Suppression of parasitemia in rodent filariasis (Litomosoides carinii) by immunization with BCG and microfilaria. I. Intracutaneous inoculation of BCG

After intracutaneous inoculation of BCG and challenge by subcutaneous injection of infective larvae of Litomosoides carinii, the parasitaemia of the filarial infection in cotton rats remains significantly lower when BCG and larvae are applied in the region of the same popliteal and ileal lymph nodes. However, when the infective larvae are directed to other regional lymph nodes (Ln cubitales and axillares), the depression of microfilaraemia is missed. The worm load (recovery rate) and the expulsion of microfilariae by the adult worms are not influenced by the BCG inoculation. Obviously BCG stimulates the lymphatic tissue unspecifically, and the infective larvae produce the first antigen contact, which is boostered by the microfilariae at the onset of patency. When the intracutaneous BCG inoculation is combined with specific antigen stimulation by simultaneous injection of blood microfilariae in the region of the same lymph nodes, the microfilaraemia of the challenge infection disappears completely or remains extremely low.     

Pathology and epizootiology of Dirofilaria scapiceps (Leidy, 1886) (Nematoda: Filarioidea) in Sylvilagus floridanus (J.A. Allen) and Lepus americanus erxleben

Dirofilaria scapiceps was found between the synovial sheath and tendons, i.e., within the tendon sheath, in the ankle region of eastern cottontail rabbits (Sylvilagus floridanus) and snowshoe hares (Lepus americanus). In cottontail rabbits, tendons and sheaths appeared normal and all worms were adults. Only one (4%) of 24 infected rabbits contained dead worms. All female worms were gravid in rabbits killed in late winter or early spring. Microfilaremias in rabbits were high (approximately 30-100 microfilariae/60 microliter blood) and of long duration (at least 8-28 mo), and rabbits were considered normal hosts of D. scapiceps. In some snowshoe hares, tendons and sheaths also appeared normal; however, in other hares a chronic proliferative tenosynovitis, characterized by fibrinous exudate, hyperplasia and hypertrophy of the intima and inflammatory cell (predominantly lymphocytes and plasma cells) infiltration of the intimal and fibrous layers of the synovial sheath led to encapsulation of worms. Dead subadult, dead adult, and live adult worms were found in the ankles of hares; 86 (46%) of 186 infected hares contained some or only dead worms. Fibrosis commonly occurred around dead worms. Dead subadults were also found in subcutaneous connective tissues over the trunk of the body. Degenerate embryos and amorphous material were observed in uteri of some female worms in hares killed in late winter or early spring. Few (1-5 microfilariae/60 microliter blood) or no microfilariae were observed in the peripheral blood of hares and microfilaremias were of short duration (less than 8 mo). Microfilariae in hares are probably trapped and destroyed in the chronic inflammatory lesions in the tendon sheaths since normal, degenerate, and calcified microfilariae were observed in the capsules around adult worms. Some microfilariae might also be destroyed in lymph nodes. Although D. scapiceps can be maintained within snowshoe hare populations, hares are considered abnormal hosts of D. scapiceps. Dirofilaria scapiceps may have spread from cottontail rabbits to snowshoe hares relatively recently.     

Occurrence of microfilariae in various hollow organs and in the peritoneal cavity after treatment of Litomosoides carinii infected Mastomys natalensis with diethylcarbamazine and haloxon

Treatment of Litomosoides carinii infected Mastomys natalensis with diethylcarbamazine (DEC: 500 mg/kg p.o.) was followed by increased occurrence of microfilariae in the bronchi of the host after 40 min and lasting at least until 6 h after treatment. After 4 h, increased levels of larvae were observed in the gut. Only a few microfilariae occurred in the bladder and sputum. Accumulations of microfilariae were found furthermore in the Lnn. hepaticae whereas no changes were observed in the inguinal or jejunal and lung and pleura associated lymph nodes. Increased numbers of microfilariae were found in the peritoneal cavity only after 8 and continuing until at least 48 h after treatment. In contrast, after haloxon treatment (100 mg/kg p.o.) an accumulation of microfilariae was found in the peritoneal cavity only, following a time course similar to that after DEC.     

