Fernanda Barbosa de Almeida

Equinococose policística na Amazônia oriental brasileira: atualização da casuística

Mediante criterios epidemiologicos, clinicos e laboratoriais, foi levantada a casuistica de equinococose policistica no periodo de 1962 a 2003, no âmbito da Amazonia oriental brasileira, incluindo casos ineditos e aqueles ja publicados. Dessa forma, foram identificados 40 casos da doenca no referido periodo, compreendendo casos procedentes dos estados do Para e Amapa, Brasil. A amplitude das idades foi de 10 a 72 anos. Do total 47,5% pertenciam ao sexo masculino. O figado foi o orgao mais acometido (82,5% dos casos). O Echinococcus vogeli (Rausch e Bernstein, 1972), apresentou-se como o principal agente etiologico envolvido. A partir do reconhecimento da importância e das implicacoes do manejo da equinococose para a regiao tropical, acredita-se que devera ocorrer uma implementacao do diagnostico precoce, tratamento adequado e de um melhor registro da doenca.

Dirofilaríase pulmonar humana no Estado do Rio de Janeiro, Brasil: relato de um caso

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.

First molecular identification of Echinococcus vogeli and Echinococcus granulosus (sensu stricto) G1 revealed in feces of domestic dogs (Canis familiaris) from Acre, Brazil.

BackgroundEchinococcus 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.MethodsSixty-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.ResultsEchinococcus vogeli was molecularly confirmed in a sample from Sena Madureira and E. granulosus (sensu stricto) (s.s.) (G1) in a sample from Rio Branco.ConclusionsThese 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.

Morphometric characteristics of the metacestode Echinococcus vogeli Rausch & Bernstein, 1972 in human infections from the northern region of Brazil

Polycystic echinococcosis, caused by the larval stage (metacestode) of the small-sized tapeworm, Echinococcus vogeli, is an emerging parasitic zoonosis of great public health concern in the humid tropical rainforests of South and Central America. Because morphological and morphometric characteristics of the metacestode are not well known, hydatid cysts from the liver and the mesentery were examined from patients following surgical procedures. Whole mounts of protoscoleces with rostellar hooks were examined under light and confocal laser scanning microscopy. Measurements were made of both large and small hooks, including the total area, total length, total width, blade area, blade length, blade width, handle area, handle length and handle width. The results confirmed the 1:1 arrangement of hooks in the rostellar pad and indicated, for the first time, that the morphometry of large and small rostellar hooks varies depending upon the site of infection. Light and confocal microscopy images displayed clusters of calcareous corpuscles in the protoscoleces. In conclusion, morphological features of large and small rostellar hooks of E. vogeli are adapted to a varied environment within the vertebrate host and such morphological changes in calcareous corpuscles occur at different stages in the maturation of metacestodes.

First parasitological, histopathological and molecular characterization of Echinococcus vogeli Rausch and Bernstein, 1972 from Cuniculus paca Linnaeus, 1766 in the Cerrado biome (Mato Grosso do Sul, Brazil)

Polycystic echinococcosis (PE) is caused by Echinococcus vogeli metacestodes (larval stage) in Neotropical countries. E. vogeli is trophically-transmitted between predators bush dogs (Speothos venaticus) and prey pacas (Cuniculus paca). In Brazil, reported PE cases are restricted to the Amazon biome. In this study, metacestodes from a paca hunted in Mato Grosso do Sul state (Cerrado biome) were identified morphological and histopathological techniques and further confirmed by molecular testing (sequencing of cytochrome C oxidase subunit I (cox1) gene) for the first time. Images of the whole liver showed superficial bubble-like hepatic masses. The parasitological analysis revealed large hooks (41.3 ± 1.2 μm length/12.8 ± 0.8 μm width) and small hooks (33.0 ± 1.5 μm length/11.1 ± 1.2 μm width), consistent with E. vogeli. Microscopically, the liver showed protoscoleces, a thick laminated layer, fibrosis, and inflammatory infiltrate in the adventitial layer. The DNA sequencing confirmed E. vogeli with 99% homology with sequences deposited in the GenBank. In addition, this finding greatly extends the geographic range of animal polycystic echinococcosis into the Cerrado. It is likely to occur in new biomes, where bush dogs and pacas share a given area in a trophic relationship.

Histopathological findings of an uncommon co-infection: Echinococcus vogeli, HIV, hepatitis C virus, and hepatitis B virus

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.