1/8. A case of gastric pseudoterranoviasis in a 43-year-old man in korea. A case of Pseudoterranova decipiens infection was found in a 43-year-old man by gastroendoscopic examination on August 20, 1996. On August 6, 1996, he visited a local clinic, complaining of epigastric pain two days after eating raw marine fishes. Although the symptoms were relieved soon, endoscopic examination was done for differential diagnosis. A white, live nematode larva was removed from the fundus of the stomach. The larva was 38.3 x 1.0 mm in size and had a cecum reaching to the mid-level of the ventriculus. A lot of transverse striations were regularly arranged on the cuticle of its body surface, but the boring tooth and mucron were not observed at both ends of the worm. The worm was identified as the 4th stage larva of P. decipiens. ( info) |
2/8. Raccoon roundworm (Baylisascaris procyonis) encephalitis: case report and field investigation. Baylisascaris procyonis is a common and widespread parasite of raccoons in the united states and canada. With large raccoon populations occurring in many areas, the potential risk of human infection with B procyonis is high. We report a case of severe raccoon roundworm (B procyonis) encephalitis in a young child to illustrate the unique clinical, diagnostic, and treatment aspects, as well as public health concerns of B procyonis infection. Acute and convalescent serum and cerebrospinal fluid samples from the patient were tested for antibodies against B procyonis to assist in documenting infection. An extensive field survey of the patient's residence and the surrounding community was performed to investigate raccoon abundance and to determine the extent of raccoon fecal contamination and B procyonis eggs in the environment. The patient evidenced serologic conversion, and the field investigation demonstrated a raccoon population far in excess of anything previously reported. There was abundant evidence of B procyonis eggs associated with numerous sites of raccoon defecation around the patient's residence and elsewhere in the community. Because B procyonis can produce such severe central nervous system disease in young children, it is important that pediatricians are familiar with this infection. The public should be made aware of the hazards associated with raccoons and B procyonis to hopefully prevent future cases of B procyonis infection. ( info) |
3/8. Eosinophil-associated inflammation and elaboration of eosinophil-derived proteins in 2 children with raccoon roundworm (Baylisascaris procyonis) encephalitis. OBJECTIVE: Eosinophil-associated proteins, especially eosinophil-derived neurotoxin, may be important contributors to the neurologic pathology and symptoms caused by Baylisascaris procyonis infection. methods: Two cases of severe B procyonis encephalitis with evidence of marked eosinophil degranulation in the central nervous system are presented. Serial cerebrospinal fluid (CSF) specimens were collected from each patient during the course of their illness. antibodies against B procyonis were measured in the patients' serum and CSF. Levels of the eosinophilopoietin interleukin-5 (IL-5) and 2 important eosinophil proteins, eosinophil-derived neurotoxin and major basic protein, were assayed in the CSF. RESULTS: Both patients had rapidly progressive central nervous system disease with evidence of eosinophilic meningoencephalitis. Both tested positive for antibodies to B procyonis in serum and CSF and had progressively worsening deep white matter changes on magnetic resonance images of the brain. CSF levels of IL-5, eosinophil-derived neurotoxin, and major basic protein were markedly elevated over controls. CONCLUSIONS: This is the first report of the measurement of IL-5, eosinophil-derived neurotoxin, and major basic protein in human CSF. In addition to traumatic damage and necrosis caused by migrating larvae, eosinophil-derived neurotoxin from associated eosinophilic inflammation may be an important contributory factor in the pathogenesis of B procyonis encephalitis. parasite, eosinophil-derived-neurotoxin, major basic protein, eosinophilia, hypereosinophilia, interleukin-5, encephalitis, child. ( info) |
4/8. Eye findings of diffuse unilateral subacute neuroretinitis and multiple choroidal infiltrates associated with neural larva migrans due to Bbaylisascaris procyonis. PURPOSE: To report childhood infection with Baylisascaris procyonis (raccoon round worm) manifesting as diffuse unilateral subacute neuroretinitis (DUSN) and choroidal infiltrates in association with neurologic disease (neural larva migrans).METHOD: Observational case series, one with eye manifestations of DUSN, the other with choroidal infiltrates, both with severe neurologic degeneration. RESULTS: Indirect immunofluorescence assays on serum and cerebrospinal fluid were positive for B. procyonis in one and serially positive and increasing in the other. Both children had a history of pica and raccoon exposure. CONCLUSIONS: Baylisascaris procyonis infection is associated with two cases of severe neurologic degeneration with ocular lesions: DUSN and choroidal infiltrates. Although B. procyonis is known to cause DUSN, these cases indicate that concomitant ocular migration may accompany neural larva migrans. These are the third and forth cases in the US literature of neural larva migrans due to B. procyonis with eye findings. ( info) |
