Melting temperature shift (T(m)-shift) is a new detection method that analyze the melting curve on real-time PCR thermocycler using SYBR Green I fluorescent dye. To establish a T(m)-shift method for the detection of Ancylostoma ceylanicum and A. tubaeforme in cats, specific primers, with GC tail of unequal length attached to their 5′ end, were designed based on 2 SNP loci (ITS101 and ITS296) of the internal transcribed spacer 1 (ITS1) sequences. The standard curve of T(m)-shift was established using the standard plasmids of A. ceylanicum (AceP) and A. tubaeforme (AtuP). The T(m)-shift method stability, sensitivity, and accuracy were tested with reference to the standard curve, and clinical fecal samples were also examined. The results demonstrated that the 2 sets of primers based on the 2 SNPs could accurately distinguish between A. ceylanicum and A. tubaeforme. The coefficient of variation (CV) of T(m)-values of AceP and AtuP was 0.07% and 0.06% in ITS101 and was 0.06% and 0.08% in ITS296, respectively. The minimum detectable DNA concentration was 5.22×10⁻⁶ and 5.28×10⁻⁶ ng/μl samples of AceP and AtuP, respectively. The accuracy of T(m)-shift method reached 100% based on examination of 10 hookworm DNA samples with known species. In the clinical detection of hookworm in 69 stray cat fecal sample, the T(m)-shift detection results were consistent with the microscopic examination and successfully differentiated between the 2-hookworm species. In conclusion, the developed method is a rapid, sensitive and accurate technique and can provide a promising tool for clinical detection and epidemiological investigation of cat-derived hookworms.
Ancylostoma ; Ancylostomatoidea ; Animals ; Cats ; DNA ; Freezing ; Methods ; Plasmids ; Polymorphism, Single Nucleotide ; Real-Time Polymerase Chain Reaction ; Tail

A 20-year-old Cambodian male living in Korea for 2 years as a foreign worker visited our gastroenterology outpatient clinic. He had a small farm in Cambodia. He complained of postprandial upper abdominal pain with nausea and vomiting for 2 years. Gastroduodenoscopy showed hyperemic mucosa near the major papilla in the duodenum and two small and slender reddish worms. These were removed with endoscopic biopsy forceps. Under microscopy, these were identified as Ancylostoma duodenale by the characteristic morphology of 2 pairs of cutting teeth in the buccal cavity and 3 lobes in the copulatory bursa. After removal of two worms, his symptom improved. Soil-transmitted helminths (STH) present a global health problem. In the Republic of Korea, STH, including hookworms, were highly prevalent until the 1970s. With mass fecal examination followed by selective mass chemotherapy with anthelmintics from 1969 to 1995, the prevalence of STH has rapidly decreased since the 1980s. Since 2004, no hookworms have been found in nationwide surveys on the prevalence of intestinal parasitic infection. Therefore, we report a case of in vivo endoscopic removal of A. duodenale in a patient with abdominal pain.
Abdominal Pain ; Agriculture ; Ambulatory Care Facilities ; Ancylostoma ; Ancylostomatoidea ; Anthelmintics ; Asian Continental Ancestry Group ; Biopsy ; Cambodia ; Drug Therapy ; Duodenum ; Endoscopy ; Gastroenterology ; Global Health ; Helminths ; Humans ; Korea ; Male ; Microscopy ; Mucous Membrane ; Nausea ; Parasitic Diseases ; Prevalence ; Republic of Korea ; Surgical Instruments ; Tooth ; Vomiting ; Young Adult

Hookworm infections are rare causes of acute gastrointestinal bleeding. We report a middle aged man with primary nephrotic syndrome and pulmonary embolism. During the treatment with steroids and anticoagulants, the patient presented acute massive hemorrhage of the gastrointestinal tract. The results of gastroscopy showed red worms in the duodenum. Colonoscopy and CT angiogram of abdomen were unremarkable. Capsule endoscopy revealed fresh blood and multiple hookworms in the jejunum and ileum. Hookworms caused the acute intestinal bleeding. The patient responded well to albendazole. Hematochezia was markedly ameliorated after eliminating the parasites. Hence, hookworm infection should be considered in the differential diagnosis of a patient with obscure gastrointestinal bleeding. Capsule endoscopy may offer a better means of diagnosis for intestinal hookworm infections.
Abdomen ; Albendazole ; Ancylostoma ; Ancylostomatoidea* ; Anticoagulants ; Capsule Endoscopy ; Colonoscopy ; Diagnosis ; Diagnosis, Differential ; Duodenum ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Gastroscopy ; Hemorrhage* ; Hookworm Infections* ; Humans ; Ileum ; Jejunum ; Middle Aged ; Necator americanus ; Nephrotic Syndrome ; Parasites ; Pulmonary Embolism ; Steroids

Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.
Albendazole ; Ancylostoma ; Ancylostomatoidea* ; Anemia, Iron-Deficiency ; Blood Transfusion ; Capsule Endoscopy ; Colonoscopy ; Diagnosis ; Double-Balloon Enteroscopy ; Eggs ; Endoscopy, Digestive System ; Follow-Up Studies ; Hematologic Tests ; Hemorrhage* ; Hookworm Infections* ; Humans ; Intestine, Small ; Iron ; Necator americanus ; Ovum

A 26-year-old male member of the Australian Defense Force presented with a history of central abdominal pain of 4 weeks duration and peripheral eosinophilia consistent with eosinophilic enteritis. Acute hookworm disease was diagnosed as the cause. Adult worms recovered from feces after therapy with albendazole were morphologically consistent with Ancylostoma ceylanicum. As the patient had been deployed with the Regional Assistance Mission to Solomon Islands for 6 months prior to this presentation, it is very likely that the A. ceylanicum was acquired in Solomon Islands. Until now, it has been assumed that any Ancylostoma spp. recovered from humans in Solomon Islands is A. duodenale. However, this case demonstrates that human hookworm infection acquired in the Solomon Islands could be caused by A. ceylanicum.
Abdominal Pain ; Adult ; Albendazole ; Ancylostoma* ; Ancylostomatoidea ; Enteritis ; Eosinophilia ; Eosinophils ; Feces ; Hookworm Infections ; Humans ; Male ; Melanesia* ; Military Personnel*

Irritable bowel syndrome (IBS) is a gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any organic cause. As the clinical manifestations are very diverse and associated with nonspecific symptoms, research seeking to identify organic causes to rule out IBS and to enable differential diagnosis is required. A 24-year-old man was referred to our hospital for specialized management of IBS. He had a 7-month history of intermittent epigastric and lower abdominal pain. On the basis of clinical examination, he was diagnosed with IBS and administered medication at a primary clinic. However, his symptoms did not improve after treatment. We performed capsule endoscopy at our hospital and identified a parasite (Ancylostoma duodenale) in the proximal jejunum. We therefore report a case of parasitic infection found by additional examination while evaluating symptoms associated with a previous diagnosis of refractory IBS.
Abdominal Pain ; Ancylostoma ; Ancylostomatoidea ; Capsule Endoscopy ; Diagnosis* ; Diagnosis, Differential ; Humans ; Irritable Bowel Syndrome* ; Jejunum ; Parasites* ; Young Adult

The 2 principal species of hookworms infecting humans are Necator americanus and Ancylostoma duodenale. Case studies on zoonotic hookworm infections with Ancylostoma ceylanicum and/or Ancylostoma caninum are known mainly from Asian countries. Of these 2 zoonotic species, only A. ceylanicum can develop to adulthood in humans. In the present study, we report a molecular-based survey of human hookworm infections present in southern and northeastern Thailand. Thirty larval hookworm samples were obtained from fecal agar plate cultures of 10 patients in northeastren Thailand and 20 in southern Thailand. Partial ITS1, 5.8S, and ITS2 regions of the ribosomal DNA genes were amplified using PCR. The amplicons were sequenced, aligned, and compared with other hookworm sequences in GenBank database. The results showed that, in Thailand, N. americanus is more prevalent than Ancylostoma spp. and is found in both study areas. Sporadic cases of A. ceylanicum and A. duodenale infection were seen in northeastern Thailand.
Ancylostoma/classification/genetics/*isolation & purification ; Ancylostomiasis/*epidemiology ; Animals ; Cluster Analysis ; DNA, Ribosomal Spacer/chemistry/genetics ; Feces/parasitology ; Humans ; Molecular Sequence Data ; Necator americanus/classification/genetics/*isolation & purification ; Necatoriasis/*epidemiology ; Phylogeny ; Polymerase Chain Reaction ; Prevalence ; RNA, Ribosomal, 5.8S/genetics ; Sequence Analysis, DNA ; Sequence Homology, Nucleic Acid ; Thailand/epidemiology

