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The authors report one case of late cutaneous Schistosomiasis mansoni in a biopsy of a skin lesion in the sacral region in a 51-year-old female living in Contagem, Minas Gerais. The patient was treated successfully with oxamniquine (Mansil®).

The aim of this study was to evaluate the diffuse intralobular fibrosis in dogs naturally infected with Leishmania (Leishmania) chagasi. One hundred five infected animals with positive serologic tests for Leishmania were divided into two clinical groups: 69 symptomatic animals and 36 asymptomatic. Special staining with Gomori, Heidenhain, Silver, and Picrosirius Red was applied to characterize fibrilopoesis. The tissue parasite load was measured by immunohistochemistry and associated histomorphometric analyses. Intralobular fibrosis was observed in all dogs, and more collagen deposition was confirmed in the infected animals than in the controls by these histomorphometric studies. There were significant differences among the distinct clinical groups. In fact, symptomatic dogs showed an increased collagen deposition in the liver compared with asymptomatic ones. A peculiar diffuse intralobular fibrosis, where the collagen fibers encircled small groups of hepatocyte(s), was observed in two cases (1.9%).

Caso raro de forma tumoral da esquistossomose mansoni cerebelar diagnosticada pela biópsia, em um paciente de 15 anos, que apresentou sinais e sintomas neurológicos 60 dias antes da cirurgia. A tomografia computadorizada revelou lesão expansiva, hiperdensa, localizada no cerebelo, sugestiva de glioma. O exame histopatológico mostrou numerosos ovos de S. mansoni envolvidos por reação inflamatória granulomatosa na fase necrótico-exsudativa, confluentes, localizados principalmente na camada interna, granular, do cerebelo, formando pseudotumor no verme cerebelar e hemorragia recente na ponte. Foram medidas as áreas dos granulomas.

We describe a schistosomal polyp in the anus of a 24-year-old patient, born in Viçosa, State of Minas Gerais, and living in Belo Horizonte, State of Minas Gerais. From 8 to 13 years of age, he swam in the rivers that bathe Viçosa. The histopathological examination has shown a lesion, lined by a keratinized squamous epithelium, ulcerated, with granulomas, centered or not by Schistosoma mansoni egg, laid, in loco, by the female present in the vascular lumen of a vein of the hemorrhoidal plexus. There was also a diffuse, nonspecific inflammation in the dermis. The patient was treated with praziquantel. Four months after the treatment, sigmoidoscopy showed a normal rectal mucosa, and negative oogram and stool tests. Ultrasound of abdomen was normal.

Background Strongyloides stercoralis can undergo an alternative autoinfective life cycle in the host, which, in some individuals can lead to a lethal infection. However, due to a number of factors, such as, the majority of those infected are from low-income backgrounds and the limitation in experimental models for studying human S. stercoralis, strongyloidiasis remains neglected. Improved knowledge of animal models that are susceptible to this parasite is needed in order to investigate the immunological mechanisms involved during infection and in particular to further understand the natural history of the autoinfective cycle. Methods Callithrix penicillata were inoculated subcutaneously with 100 (n = 2), 300 (n = 4) or 500 (n = 9) third-stage infective larvae (L3i) of S. stercoralis of human origin. Three marmosets received smaller inocula (i.e., one received 100 and two received 300 L3i) to ensure a greater capacity to withstand the infection after immunosuppression, which was triggered by administration of dexamethasone during early patency. Qualitative faecal analyses began at 7 days post-infection (DPI), and semi-quantitative tests were also performed for the dexamethasone-treated primates and the three matched controls. During the necropsies, specimens of S. stercoralis were recovered and tissue fragments were processed for histopathology. Results The mean prepatency and patency periods were 16.1 ± 3.0 and 161.1 ± 72.2 DPI, respectively. The marmosets typically tolerated the infection well, but immunosuppressed individuals exhibited higher numbers of larvae in the faeces and progressive clinical deterioration with late disseminated infection. In these cases, the number of females recovered was significantly higher than the number of inoculated L3i. Large quantities of larvae were observed migrating through the host tissues, and histopathology revealed pulmonary and intestinal injuries consistent with those observed in human strongyloidiasis. Conclusions Both complicated and uncomplicated strongyloidiasis occur in C. penicillata that is described as a susceptible small non-human primate model for S. stercoralis. This host permits the maintenance of a human strain of the parasite in the laboratory and can be useful for experimental investigations of strongyloidiasis. In parallel, we discuss data related to the autoinfective cycle that provides new insights into the biology of S. stercoralis. Electronic supplementary material The online version of this article (doi:10.1186/s13071-014-0579-2) contains supplementary material, which is available to authorized users.

