S. Pampiglione

Dirofilariasis due to Dirofilaria repens in Italy, an emergent zoonosis: report of 60 new cases.

Aims: Sixty new cases of human dirofilariasis due to Dirofilaria repens, occurring in Italy between 1990 and 1999, are presented. This is the most extensive case study of this zoonosis reported worldwide by a single study group. The aim is to utilize this large experience to characterize the different histopathological findings in the parasitic lesions in man.

Studies in Mediterranean leishmaniasis. 3. The leishmanin skin test in kala-azar.

Leishmanin skin testing was carried out in the Emilia-Romagna region of Northern Italy, the site of an outbreak of kala-azar in 1971-72, and in Catania, Eastern Sicily an old endemic focus of Mediterranean kala-azar. Nearly all the people who had recovered from kala-azar in the past gave positive skin tests. Active cases of kala-azar gave negative tests. There was a higher proportion of positive reactors amongst the household contacts and neighbours of cases of kala-azar than among the general population. Age specific leishmanin rates showed an increasing positive rate with age in Catania, comparable to those found in endemic areas in Kenya, but in the Emilia-Romagna area all age groups showed a high positivity rate suggesting a simultaneous exposure to infection. The age specific rates from Catania suggest an interruption in transmission 20-30 years ago. The leishmanin skin test is a useful tool for the study of the epidemiology of Mediterranean kala-azar.

Studies on mediterranean leishmaniasis 2. Asymptomatic cases of visceral leishmaniasis

Abstract Serological screening of the population during an outbreak of visceral leishmaniasis (VL) in the Emilia-Romagna region (Northern Italy) in 1971–1972 showed 6 individuals to have high titres of complement fixing antibody to BCG antigen, multiple hepatic epithehoid granulomata (with the presence of intracellular leishmania in one) and subsequent reaction to leishmanin. All individuals were asymptomatic with the exception of one in whom there was slight splenic enlargement.

Dirofilarial human cases in the Old World, attributed to Dirofilaria immitis: a critical analysis.

Aims:  To review 28 cases of human dirofilariasis reported in the last 30 years in the Old World and attributed, by their respective authors, to Dirofilaria immitis or a species of Dirofilaria other than D. repens.

Studies on mediterranean leishmaniasis I. An outbreak of visceral leishmaniasis in Northern Italy

Abstract Epidemiological, clinical and laboratory data are reported on the outbreak of human visceral leishmaniasis in Emilia-Romagna in 1971–1972 which affected 60 individuals (42 adults and 18 children) with 13 deaths. A serological mass screening of 2,485 people in the area revealed the occurrence of 91 serum positive cases. Liver biopsy was carried out in 6 of these cases and revealed a peculiar form of granulomatous hepatitis which in 1 was accompanied by the presence of Leishmaniae. Some hypotheses are suggested on the possible causes of this outbreak.

Human dirofilariosis in Hungary: an emerging zoonosis in central Europe

ZusammenfassungEINLEITUNG: In den gemäßigten Regionen Europas, vorwiegend in Italien, Frankreich und Griechenland, und in den letzten Jahren auch in Ungarn, führte ein spezieller Wurm, die Dirofilaria (Nochtiella) repens, zu Infektionen beim Menschen und verursacht eine autochthone humane Dirofiariose. D. repens ist ein Parasit von Hunden, Katzen und einigen anderen Raubtieren, und wird durch Mücken übertragen. Wir berichten über einen weiteren Fall und fassen die bisher in Ungarn beobachteten Fälle zusammen. PATIENTEN UND METHODEN: Die Autoren präsentieren einen Fall einer humanen Dirofilariose bei einem 56-jährigen Patienten mit Jucken und brennendem Gefühl in seinem rechtem Auge. Ein sich langsam bewegender, weißlicher, Zwirn-ähnlicher Wurm wurde durch Spaltlampenuntersuchung entdeckt. Die parasitologische Untersuchung identifizierte ihn als junge männliche Dirofilaria repens. Eine aktualisierte Übersicht über die ungarischen Fälle von 1880–2002 wird vorgestellt und zusätzlich 16 neuen Fälle analysiert, die in der Periode von 2001 zu 2006 diagnostiziert wurden. Das Durchschnittsalter dieser 16 neuen Patienten war 60 Jahre, acht Patienten hatten eine okulare, sieben eine subkutane Lokalisation. Bei einem Patienten mit akuter lymphatischer Leukämie wurde histopatologisch aus einem axillärem Lymphknoten diagnostiziert. Keiner der Patienten hatte sich im Ausland aufgehalten. KONKLUSION: Die Mehrheit der in Urgarn beobachteten Fälle von Dirofilariasis muss als autochthon aquiriert angesehen werden. Die zunehmende Zahl an diagnostizierten Fällen spricht dafür, dass diese Zoonose auch in Zentraleuropa Verbreitung erlangt.SummaryINTRODUCTION: In the temperate regions of Europe, mainly Italy, France, Greece, and in recent years Hungary, a specific filarioid worm, Dirofilaria (Nochtiella) repens, a parasite of dogs, cats and some other carnivores, transmitted by mosquitoes, has occasionally been contracted, causing dirofilariosis in humans. We report a case of dirofilariosis and review all previously observed cases in Hungary. MATERIALS, METHODS AND RESULTS: The authors present a case of human subconjunctival dirofilariosis in a 56-year-old man with mild itching and a burning sensation in his right eye. A slow-moving, whitish, thread-like worm was detected by slit-lamp examination. The worm was surgically removed and parasitological examination identified it as an immature male Dirofilaria repens. A review of Hungarian cases from 1880 to 2000 is presented, with updates of earlier reports. In addition, 16 new cases (8 men; 8 women) diagnosed between 2001 and 2006 are reviewed. The mean age of these 16 patients was 60 years; eight cases had ocular localization, seven were subcutaneous and one was diagnosed in a histopathological section of removed axillary lymph node in a patient with lymphoid leukemia. Twelve of the 16 identified Dirofilariae were females, four were males. According to their recorded histories the patients had not traveled internationally. CONCLUSION: Most of the above cases of dirofilariosis are certainly autochthonous infections. The increasing number of diagnosed cases suggests that this zoonosis is becoming more important in central Europe and that the incidence may increase with the improvement of clinical diagnosis.

