RESUMEN
This paper describes 2 new myxosporean species, Henneguya lepturus sp. nov. and Thelohanellus lepturus sp. nov., simultaneously infecting the brain and spinal cord of Hypopygus lepturus Hoedeman, 1962 (Teleostei, Hypopomidae) from the Brazilian Amazon (Roraima State). Several spherical cysts of varying dimensions (up to 135 µm) were microscopically observed. The myxospores of H. lepturus sp. nov. measured 25.8 µm in total length, having an ellipsoidal body (12.4 × 6.4 × 2.2 µm) and 2 equal tapering tails (13.4 µm in length). Each of the 2 pyriform polar capsules measured 4.4 × 1.6 µm and possessed a polar filament coiled in 8-9 turns. The myxospores of T. lepturus sp. nov. were pyriform, formed by 2 equal valves (17.7 × 9.1 × 4.3 µm) surrounding a single polar capsule (10.9 × 3.5 µm) that had a coiled polar filament with 13-16 turns and a binucleated sporoplasm that contained several circular sporoplasmosomes. Molecular analysis of the small subunit (SSU) rRNA gene sequences of these 2 species were in agreement with the taxonomic classification derived from the ultrastructure of the myxospores. Histopathology of the host tissue showed degradation of the myelinated axons surrounding the cysts of both species, with the hosts displaying behavioural changes and erratic movements when observed in an aquarium.
Asunto(s)
Infecciones Parasitarias del Sistema Nervioso Central/veterinaria , Enfermedades de los Peces/parasitología , Peces , Myxozoa/clasificación , Enfermedades Parasitarias en Animales/parasitología , Animales , Brasil/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/parasitología , Enfermedades de los Peces/epidemiología , Myxozoa/anatomía & histología , Myxozoa/genética , Myxozoa/aislamiento & purificación , Enfermedades Parasitarias en Animales/epidemiología , Filogenia , Especificidad de la EspecieAsunto(s)
Alveolados , Infecciones Parasitarias del Sistema Nervioso Central/parasitología , Infecciones por Protozoos/parasitología , Enfermedades por Picaduras de Garrapatas/parasitología , Alveolados/genética , Antibacterianos/uso terapéutico , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/tratamiento farmacológico , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , China/epidemiología , Doxiciclina/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Infecciones por Protozoos/sangre , Infecciones por Protozoos/tratamiento farmacológico , Infecciones por Protozoos/epidemiología , Enfermedades por Picaduras de Garrapatas/tratamiento farmacológico , Enfermedades por Picaduras de Garrapatas/epidemiologíaRESUMEN
Parasitic diseases of the central nervous system are associated with high mortality and morbidity, especially in resource-limited settings. The burden of these diseases is amplified as survivors are often left with neurologic sequelae affecting mobility, sensory organs, and cognitive functions, as well as seizures/epilepsy. These diseases inflict suffering by causing lifelong disabilities, reducing economic productivity, and causing social stigma. The complexity of parasitic life cycles and geographic specificities, as well as overlapping clinical manifestations in the host reflecting the diverse pathogenesis of parasites, can present diagnostic challenges. We herein provide an overview of these parasitic diseases and summarize clinical aspects, diagnosis, therapeutic strategies and recent milestones, and aspects related to prevention and control.
Asunto(s)
Personal Administrativo , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/terapia , Manejo de la Enfermedad , Personal Administrativo/psicología , Antiparasitarios , Infecciones Parasitarias del Sistema Nervioso Central/complicaciones , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , HumanosRESUMEN
Most of the parasitoses manifest systemically, including the central nervous system (CNS). Among the most prevalent parasitoses in Central Europe (cysticercosis, toxocarosis, echinococcosis, and toxoplasmosis), cerebral involvement is well recognized and part of the clinical presentation, which cannot be neglected. CNS involvement results from invasion of larvae of these parasites via the blood stream or by direct migration into the CNS. Most frequently larvae reside within the cerebral parenchyma, but sometimes also within the ventricles, in the meningeas within cerebral aneurysms, or in the parenchyma of the spinal cord. Depending on the stage of their development, they cause a local defect or more widespread damage, such as encephalitis, ventriculitis, ependymitis, arachnoiditis, meningitis, myelitis, polyradiculitis, mechanical obstruction of the arterial or cerebrospinal fluid (CSF) flow, or vasculitis with appropriate clinical presentations. These include epilepsy, headache, impaired consciousness, orientation, cognition, focal neurological motor, sensory, or vegetative deficits, or visual impairment. CNS involvement is diagnosed on the clinical presentation, the epidemiological background, blood and CSF investigations, imaging studies, and sometimes biopsy. Treatment is based on various antihelminthic agents and, occasionally, surgery.