Dia 30 de marco de 2013, 16h30m, sabado que antecedeu o dia da festa de Ressurreicao de Cristo. Vespera da Pascoa. Na pacata cidade de Desterro do Melo, pescando na lagoa do seu sitio, sem dor e sem sofrimento, mantendo nos labios o sorriso maroto, sua identidade desde moco, tendo ao lado dois peixes do tamanho de dois palmos e um terceiro peixe do mesmo tamanho ja fisgado debatendo-se na ponta do anzol, sem forcas para tira-lo da agua pediu ajuda ao seu neto Daniel e ao Didi, filho do caseiro.

An unusual case of the tumoral form of cerebellar Schistosomiasis mansoni, in a 15 year-old male diagnosed by biopsy, with neurological signs and symptoms 60 days prior to surgery. Computerized tomography show a hyperdense expanding lesion located in cerebellum, suggesting glioma. Histopathological examination showed numerous S. mansoni ova involved by granulomatous inflammation in necrotic-exudative phase, located mainly in the internal, granular layer of the cerebellum, creating a pseudotumor in the cerebellar vermis and a recent hemorrhage in the trunk. The areas of granulomas were measured.

We describe a rare case of nodular and low grade non-Hodgkin malignant lymphoma, MALT type, with morphological and immunohistochemical features of lymphoplasmocytic (REAL classification), of immunophenotype of B lymphocytes and detected monoclonal of immunoglobulin kappa light chains, with low proliferation grade (10%). The tumor was primitive of the left parietal duramater in a 36 years old woman, who presented neurological clinical symptoms four months before the surgery. After surgery, she was submitted to chemotherapy and radiotherapy with good results.

In this study, which was undertaken in relation to the histopathologic behavior of two different strains (LE-Belo Horizonte, MG and SJ - São José dos Campos, SP) in infections and reinfections (homologous or heterologous) with Schistosoma mansoni, the authors confirmed a more accentuated pathogenicity of the SJ strain. All the reinfections showed the presence of typical granulomas of the acute phase, when performed either with the same strain (homologous) or with a different strain (heterologous) of the parasite of the primo infection. The possible mechanisms responsible for reactivation of the immunopathologic response in reinfections are discussed.No presente estudo, verificou-se o comportamento histopatológico das infecções e reinfecções, homólogas ou heterólogas, das cepas LE (Belo Horizonte, MG) e SJ (São José dos Campos, SP) de Schistosoma mansoni. Confirmou-se uma maior patogenicidade da cepa SJ de S. mansoni. As reinfecções, independentemente de terem sido feitas com a mesma cepa (homóloga) ou cepa diferente da primo infecção (heteróloga) do parasito, mostraram a presença de granulomas típicos da fase aguda. São discutidos os possíveis mecanismos responsáveis pela reagudização da resposta imunopatológica nas reinfecções.

Two cases of ischaemic necrosis of the sigmoid colon (necrotizing colitis) are reported in 2 brothers aged 7 and 4 years, diagnosed within a 10 d interval. The children had bathed in streams suspected to be contaminated by Schistosoma mansoni about 50–60 d before the onset of acute disease. Both patients had been previously exposed to schistosome-infested streams without showing signs or symptoms of infection. Before admission, S. mansoni eggs had not been found in the stool. Both patients presented with an apparently identical, relatively symptomatic clinical course with rapid evolution to an acute abdomen. Laparotomy disclosed, in both patients, extensive necrosis (ischaemic necrotizing colitis of schistosomal aetiology) of about 20 cm in the first child and 8 cm in the second, extending from part of the descending colon to the sigmoid. The patients were successfully operated upon (hemicolectomy plus colostomy). The histopathological findinngs were similar in both patients. Ischaemic necrosis with complete destruction of the mucosa and part of the submucosa was detected in the first case; in the necrotic areas a few eggs of S. mansoni were seen, with no granulomatous reaction, but surrounded by cell shadows, pycnotic nuclei and amorphous material. Necrosis extended to the muscular layer and serosa, in which schistosome granulomas in the necrotic-exudative phase were seen, as well as diffuse granulocytic exudate and fibrin. Sections of tissue from both patients contained numerous eggs and granulomas all in the same exudative phase in regional lymph nodes and near the thrombotic vessels. After surgery, the 2 patients progressed similarly. About 10 d after hospital discharge, the patients received anti-schistosomal treatment with oxamniquine. No further sign of infection was detected at subsequent recall visits.