Human anisakiasis in Italy: A report of eleven new cases

The authors report on eleven new human cases of anisakiasis occurring in Italy, and emphasize the importance of the infection in clinical medicine, histopathology and public health. For ten of these cases, the diagnosis was based on histological findings: an eosinophilic granuloma associated with a larva of Anisakis sp. For one of them, the larva was removed from the stomach by endoscopy. Nine of the subjects were from Apulia and two from Molise (regions of southern and central Italy, respectively). Ten of them were surgically treated, and in one case the endoscopical extraction of the parasite resolved the situation. In two cases, the gastric wall was affected, in three the intestinal wall, in a further three the omentum, in one the spleen, and in the final two the mesentery and the epiploic appendix. In all the cases, the parasite was discovered unexpectedly during surgical treatment of the patients for supposed illnesses, which had originally been misdiagnosed. In three cases, the patients were also affected by cancer. Human anisakiasis must be taken into account in the differential diagnosis of acute, abdominal synddromes in subjects who have ingested raw fish or squid a few hours to a few days before the onset of symptoms. Histopathologists should consider the possibility of this parasitic infection when confronted with an eosinophilic granuloma of the digestive tract, mesentery or peritoneum. The incidence of anisakiasis in Italy is probably higher than reported, as some cases might not be diagnosed and others might heal spontaneously.

Acaricidal activity of aqueous extracts of camomile flowers, Matricaria chamomilla, against the mite Psoroptes cuniculi

Abstract.  Arcaricidal properties of decoctions, infusions and macerates of dried flower heads of camomile, Matricaria chamomilla L. (Asterales: Asteraceae) were tested in vitro against the mite Psoroptes cuniculi Delafond (Parasitiformes: Psoroptidae). This mite species is responsible for otoacariasis in domestic animals. Mites were exposed to the extracts for 24, 48 or 72 h. All the extracts tested showed highly significant acaricidal activity when compared with controls. Among them, a decoction of 10% was the only formulation which gave 100% activity at all the three observations times.

Sand flea (Tunga spp.) infections in humans and domestic animals: state of the art

Tungiasis is a parasitic disease of humans and animals caused by fleas (Siphonaptera) belonging to the genus Tunga. Two species, Tunga penetrans (L.) and Tunga trimamillata, out of 10 described to date, are known to affect man or domestic animals; the other eight are exclusive to a few species of wild mammals. Tunga penetrans and T. trimamillata originated from Latin America, although the first species is also found in sub‐Saharan Africa (between 20° N and 25° S). Hundreds of millions of people are at risk of infection in more than 70 nations, mostly in developing countries. The second species has been reported only in Ecuador and Peru. Males and non‐fertilized females of Tunga are haematophagous ectoparasites; pregnant females penetrate the skin where, following dilatation of the abdomen, they increase enormously in size (neosomy) and cause inflammatory and ulcerative processes of varying severity. The importance of Tunga infection in humans concerns its frequent localization in the foot, which sometimes causes very serious difficulty in walking, thereby reducing the subjects ability to work and necessitating medical and surgical intervention. Tungiasis in domestic animals can be responsible for economic losses resulting from flea‐induced lesions and secondary infections. Because tungiasis represents a serious problem for tropical public health and because of the recent description of a new species (Tunga trimamillata), it seems appropriate to review current knowledge of the morphology, molecular taxonomy, epidemiology, pathology, treatment and control of sand fleas of the genus Tunga.

Human sparganosis in Italy. Case report and review of the European cases.

Infections with Spargana, the larvae of Spirometra spp., are rarely found in humans in Europe. So far only six cases have been discussed in the literature, four from Italy and two from France. We here report a new case in a 50‐year‐old workman, a freshwater sports fisherman from Bologna in Northern Italy. The infection manifested as a subcutaneous nodule in the thigh, 2×3 cm in size, slightly painful when compressed, somewhat mobile under the skin, present for 9 months, with recurrent periods of local itchiness associated with redness and slight oedema. The lump was removed surgically. Histological sections of the biopsied material revealed the presence of a sparganum. Drinking water contaminated by copepods, containing procercoid larvae of this parasite, seems to be the medium of infection.