Asunto(s)
Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/terapia , Infecciones Parasitarias del Sistema Nervioso Central/transmisión , Comorbilidad , Estudios Transversales , Países en Desarrollo , Emigrantes e Inmigrantes , Europa (Continente) , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/epidemiología , Infecciones Oportunistas/terapia , Infecciones Oportunistas/transmisión , ViajeRESUMEN
Eosinophilic meningitis (EoM) is an acute disease that affects the central nervous system. It is primarily caused by infection with the nematode Angiostrongylus cantonensis. This infection was previously restricted to certain Asian countries and the Pacific Islands, but it was first reported in Brazil in 2007. Since then, intermediate and definitive hosts infected with A. cantonensis have been identified within the urban areas of many states in Brazil, including those in the northern, northeastern, southeastern and southern regions. The goals of this review are to draw the attention of the medical community and health centres to the emergence of EoM in Brazil, to compile information about several aspects of the human infection and mode of transmission and to provide a short protocol of procedures for the diagnosis of this disease.
Asunto(s)
Infecciones Parasitarias del Sistema Nervioso Central , Eosinofilia , Meningitis , Infecciones por Strongylida , Angiostrongylus cantonensis , Animales , Brasil/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/tratamiento farmacológico , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Enfermedades Transmisibles Emergentes , Eosinofilia/diagnóstico , Eosinofilia/tratamiento farmacológico , Eosinofilia/epidemiología , Eosinofilia/parasitología , Humanos , Meningitis/diagnóstico , Meningitis/tratamiento farmacológico , Meningitis/epidemiología , Meningitis/parasitología , Caracoles/parasitología , Infecciones por Strongylida/diagnóstico , Infecciones por Strongylida/tratamiento farmacológico , Infecciones por Strongylida/epidemiologíaRESUMEN
Eosinophilic meningitis (EoM) is an acute disease that affects the central nervous system. It is primarily caused by infection with the nematode Angiostrongylus cantonensis. This infection was previously restricted to certain Asian countries and the Pacific Islands, but it was first reported in Brazil in 2007. Since then, intermediate and definitive hosts infected with A. cantonensis have been identified within the urban areas of many states in Brazil, including those in the northern, northeastern, southeastern and southern regions. The goals of this review are to draw the attention of the medical community and health centres to the emergence of EoM in Brazil, to compile information about several aspects of the human infection and mode of transmission and to provide a short protocol of procedures for the diagnosis of this disease.
Asunto(s)
Animales , Humanos , Infecciones Parasitarias del Sistema Nervioso Central , Eosinofilia , Meningitis , Infecciones por Strongylida , Angiostrongylus cantonensis , Brasil/epidemiología , Enfermedades Transmisibles Emergentes , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/tratamiento farmacológico , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Eosinofilia/diagnóstico , Eosinofilia/tratamiento farmacológico , Eosinofilia/epidemiología , Eosinofilia/parasitología , Meningitis/diagnóstico , Meningitis/tratamiento farmacológico , Meningitis/epidemiología , Meningitis/parasitología , Caracoles/parasitología , Infecciones por Strongylida/diagnóstico , Infecciones por Strongylida/tratamiento farmacológico , Infecciones por Strongylida/epidemiologíaRESUMEN
Infections of the central nervous system are a significant cause of neurologic dysfunction in resource-limited countries, especially in Africa. The prevalence is not known and is most likely underestimated because of the lack of access to accurate diagnostic screens. For children, the legacy of subsequent neurodisability, which affects those who survive, is a major cause of the burden of disease in Africa. Of the parasitic infections with unique effect in Africa, cerebral malaria, neurocysticercosis, human African trypanosomiasis, toxoplasmosis, and schistosomiasis are largely preventable conditions, which are rarely seen in resource-equipped settings. This article reviews the current understandings of these parasitic and other rarer infections, highlighting the specific challenges in relation to prevention, diagnosis, treatment, and the complications of coinfection.