Brugia pahangi: infections and their effect on the lymphatic system of Mongolian jirds (Meriones unguiculatus)

Brugia pahangi has been found to be primarily a lymphatic-dwelling parasite in jirds when infections are induced by the subcutaneous injection of infective larvae or by allowing infected Aedes aegypti to feed.Migration to the regional lymphatics occurred as early as 1–4 days. Although some injected larvae remained in the skin for as long as 30 days and some became localized in the heart, lungs, pleural cavity, or peritoneal cavity, about three-fourths of the recovered filariae were found in the regional lymphatics. In contrast, when larvae were injected peritoneally they remained largely in the peritoneal cavity for at least 30 days.The relevant lymphatics and their drainage patterns in jirds have been described.The major pathological changes noted in jirds involved the regional lymphatic vessels and nodes, which were severely affected when they contained dead worms. Pulmonary granulomas due to dead microfilariae and occasionally to dead larvae or adult worms were noted.Observations are included on the susceptibility and course of B. pahangi infections in jirds.     

Lymphadenovarix in the axilla – an unusual presentation of filariasis

Clinical manifestations of lymphatic filariasis depend on the area of lymphatic involvement and the duration of infection. A 21 year old man, resident in a filariasis endemic region, presented with multiple matted lymph nodes with cystic areas forming a large mass in his left axilla. An ultrasound scan of the axilla using a 7.5 MHz transducer revealed grossly dilated lymphatics but no filarial dance sign. Fine needle (21 G) aspiration cytology (FNAC) from the dilated lymphatics and solid areas in the lymph node mass revealed multiple microfilariae in a background of reactive lymphoid cells. Peripheral blood smears revealed microfilaremia with significant eosinophilia. Diagnosis of left axillary Bancroftian lymphadenovarix was made. On the administration of oral diethylcarbamazine, the diameter of the lymphatic vessels in the lymphadenovarix reduced considerably in size and microfilaremia disappeared. We report this case because axillary lymphadenovarix is a rare presentation of filariasis. This case is also unique since microfilariae were demonstrated in the fluid aspirated from the dilated lymphatics of the lymphadenovarix in the absence of live adult worms.     

The localization of CD3, CD79a,CD68 and S100 protein immunoreactive cells in hemal nodes of Saanen goat (Capra hircus)

We investigated the structure of hemal nodes in Saanen goats using immunohistochemical staining. We examined the distribution of CD3 positive T lymphocytes, CD79a positive B lymphocytes, CD68 positive macrophages and S100 protein positive follicular dendritic cells. Hemal nodes of six healty adult female goats were used. Hemal nodes were removed from the thoracic and abdominal cavities. The oval to round hemal nodes were observed especially between the abdominal aorta and vena cava, and near the kidneys and adrenal glands. Tissue sections were stained with Crossmon’s modified triple stain to demonstrate general histological structure. The avidin-biotin-peroxidase technique using anti-CD3, anti-CD79a, anti-CD68 and anti-S100 primary antibodies was used for immunohistochemistry. Many CD3 positive T lymphocytes were found in the germinal center of the lymph follicles and in the lymphatic cords of hemal nodes; CD3 positive cells also were observed in the sinuses. CD79a and CD68 positive cells were found at the germinal center of the lymph follicles. In the lymph follicles near the subcapsular sinuses, CD79a and CD68 positive cells were found especially in e areas bordering the mantle zone. S100 positive cells were found in the lymph follicles, lymphatic cords and sinuses.     

Chronic wuchereriasis presenting as a vaginoperineal fistula: report of a case with aspiration cytologic diagnosis

BACKGROUND: Filariasis is often an occult disease with myriad presentations. Cytology has an established role in diagnosing clinically unsuspected cases. CASE: A 20-year-old female presented with recurring perineal ulcers, vaginal discharge and inguinal lymphadenopathy. Radiology revealed a vaginoperineal fistula. Fine needle aspiration (FNA) of the ulcer bed and smears prepared from the ulcer discharge showed an adult, gravid, female filarial worm and unsheathed larvae. Similar microfilariae were also seen in FNA smears from inguinal lymph nodes. The atypical clinical presentation and unusual parasite morphology posed initial difficulties in characterization of the microfilarial species. CONCLUSION: This case report highlights the morphologic clues to the dif ferential diagnosis offilarial species on cytologic specimens. Chronic wuchereriasis presenting as a vaginoperineal fistula has not been reported previously.     

