La leptospirose est une zoonose bactérienne (
Leptospira spp.
; bacille à Gram négatif) de répartition mondiale. Son incidence est croissante en France ces dernières années, avoisinant maintenant ...celle de l'hépatite A (1/100 000). Face à un patient présentant une fièvre en retour de voyage en zone tropicale, le diagnostic de leptospirose doit être évoqué. Mais cette hypothèse diagnostique doit rester envisageable en dehors de tout déplacement, notamment lors des périodes à risque (été-automne), et lors d'activités récréatives avec exposition à l'eau douce (canoë-kayak, baignade, canyoning). La symptomatologie clinique à la phase initiale va mimer un syndrome pseudogrippal, rendant le diagnostic difficile. Le clinicien doit s'efforcer de rechercher les facteurs de risque d'exposition et s'appuyer sur des arguments clinicobiologiques (myalgies, toux, atteinte conjonctivale, thrombopénie, rhabdomyolyse, cholestase) fréquemment associés à la leptospirose. Le but étant la mise en place d'une antibiothérapie précoce avant l'apparition de formes graves ictérohémorragique ou respiratoire, responsables d'une mortalité accrue. Le traitement repose principalement sur l'usage d'antibiotiques (bêtalactamines injectables dans les formes sévères céphalosporines ou l'amoxicilline, doxycycline ou l'azithromycine dans les formes non sévères) associés à des soins de support (hydratation, recharge potassique, hémodialyse), pouvant nécessiter une hospitalisation en service de réanimation.
Leptospirosis is a worldwide bacterial zoonotic disease caused by
Leptospira spp.
, a Gram-negative bacillus. Its incidence has been increasing in France in recent years, reaching similar level to hepatitis A (1/100,000). Leptospiro-sis should be considered when patient suffers from fever after traveling to a tropical area. However, this diagnostic should also be considered even without travel, especially during high-risk periods (summer-autumn) and during recreational activities involving freshwater exposure (such as canoeing-kayaking, swimming, and canyoning). The initial clinical symptoms often mimic a flu-like syndrome, making the diagnosis challenging. The clinician should try to identify risk factors for exposure and rely on clinical and laboratory evidence (such as myalgia, cough, conjunctival involvement, thrombocytopenia, rhabdomyolysis, and cholestasis), which are frequently associated with leptospirosis. The goal is to initiate early antibiotic therapy before the development of severe icterohemorrhagic or respiratory forms, which are associated with increased mortality. The treatment mainly involves the use of antibiotics along with supportive care (hydration, potassium replacement, and hemodialysis), sometimes in an intensive care unit. The recommended antibiotic therapy is the use of injectable beta-lactams (cephalosporins) for severe forms or amoxicillin, doxycycline, and azithromycin for non-severe forms.
Canine Leishmaniasis visceral is a common disease in countries of the Americas. In Brazil, its occurrence has been increasing in municipalities in the Brazilian Northeast due to the increase in the ...number of animals within the country, which may increase the number of animals infected by the protozoan Leishmania. The objective was to report the temporal trend and describe the distribution of incidence rates of Leishmaniose visceral in the municipality of Coité do Noia, state of Alagoas, from 2013 to 2019. An epidemiological survey was carried out in the State of Alagoas and in the municipality of Coité de Nóia - AL, from 2013 to 2019. The data used were obtained from the website of the Department of Informatics of the Sistema Único de Saúde (DATASUS), selecting the Leishmaniose Visceral item, the information was compiled from the number of cases notified in the region of Alagoas in Brazil. From 2013 to 2019, 15 cases of Leishmaniose Visceral were confirmed, with 2 deaths. There was a predominance of cases in women with 12 cases, and 4 for men. The study showed a higher occurrence for the municipality of Coite do Noia between 2018 and 2019 with prevalence for women.