5/8. Diffuse unilateral subacute neuroretinitis with unusual findings. PURPOSE: To report two cases of diffuse unilateral subacute neuroretinitis (DUSN) with unusual findings. DESIGN: Observational and interventional case series. methods: Two patients with DUSN were found to have the unusual findings of a large live worm in one eye and macular cyst in the other. Both patients underwent fundus fluorescein angiography and optical coherence tomography. RESULTS: Photocoagulation to the worm was performed in one patient; the other received a course of oral albendazole. Both remained stable over six months of follow-up. CONCLUSIONS: We report a case of DUSN due to a worm, the large size of which suggests it to be different from the usual reported causative agents. We also report macular cyst as an associated finding in DUSN. ( info) |
| Baylisacaris procyonis, the common raccoon ascarid, is known to cause life-threatening visceral, neural, and ocular larva migrans in mammals and birds. Two human fatalities have been previously described; however, little is known about the spectrum of human disease caused by B. procyonis. In this report, the case of a 13-month-old child who had nonfatal meningoencephalitis secondary to B. procyonis infection is presented. The suspected diagnosis was confirmed with use of newly developed enzyme immunoassay and immunoblot techniques. The diagnosis, management, and prevention of B. procyonis infection in humans is discussed. Clinical, serological, and epidemiological evaluations established B. procyonis as the etiologic agent. The child survived his infection but continued to have severe neurological sequelae. The potential for human contact and infection with B. procyonis is great. There is no effective therapy; therefore, prevention is paramount. ( info) |
7/8. Diffuse unilateral subacute neuroretinitis. Morphometric, serologic, and epidemiologic support for Baylisascaris as a causative agent. PURPOSE: Several nematodes have been postulated as etiologic agents in diffuse unilateral subacute neuroretinitis (DUSN), but the cause of this condition remains uncertain. The authors report the first case of DUSN from the western united states (northern california), along with morphometric, serologic, and epidemiologic evidence supporting Baylisascaris procyonis as its cause. methods: One patient was examined and evaluated for disc edema and transient obscurations of vision. A diagnosis of DUSN was confirmed when a motile nematode was identified within the substance of the patient's retina. Morphometric analysis of the nematode was done from projected fundus photographs. Serologic evidence of Baylisascaris infection was suggested by Western blot analysis. A necropsy was done on 12 raccoons from the area. They were examined for evidence of Baylisascaris infection, previously believed to be nonendemic in the region. RESULTS: The intraocular nematode measured 1727 x 67 microns, most consistent with Baylisascaris. The patient had considerable exposure to raccoons, and was seropositive for B. procyonis infection on Western blot analysis. Necropsy evaluation showed B. procyonis infection in 8 of 12 raccoons examined from the area. CONCLUSIONS: The morphometric, serologic, and epidemiologic findings in this case provide evidence that the raccoon ascarid, B. procyonis, is a cause of the large nematode variant of DUSN. ( info) |
8/8. Infestation from Lagochilascaris minor in mexico. An 11-year-old girl presented from Villa Azueta, Veracruz, a poor and small town on the Tesechoacan riverside. The Tesechoacan riverside is a tropical area in the south-east of mexico, between 18 degrees, 04',32" latitude and 95 degrees, 42',23" longitude. Her family consisted of both parents and 12 brothers, all apparently healthy and living in a humble hut, with poor nutrition and hygiene. The main sign was a tumor on her neck that had developed during the previous 6 months. On clinical examination, the patient's temperature was normal and her weight was 27.5 kg. Below the right angle of the jaw a firm-to-hard tumor was noted measuring 5 x 3 cm, it was tender and lobulated (Fig. 1) with a central purulent fistula containing small worms with morphology of Lagochilascans minor (Fig. 2). Iron-deficiency anemia was found with no increase of blood eosinophils and a while blood count of 9000/mm3 with 72% of neutrophils. Roentgenograms of the head and chest were both normal. A stool was negative for parasites; glutamic oxalade and glutamic pyruvate transaminases were normal. Histopathologic examination revealed parakeratosis and mild acanthosis with exocytosis of eosinophils. The superficial dermis showed an inflammatory reaction, mainly composed of eosinophils, plasma cells, and histiocytes, and in the deep dermis an abscess containing different sections of the parasite was seen surrounded by a thin fibrous capsule (Fig. 3). There was no clinical improvement after medical treatment with two courses of thiabendazole (50 mg/kg orally, two 5-day pulses) and praziquantel (400 mg orally for 3 days). Therefore, the growth was extirpated under general anesthesia; however, the clinical condition of the patient did not improve. eggs, larvae, and adult worms continued to be present in the pus after surgical excision. Finally, the patient asked for a discharge and did not return to the institute. ( info) |