Disseminated bovine tuberculosis in a wild red fox (Vulpes vulpes) in southern Spain

A wild-caught, adult red fox (Vulpes vulpes) from Do?ana National Park (southern Spain), in very poor condition, died during anesthesia. At necropsy, the submandibular, retropharyngeal, mediastinal, axillary, mesenteric, and popliteal lymph nodes were enlarged, and the right submandibular and mesenteric lymph nodes had hard, white-colored concretions (calcifications). Multiple white pinpoint foci were observed in the lungs, and abscesses were present in the left dorsal lung lobes. No lesions were seen in tonsils, liver, or spleen. On histopathology multiple tuberculous granulomas, with Ziehl-Neelsen-positive bacilli, were observed in the lung, and multifocal necrotic areas with calcification were present in the submandibular and mesenteric lymph nodes. Nucleic acid amplification from lymph node samples demonstrated the presence of mycobacteria belonging to the Mycobacterium tuberculosis complex. One strain was isolated by culture and identified as Mycobacterium bovis. The suspected route of infection was oral, probably after repeated scavenging of infected wild ungulate carcasses. This is the first report of generalized bovine tuberculosis (bTB) in a wild canid. This finding raises concerns about bTB as a disease risk for protected species, livestock, and humans in Mediterranean Spain.     

The anatomy and topography of the human axillary lymph nodes]

The anatomy and topography of the right and left axillary nodes were studied by the method of polychrome injections in 25 corpses of adult people dead from trauma or illnesses not related to lesions of axillary lymph nodes. Injections were made into the skin of fingers, palm and back of the hand, in the delta-shaped area, lateral surface of the chest and exterior half of the mamillary gland and also immediately into the lymph vessels of the upper extremity found with the help of interstitial injections. Detailed data on the topography of axillary lymph nodes relative to the walls, blood vessels and nerves of the axillary fossa were obtained, and the relations between the nodes were specified. From the topography of the axillary lymph nodes under study and approaching the lymph vessels as well as from literature data it is expedient to divide the axillary lymph nodes into 6 groups: lateral, medial, posterior, inferior, central and apical.     

Immunocytochemical localization of cytokines and inducible nitric oxide synthase (iNOS) in oral mucosa and lymph nodes of patients with paracoccidioidomycosis

Paracoccidioidomycosis (PCM) is a deep mycosis caused by Paracoccidioides brasiliensis, with high incidence in Brazil. In order to examine the immune response in lesional tissue from patients with PCM, we analyzed cytokines as well as the phenotype of the cell infiltrate. Paraffin-embedded tissue from the oral mucosa of eight patients with the localized adult form (AF) of PCM and from the lymph nodes of 10 patients with the juvenile form (JF) of PCM was analyzed by immunohistochemistry to detect tumor necrosis factor-alpha (TNF-alpha), inducible nitric oxide synthase (iNOS), transforming growth factor-beta (TGF-beta) and interleukin-10 (IL-10). Most of the inflammatory cells in the lymph nodes were CD68+ (macrophages, epithelioid and giant cells), while a mixed infiltrate with macrophages, plasma cells and neutrophils was detected in the oral mucosa. TNF-alpha as well as iNOS expression was similar in lymph nodes and oral mucosa, whereas TGF-beta and IL-10 were observed in a larger number of macrophages, epithelioid and giant cells in the lymph nodes, where numerous yeast cells were visualized. The higher expression of anti-inflammatory cytokines (IL-10 and TGF-beta) in lesions of patients with the JF of PCM (lymph nodes) may represent a mechanism by which the fungus evades the host immune response, contributing to a more severe and disseminated form of the disease.     

