As gastroduodenoscopy performed more frequently, case reports of human echinostomiasis are increasing in Korea. A Korean woman presented at a local clinic with complaints of abdominal pain and discomfort that had persisted for 2 weeks. Under gastroduodenoscopy, two motile flukes were found attached on the duodenal bulb, and retrieved with endoscopic forceps. She had history of eating raw frog meat. The two flukes were identified as Echinostoma hortense by egg morphology, 27 collar spines with 4 end-group spines, and surface ultrastructural characters. This report may prove frogs to be a source of human echinostome infections.
Animals ; Duodenal Diseases/*parasitology ; Duodenum/*parasitology ; Echinostoma/*isolation & purification ; Echinostomiasis/*diagnosis ; Endoscopy ; Female ; Humans ; Korea ; Middle Aged

Animals ; Duodenal Diseases ; diagnosis ; parasitology ; pathology ; Duodenum ; parasitology ; pathology ; Humans ; Intestinal Perforation ; diagnosis ; parasitology ; pathology ; Male ; Middle Aged ; Taenia saginata ; pathogenicity

Animals ; Duodenal Diseases ; diagnosis ; Duodenum ; parasitology ; pathology ; Humans ; Intestinal Perforation ; diagnosis ; Male ; Taenia saginata ; pathogenicity

Arthrostoma miyazakiense (Nematoda: Ancylostomatidae) is a hookworm species reported from the small intestines of raccoon dogs (Nyctereutes procyonoides) in Japan. Five Korean raccoon dogs (N. procyonoides koreensis) caught from 2002 to 2005 in Jeollanam-do (Province), a southeastern area of South Korea, contained helminth eggs belonging to 4 genera (roundworm, hookworm, whipworm, and Capillaria spp.) and cysts of Giardia sp. in their feces. Necropsy findings of 1 raccoon dog revealed a large number of adult hookworms in the duodenum. These hookworms were identified as Arthrostoma miyazakiense based on the 10 articulated plates observed in the buccal capsule and the presence of right-sided prevulval papillae. Eggs of A. miyazakiense were 60-65 x 35-40 micrometer (av. 62.5 x 35 micrometer), and were morphologically indistinguishable from those of Ancylostoma caninum. The eggs were cultured to infective 2nd stage larvae via charcoal culture, and 100 infective larvae were used to experimentally infect each of 3 mixed-bred puppies. All puppies harbored hookworm eggs in their feces on the 12th day after infection. This is the first report thus far concerning A. miyazakiense infections in raccoon dogs in Korea, and the first such report outside of Japan.
Ancylostomatoidea/anatomy & histology/*classification/*isolation & purification ; Animals ; Disease Models, Animal ; Dog Diseases/*parasitology ; Dogs ; Duodenum/parasitology ; Feces/parasitology ; Female ; Hookworm Infections/parasitology/*veterinary ; Korea ; Larva/growth & development ; Male ; *Raccoon Dogs

Toxoplasma gondii Korean isolate (KI-1) tachyzoites were inoculated intraduodenally to BALB/c mice using a silicon tube, and the course of infection and immune responses of mice were studied. Whereas control mice, that were infected intraperitoneally, died within day 7 post-infection (PI), the intraduodenally infected mice survived until day 9 PI (infection with 1x10(5) tachyzoites) or day 11 PI (with 1x10(6) tachyzoites). Based on histopathologic (Giemsa stain) and PCR (B1 gene) studies, it was suggested that tachyzoites, after entering the small intestine, invaded into endothelial cells, divided there, and propagated to other organs. PCR appeared to be more sensitive than histopathology to detect infected organs and tissues. The organisms spread over multiple organs by day 6 PI. However, proliferative responses of splenocytes and mesenteric lymph node (MLN) cells in response to con A or Toxoplasma lysate antigen decreased significantly, suggesting immunosuppression. Splenic CD4+ and CD8+ T-lymphocytes showed decreases in number until day 9 PI, whereas IFN-gamma and IL-10 decreased slightly at day 6 PI and returned to normal levels by day 9 PI. No TNF-alpha was detected throughout the experimental period. The results showed that intraduodenal infection with KI-1 tachyzoites was successful but did not elicit significant mucosal immunity in mice and allowed dissemination of T. gondii organisms to systemic organs. The immunosuppression of mice included reduced lymphoproliferative responses to splenocytes and MLN cells to mitogen and low production of cytokines, such as IFN-gamma, TNF-alpha, and IL-10, in response to T. gondii infection.
Animals ; Cell Proliferation ; Cytokines/secretion ; Disease Models, Animal ; Duodenum/immunology/parasitology/pathology ; Endothelial Cells/parasitology ; Histocytochemistry ; Immune Tolerance ; Lymph Nodes/immunology ; Mice ; Mice, Inbred BALB C ; Polymerase Chain Reaction ; Rodent Diseases/immunology/parasitology/pathology ; T-Lymphocyte Subsets/immunology ; Toxoplasma/*immunology/pathogenicity ; Toxoplasmosis, Animal/*immunology/parasitology/pathology

We describe an unusual presentation of Clonorchis sinensis infection with obstructive jaundice due to duodenal papillitis which was relieved dramatically by endoscopic sphincterotomy. A 26-yr-old male presented with complaints of fatigue, weight loss and painless jaundice. The history was significant for frequent ingestion of raw freshwater fish. The patient underwent endoscopic retrograde cholangiopancreatography for evaluation of obstructive jaundice. The duodenal papilla was markedly edematous with a bulging configuration and hyperemic changes at the orifice. Cholangiography revealed mild bile duct dilatation and irregular wall changes with multiple indentations. However, there were no biliary stricture or stones noted as the cause of obstructive jaundice. We performed an endoscopic sphincterotomy for effective bile drainage through the duodenal papilla. After the sphincterotomy, the patient's jaundice was dramatically improved. Pathology of the duodenal papilla showed eosinophilic infiltration of the mucosa. Parasitic eggs, consistent with the diagnosis of C. sinensis, were found in the bile sample.
Adult ; *Ampulla of Vater ; Animals ; Anthelmintics/therapeutic use ; Bile/parasitology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis/*diagnosis/parasitology/pathology ; Clonorchiasis/*diagnosis ; Clonorchis sinensis/drug effects/isolation & purification ; Duodenum/pathology ; Humans ; Jaundice, Obstructive/*diagnosis/etiology ; Male ; Praziquantel/therapeutic use ; Sphincterotomy, Endoscopic ; Tomography, X-Ray Computed