Asunto(s)
Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Enfermedades Transmisibles/epidemiología , Neurología , Pediatría , África/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/terapia , Niño , HumanosRESUMEN
Rhizobiales (formerly named Rickettsiales) cause in rare instances meningitis and meningovasculitis, respectively. In case of history of exposure, infection by Rhizobiales needs to be considered since both diagnosis and therapy may be extremely difficult and pathogen-specific. The same applies to protozoa; in this chapter, Babesia species, free-living amoebae and Entamoeba histolytica infection, including severe meningitis and brain abscess, infection by Trypanosoma species (South American and African trypanosomiasis) are discussed with respect to history, epidemiology, clinical signs, and symptoms as well as differential diagnosis and therapy. Parasitic flatworms and roundworms, potentially able to invade the central nervous system, trematodes (flukes), cestodes (in particular, Cysticercus cellulosae), but also nematodes (in particular, Strongyloides spp. in the immunocompromised) are of worldwide importance. In contrast, filarial worms, Toxocara spp., Trichinella spp., Gnathostoma and Angiostrongylus spp. are seen only in certain geographically confined areas. Even more regionally confined are infestations of the central nervous system by metazoa, in particular, tongue worms (=arthropods) or larvae of flies (=maggots). The aim of this chapter is (1) to alert the neurologist to these infections, and (2) to enable the attending emergency neurologist to take a knowledgeable history, with an emphasis on epidemiology, clinical signs, and symptoms as well as therapeutic management possibilities.
Asunto(s)
Infecciones Bacterianas del Sistema Nervioso Central/terapia , Infecciones Parasitarias del Sistema Nervioso Central/terapia , Infecciones Protozoarias del Sistema Nervioso Central/terapia , Infecciones por Rickettsia/terapia , Animales , Infecciones Bacterianas del Sistema Nervioso Central/epidemiología , Infecciones Bacterianas del Sistema Nervioso Central/microbiología , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/parasitología , Infecciones Protozoarias del Sistema Nervioso Central/epidemiología , Infecciones Protozoarias del Sistema Nervioso Central/parasitología , Helmintiasis/epidemiología , Helmintiasis/parasitología , Helmintiasis/terapia , Humanos , Enfermedades Parasitarias/epidemiología , Enfermedades Parasitarias/parasitología , Enfermedades Parasitarias/terapia , Pentastomida , Infecciones por Rickettsia/epidemiología , Infecciones por Rickettsia/microbiologíaRESUMEN
Cerebral parasitic cysts constitute a major problem for livestock. Among these, coenurosis and toxoplasmosis are predominant. Here, a total number of 60 sheep obtained from a private farm in Suez province, Egypt, were examined postmortem to detect visible parasitic cysts, and microscopically to detect small-sized entities. Necropsy revealed bladder-like cysts measuring 0.5-6.5 cm in diameter that were filled with a translucent fluid containing a large number of protoscolices. Accordingly, the cysts were identified as the metacestode Coenurus cerebralis. Among the sheep examined, 11 animals (7 males and 4 females) (18.3%) were infected. Most of the cysts were located in the cerebral hemispheres, with numbers ranging from one to three per infected animal. The effect of the presence of cysts in the brain tissue was evaluated. Histopathologically, pseudocysts of the apicomplexan Toxoplasma gondii were found in two animals with no detectable inflammatory cell reactions. In conclusion, coenurosis and toxoplasmosis are serious parasitic problems that play a significant role in sheep management in Egypt, as a result of close contact between livestock and dogs and cats, which play a critical role in the life cycle of these parasites.
