RESUMO
Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterised by multi-factorial aetiology. In IBS physiopathology are involved diverse factors between them biological, psychosocial, and environmental components which affect the immune activation status of gut mucosa. Among these factors is recognized the intestinal parasitosis. Post-infection IBS (PI-IBS) is recognised as a subgroup of functional disorders whose symptoms onset appear after a symptomatic intestinal infection caused by microbial agents. There are few studies regarding of relationship between IBS and intestinal parasitosis in Chile. However, is has been well described a positive association between IBS and Blastocystis hominis infections, one of prevalent parasites in Chile. In other countries, is also described a relationship between IBS and amebiasis and giardiasis. Both, characterized by a common mode of transmission through water as well as contaminated food. Because the high prevalence of parasitosis in our country it is necessary to expand the association studies to clarify the strength of the parasites ethiology in IBS.
Assuntos
Enteropatias Parasitárias/complicações , Síndrome do Intestino Irritável/parasitologia , Infecções por Blastocystis/complicações , Blastocystis hominis/patogenicidade , Chile , Entamoeba histolytica/patogenicidade , Entamebíase/complicações , Giardia lamblia/patogenicidade , Giardíase/complicações , Humanos , Enteropatias Parasitárias/fisiopatologia , Mucosa Intestinal/parasitologia , Síndrome do Intestino Irritável/fisiopatologiaRESUMO
El síndrome de intestino irritable (SII) es un trastorno funcional digestivo de etiología multifactorial. En su fisiopatología se describen diversos factores, tanto biológicos, como psicológicos y ambientales, que afectan el estado de activación de células inmunes en la mucosa intestinal. Entre los factores ambientales se incluye la presencia de alguna parasitosis intestinal. El síndrome de intestino irritable post-infeccioso (SII-PI) es reconocido como un subgrupo de estos trastornos, cuya aparición de los síntomas es posterior a una infección intestinal provocada por agentes microbianos. A pesar de que en Chile hay pocos estudios respecto a la relación entre SII y parasitosis intestinal, se ha descrito la existencia de una asociación positiva entre SII e infecciones por Blastocistis hominis, uno de los parásitos prevalentes en Chile. En otros países, se ha descrito además una relación entre SII, amebiasis y giardiasis. Por la alta prevalencia de parasitosis en nuestro país, existe la necesidad de ampliar los estudios para clarificar la fuerza de la asociación entre parasitosis y SII.
Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterised by multi-factorial aetiology. In IBS physiopathology are involved diverse factors between them biological, psychosocial, and environmental components which affect the immune activation status of gut mucosa. Among these factors is recognized the intestinal parasitosis. Post-infection IBS (PI-IBS) is recognised as a subgroup of functional disorders whose symptoms onset appear after a symptomatic intestinal infection caused by microbial agents. There are few studies regarding of relationship between IBS and intestinal parasitosis in Chile. However, is has been well described a positive association between IBS and Blastocystis hominis infections, one of prevalent parasites in Chile. In other countries, is also described a relationship between IBS and amebiasis and giardiasis. Both, characterized by a common mode of transmission through water as well as contaminated food. Because the high prevalence of parasitosis in our country it is necessary to expand the association studies to clarify the strength of the parasites ethiology in IBS.
Assuntos
Humanos , Síndrome do Intestino Irritável/parasitologia , Enteropatias Parasitárias/complicações , Chile , Giardíase/complicações , Giardia lamblia/patogenicidade , Infecções por Blastocystis/complicações , Blastocystis hominis/patogenicidade , Síndrome do Intestino Irritável/fisiopatologia , Entamoeba histolytica/patogenicidade , Entamebíase/complicações , Enteropatias Parasitárias/fisiopatologia , Mucosa Intestinal/parasitologiaRESUMO
TNF blockade has been successful in the treatment of some rheumatic diseases such as spondyloarthritis. Many infectious complications have been reported with anti-TNF therapy, mainly bacterial, mycobacterial, viral and fungal infections. Entamoeba histolytica is an extracellular protozoan parasite that mainly causes colitis and hepatic abscess; bowel perforation is an uncommon complication with high mortality. TNF is considered the principal mediator of cell immunity against amebiasis. Initially, it is chemotactic to E. histolytica, enhancing its adherence to enterocyte via galactose inhibitable lectin, and then activating macrophages to kill ameba though the release of NO, so that TNF blocking could be harmful, increasing amebic virulence. We describe the case of a 46-year-old woman with spondyloarthritis who presented a colonic perforation due to invasive amebic colitis during anti-TNF use.
