Parasite Genotypically Related to a Monoxenous Trypanosomatid of Dog's Flea Causing Opportunistic Infection in an HIV Positive Patient

Pacheco, Raquel S.; Marzochi, Mauro Célio de Almeida; Pires, Marize Quinhones; Brito, Celia Maria Marques; Madeira, Maria de Fátima; Barbosa-Santos, Elizabeth Gloria Oliveira

doi:10.1590/s0074-02761998000400021

Cited by 70 publications

(47 citation statements)

References 27 publications

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“…Most likely, humans could be infected through contact with feces of parasitized insects, as observed for the human pathogen Trypanosoma cruzi (3,9,11). In the present report, it could not be determined how our patient was infected, but since he had no history of intravenous drug abuse, the hypothesis of contamination through needle sharing, as demonstrated for Leishmania parasites, is unlikely (4, 7).…”

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confidence: 67%

“…Nevertheless, a few potential cases have been described in the literature, but questions remain due to the absence of an exact identification of the causative agents. Interestingly, most of these cases, excluding one, were in HIV-infected patients (5,7,9,11,13). In this article, we describe the first isolation of a protozoan that is genetically closely related to a parasite of insects, H. samuelpessoai, in an HIV-infected patient.…”

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confidence: 98%

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Isolation of a Protozoan Parasite Genetically Related to the Insect Trypanosomatid Herpetomonas samuelpessoai from a Human Immunodeficiency Virus-Positive Patient

et al. 2008

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Severely immunocompromised human immunodeficiency virus (HIV) patients can develop various opportunistic infections due to bacteria, viruses, fungi, or protozoa. Here we report the first isolation of a flagellated protozoan genetically closely related to Herpetomonas samuelpessoai, which is usually a parasite of insects, from the blood of an HIV-infected patient. CASE REPORTIn November 2003, a 42-year-old man living in the south of France with no history of recent travel outside France was admitted to Montpellier University Hospital with a fever (38.9°C) and left-side continual frontal headache that had persisted for 15 days. The patient was working as a florist, was homosexual, and had no history of drug abuse. He had been human immunodeficiency virus (HIV)-positive since 1991 and had experienced multiple antiretroviral therapy failures. His CD4 cell count had been below 20 cells/mm 3 for 7 years. He had presented with several opportunistic infections, such as anal condyloma, herpes zoster, and multiple episodes of oral candidiasis. At the time of admission, he was treated with abacavir, lamivudine, ritonavir, amprenavir, and cotrimoxazole.Upon admission, physical examination was normal. No neurological signs or primary infection site was noted. Cerebral tomodensitometry showed no abnormality. Laboratory findings revealed a moderate inflammatory syndrome (C-reactive protein, 18.8 mg/liter) and pancytopenia: anemia (hemoglobin, 10.7 g/dl), neutropenia (white blood cell count, 0.9 ϫ 10 3 /mm 3 with 65% neutrophils, 19% lymphocytes, 11% monocytes, and 3% eosinophils), and thrombocytopenia (83 ϫ 10 3 / mm 3 ). A bone marrow biopsy performed on day four after admission showed a regenerative process. Taking into account the fever and pancytopenia, bacterial, viral, fungal, and parasitological investigations (Toxoplasma detection by PCR) were performed on the sputum, blood, cerebrospinal fluid, and bone marrow. Results of all of these investigations were negative. Because leishmaniasis is endemic in the south of France, a blood sample was inoculated on Novy-MacNeal-Nicolle (NNN) medium, a specific blood-enriched culture medium (6), at 27°C and checked weekly for the presence of Leishmania parasites. Four weeks after seeding, a flagellated protozoan was isolated, and the Giemsa-stained preparations from this culture showed a cell body mean size of 10 m by 2.5 m and a flagellum mean size around 12 m. The kinetoplast was generally located close to the nucleus in a para-or promastigote position. The global morphology of the cells was clearly different from that of the Leishmania promastigotes (Fig. 1).Therefore, molecular identification was performed based on nucleotide sequence analysis of 5S and 18S ribosomal DNA regions. Amplification of the 5S region was performed using the previously described primer pair 5S-L and 5S-R, whereas amplification of the 18S region was performed using two primers designed for this study, SSUeuglenD (5Ј-GCGTGCGGTT TAATTTGACT-3Ј) and SSUeuglenR (5Ј-GGACGTAATCG GCACAGTTT-3Ј) (12). PCR product...

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confidence: 67%

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Isolation of a Protozoan Parasite Genetically Related to the Insect Trypanosomatid Herpetomonas samuelpessoai from a Human Immunodeficiency Virus-Positive Patient

et al. 2008

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“…The most recent report of a lower trypanosomatid-HIV coinfection in a Brazilian male was described by Pacheco et al (417). The patient presented to a local hospital complaining of weakness and fever.…”

Section: Lower Trypanosomatidsmentioning

confidence: 98%

Importance of Nonenteric Protozoan Infections in Immunocompromised People

et al. 2010

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SUMMARY There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed.

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“…The occurrence of insect trypanosomatids in humans is exceptional, but reports are available that HIV-positive patients are additionally infected with nonpathogenic insect trypanosomatids (6). In Brazil, Pacheco et al (15) described a flagellate, appar-ently a monoxenous trypanosomatid, in a 35-year-old HIV-positive male who presented with symptoms of VL. Hybridization analyses, against a panel of many different trypanosomatids, revealed that the unknown flagellate had kinetoplastid DNA (kDNA) cross-homology only with Leptomonas pulexsimulantis, a parasite of a dog flea (18).…”

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Coinfection of Leptomonas seymouri and Leishmania donovani in Indian Leishmaniasis

et al. 2012

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Leishmania donovani is considered the causative organism of visceral leishmaniasis (VL) and post-kala-azar dermal leishmaniasis (PKDL). Testing of 4/29 DNA samples from VL and PKDL patients as well as 2/7 field isolates showed an aberrant internal transcribed spacer 1 (ITS1) restriction fragment length polymorphism (RFLP) pattern, which upon sequencing strongly matched Leptomonas seymouri, thus confirming its presence in Indian leishmaniasis.

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Parasite Genotypically Related to a Monoxenous Trypanosomatid of Dog's Flea Causing Opportunistic Infection in an HIV Positive Patient

Cited by 70 publications

References 27 publications

Isolation of a Protozoan Parasite Genetically Related to the Insect Trypanosomatid Herpetomonas samuelpessoai from a Human Immunodeficiency Virus-Positive Patient

Isolation of a Protozoan Parasite Genetically Related to the Insect Trypanosomatid Herpetomonas samuelpessoai from a Human Immunodeficiency Virus-Positive Patient

Importance of Nonenteric Protozoan Infections in Immunocompromised People

Coinfection of Leptomonas seymouri and Leishmania donovani in Indian Leishmaniasis

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