Asunto(s)
Encefalopatías/veterinaria , Infecciones Parasitarias del Sistema Nervioso Central/veterinaria , Infecciones por Cestodos/veterinaria , Enfermedades de las Ovejas/diagnóstico , Toxoplasmosis Animal/diagnóstico , Animales , Encefalopatías/diagnóstico , Encefalopatías/epidemiología , Encefalopatías/parasitología , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Infecciones por Cestodos/diagnóstico , Infecciones por Cestodos/epidemiología , Egipto/epidemiología , Monitoreo Epidemiológico , Femenino , Masculino , Ovinos , Enfermedades de las Ovejas/epidemiología , Enfermedades de las Ovejas/patología , Toxoplasmosis Animal/epidemiologíaRESUMEN
Cerebral parasitic cysts constitute a major problem for livestock. Among these, coenurosis and toxoplasmosis are predominant. Here, a total number of 60 sheep obtained from a private farm in Suez province, Egypt, were examined postmortem to detect visible parasitic cysts, and microscopically to detect small-sized entities. Necropsy revealed bladder-like cysts measuring 0.5-6.5 cm in diameter that were filled with a translucent fluid containing a large number of protoscolices. Accordingly, the cysts were identified as the metacestode Coenurus cerebralis. Among the sheep examined, 11 animals (7 males and 4 females) (18.3%) were infected. Most of the cysts were located in the cerebral hemispheres, with numbers ranging from one to three per infected animal. The effect of the presence of cysts in the brain tissue was evaluated. Histopathologically, pseudocysts of the apicomplexan Toxoplasma gondii were found in two animals with no detectable inflammatory cell reactions. In conclusion, coenurosis and toxoplasmosis are serious parasitic problems that play a significant role in sheep management in Egypt, as a result of close contact between livestock and dogs and cats, which play a critical role in the life cycle of these parasites.
Cistos cerebrais parasitários constituem um grande problema para o gado. Entre estes, coenurosis e toxoplasmose são predominantes. Aqui, um número total de 60 ovelhas obtidas em uma fazenda particular na província Suez, Egito, foram examinadas post-mortem para a detecção de cistos parasitários visíveis e microscopicamente para detectar cistos de pequenas dimensões. A necropsia revelou cistos medindo entre 0,5-6,5 cm de diâmetro, preenchidos com um fluido transparente, contendo um grande número de protoscolices. Por conseguinte, os cistos foram identificados como o metacestóide Coenurus cerebralis. Entre as ovelhas examinadas, 11 animais (7 machos e 4 fêmeas) (18,3%) estavam infectados. A maior parte dos cistos estavam localizados nos hemisférios cerebrais, com números variando de um a três em ovinos infectados. O efeito da presença de cistos no tecido do cérebro foi avaliado. Histopatologicamente, pseudocistos de Toxoplasma gondii foram encontrados em dois animais sem reações inflamatórias detectáveis. Em conclusão, coenurosis e toxoplasmose são graves problemas parasitários que desempenham um papel significativo no manejo de ovelhas no Egito, como resultado do contacto íntimo dos animais com os cães e gatos, que desempenham um papel crítico no ciclo de vida desses parasitas.
Asunto(s)
Animales , Masculino , Femenino , Cisticercosis/veterinaria , Encefalopatías/veterinaria , Infecciones Parasitarias del Sistema Nervioso Central/veterinaria , Infecciones por Cestodos/veterinaria , Enfermedades de las Ovejas/diagnóstico , Toxoplasmosis Animal/diagnóstico , Encefalopatías/diagnóstico , Encefalopatías/epidemiología , Encefalopatías/parasitología , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Infecciones por Cestodos/diagnóstico , Infecciones por Cestodos/epidemiología , Egipto/epidemiología , Monitoreo Epidemiológico , Ovinos , Enfermedades de las Ovejas/epidemiología , Enfermedades de las Ovejas/patología , Toxoplasmosis Animal/epidemiologíaRESUMEN
HIV infection is an important medical and social problem. In Poland, similarly to other countries, patients with HIV infections are mostly young people. Apart from typical immunologic pathologies, the HIV infection leads to some neurocognitive, motoric and behavioral disorders. The aim of this paper is to present the up-to-date knowledge of HIV-associated neurocognitive disorders (HAND).