Assuntos
Adalimumab/efeitos adversos , Anti-Inflamatórios/efeitos adversos , Colite/complicações , Colite/parasitologia , Disenteria Amebiana/induzido quimicamente , Entamoeba histolytica , Entamebíase/induzido quimicamente , Perfuração Intestinal/parasitologia , Disenteria Amebiana/complicações , Entamebíase/complicações , Feminino , Humanos , Pessoa de Meia-Idade , Espondilartrite/tratamento farmacológico , Fator de Necrose Tumoral alfa/antagonistas & inibidoresRESUMO
O bloqueio do TNF tem tido sucesso no tratamento de algumas doenças reumáticas, como a espondiloartrite. Relatam-se muitas complicações infecciosas com a terapia anti-TNF, principalmente infecções bacterianas, micobacterianas, virais e fúngicas. A Entamoeba histolytica é um protozoário extracelular que causa principalmente colite e abscesso hepático, sendo que a perfuração intestinal é uma complicação rara, com alta mortalidade. O TNF é considerado o principal mediador da imunidade celular contra a amebíase. Inicialmente, é quimiotático para a E. histolytica, potencializando sua adesão ao enterócito por meio da lectina galactose-inibível, e depois ativando os macrófagos para matarem a ameba pela liberação de NO; assim, o bloqueio do TNF poderia ser prejudicial, aumentando a virulência amebiana. Descreve-se o caso de uma mulher de 46 anos com espondiloartrite que apresentou uma perfuração do colo por colite amebiana invasiva durante uso de anti-TNF.
TNF blockade has been successful in the treatment of some rheumatic diseases such as spondyloarthritis. Many infectious complications have been reported with anti-TNF therapy, mainly bacterial, mycobacterial, viral and fungal infections. Entamoeba histolytica is an extracellular protozoan parasite that mainly causes colitis and hepatic abscess; bowel perforation is an uncommon complication with high mortality. TNF is considered the principal mediator of cell immunity against amebiasis. Initially, it is chemotactic to E. histolytica, enhancing its adherence to enterocyte via galactose inhibitable lectin, and then activating macrophages to kill ameba though the release of NO, so that TNF blocking could be harmful, increasing amebic virulence. We describe the case of a 46-year-old woman with spondyloarthritis who presented a colonic perforation due to invasive amebic colitis during anti-TNF use.
