A 25-year old Korean male was admitted to Seoul National University Hospital on July 5, 1982 because of fever, epigastric discomfort and diarrhea. Laboratory examination revealed moderate eosinophilia, and large operculated helminth eggs in stool repeatedly. Other laboratory test resulted in normal range and bacteriological cultures were nefative. Under the impression of intestinal fluke infection, bithionol treatment with magnesium purgation was tried. From the diarrheal stool after treatment, a total of 79 small adult trematodes was collected, and identified as Fibricola seoulensis. The patient had eaten raw viscera of 2 snakes 9 days before admission in a rural village in Korea. It was assumed that this is the first record that described human infection by an adult diplostomatid fluke.
parasitology-helminth-trematoda ; Fibricola seoulensis ; case report ; eosinophilia ; fever ; epigastric discomfort ; diarrhea ; magnesium

We had an opportunity to evaluate a child who developed fever approximately two to three weeks after the open heart surgery for tetralogy of Fallot. His peripheral blood smear showed rings and various stages of Plasmodium vivax. The patient had received packed red blood cells during the surgery and postoperative care, one unit of which was later proved sero-positive for malaria. The possibility of malaria should be included in the differential diagnosis of the patients with unexplained fever after multiple blood product transfusions for the open heart surgery.
Animal ; Blood Transfusion/*adverse effects ; Cardiac Surgical Procedures ; Case Report ; Fever/parasitology ; Human ; Infant ; Korea ; Malaria, Vivax/*transmission ; Male ; *Plasmodium vivax ; Tetralogy of Fallot/*surgery

OBJECTIVETo investigate whether Leptotrombidium scutellare could be naturally infected by both Hantaan virus (HV) and Orientia tsutsugamushi (OT) and transmission status by stinging.

METHODS3459 Leptotrombidium scutellares from mice bodies and 3265 which were free were collected in the epidemic area of hemorrhagic fever with renal syndrome (HFRS) and tsutsugamushi disease.15 days later, the suspensions of lung and spleen of mice with 6 in a group stung by 1, 5 or 10 infected mites were injected intra-cerebrally into other mice for the detection of HV and OT in the next 6 generations of the mice, with immunofluorescent antibody technique (IFAT) and Giemsa staining technique. The passages of Vero-E6 cells inoculated on the aseptic filtrations from different number of infected mites were used to detect HV and OT pathogens. HV-RNA and OT-DNA were detected by PCR.

RESULTSAfter passage, HV positive mouse body mite group out of both 5 and 10 mites in the sixth generation, OT positive mouse body mite group out of the 10 mites in the sixth generation, both HV and OT positive mouse body mite group out of 1 mite in the fifth and sixth generation, both HV and OT positive mouse body mite group out of 5 and 10 mites in the sixth generation, and free mites group out of 1, 5 and 10 mites in the sixth generation, were found one mouse infected by both HV and OT, respectively. Out of the fourth generation of Vero-E6 cells, one sample was found both HV and OT positive out of 5 and 10 HV and OT mouse body mite group, respectively. In the sixth generation, both HV and OT positive cells were detected in one mouse mite group and the 1, 5, 10 free mite groups, respectively. HV-RNA and OT-DNA were all detected by PCR.

CONCLUSIONBoth HV and OT could be coexisted in wild Leptotrombidium scutellare and transmitted by stinging.

Animals ; Hantaan virus ; Hemorrhagic Fever with Renal Syndrome ; transmission ; Insect Bites and Stings ; Mice ; Mice, Inbred Strains ; Mites ; parasitology ; virology ; Murinae ; Orientia tsutsugamushi ; Scrub Typhus ; transmission ; Trombiculidae

Malaria is endemic across lowland Papua New Guinea (PNG) and case management has been based on symptomatic diagnosis and presumptive treatment of fever cases with an antimalarial. This study aimed to investigate the prevalence of malaria infection among fever cases presenting to 5 purposely selected sentinel health facilities in order to estimate the proportion of patients requiring antimalarial drugs. A total of 1807 fever patients were screened. Overall, 45% of fever patients had a positive malaria blood slide; 35% were infected with Plasmodium falciparum, 9% with P. vivax and 2% with P. malariae. Slide positivity was highest in Dreikikir (75%) and lowest in Wipim (2%). Among patients aged 1-4 years, 22% had moderate to severe anaemia (Hb < 8 g/dI) and 21% of children 2-9 years of age showed signs of splenomegaly (Hackett score 1-5). Comorbidity differed significantly between study sites and was not closely correlated with malaria infection. Clinical diagnosis by health facility staff was malaria for 67% of all fever cases, including 89% of slide-positive and 48% of slide-negative patients. 70% of rapid diagnostic test-negative cases were treated with an antimalarial. It is estimated that due to the lack of parasitological diagnosis the selected health facilities reported an excess of 18% (Dreikikir) to 98% (Wipim) malaria patients on average each month. In consideration of the significant differences in malaria-attributable fevers between study sites, the implementation of parasitological diagnosis in health facilities and administration of antimalarials only to test-positive patients has the potential to significantly improve the management of fever cases and reporting of malaria. A better tailoring to different settings may increase the effectiveness of malaria control interventions.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Fever/*parasitology ; Humans ; Infant ; Malaria/complications/diagnosis/*epidemiology ; Male ; Papua New Guinea/epidemiology ; Young Adult