Asunto(s)
Enfermedades Virales del Sistema Nervioso Central/epidemiología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Salud Mental/estadística & datos numéricos , Adolescente , Fármacos Anti-VIH/uso terapéutico , Infecciones Bacterianas del Sistema Nervioso Central/epidemiología , Infecciones Bacterianas del Sistema Nervioso Central/virología , Infecciones Fúngicas del Sistema Nervioso Central/epidemiología , Infecciones Fúngicas del Sistema Nervioso Central/virología , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/virología , Enfermedades Virales del Sistema Nervioso Central/tratamiento farmacológico , Enfermedades Virales del Sistema Nervioso Central/virología , Comorbilidad , Femenino , Estado de Salud , Humanos , Masculino , Pruebas Neuropsicológicas , Polonia/epidemiología , Adulto JovenRESUMEN
Cerebral involvement in parasitoses is an important clinical manifestation of most of the human parasitoses. Parasites that have been described to affect the central nervous system (CNS), either as the dominant or as a collateral feature, include cestodes (Taenia solium (neurocysticerciasis), Echinococcus granulosus (cerebral cystic echinococcosis), E. multilocularis (cerebral alveolar echinococcosis), Spirometra mansoni (neurosparganosis)), nematodes (Toxocara canis and T. cati (neurotoxocariasis), Trichinella spiralis (neurotrichinelliasis), Angiostrongylus cantonensis and A. costaricensis (neuroangiostrongyliasis), Gnathostoma spinigerum (gnathostomiasis)), trematodes (Schistosoma mansoni (cerebral bilharziosis), Paragonimus westermani (neuroparagonimiasis)), or protozoa (Toxoplasma gondii (neurotoxoplasmosis), Acanthamoeba spp. or Balamuthia mandrillaris (granulomatous amoebic encephalitis), Naegleria (primary amoebic meningo-encephalitis), Entamoeba histolytica (brain abscess), Plasmodium falciparum (cerebral malaria), Trypanosoma brucei gambiense/rhodesiense (sleeping sickness) or Trypanosoma cruzi (cerebral Chagas disease)). Adults or larvae of helminths or protozoa enter the CNS and cause meningitis, encephalitis, ventriculitis, myelitis, ischaemic stroke, bleeding, venous thrombosis or cerebral abscess, clinically manifesting as headache, epilepsy, weakness, cognitive decline, impaired consciousness, confusion, coma or focal neurological deficits. Diagnosis of cerebral parasitoses is dependent on the causative agent. Available diagnostic tools include clinical presentation, blood tests (eosinophilia, plasmodia in blood smear, antibodies against the parasite), cerebrospinal fluid (CSF) investigations, imaging findings and occasionally cerebral biopsy. Treatment relies on drugs and sometimes surgery. Outcome of cerebral parasitoses is highly variable, depending on the effect of drugs, whether they are self-limiting (e.g. Angiostrongylus costaricensis) or whether they remain undetected or asymptomatic, like 25% of neurocysticerciasis cases.
Asunto(s)
Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/parasitología , Parásitos/clasificación , Parásitos/aislamiento & purificación , Animales , Antiparasitarios/uso terapéutico , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/patología , Técnicas de Laboratorio Clínico/métodos , Medicina Clínica/métodos , HumanosRESUMEN
In cases of central nervous system infection, it is crucial for the neuroradiologist to provide an accurate differential diagnosis of the possible pathogens involved so that treating physicians can be aided in the choice of empiric therapy. This approach requires the radiologist to be aware of local epidemiology and have knowledge of infectious agents that are endemic to their area of practice. This article reviews and discusses the changing epidemiology of pathogens most often observed in meningitis, brain abscess, epidural abscess, postoperative infections, and human immunodeficiency virus infection.
