Visceral Pentastomiasis Research Articles

Co-infections in Visceral Pentastomiasis, Democratic Republic of the Congo.

Snakeborne Armillifer pentastomiasis is an emerging human parasitic infection in rural tropical areas where snake meat is eaten. After a series of severe ocular A. grandis larval infections and anecdotal abdominal infection in Sankuru District, Democratic Republic of the Congo, during 2014-2015, we systematically investigated possible pentastomid etiology in patients who underwent surgery in the region. Histologic and molecular analyses by established pentastomid 18S rDNA- and newly developed Armillifer-specific cytochrome oxidase PCRs revealed larval pentastomid lesions in 3.7% of patients. Some persons had A. armillatus and A. grandis co-infections. Another pentastomid larva, Raillietiella sp., was molecularly detected in 1 patient who had concomitant A. grandis and A. armillatus infection. The PCRs used were suitable for detecting pentastomid species even in highly necrotic tissues. Phylogenetic analyses of Armillifer cytochrome oxidase genes detected multiple local strains.

Visceral pentastomiasis caused by Armillifer armillatus in a captive striped hyena (Hyaena hyaena) in Chiang Mai Night Safari, Thailand

Visceral pentastomiasis (porocephalosis) caused by Armillifer armillatus larvae was incidentally diagnosed in a female striped hyena (Hyaena hyaena) of unknown age which died unexpectedly in 2013. The hyena had been imported from Tanzania 8years earlier and have been since then in a zoo in Chiang Mai, northern Thailand. Pathological examination revealed visceral nymph migrans of pentastomes throughout the intestine, liver, diaphragm, omentum and mesentery, spleen, kidneys, and urinary bladder. Polymerase chain reaction and sequencing that targeted the pentastomid-specific 18S rRNA gene determined 100% identity with reference sequence for A. armillatus, suggesting that its ova can infect the hyena to serve as an intermediate host for the parasite. Further studies to identify the source of infection, its risk factors, and host range for A. armillatus are important to determine its zoonotic potential and to better prevent and manage the disease to protect animal and human health.

Armillifer armillatusPentastomiasis in African Immigrant, Germany

<i>Armillifer armillatus</i>Pentastomiasis in African Immigrant, Germany

Massive visceral Pentastomiasis in a long‐tailed macaque – an incidental finding

An unusual case of visceral pentastomiasis in a male adult long-tailed macaque imported from China is reported. The monkey was part of a toxicologic study. A massive accumulation of C-shaped parasites in various visceral organs was found post-mortem. Based on the morphology of the nymphs, pentastomiasis was diagnosed etiopathologically. The pentastome genus and species was identified as Armillifer agkistrodontis by PCR and respective sequencing. Molecular diagnostic methods are necessary tools to determine the exact species involved.

Human Pentastomiasis Caused by Armillifer moniliformis in Malaysian Borneo

We report a case of visceral pentastomiasis caused by Armillifer moniliformis in a 70-year-old aboriginal farmer from rural Malaysian Borneo. The patient complained of upper abdominal pain, jaundice, and loss of weight. Radiological investigations and subsequent histopathological examination revealed an adenocarcinoma of the pancreas with an adjacent liver nodule containing a nymph of A. moniliformis. This report constitutes the first documented human pentastomid infection in the whole of Malaysia after nearly 40 years, and it is the third description from Malaysian Borneo. Cases of human and animal pentastomiasis in Malaysia are discussed.

Transmission ofArmillifer armillatusOva at Snake Farm, The Gambia, West Africa

Visceral pentastomiasis caused by Armillifer armillatus larvae was diagnosed in 2 dogs in The Gambia. Parasites were subjected to PCR; phylogenetic analysis confirmed relatedness with branchiurans/crustaceans. Our investigation highlights transmission of infective A. armillatus ova to dogs and, by serologic evidence, also to 1 human, demonstrating a public health concern.

Diagnosis of Human Visceral Pentastomiasis

Visceral pentastomiasis in humans is caused by the larval stages (nymphs) of the arthropod-related tongue worms Linguatula serrata, Armillifer armillatus, A. moniliformis, A. grandis, and Porocephalus crotali. The majority of cases has been reported from Africa, Malaysia, and the Middle East, where visceral pentastomiasis may be an incidental finding in autopsies, and less often from China and Latin America. In Europe and North America, the disease is only rarely encountered in immigrants and long-term travelers, and the parasitic lesions may be confused with malignancies, leading to a delay in the correct diagnosis. Since clinical symptoms are variable and serological tests are not readily available, the diagnosis often relies on histopathological examinations. This laboratory symposium focuses on the diagnosis of this unusual parasitic disease and presents its risk factors and epidemiology.

Cardiac pentastomiasis and tuberculosis: The worm-eaten heart

We report an autopsy case of disseminated tuberculosis and a coexisting, extremely rare parasitic zoonosis: pentastomiasis. The parasite was incidentally found in the pericardial sac and epicardium, associated with tuberculous pericarditis, in a 43-year-old woman from Georgia with presumptive Acquired Immunodeficiency Syndrome (AIDS). The cuticle was the only remaining intact structure of the parasite. The internal organs had undergone autolysis, but recognizable features were apparent. Gross and microscopic findings were highly suggestive of pentastomid species. The ultrastructure of the cuticle was consistent with a pentastomid arthropod. This is one of the few cases of visceral pentastomiasis reported in North America, and the first known example of heart involvement. The association of the parasitic infection and tuberculous pericarditis makes the case even more unusual.