Human ascariasis is a soil-transmitted helminthiasis and remains a neglected tropical disease. Ascaris suum has the potential to cause cross-infections between humans and pigs. In this study, we ...present a rare case of a patient with asymptomatic infection by Ascaris suum. A 66-year-old male underwent colonoscopy, and a white linear worm body was found in the hepatic curvature. The worm was collected by aspiration and submitted to the laboratory for parasite identification. The patient had no symptoms related to parasitic infection. The worm was highly suspected to be of the genus Ascaris. Because of the difficulty of morphological classification, genetic analysis was performed. From PCR-restriction fragment length polymorphism results and sequence analysis of the internal transcribed spacer-1 region, it was determined to be A. suum. The experience with rapid differentiation of A. suum by performing genetic analysis will be useful for future examinations of parasitic infections.
The aim . To present a clinical case of surgical treatment of parasitic invasion of the vitreous body caused by dirofilaria. Material and methods . One patient with intraocular dirofilariasis ...got operated underwent surgical treatment including vitrectomy, phacoemulsification with implantation of an intraocular lens. At the stage of vitrectomy, a whole helminth was removed from the vitreal cavity using collet tweezers for subsequent typing. The uncorrected visual acuity of the right eye at the time of treatment was 0.4, of the left eye – 0.45. Results . The postoperative period had no signs of an active inflammatory reaction. 4 months after surgical treatment, at a follow-up visit, visual acuity of the left eye reached 1.0. According to the parasitological study, a female Dirofilaria repens was identified. In the postoperative period, the areas of pronounced chorioretinal atrophy in the peripheral parts of the retina were visualized, which may be a consequence of mechanical contact of the parasite or the toxic effects of its metabolic products. Conclusion . This clinical example demonstrates the possibility of infection with the ocular form of dirofilariasis in a region that is atypical for the presence of this helminth. Despite the positive outcome of the disease, in the presented patient, the long-term presence of the parasite in the vitreal cavity led to the formation of chorioretinal atrophy in the peripheral retina, which confirms the need for timely diagnosis and surgical treatment.
The anisakid nematodes Anisakis simplex (Rudolphi, 1809), Pseudoterranova decipiens (Krabbe, 1878) and Contracaecum osculatum (Rudolphi, 1802) occur as third-stage larvae in marine fish products and ...may infect consumers ingesting raw or under-cooked fish products. Clinical symptoms associated with the infection, termed anisakidosis, vary from irritation of the oesophagus and stomach, via nausea, vomiting and diarrhoea to severe epigastric and abdominal pain. Third-stage larvae of A. simplex are found in the body cavity, musculature and various organs, P. decipiens occur mainly in the fish musculature (fillet) and C. osculatum larvae reside predominantly in the liver, body cavity, mesenteries and pyloric caeca. Preventive measures, including mechanical removal of worms, heat treatment or freezing to kill worms, are needed in order to reduce the risk of human infections. The anisakid life cycle involves several hosts. A. simplex nematodes use cetaceans (whales) as final hosts whereas P. decipiens and C. osculatum have their adult stage in pinnipeds (seals). Eggs released by worms in these hosts pass with feces to seawater where free-living third-stage larvae hatch from the eggs. Various invertebrates – including euphausiids, copepods and amphipods – feed on these larvae, become infected and serve as intermediate hosts. A range of fish species may serve as transport hosts following ingestion of infected invertebrates and the final stage develops after two additional moults in the stomach of marine mammals which consumed infected fish. Control measures may be implemented to reduce infections of fish stocks and thereby risk of human infections.
•General description of zoonotic anisakid nematode larvae•Description of clinical disease caused by anisakid nematode larvae•Geographic distribution of anisakidosis cases reported•Diagnostic methods and treatment options are presented•The effects of larvae on fish are described
Brucellosis is the most common bacterial zoonosis and it causes approx half million human infections per year worldwide. Neurobrucelosis should be considered as possible differential diagnosis when a ...patient presents with symptomps of neruropasychiatric spectrum and fever. We report a case of neurobrucellosis in a patient who presented with headache, vomiting and an episode of generalized tonic clonic seizure.
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