Asunto(s)
Infecciones Bacterianas/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Meningitis Bacterianas/epidemiología , Meningitis Fúngica/epidemiología , Meningitis Viral/epidemiología , Meningitis/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/prevención & control , Infecciones Oportunistas Relacionadas con el SIDA/transmisión , Infecciones Bacterianas/diagnóstico , Infecciones Bacterianas/prevención & control , Infecciones Bacterianas/transmisión , Absceso Encefálico/diagnóstico , Absceso Encefálico/epidemiología , Absceso Encefálico/prevención & control , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/prevención & control , Infecciones Parasitarias del Sistema Nervioso Central/transmisión , Estudios Transversales , Países en Desarrollo , Diagnóstico Diferencial , Humanos , Meningitis/diagnóstico , Meningitis/prevención & control , Meningitis Bacterianas/diagnóstico , Meningitis Bacterianas/prevención & control , Meningitis Bacterianas/transmisión , Meningitis Fúngica/diagnóstico , Meningitis Fúngica/prevención & control , Meningitis Fúngica/transmisión , Meningitis Viral/diagnóstico , Meningitis Viral/prevención & control , Meningitis Viral/transmisión , Pronóstico , Factores de Riesgo , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/epidemiología , Infección de la Herida Quirúrgica/prevención & control , Viaje , VacunaciónRESUMEN
Neurocysticercosis is an endemic disease in Latin America, Asia and Africa with growing occurrence in industrialized countries due to the increase in migration from low- and middle-income to high-income countries. The most severe clinical presentation is when the parasite is located in the subarachnoid space at the base of the brain (NCSAB). Aside from its clinical presentation, the severity of this form of the disease is due to the difficulties in diagnosis and treatment. Although NCSAB frequency is lower than that reported for the parenchymal location of the parasite, its clinical relevance must be emphasized. We provide a critical review of the central epidemiological, clinical, diagnostic and therapeutic features of this particular form of the disease, which is still associated with unacceptably high rates of morbidity and mortality.
Asunto(s)
Infecciones Parasitarias del Sistema Nervioso Central/fisiopatología , Neurocisticercosis/fisiopatología , Espacio Subaracnoideo/parasitología , Adulto , África/epidemiología , Animales , Asia/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico por imagen , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/parasitología , Niño , Preescolar , Enfermedades Endémicas , Humanos , América Latina/epidemiología , Imagen por Resonancia Magnética , Neurocisticercosis/diagnóstico por imagen , Neurocisticercosis/epidemiología , Neurocisticercosis/parasitología , Radiografía , Espacio Subaracnoideo/diagnóstico por imagen , Taenia soliumRESUMEN
Parasitic infections, though endemic to certain regions, have over time appeared in places far removed from their original sites of occurrence facilitated probably by the increase in world travel and the increasing migration of people from their native lands to other, often distant, countries. The frequency of occurrence of some of these diseases has also changed based on a variety of factors, including the presence of intermediate hosts, geographic locations, and climate. One factor that has significantly altered the epidemiology of parasitic diseases within the central nervous system (CNS) is the HIV pandemic. In this review of the pathology of parasitic infections that affect the CNS, each parasite is discussed in the sequence of epidemiology, life cycle, pathogenesis, and pathology.
Asunto(s)
Infecciones Parasitarias del Sistema Nervioso Central/patología , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/fisiopatología , HumanosRESUMEN
Although helminth infections of the central nervous system (CNS) are rare, their public health implications must not be neglected. Indeed, several helminth species can cause cerebrospinal infections, especially if humans serve as intermediate or non-permissive host. The diagnosis of cerebrospinal helminthiases is difficult, and the detection of parasites in cerebrospinal fluid is rarely successful. Cerebrospinal helminth infections therefore often remain undetected, and hence prognosis is poor. Increases in tourism and population movements are risk factors for cerebrospinal helminthiases and infections pose particular challenges to clinicians in non-endemic areas. In this review, we focus primarily on food-borne helminthiases that are endemic and often emerging in Southeast Asia and the Far East, namely angiostrongyliasis, gnathostomiasis, sparganosis, paragonimiasis and cysticercosis. Additionally, we discuss neuroschistosomiasis, a disease that is transmitted through human-water contact. For each disease, we describe the pathogen, its transmission route and possible mechanisms for entering the CNS. We also summarise common signs and symptoms, challenges and opportunities for diagnosis, treatment, clinical management, geographical distribution and epidemiology. The adoption of a comprehensive set of diagnostic criteria for different cerebrospinal helminthiases is proposed, including epidemiological history, typical signs and symptoms, neuroimaging and laboratory findings. Finally, risk factors, and research needs for enhanced patient management and population-based control measures are discussed.