Os Autores descrevem um caso grave de esquistossomose mansoni numa criança de 9 anos de idade (forma hepática com hipertensão portai associada a forma pulmonar com hipertensão pulmonar e cor pulmonale) clinicamente caracterizado por episódios de insuficiência respiratória desencadeados em face de esforços físicos moderados. Sucessivos exames radiológicos de tórax revelaram comprometimento predominantemente arteriolar ao iado de uma micronodulação delicada e difusamente distribuída e configuração de cor pulmonale. Ao contrário do caso anteriormente descrito, a evolução se deu sem que se verificassem manifestações febris. Embora tenham sido afastadas várias hipóteses de associação da esquistossomose a concausas infectuosas, optou-se pelo tratamento de prova da tuberculose pulmonar. O fundo de olho também apresentava vários nódulos esbranquiçados disseminados pelo coróide e retina, caracterizando provável coroidite e retinite esquistossomótica. O tratamento antituberculoso resultou praticamente nulo. Não se procedeu ao tratamento específico da esquistossomose, considerando-se o alto risco da cardiopatia face aos esquistossomicidas disponíveis. A alta foi fornecida após treze meses de observação hospitalar. Não compareceu a ulterior controle.The Authors report a severe case of schistosomiasis mansoni in a 9-year-old child (heplus pulmonary form with pulmonary hypertension and cor pulmonalel The clinical features comprised episodes of respiratory insufficiency induced by moderate physical exercise. Serial chest X-raysshowed a predominantly arteriolar involvement associated with fine micronodules and the features of cor pulmonale. The fever episodes found in the case previously reported did not happen in th is patient. Even though various hypothesis of association of schistosomiasis and other infectious diseases were discarted, a trial of anti-tuberculous drugs was performed. Eye examination disclosed various whitish nodules disseminated throughout the retina and choroid, and this suggested schistosomiasis as the cause for the eye involvement. The antituberculous drugs did not change the clinical picture at all. Antischistosome drugs were. not used due to the risk of circulatory side-effects of the drugs available. The patient was discharged after 13' months and no follow-up has been done since.

Foi feita a identificação dos tipos de colágeno em cortes histológicos de fragmentos de 15 corações de indivíduos portadores de doença de Chagas crônica com lesão vorticilar esquerda e ICC. As preparações coradas pelo Sirius Supra Red F3BA, preconizada por Junqueira e cols e examinadas em microscópio de polarização (Leitz) revelaram colágeno de tipo I e III nas zonas de fibrose. As primeiras preponderaram nos dois terços externos da região vorticilar, nas áreas de fibrose endomisial e perimisial do miocárdio sem ou com escasso infiltrado inflamatório e na região subendocárdica dos músculos papilares. O tipo III foi mais freqüente no terço interno da região vorticilar, no endocárdio da parede ventricular, em certas áreas do miocárdio onde a inflamação ainda estava em atividade e nas porções mais centrais dos músculos papilares. Os AA fazem um breve comentário sobre o possível mecanismo patogenético da fibrose na doença de Chagas.Histologic typing of collagen fibers from 15 hearts of patients with chronic Chagas' disease was made by using the Sirius Supra Red F3BA stain according to Junqueira's method. All patients had congestive heart failure and left vorticilar lesion. The preparations were stained with Sirius Supra Red F3BA and were examined under polarized light (Leitz photomicroscope) which revealed collagen fibers types I and III in the fibrotic areas. Type I was predominant in the vorticilar area, but it was also present in other areas of the myocardium, such as endomysium and perimysium of the left ventricle and in subendocardial areas of the papillary muscles. Type III was more often encountered in inner third of the vorticilar lesions, endocardium of left ventricular wall and in the areas of the myocardium where the inflammation was still present.