Assuntos
Humanos , Feminino , Colite/complicações , Colite/parasitologia , Disenteria Amebiana/induzido quimicamente , Entamoeba histolytica , Entamebíase/induzido quimicamente , Adalimumab/efeitos adversos , Perfuração Intestinal/parasitologia , Anti-Inflamatórios/efeitos adversos , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Espondilartrite/tratamento farmacológico , Disenteria Amebiana/complicações , Entamebíase/complicações , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Nicaragua was the first developing nation to implement routine immunization with the pentavalent rotavirus vaccine (RV5). In this RV5-immunized population, understanding infectious etiologies of childhood diarrhea is necessary to direct diarrhea treatment and prevention efforts. METHODS: We followed a population-based sample of children <5 years in León, Nicaragua for diarrhea episodes through household visits. Information was obtained on RV5 history and sociodemographics. Stool samples collected during diarrhea episodes and among healthy children underwent laboratory analysis for viral, bacterial and parasitic enteropathogens. Detection frequency and incidence of each enteropathogen was calculated. RESULTS: The 826 children in the cohort experienced 677 diarrhea episodes during 607.5 child-years of exposure time (1.1 episodes per child-year). At least 1 enteropathogen was detected among 61.1% of the 337 diarrheal stools collected. The most common enteropathogens among diarrheal stools were: norovirus (20.4%), sapovirus (16.6%), enteropathogenic Escherichia coli (11.3%), Entamoeba histolytica/dispar (8.3%), Giardia lamblia (8.0%) and enterotoxigenic E. coli (7.7%), with rotavirus detected among 5.3% of diarrheal stools. Enteropathogenic Escherichia coli and enterotoxigenic E. coli were frequently detected among stools from healthy children. Among children with diarrhea, norovirus was more commonly detected among younger children (< 2 years) and G. lamblia was more commonly detected among older children (2-4 years). The mean age of rotavirus detection was 34.6 months. CONCLUSIONS: In this Central American community after RV5 introduction, rotavirus was not commonly detected among children with diarrhea. Prevention and appropriate management of norovirus and sapovirus should be considered to further reduce the burden of diarrheal disease.
Assuntos
Infecções por Caliciviridae/complicações , Diarreia/microbiologia , Diarreia/parasitologia , Entamebíase/complicações , Infecções por Escherichia coli/complicações , Gastroenterite/complicações , Giardíase/complicações , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus , Fatores Etários , Infecções por Caliciviridae/virologia , Pré-Escolar , Entamoeba histolytica/isolamento & purificação , Escherichia coli Enteropatogênica/isolamento & purificação , Escherichia coli Enterotoxigênica/isolamento & purificação , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Fezes/parasitologia , Feminino , Gastroenterite/virologia , Giardia lamblia/isolamento & purificação , Humanos , Lactente , Masculino , Nicarágua , Norovirus/isolamento & purificação , Estudos Prospectivos , Rotavirus/isolamento & purificação , Infecções por Rotavirus/complicações , Sapovirus/isolamento & purificaçãoRESUMO
We conducted a case-control study to examine associations between parasite infection, including protozoa infection, and tuberculosis (TB) in children in Lima, Peru. We enrolled 189 matched-pairs. In multivariable conditional logistic regression analyses, Blastocystis hominis infection (rate ratio = 0.30, 95% confidence interval = 0.14-0.64, P = 0.002) was strongly associated with a lower risk of TB. We observed a statistically significant inverse linear dose-response relationship between Blastocystis hominis infection and TB. These findings should be confirmed in future prospective studies.
Assuntos
Amebíase/epidemiologia , Infecções por Blastocystis/epidemiologia , Entamebíase/epidemiologia , Giardíase/epidemiologia , Infecções por Protozoários/epidemiologia , Tuberculose/epidemiologia , Amebíase/complicações , Infecções por Blastocystis/complicações , Blastocystis hominis/isolamento & purificação , Estudos de Casos e Controles , Criança , Pré-Escolar , Endolimax/isolamento & purificação , Entamoeba/isolamento & purificação , Entamebíase/complicações , Feminino , Giardia lamblia/isolamento & purificação , Giardíase/complicações , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Peru , Infecções por Protozoários/complicações , Fatores de Risco , Tuberculose/complicações , Tuberculose/parasitologiaRESUMO
We tested a prototype stool enzyme-linked immunosorbent assay (ELISA) (TRI-COMBO) that is simultaneously diagnostic for Giardia lamblia, Cryptosporidium parvum, and Entamoeba histolytica in a rural pediatric clinic in Guatemala. We compared its results to those of three individual ELISAs for these parasites, assessed the prevalence of these parasites, and compared our findings to those found by stool microscopy. We tested 620 non-diarrheal stools. The TRI-COMBO diagnosed 57 positive samples and 52 (91%) had a correlating positive result in an individual assay, giving a kappa coefficient of 0.90. Giardia spp., E. histolytica, and Cryptosporidium spp. were detected in 52 (8.4%), 2 (0.3%), and 3 (0.5%) samples, respectively. Twenty-three (40%) samples positive by ELISA for Giardia spp. were identified by microscopy. This study is the first to test the TRI-COMBO in this setting and, to our knowledge, represents the first assessment of these parasites in Guatemala by stool ELISA.