Asunto(s)
Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Enfermedades Transmitidas por los Alimentos/epidemiología , Helmintiasis/epidemiología , Animales , Antihelmínticos/uso terapéutico , Asia Sudoriental/epidemiología , Sistema Nervioso Central/diagnóstico por imagen , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/parasitología , Infecciones Parasitarias del Sistema Nervioso Central/patología , Líquido Cefalorraquídeo/parasitología , Control de Enfermedades Transmisibles/métodos , Emigración e Inmigración , Asia Oriental/epidemiología , Enfermedades Transmitidas por los Alimentos/diagnóstico , Enfermedades Transmitidas por los Alimentos/parasitología , Enfermedades Transmitidas por los Alimentos/patología , Helmintiasis/diagnóstico , Helmintiasis/parasitología , Helmintiasis/patología , Helmintos/aislamiento & purificación , Humanos , Anamnesis , Radiografía , Factores de Riesgo , ViajeRESUMEN
OBJECTIVE: To investigate the epidemiology, clinical characteristics, therapeutic approaches and outcomes of parasitic encephalopathy. METHODS: A retrospective study was carried out to analyze 78 cases of parasitic encephalopathy in Huashan Hospital between June 2003 and June 2008. RESULTS: There were 52 male and 26 female patients with a mean age of (34.5+/-11.4) years. Among these patients, 32.1% (25/78) had a history of eating raw, neurocysticercosis accounted for 78.2% (61/78), cerebral sparganosis 15.4% (12/78), cerebral paragonimiasis 3.8% (3/78), and cerebral toxoplasmosis 2.6% (2/78). The common clinical features were epilepsy, headache, nausea, vomiting, vision and hearing loss, facial paralysis and mental retardation. Internal medical therapy resulted in an improvement in 69.2% of the patients. 7 out of 9 patients got improved or cured by combined surgical and internal medical treatment. 42 cases were diagnosed as parasitic encephalopathy while 36 cases (46.1%) were once misdiagnosed as other disorders. CONCLUSION: Parasitic encephalopathy is associated with a history of eating raw, with a high rate of misdiagnosis. Internal medicine combined with surgery is an effective way for the therapy.
Asunto(s)
Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neurocisticercosis/epidemiología , Neuroesquistosomiasis/epidemiología , Estudios Retrospectivos , Toxoplasmosis Cerebral/epidemiología , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVES: This retrospective study was carried out to describe the epidemiological, clinical and aetiological profile of parasitic and fungal neuroinfections at the Infectious Diseases Clinic in Fann Teaching Hospital in Dakar. PATIENTS AND METHODS: Data were collected for analysis from patients files recorded from January 1, 2001 to December 31, 2003. RESULTS: We found 126 cases of parasitic and fungal neuroinfections, representing 62% of the total of neuroinfections cases (126/203) and 27% of cerebro-meningeal diseases encountered at the clinic during the study period (126/470). Sex ratio M/F was 1.7 and the mean age of patients was 32 years +/- 14.4. Thirty seven patients (30%) were HIV seropositive. Aetiologies were represented by cerebral malaria (85 cases), neuromeningeal cryptococcosis (37 cases) and toxoplasmosis (4 cases). The overall case fatality rate was 38% (48 deaths/126). The fatality rate varied according to aetiologies: 27% in cerebral malaria, and 59.5% in neuromeningeal cryptococcosis that was found mainly among HIV positive patients (34 cases/37). CONCLUSION: These results give evidence of the frequency and the gravity of the adult's cerebral malaria in Dakar, but also the growing place of the neuromeningeal cryptococcosis in the neuromeningeal opportunist pathology of HIV positive patients.