Visceral leishmaniasis or kala-azar is an endemic parasitic disease in some parts of the world which is characterized by fever, splenomegaly, and pancytopenia in most of the cases. Herein we report an 11 month-old male infant with diagnosis of kala-azar who presented with pallor, hepatosplenomegaly, failure to gain weight, and no history of fever. Surprisingly, fever started after beginning of meglumine antimoniate treatment in this patient. As far as we are aware of, this is a rare presentation of visceral leishmaniasis. Therefore, clinicians especially in endemic areas are highly recommended to include kala-azar among differential diagnosis of unexplained anemia without fever to prevent misdiagnosis of this potentially fatal, but treatable condition.
Amphotericin B/therapeutic use ; Anemia/*diagnosis/parasitology ; Antiprotozoal Agents/*therapeutic use ; Deoxycholic Acid/therapeutic use ; Diagnosis, Differential ; Drug Combinations ; Endemic Diseases ; *Fever ; Humans ; Infant ; Iran ; Leishmania infantum/pathogenicity ; Leishmaniasis, Visceral/*diagnosis/*drug therapy/parasitology ; Male ; Meglumine/therapeutic use ; Organometallic Compounds/therapeutic use ; Splenomegaly/parasitology

From nine species of small mammals collected during the 12 month study period, nine species of fleas were recovered. Of the fleas, Ctenophthamus congeneroides congeneroides were obtained from seven host species, were recovered every month but January, comprised greater than 60% of the freas recovered each month except Noverber, December and January, accounted for more than 60% of all fleas and were collected from 15 of 17 localities visited. During November, December and January more than 50% of all fleas recovered were Stenoponia sidimi. Too, the greatest variety of flea species were recovered during November and December. Among the hosts, all nine flea species were recovered from Apodemus agrarius, six species were obtained from Microtus fortis and four from both Eothenomys regulus and Crocidura laciura. The highest rates of infested individuals, highest to lowest E. regulus, M.fortis, C.lasiura and A. agrarius. The highest general and specific indices were found in M.agrarius occurred in April and May and the highest monthly specific indices were noted for January, April and May. Ctenophthalmus congeneroides was the most abundant flea, had the widest host range, seasonal occurrence and the widest habitat distribution of the flea collected during this study. These fleas exhibited a decline in abundance in midwinter and an increase in numbers in the early spring. Among the small mammals, Apodemus agrairus yielded the greatest number of fleas species and was most heavily infested with during April and May.
parasitology-arthropoda-flea ; hemorrhagic fever ; epidemiology ; Ctenophthamus congeneroides congeneroides ; Stenoponia sidimi ; rat ; Apodemus agrarius ; Microtus fortis ; Eothenomys regulus ; Crocidura laciura ; Microtus agrarius ; Xenopsylla cheopsis ; Hystricopsylla microti ; Neopsylla bidentatiformis ; Rhadinopsylla insolita ; Peromiscopsylla hamifer cuneata ; Monopsylla anisus

A single dose of Tetramisole, 2.5 mg/kg body weight, was given to the infected cases of intestinal parasites. The number of cases were: Ascaris lumbriocides 96, hookworm 16, Trichostrongylus orientalis 10, Trichocephalus trichiurus 114 and Clonorchis sinensis 19. No dietary restriction before and after the administration of Tetramisole was required. In Ascaris infection the egg negative conversion rate and the egg reduction rate were 92.7 per cent and 99.5 per cent, respectively. In Trichostrongylus orientalis infections, 9 out of 10 cases were resulted egg negative after the single dose of Tetramisole, and hookworm, 12 out of 16 administered showed egg negative. However, there were no appreciable effectiveness to the cases of Trichocephalus trichiurus and Clonorchis sinensis. Mild and transient side effects were noted in 75 cases (54.5%) out of 140 cases. The main symptoms were dizziness (25.5%), anorexia (25.5%), abdominal pain (18.6%), diarrhea (16.6%), headache (15.2%), nausea (14.4%) and fever (11.0%). From the above results, it is anticipated that Tetramisole is an effective anthelminthic for elimination of Ascaris, Trichostrongylus and hookworm.
parasitology-helminth-trematoda-nematoda ; Ascaris lumbricoides ; hookworm ; Trichostrongylus orientalis ; Trichocephalus trichiurus ; Clonorchis sinensis ; chemotherapy-Tetramisole ; 2,3,5,6,- tetrahydro 6- phenyl-imidazole (2,1-b) thiazole hydrochloride ; dizziness ; anorexia ; abdominal pain ; diarrhea ; headache ; nausea ; fever ; Tetramisole