Feline parasites were investigated in the area of Suwon in Korea from September to October, 2003. Wild cat had spread to zoonotic parasites, these parasites could cause infection with a person. People have a lot of interest in parasite infection of wild cat. This article reviews rate of infection of a parasites and kind of a parasite of wild cats. We will report the critical characteristic features of parasites to a better understanding of the disease. The incidence rates of Toxocara cati, Trichuris felis, Ancylostoma braziliense and Capillaria sp were 37.0, 4.3, 1.1 and 1.1% in nematodes. Those of Taenia taeniaformis and Opisthorchis sp were 2.2 and 1.1% in cestode and trematode. Those of Isospora felis, Toxoplasma gondii, and Sarcocystis sp were 8.7, 9.8, and 2.2% in protozoa. Almost of these were zoonotic parasites without Isospora felis.
Ancylostoma ; Animals ; Capillaria ; Cats ; Cestoda ; Felis ; Humans ; Incidence ; Isospora ; Korea ; Opisthorchis ; Parasites ; Prevalence ; Sarcocystis ; Taenia ; Toxocara ; Toxoplasma ; Trichuris

Approximately 60% of U.S. and 22% of Korean households have at least one or more pet animals, and a considerably large percentage of which are considered family members. Although these companion animals can offer substantial physical and psychological benefits to humans, zoonotic diseases can be transmitted from them especially when animals are taken directly from the wild to serve as pets. Although zoonoses of traditional pets such as dogs and cats are relatively well recognized compared to those from wild animals by veterinary practitioners, their prevention and treatment are generally poorly understood by physicians. This review covers commonly recognized parasitic agents that can potentially cause illness to both human and animal household members in Korea. Ectoparasites such as fleas, ticks and sarcoptic mites can transmit vector-borne diseases and also directly cause illness, while endoparasites such as Toxocara spp., Ancylostoma spp., Dipylidum caninum. Giardia spp. and Cryptosporidium parvum can cause zoonotic infections in humans. Toxoplasma gondii which is one of the most important zoonotic infections from cat is covered in depth at the end of this article since Koreans, especially young household members, have recently been increasingly recognizing pedigree cats as their family members.
Ancylostoma ; Animals ; Animals, Wild ; Cats ; Cryptosporidium parvum ; Dogs ; Family Characteristics ; Friends ; Giardia ; Humans ; Korea ; Mites ; Parasitic Diseases ; Pedigree ; Pets ; Siphonaptera ; Ticks ; Toxocara ; Toxoplasma ; Zoonoses

Trichostrongylus eggs observed in cellophane-thick smears are difficult, in practice, to distinguish from hookworm eggs. In order to overcome these limitations, a molecular approach was conducted. A Trichostrongylus colubriformis adult worm was obtained from a human in Laos, which was identified morphologically. ITS-1 sequence of this worm was determined, and found to be most similar with that of T. colubriformis among the Trichostrongylus spp. reported so far. Then, this sequence was compared with those of human hookworm species, Ancylostoma duodenale and Necator americanus, and species-specific oligonucleotide primers were designed. Polymerase chain reaction (PCR) using these primers evidenced specifically amplified PCR products of Trichostrongylus sp., A. duodenale and N. americanus from the eggs of each (520 bp, 690 bp, and 870 bp, respectively). A species-specific PCR technique can be developed in order to study the epidemiology of Trichostrongylus spp. and hookworms in endemic areas.
Ancylostoma/*genetics/isolation & purification ; Ancylostomiasis/*diagnosis/parasitology ; Animals ; Base Sequence ; DNA, Intergenic/genetics ; DNA, Protozoan/genetics ; DNA, Ribosomal Spacer/genetics ; Diagnosis, Differential ; Humans ; Molecular Sequence Data ; Necator americanus/*genetics/isolation & purification ; Phylogeny ; Polymerase Chain Reaction/*methods ; Sequence Alignment ; Trichostrongylosis/*diagnosis/parasitology ; Trichostrongylus/*genetics/isolation & purification