Asunto(s)
Infecciones Fúngicas del Sistema Nervioso Central , Infecciones Parasitarias del Sistema Nervioso Central , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Infecciones Fúngicas del Sistema Nervioso Central/diagnóstico , Infecciones Fúngicas del Sistema Nervioso Central/epidemiología , Infecciones Fúngicas del Sistema Nervioso Central/microbiología , Infecciones Parasitarias del Sistema Nervioso Central/diagnóstico , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Infecciones Parasitarias del Sistema Nervioso Central/parasitología , Niño , Femenino , Hospitales de Enseñanza , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Senegal , Adulto JovenRESUMEN
BACKGROUND: Hydatidosis is a parasitic endemic disease in Tunisia. The liver and lung are the most common sites of involvement; however, it can develop anywhere in the body. AIM: The aim of the present study was to analyse the epidemiological features of extrapulmonary hydatid cysts and compare our results with those reported in literature. METHODS: A retrospective study of 265 extrapulmonary hydatid cysts collected over the 18-year period from 1990 to 2007 was undertaken. RESULTS: There were 101 male and 164 female patients (sex ratio M/F = 0.61) ranging in age from 2 to 84 years (mean age = 38.7). In our series, hydatid cysts involved mainly the kidney (24.1%), the central nervous system (22.6%), the liver (19.6%) and the spleen (11.3%). The other less frequent sites included the peritoneum (n = 9), heart (n = 9), bone (n = 6), adrenal gland (n = 4), epiploon (n = 4), orbit (n = 4), ovary (n = 3), prostate (n = 2), bladder (n = 2), breast (n = 2), Douglas' cul-de-sac (n = 2), diaphragm (n = 1), testis (n = 1), broad ligament (n = 1), mediastinum (n = 1), nasal cavity (n = 1), soft tissue (n = 1), abdominal wall (n = 1), parotid gland (n = 1), psoas muscle (n = 1), synovia (n = 1), thymus (n = 1) et le pancreas (n = 1). CONCLUSION: In contrast to literature, our results show that hydatid cysts of the kidney and of the central nervous system are more frequent than hepatic location which occupies the 3rd rank.
Asunto(s)
Equinococosis/epidemiología , Equinococosis/parasitología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Infecciones Parasitarias del Sistema Nervioso Central/epidemiología , Niño , Preescolar , Enfermedades del Sistema Digestivo/epidemiología , Enfermedades del Sistema Digestivo/parasitología , Equinococosis/patología , Enfermedades del Sistema Endocrino/epidemiología , Enfermedades del Sistema Endocrino/parasitología , Femenino , Enfermedades Urogenitales Femeninas/epidemiología , Enfermedades Urogenitales Femeninas/parasitología , Cardiopatías/epidemiología , Cardiopatías/parasitología , Humanos , Incidencia , Masculino , Enfermedades Urogenitales Masculinas/epidemiología , Enfermedades Urogenitales Masculinas/parasitología , Enfermedades del Mediastino/epidemiología , Enfermedades del Mediastino/parasitología , Persona de Mediana Edad , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Musculoesqueléticas/parasitología , Estudios Retrospectivos , Túnez/epidemiologíaRESUMEN
Eosinophilic meningoencephalitis is caused by a variety of helminthic infections. These worm-specific infections are named after the causative worm genera, the most common being angiostrongyliasis, gnathostomiasis, toxocariasis, cysticercosis, schistosomiasis, baylisascariasis, and paragonimiasis. Worm parasites enter an organism through ingestion of contaminated water or an intermediate host and can eventually affect the central nervous system (CNS). These infections are potentially serious events leading to sequelae or death, and diagnosis depends on currently limited molecular methods. Identification of parasites in fluids and tissues is rarely possible, while images and clinical examinations do not lead to a definitive diagnosis. Treatment usually requires the concomitant administration of corticoids and anthelminthic drugs, yet new compounds and their extensive and detailed clinical evaluation are much needed. Eosinophilia in fluids may be detected in other infectious and noninfectious conditions, such as neoplastic disease, drug use, and prosthesis reactions. Thus, distinctive identification of eosinophils in fluids is a necessary component in the etiologic diagnosis of CNS infections.