Studies with Brugia pahangi. I. Parasitological observations on primary infections of cats (Felis catus)

The large majority of cats given a single inoculation of third stage larvae of Brugia pahangi became microfilaraemic. Some cats had microfilariae in their blood 53 or 54 days after infection and most had become positive before 72 days after infection. In the majority of cats microfilarial counts remained very steady between 2 and 10 microfilariae per mm³ for long periods. At autopsy 10·7% of the infective larvae injected were recovered as adult worms. The recovery of adult worms was directly related to the number of larvae injected. The microfilarial level did not increase significantly with an increase in the number of adult worms.     

Standard sampling techniques underestimate prevalence of avian hematozoa in willow ptarmigan (Lagopus lagopus)

A total of 68 willow ptarmigan (Lagopus lagopus L.) was collected during September 1995 from two localities in Troms County, northern Norway. Thin blood smears were prepared and examined for blood parasites. Of the 68 willow ptarmigan examined, 94% harbored one or more species of hematozoa. There were four (6%), 44 (65%), 16 (24%), and four (6%) birds infected by zero, one, two, and three species of parasites, respectively. Prevalences at the coastal locality, Kattfjord (n = 43), were Leucocytozoon lovati 86%, Trypanosoma avium (26%), and microfilariae (30%). At the inland locality, Iselvdalen (n = 25), prevalences were L. lovati 96%, T. avium 12%, and microfilariae 0%. We also searched connective tissues for the filaroid nematode Splendidofilaria papillocerca; in Kattfjord this parasite only occurred in adult hosts where prevalence was 94%, but the parasite was not found in Iselvdalen. To estimate the efficiency of parasite detection by standard blood sampling techniques, we sampled peripheral blood from the brachial wing vein and blood from the pulmonary system from willow ptarmigan. Sampling peripheral blood from the brachial vein led to underestimates of the prevalence of microfilariae. There was no significant difference between L. lovati and T. avium prevalence in blood collected from the brachial vein or deep circulation. Age of host had a strong impact on prevalence, especially for S. papillocerca and microfilariae.     

Early detection of Leishmania (Leishmania) chagasi in draining lymph node after subcutaneous inoculation in hamster

To study the route of migration of Leishmania (Leishmania) chagasi to the viscera from the subcutaneous inoculation site, ultrastructural studies were carried out. These studies on popliteal draining lymph nodes of hamsters inoculated with 10⁷ promastigotes of Leishmania (Leishmania) chagasi in the hind footpad were carried out. Parasites were detected in lymph nodes just 2 h after inoculation. Parasites were either preserved or degenerated in macrophages. In 24 h signs of binary division of the parasites were found in macrophages. This fact suggests that the parasites migrate from skin to the lymph node early in the infection within phagocytes and proliferate in lymph nodes before dissemination to the viscera.     

Systemic infection with Alaria americana (Trematoda).

Alaria americana is a trematode, the adult of which is found in mammalian carnivores. The first case of disseminated human infection by the mesocercarial stage of this worm occurred in a 24-year-old man. The infection possibly was acquired by the eating of inadequately cooked frogs, which are intermediate hosts of the worm. The diagnosis was made during life by lung biopsy and confirmed at autopsy. The mesocercariae were present in the stomach wall, lymph nodes, liver, myocardium, pancreas and surrounding adipose tissue, spleen, kidney, lungs, brain and spinal cord. There was no host reaction to the parasites. Granulomas were present in the stomach wall, lymph nodes and liver, but the worms were not identified in them. Hypersensitivity vasculitis and a bleeding diathesis due to disseminated intravascular coagulation and a circulating anticoagulant caused his death 8 days after the onset of his illness.     

Maxillary lymphosarcoma in a white-tailed deer (Odocoileus virginianus)

In 1996, lymphosarcoma was observed in a captive adult female white-tailed deer (Odocoileus virginianus) from northeastern Kansas (USA). A subcutaneous mass on the deer's left cheek was surgically removed and lymphosarcoma was diagnosed. The mass recurred within 3 wk. A second surgical removal was attempted but the tumor had grown much larger, had become intimately involved with the buccal mucosa, and was beginning to interfere with mastication. For these reasons, the deer was euthanized. At postmortem examination the only abnormal findings were the primary tumor and enlarged ipsilateral parotid and mandibular lymph nodes. Histologically these tissues demonstrated changes characteristic of lymphosarcoma but no other organs had evidence of neoplastic disease. A diagnosis of focal lymphosarcoma with local metastasis was made. The organ distribution of lymphosarcoma in this deer differs from previously described cases of lymphosarcoma in cervids.     

