RESUMEN
Echinococcus granulosus sensu lato (s.l.) is a species complex with the potential to cause cystic echinococcosis (CE). Contact with the feces of domestic dogs (Canis familiaris) fed with raw viscera of intermediate livestock hosts is a risk factor for this infection in the southern region of Brazil. Although the region has been considered endemic to CE for many years, molecular data regarding the species of the complex causing CE in humans are scarce. This study aimed to perform a molecular analysis of the biological fluid from a human liver cyst to investigate the species responsible for CE. Genetic material obtained from the hydatid fluid of a hepatic cyst from a human with CE was subjected to PCR to amplify mitochondrial and nuclear DNA sequences. The phylogenetic analysis confirmed the human infection by Echinococcus canadensis G7 in the state of Paraná, Brazil. This is the first molecular record of E. canadensis G7 infecting a human in Brazil, and it is important to reiterate the risk of human CE caused by this species in South America, as reported by a previous study in Patagonia, Argentina. From the epidemiological point of view, this finding is of great relevance for the southern region of Brazil, since this parasite has previously only been detected in pigs in the state of Rio Grande do Sul, neighboring Paraná. The finding points to the importance of this identification in the molecular epidemiology of E. granulosus s.l., especially in South America.
Asunto(s)
ADN de Helmintos , Echinococcus , Filogenia , Animales , Humanos , Masculino , Brasil/epidemiología , ADN de Helmintos/genética , ADN Mitocondrial/genética , Equinococosis/veterinaria , Equinococosis/parasitología , Equinococosis/epidemiología , Echinococcus/genética , Echinococcus/clasificación , Echinococcus/aislamiento & purificación , Reacción en Cadena de la Polimerasa , Análisis de Secuencia de ADNRESUMEN
BACKGROUND: Echinococcus granulosus (sensu lato) (s.l.) and Echinococcus vogeli are causative agents of chronic zoonotic diseases such as cystic and polycystic echinococcosis, respectively. In Brazil, polycystic echinococcosis has a restricted geographical distribution in the North Region, while cystic echinococcosis is observed in the South Region. Domestic dogs (Canis familiaris) fed with raw viscera represent a risk factor for E. granulosus (s.l.) infection in the South Region. Although this practice is frequent, it remains unclear whether domestic dogs are infected with E. vogeli in the state of Acre, located in the Amazon basin in the North Region of Brazil. The aim of this study was to investigate this gap in the polycystic echinococcosis epidemiology. METHODS: Sixty-five fecal samples were collected from the ground in five municipalities (Sena Madureira, n = 14; Rio Branco, n = 06; Bujari, n = 06; Xapuri, n = 30; and Epitaciolândia, n = 09) located in the state of Acre, northern Brazil. The samples were screened for parasites by copro-PCR using the cox1 gene associated with automated sequencing. RESULTS: Echinococcus vogeli was molecularly confirmed in a sample from Sena Madureira and E. granulosus (sensu stricto) (s.s.) (G1) in a sample from Rio Branco. CONCLUSIONS: These findings indicate that molecular assays are useful in typing Echinococcus taxa from fecal samples of dogs in northern Brazil. The present study is the first molecular record of E. vogeli in domestic dogs found in the state of Acre, reinforcing their role as a source of infection for humans. Because E. granulosus (s.s.) (G1) was detected for the first time in the North Region, from the epidemiological standpoint this finding is highly relevant, because it expands the known geographical distribution, which was previously restricted to the South Region of Brazil.
Asunto(s)
Enfermedades de los Perros/parasitología , Equinococosis/veterinaria , Echinococcus/aislamiento & purificación , Heces/parasitología , Animales , Brasil/epidemiología , Enfermedades de los Perros/epidemiología , Perros , Equinococosis/epidemiología , Equinococosis/parasitología , Echinococcus/genética , Filogenia , ZoonosisRESUMEN
Our work represents the first case report of polycystic echinococcosis co-infection with HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV). Structural liver alterations were found to be related to parasitic structures and necroinflammatory foci (karyopyknosis, karyorrhexis, and karyolysis), consistent with Echinococcus vogeli. Visceral adipose tissue and intrahepatic triglyceride droplets (macrovesicular and microvesicular steatosis) indicated abnormal fat anabolism, which probably resulted from both viral-induced hepatopathy and drug-related toxicity. In summary, our results suggest that the observed liver abnormalities reflected the coincident exposure to hepatotropic viruses and parasites causing polycystic echinococcosis and were not indicative of opportunistic relationships among these pathogens.
Asunto(s)
Coinfección/patología , Equinococosis/patología , Infecciones por VIH/patología , Hepatitis B/patología , Hepatitis C/patología , Albendazol/uso terapéutico , Fármacos Anti-VIH/uso terapéutico , Anticestodos/uso terapéutico , Terapia Antirretroviral Altamente Activa , Coinfección/tratamiento farmacológico , Equinococosis/tratamiento farmacológico , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Hígado/parasitología , Hígado/patología , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
Echinococcus vogeli has been reported to cause human polycystic echinococcosis. A 43-year-old Brazilian woman was admitted to hospital complaining of mild epigastric discomfort. Computed tomography (CT) revealed multiple cystic lesions with calcified edges in several hepatic segments. At exploratory laparotomy, polycystic lesions were excised from the liver, omentum and peritoneum. No remaining cysts were observed on a post-surgery CT scan. The patient was asymptomatic when discharged on Day 19 post-operatively. She was prescribed albendazole therapy for 6 months. Follow-up CT performed 11 months later revealed no evidence of recurrence. Surgery combined with chemotherapy may improve the quality of life of patients with polycystic echinococcosis.
Asunto(s)
Equinococosis Hepática/tratamiento farmacológico , Equinococosis Hepática/cirugía , Adulto , Albendazol/uso terapéutico , Anticestodos/uso terapéutico , Terapia Combinada/métodos , Femenino , Humanos , Hígado/cirugía , Epiplón/cirugía , Peritoneo/cirugía , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
We report a case of human pulmonary dirofilariasis in a female patient 45-years-old, derived from Rio de Janeiro, Brazil. The chest radiologic finding consisted of single pulmonary nodule located on the left lower lobe that simulated lung tumor. Human pulmonary dirofilariasis might be investigated in nodules that are not malignants and require conclusive diagnosis.