Mucosal Leishmaniasis Caused by Leishmania (Viannia) braziliensis and Leishmania (Viannia) guyanensis in the Brazilian Amazon

Background: Leishmania (Viannia) braziliensis is a parasite recognized as the most important etiologic agent of mucosal leishmaniasis (ML) in the New World. In Amazonia, seven different species of Leishmania, etiologic agents of human Cutaneous Leishmaniasis, have been described. Isolated cases of ML have been described for several different species of Leishmania: L. (V.) panamensis, L. (V.) guyanensis and L. (L.) amazonensis. Methodology: Leishmania species were characterized by polymerase chain reaction (PCR) of tissues taken from mucosal biopsies of Amazonian patients who were diagnosed with ML and treated at the Tropical Medicine Foundation of Amazonas (FMTAM) in Manaus, Amazonas state, Brazil. Samples were obtained retrospectively from the pathology laboratory and prospectively from patients attending the aforementioned tertiary care unit. Results: This study reports 46 cases of ML along with their geographical origin, 30 cases caused by L. (V.) braziliensis and 16 cases by L. (V.) guyanensis. This is the first record of ML cases in 16 different municipalities in the state of Amazonas and of simultaneous detection of both species in 4 municipalities of this state. It is also the first record of ML caused by L. (V.) guyanensis in the states of Para, Acre, and Rondonia and cases of ML caused by L. (V.) braziliensis in the state of Rondonia. Conclusions/Significance: L. (V.) braziliensis is the predominant species that causes ML in the Amazon region. However, contrary to previous studies, L. (V.) guyanensis is also a significant causative agent of ML within the region. The clinical and epidemiological expression of ML in the Manaus region is similar to the rest of the country, although the majority of ML cases are found south of the Amazon River.SUFRAMA[016/2004

Efficacy of a targeted selective treatment in dairy herds affected by clinical dictyocaulosis.

International audienceBovine dictyocaulosis is a pulmonary disease caused by the presence and development of the strongyle Dictyocaulus viviparus in the trachea and bronchi of cattle. This parasite is mostly observed in temperate countries, with potential important clinical and economical impacts. Individuals that already had contact with the parasite normally develop a strong acquired immunity. However, when the first contact with the parasite was poor and the contamination of the environment is high, clinical signs can occur. In such a context of clinical dictyocaulosis outbreak in dairy herds, current recommendations are to treat the whole herd with anthelmintic because of the presence of subclinical infestations. However, current guidelines against anthelminthic resistance recommend the use of selective treatment on adult cattle in order to maintain a refuge helminth population unexposed to anthelmintic. According to the heterogeneity of acquired immunity in a herd, and hence, of sensitivity of animals to parasitic infestation by D. viviparus, an early targeted selective treatment of clinically affected and main shedders animals may be effective to control the disease in the herd. Such a strategy was never tested for dictyocaulosis and a field validation is thus necessary to ensure a proper control of ditycocaulosis at the herd level.ObjectivesThis study is a pilot study designed to assess the clinical relevance of a targeted selected treatment against D. viviparus at the beginning of a dictyocaulosis outbreak in dairy herds.Materials and methods. In each herd with clinical signs of dictyocaulosis, we performed broncho-alveolar lavage on 6 cows and a pooled McKenna sedimentation on 10 cows of the herd to test for the presence of D. viviparous. We implemented a targeted selective treatment in three positive dairy herds by treating with injectable eprinomectine approximately 50% of the dairy cows including clinically affected, primiparous and postpartum cows. The follow-up was implemented one and three months after the targeted selected treatment by performing broncho-alveolar lavage and a pooled McKenna sedimentation. The farmers recorded clinical signs of dictyocaulosis at the herd level during the whole study period.ResultsIn the three followed dairy herds, symptoms of dictyocaulosis vanished after the targeted selective treatment. After the treatment, we assessed a dictyocaulosis incidence rate of 2% by month during the whole follow-up, which indicates a low but persistent circulation of the parasite in the herd. Clinical signs of dictyocaulosis, remained very low to inexistent in the three herds during the whole study period. ConclusionThe targeted selective treatment implemented in the three herds of this study was efficient to control dictyocaulosis at the herd levels. To our knowledge, this study is the first to prove the potential interest of a targeted selective treatment to control dictyocaulosis at the herd level. These results should be confirmed in a larger study with more herds

Emergence of murine typhus in La Réunion, France, 2012–2017

International audienc

BMC Infect Dis

BACKGROUND : Cerebral involvement in schistosomiasis is not rare, but it is underdiagnosed because of the lack of clinical suspicion and the frequency of asymptomatic forms. Neurologic complications are generally supported by granuloma formation around ectopic eggs which have migrated to the brain. Moreover, vascular lesions and cerebral arteritis have been well documented in histopathological studies. Nevertheless, cerebral vasculitis in later stages of the Schistosoma mansoni infection have not yet been described in living subjects. CASE PRESENTATION : A 28-year-old french woman had a stroke linked with cerebral vasculitis, 6 monthes after returning from Burkina-Faso. At the same time, a S. mansoni disseminated infection was diagnosed. She suffered from a new stroke after undertaking praziquantel therapy, which lead us to associate the S. mansoni infection and cerebral vasculitis. CONCLUSION : This is the first report of such association, since cerebral vasculitis has never been described in later stages of the S. mansoni infection. Although the causal link between the two pathologies could not be proved, we suggest that S. mansoni is able to cause severe vascular damage in cerebral vessels. Schistosomiasis must be investigated in the event of a brain infarct in young people, particularly in patients originating or returning from an endemic area

Prevalence of urogenital, anal, and pharyngeal infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium: a cross-sectional study in Reunion island

International audienceBackground: Recommendations for sexually transmitted infection (STI) screening vary significantly across countries. This study evaluated the prevalence of urogenital and extragenital infections with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) in patients visiting a French STI clinic in the Indian Ocean region to determine whether current STI screening practices should be updated.Methods: This cross-sectional study examined all patients who visited the STI clinic between 2014 and 2015. Triplex polymerase chain reaction screening for CT, NG, and MG was performed on urine, vaginal, pharyngeal, and anal specimens (FTD Urethritis Basic Kit, Fast Track Diagnostics, Luxembourg).Results: Of the 851 patients enrolled in the study, 367 were women (367/851, 43.2%) and 484 were men (484/851, 56.0%). Overall, 826 urogenital specimens (826/851, 97.1%), 606 pharyngeal specimens (606/851, 71.2%), and 127 anal specimens (127/851, 14.9%) were taken from enrolled patients. The prevalence of urogenital CT and MG was high in women ≤25 years (19/186, 10.21%; 5/186, 2.69%) and in men who have sex with women ≤30 years (16/212, 7.54%; 5/212, 2.36%). Among patients with urogenital CT infection, 13.7% (7/51) had urethritis. All patients with urogenital MG infection were asymptomatic. Men who have sex with men had a high prevalence of pharyngeal CT (2/45, 4.44%) and NG (3/44, 6.81%) and a high prevalence of anal CT (2/27, 7.41%), NG (2/27, 7.40%), and MG (1/27, 3.70%). After excluding patients with concomitant urogenital infection, extragenital infections with at least 1 of the 3 pathogens were found in 20 swabs (20/91, 21.9%) taken from 16 patients (16/81, 19.7%), all of them asymptomatic.Conclusions: Routine multisite screening for CT, NG, and MG should be performed to mitigate the transmission of STIs in high-risk sexually active populations