Biliary adenocarcinoma in a stranded northern elephant seal (Mirounga angustirostris)

A stranded adult female northern elephant seal (Mirounga angustirostris) was admitted to a rehabilitation hospital grossly underweight and lethargic in April 2001. The animal was icteric, had severe bilirubinemia, and elevated serum gamma glutamyl transferase concentrations. Laparoscopy under anesthesia revealed multiple masses up to 3 cm diameter throughout the liver and spleen and the animal was euthanized. Abnormal gross postmortem findings included green serous fluid in the abdominal cavity and 0.5 to 3 cm diameter yellow nodules scattered throughout the liver, spleen, and lymph nodes. Histopathology revealed a biliary adenocarcinoma with metastases to the liver, spleen, lymph nodes, adrenal gland, and pancreas. This is believed to be the first reported case of neoplasia in a northern elephant seal.     

The effect of infusions of microfilariae (L1 larvae) of Dirofilaria immitis in dogs

Four pups were given three intravenous infusions of microfilariae over a 7-month period to determine if radiographic changes could be detected in the lungs while sensitivity to first stage microfilariae was being induced. Mild pathological changes occurred but these could not be detected on any of the radiographs. Radiographic changes described by others and 'Eosinophilic lungs' did not result from the immune response to the first stage larvae.     

Correlation of the Apparent Diffusion Coefficient (ADC) with the Standardized Uptake Value (SUV) in Lymph Node Metastases of Non-Small Cell Lung Cancer (NSCLC) Patients Using Hybrid 18F-FDG PET/MRI

ObjectiveTo compare the apparent diffusion coefficient (ADC) in lymph node metastases of non-small cell lung cancer (NSCLC) patients with standardized uptake values (SUV) derived from combined 18F-fluoro-deoxy-glucose-positron emission tomography/magnetic resonance imaging (18F-FDG PET/MRI).ResultsA total of 146 suspicious lymph nodes were found in 25 patients. One hundred lymph nodes were eligible for final analysis. Ninety-one lymph nodes were classified as malignant and 9 as benign according to the reference standard. In malignant lesions, mean SUV_max was 9.1 ± 3.8 and mean SUV_mean was 6.0 ± 2.5 while mean ADC_mean was 877.0 ± 128.6 x10^-5 mm²/s in PET/MRI. For all malignant lymph nodes, a weak, inverse correlation between SUV_max and ADC_mean as well as SUV_mean and ADC_mean (r = -0.30, p<0.05 and r = -0.36, p<0.05) existed.ConclusionThe present data show a weak inverse correlation between increased glucose-metabolism and cellularity in lymph node metastases of NSCLC patients. 18F-FDG-PET and DWI thus may offer complementary information for the evaluation of treatment response in lymph node metastases of NSCLC.     

Setaria digitata infections in cattle: parasite load, microfilaraemia status and relationship to immune response

A total of 110 cattle were examined in an area endemic for Bancroftian filariasis for the prevalence of infection of the bovine filarial parasite Setaria digitata. About 12.5% of cattle were found to harbour both adult worms in the peritoneum and microfilariae (mf) in circulation; 70% of the cattle were amicrofilaraemic but with an adult worm infection. A third group of cattle (16.5%) was free of detectable mf and adult worms. The presence of adult worms and/or mf did not influence the antibody levels to any of the four antigen preparations of S. digitata. However, there was a significant inverse relationship between the presence of antibodies to microfilarial sheaths and the absence of circulating mf as shown by the immunoperoxidase assay. Cattle immunoglobulin containing high titres of anti-sheath antibodies cleared circulating microfilariae very effectively in Mastomys coucha thus demonstrating the protective nature of anti-sheath antibodies in eliminating circulating microfilariae in vivo.