Assuntos
Criptosporidiose/diagnóstico , Entamebíase/diagnóstico , Ensaio de Imunoadsorção Enzimática/métodos , Giardíase/diagnóstico , Criptosporidiose/complicações , Entamebíase/complicações , Giardíase/complicações , Guatemala , HumanosRESUMO
The sequence of hepatic necrotic-inflammatory events produced by Entamoeba dispar are originally described in this work. For the first time were described in details the experimental lesions produced by E. dispar, as well as the distribution of the trophozoites detected by the immunohistochemistry. Animals experimentally infected with E. dispar presented necrosis, thrombosis and chronic granulomatous inflammation. Immunoreactive products derived from trofozoites were observed close or associated with trophozoites, epithelioid cells, leucocytes and hepatocytes. Few are the articles on the literature about virulence of E. dispar, which is approximately 9 times more frequent than to E. histolytica. Variation in the virulence is, therefore expected and signalizing the need of the continuity of studies with E. dispar strains from different places in the world. Taking into account that E. dispar is a closely related species to E. histolytica, these studies could determine new elements involved with E. histolytica pathogenesis, helping us to understand better the disease.
Assuntos
Entamoeba/fisiologia , Entamebíase/complicações , Hepatopatias Parasitárias/patologia , Fígado/patologia , Animais , Cricetinae , Entamebíase/imunologia , Entamebíase/patologia , Doença Granulomatosa Crônica/patologia , Imuno-Histoquímica , Inflamação/patologia , Necrose/etiologia , Necrose/patologia , Ratos , Trombose/etiologia , Trombose/patologiaRESUMO
Amebiasis secondary to Entamoeba histolytica (E. histolytica) continues to be a major source of morbidity and mortality worldwide, mainly in developing countries. An association between amebic dysentery and hemolytic uremic syndrome (HUS) has been mentioned, but a cause-and-effect relationship has never been confirmed. We report the case of an 11-year-old healthy white female who developed severe bloody diarrhea after drinking contaminated unboiled water, developing classic HUS and requiring acute intermittent hemodialysis. The etiological study confirmed numerous cysts and hematophagous trophozoites of E. histolytica on stool smear, but without evidence of other pathogens. This report contributes to the concept that classic post-diarrheal HUS, usually related to colitis secondary to enterohemorragic Shiga-toxin producing Escherichia coli (E.coli) strains, may be associated with other pathogens, including E. histolytica. Additional information regarding mechanisms of virulence of E. histolytica and host immunological reaction is needed to clarify the temporal association of these two disorders (HUS and amebiasis).
Assuntos
Entamebíase/complicações , Síndrome Hemolítico-Urêmica/parasitologia , Enteropatias Parasitárias/complicações , Criança , Feminino , HumanosRESUMO
The objective of this work was to evaluate the frequency of Entamoeba histolytica/Entamoeba dispar intestinal infection in HIV+/AIDS subjects and their HIV- close relatives or sexual partners. Enteric parasites were investigated in stool samples by microscopic examination and E. histolytica and E. dispar were identified by PCR. We found by microscopic analysis in HIV+/AIDS group that the E. histolytica/E. dispar complex was present in 5.9% of the members, while in the HIV- group was 2.9%. With PCR we found that the E. histolytica prevalence was 25.3% in the HIV+/AIDS group and 18.5% in the HIV-group. The difference in the results obtained with the microscopic and PCR is due to the different sensibility of the procedures. Besides, we found patients who were infected with E. histolytica in both groups were asymptomatic cyst passers. Our results suggest that E. histolytica strains prevalent in the studied community appear to be of low pathogenic potential.