First detection of acalculous cholecystitis associated with Sarcocystis infection in a patient with AIDS

Agholi, Mahmoud; Heidarian, Hamid Reza; Moghadami, Mohsen; Hatam, Gholamreza

doi:10.2478/s11686-014-0243-1

Cited by 12 publications

(13 citation statements)

References 27 publications

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“…Only a few studies have discussed the host's immune response against Sarcocystis spp. From the reported cases, it was obvious that infection elicits a strong eosinophilic and T cell-mediated response [11]. In vivo, experimental infection results suggested that S. neurona and S. calchasi might be able to down-regulate the interferon-γ (IFN-γ) signaling pathway [12,13].…”

Section: Introductionmentioning

confidence: 99%

Detection of Humoral and Cellular Immune Responses in Buffaloes Naturally Infected with Sarcocystosis with Risk Factor Assessment

2019

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Sarcocystosis is a silent, parasitic disease which affects various animal species and causes significant economic losses. It is caused by a number of different intracellular Sarcocystis spp. This study was aimed to detect the host humoral and cellular immune response due to natural infection. Adding to the determination of the infection rate in Monufia Governorate, Egypt. A total number of 127 Egyptian buffaloes (Bubalus bubalis); 30 males and 97 females between 2-11 years of age were examined during 2018. An infection rate of 74% (94/127) was detected by macroscopic examination. The old age females were found to be at a high risk of 90.7% (88/97) in comparison with the young males 20% (6/30). Immunologically, the cellular and humoral immune response was determined using ELISA. A marked down-regulation of the proinflammatory Th-1 cytokine (IFN-γ) and up-regulation of the anti-inflammatory Th-2 cytokine (IL-5) adding to a high level of IgG and IgE were detected in the infected animals compared to the non infected ones. The local cellular immune response in the infected tissues was characterized by an accumulation of mixed inflammatory cells, granuloma formation, eosinophilic infiltration, muscular edema, and necrotic degeneration. In conclusion, the Sarcocystis infection rate in the naturally infected buffaloes in Monufia Governorate was high. This is the first study to provide a fundamental insight into the immune profile in buffaloes infected with Sarcocystis spp. So, it will provide valuable insights to develop novel effective vaccines in future studies. Moreover, sensitive and specific tools should be established for the accurate diagnosis of this disease in the different Egyptian governorates through well-structured serological surveys.

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Section: Introductionmentioning

confidence: 99%

Detection of Humoral and Cellular Immune Responses in Buffaloes Naturally Infected with Sarcocystosis with Risk Factor Assessment

2019

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“…Diffuse biliary cystoisosporiasis has been also reported in a West African man who presented with acute illness and dilated bile ducts, and unknown HIV status [17]. The first case of Sarcocystis-related human non-calculous cholecystitis worldwide was reported in 2014 in an AIDS patient [4].…”

Section: Discussionmentioning

confidence: 98%

“…Also, during a histopathologic review of the gallbladder, infection with Cystoisospora belli was diagnosed on sections stained with hematoxylin and eosin and then confirmed by a C. belli-specific nested PCR of recuts from the paraffin block [4].…”

Section: Casementioning

confidence: 99%

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Cystoisosporiasis-related human acalculous cholecystitis: the need for increased awareness

Agholi¹,

Aliabadi²,

Hatam³

2016

pjp

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Cholecystitis is one of the common surgical indications affecting human beings in many countries. A variety of infectious agents can be associated with acute or chronic acalculous cholecystitis, especially in HIV/AIDS patients. In this investigation, the authors aim to describe two cases of histologically and molecularly documented cystoisosporiasis (syn. isosporiasis) as the cause of chronic acalculous cholecystitis in two immunodeficient patients. During microscopic examinations of more than 2500 diarrheic patients' samples, 11 cases of cystoisosporiasis-related recurrent persistent/chronic diarrhea were detected. A review of the medical records of Cystoisospora belli (syn. Isospora belli)-positive patients showed that two of them, i.e. a patient with prolonged corticosteroid therapy and an AIDS patient, several months prior to fecal examinations had undergone cholecystectomy due to acalculous cholecystitis. The study was continued by a review of the histopathological investigation of the recuts prepared from the excised gallbladder tissue sections and stained with hematoxylin and eosin in order to detect a possible specific clinical correlation with cystoisosporiasis. Light microscopic examination revealed the presence of various developmental stages of a coccidial parasite, namely Cystoisospora belli, in both patients' gallbladder tissue sections. To the best of our knowledge, C. belli-associated cholecystitis has not been previously reported in a patient with prolonged corticosteroid therapy.

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“…The paucity of clinical disease among residents in areas where outbreaks have been noted amongst foreigners suggests that the infection stimulates a humoral (yet T-cell-mediated) memory. However, there is only one single case report in the literature [ 7 ] on an AIDS patient in an advanced stage of immunosuppression with concomitant sarcocystosis, manifesting itself atypically as an acalculous cholecystitis; suggesting, apart from an eosinophilic reaction, a role for T-cell-mediated defense. In immune-competent individuals developing disease, the average cytokine production seems to decrease as a sign of early-phase immunosuppression.…”

Section: Biology Epidemiological Immunological and Clinical Featurmentioning

confidence: 99%

Human Extraintestinal Sarcocystosis: What We Know, and What We don’t Know

Harris

Vugt

Aronica

et al. 2015

Curr Infect Dis Rep

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There are over 150 known Sarcocystis species, and at least one is capable of infecting and causing disease in man. Extraintestinal (muscular) sarcocystosis and intestinal sarcocystosis are the two known manifestations of disease in humans. In this series of six cases and review, we focus on the invasive extraintestinal (“muscular”) form of sarcocystosis in humans. This disease, which until recently was rarely described, has become relevant particularly as an imported condition in travelers due to a recent series of outbreaks reported from Malaysia. Human intestinal sarcocystosis is ubiquitous across the globe. However, absolute numbers of probable and particularly confirmed cases are few, with only several hundred described to date. Characteristically, patients exhibit signs and symptoms either 1–2 weeks after exposure, or after 4–8 weeks. Whether people remain asymptomatic or develop disease apparently depends on the infecting species, host factors, and the inoculum size. The definitive host(s) remain uncertain, and identification of the animal reservoir(s) requires further research. A better understanding of the epidemiology of the disease, as well as its immunological determinants, is hampered by the lack of reliable serological diagnostic methods. Additionally, DNA seems to be contained very effectively within the encysted parasite, thereby rendering PCR detection unreliable. Physicians should suspect the condition in patients with suggestive symptoms and a possible history of exposure. Surveillance networks for imported infectious diseases are formidable tools to help detect and localize outbreaks.

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First detection of acalculous cholecystitis associated with Sarcocystis infection in a patient with AIDS

Cited by 12 publications

References 27 publications

Detection of Humoral and Cellular Immune Responses in Buffaloes Naturally Infected with Sarcocystosis with Risk Factor Assessment

Detection of Humoral and Cellular Immune Responses in Buffaloes Naturally Infected with Sarcocystosis with Risk Factor Assessment

Cystoisosporiasis-related human acalculous cholecystitis: the need for increased awareness

Human Extraintestinal Sarcocystosis: What We Know, and What We don’t Know

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