

Haemophilus Influenzae ◽

American Indian ◽

Bacterial Infections ◽

Type A ◽

Invasive Disease ◽

Haemophilus Influenzae Type ◽

Uneventful Recovery ◽

Antibiotic Administration ◽

Indian Children ◽

Disease Manifestation

Abstract Background In the pre-vaccine era, invasive disease with Haemophilus influenzae, type b (Hib) commonly presented with osteoarticular involvement. Haemophilus influenzae, type a (Hia) sepsis is a rare but emerging problem in recent years. Here, we report a case of sepsis with concomitant osteoarthritis due to Hia that was the presenting infectious disease manifestation of isolated asplenia in a young child. This unique observation adds to our understanding of sepsis and asplenia in children. Case presentation A five-year-old girl developed acute Hia bacteremia and sepsis. The patient developed arthritis shortly after onset of septic shock. Arthrocentesis was culture-negative, but given the difficulty differentiating between septic and reactive arthritis, prolonged antibiotic administration was provided for presumed osteoarticular infection, and the patient had an uneventful recovery. The finding of Howell-Jolly bodies on blood smear at the time of presentation prompted an evaluation that revealed isolated congenital asplenia. Evaluation for known genetic causes of asplenia was unrevealing. Investigation by the Minnesota Department of Health revealed an emergence of Hia infections over the past 5 years, particularly in children with an American Indian background. Conclusions Hia is an important pathogen in the differential diagnosis of invasive bacterial infections in children and shares overlap in clinical presentation and pathogenesis with Hib. Invasive Hia disease can be a presenting manifestation of asplenia in children. Hia is an emerging pathogen in American Indian children.

Download Full-text

Evaluation of a Particle-enhanced Turbidimetric Immunoassay for the Measurement of Immunoglobulin E in an ILab 900 Analyzer

Clinical Chemistry ◽

10.1093/clinchem/45.9.1557 ◽

1999 ◽

Vol 45 (9) ◽

pp. 1557-1561

Author(s):

Sandra Guaita ◽

Josep MA Simó ◽

Natàlia Ferré ◽

Jorge Joven ◽

Jordi Camps

Keyword(s):

General Chemistry ◽

Detection Limit ◽

Immunoglobulin E ◽

Parasitic Infections ◽

Attractive Alternative ◽

Allergic Reactions ◽

Automated Assay ◽

Serum Assay ◽

Microparticle Enzyme Immunoassay ◽

Turbidimetric Immunoassay

Abstract Background: The measurement of immunoglobulin E (IgE) in serum is widely used in the diagnosis of allergic reactions and parasitic infections. We describe here a fully automated assay for human IgE suitable for routine application in a general chemistry analyzer. Methods: We used an ILab 900® analyzer. This instrument automates a particle-enhanced immunoturbidimetric assay with an analysis time of 9 min. Results: The assay was linear in the range 4–1000 kIU/L (r = 0.9998). The intra- and interassay CVs at 57, 235, and 434 kIU/L were <3.5% and <7.4%, respectively. The detection limit was 4 kIU/L. Hemoglobin (≤16 g/L), bilirubin (≤250 μmol/L), and myeloma paraproteins did not interfere with the assay. The assay showed good correlation with a microparticle enzyme immunoassay (r = 0.998) with a mean difference between methods of −6 ± 26 kIU/L. Conclusion: The new automated serum assay for IgE is an attractive alternative that avoids the need for dedicated instrumentation.

Download Full-text

Ultrasonography for Interval Assessment in the Nonoperative Management of Hepatic Trauma

The American Surgeon ◽

10.1177/000313480507101010 ◽

2005 ◽

Vol 71 (10) ◽

pp. 841-846 ◽

Cited By ~ 4

Author(s):

William C. Chiu ◽

Jade J. Wong-You-Cheong ◽

Aurelio Rodriguez ◽

K. Shanmuganathan ◽

Stuart E. Mirvis ◽

...

Keyword(s):

Imaging Modality ◽

Operative Management ◽

Biliary Fistula ◽

Low Grade ◽

Trauma Patients ◽

Hepatic Trauma ◽

Abdominal Ultrasonography ◽

Radiologic Study ◽

Grade Ii

Abdominal ultrasonography (US) is gaining widespread acceptance as a valuable diagnostic tool in the initial evaluation of trauma victims. We investigated the utility of US as a follow-up radiologic study in nonoperative hepatic trauma. Patients with liver injury designated for non-operative management were prospectively studied over a 2-year period at our primary adult resource center for trauma. Computed tomography (CT) and radiologist-performed US were obtained at admission and at 1 week. The ability of US to detect lesions, fluid, and complications was evaluated by comparing with the corresponding CT. Twenty-five hepatic trauma patients in the study were successfully managed nonoperatively and had both initial and follow-up US and CT scans: 1 (4%) grade I, 5 (20%) grade II, 7 (28%) grade III, 7 (28%) grade IV, and 5 (20%) grade V. Four complications developed [biloma (3) and biliary fistula (1)] in 3 patients with grade IV injury and 1 with a grade II injury. Interval US appropriately detected a complication or confirmed the absence of complication in all (13/13, 100%) patients with low-grade (I–III) injury and only missed a small biloma in one patient with a grade IV injury. Interval US and CT agreement was 92 per cent for change in hemoperitoneum or parenchymal lesion. Ultrasonography is a convenient imaging modality in the evaluation of hepatic trauma. US is sufficient to detect or exclude complications in low-grade injuries. In high-grade injuries, US may be an adjunct to CT for definitive interval assessment.

Download Full-text