A double blind trial was set up to study the pulmonary effects of specific treatment with oxamniquine of 40 patients with chronic schistosomiasis mansoni. Radiological alterations characterized by bronchopneumonitis were seen in 17.5% of the patients after treatment, but in none of the placebo group; non-migratory condensation occurred between 25 and 72 h after treatment, with a mean duration of 7 d. 86% of the patients showed spontaneous healing with no radiological sequelae after 30 d of follow-up. Slight pulmonary clinical manifestations without any functional repercussions were also seen. The alterations were probably related to the host-parasite interaction, and the lesions may have been caused by deposition of immune complexes in the lungs with local activation of complement.

Os autores determinaram o diâmetro médio dos granulomas de fígado de camundongos infectados com cercárias de duas cepas geográficas bem definidas do, Schistosoma mansoni (LE, Belo Horizonte e SJ, São Paulo). No total foram medidos 1.170 granulomas. Os granulomas com 60 dias eram de dimensões maiores do que os de 90 dias. A modulação da resposta imunopatológica foi significativamente mais eficiente na cepa LE e os granulomas, tanto aos 60 como aos 90 dias, da cepa SJ eram significativamente maiores. Os dados obtidos indicam uma maior patogenicidade da cepa SJ. Especula-se se o significado destes achados poderiam, em parte, explicar a ocorrência das variações regionais das formas anatomo-clínicas da esquistossomose. The authors have determined the mean diameter of granulomas in the liver of mice infected with cercariae from two different and well definite geographic strains of Schistosoma mansoni (LE, Belo Horizonte, MG, and SJ, São José dos Campos, SP). A total of 1,170 granulomas has been measured. Granulomas measured on the 60th day after infection showed larger size than the other ones measured on the 90th day. Modulation of the immunopathologic response was significantly more efficient for the LE strain, whereas the granulomas ( with 60 and 90 days) related to SJ strain were significantly larger. Data suggested a higher pathogenicity for the SJ strain. It is speculated whether these findings could explain, in part, the occurence of regional variations of the anatomo-clinical forms of schistosomiasis.

5 cases of clinically unsuspected involvement of the spinal cord by S. mansoni are reported. In contrast to the cases usually described in the literature, the nervous system involvement was observed during the acute phase of the infection. One of the patients exhibited a clinical picture closely resembling that of the Guillain-Barre syndrome, and cure was not dependent upon the use of corticoid hormone or antischistosomal therapy. 2 other patients improved after neurological involvement (paraparesis and paraplegia) following the completion of specific treatment (hycanthone). The sudden appearance of a polyradiculoneuritis syndrome was observed in 1 patient during treatment with niridazole. In another patient who developed a sudden transverse myelitis at T.11 with flaccid paraplegia, antischistosomal therapy apparently did not influence the course of the neurological process. It is suggested that the nervous system involvement in the reported cases cannot be explained entirely by the mechanical action of eggs and worms and the resultant granuloma formation. In the authors' opinion an anomalous response of the nervous system to the immuno-allergic products derived from dead worms and; or their eggs probably was responsible for the clinical manifestations of spinal cord involvement.

A clinical and radiological picture of bronchopneumonia was observed in a patient between the second and third weeks post-infection with cercariae of S. mansoni. There was a spontaneous recovery without sequelae in 20 days and the clinical and radiological alterations were interpreted as associated with the passage of schistosomulae through the lungs.Relata-se o caso de um paciente que após 2 a 3 semanas de contato infectante com cercárias desenvolveu quadro clínico e radiológico de broncopneumonite. O paciente não possuía infecção esquistossomótica anterior. Houve recuperação espontânea, sem seqüela em 20 dias e as alterações clínico- radiológicas foram interpretadas em associação à passagem de esquistossômulos pelos pulmões.

The Montenegro skin test is widely used as a diagnostic method for American cutaneous leishmaniasis (ACL) but little is known about the histological changes that occur in the skin after administration of the antigen. This report is based on histological studies of biopsied material obtained, from inoculation sites, 48 hours after individuals had been given intradermal injections with a standardized Montenegro antigen. The material examined was obtained from four distinctly different test groups: naturally infected patients with parasitologically proved ACL and with positive Montenegro's reaction; individuals without previous history of ACL and not previously tested with Montenegro antigen; participants in anti-ACL vaccine trials who developed positive reactions to Montenegro antigen after vaccination; other participants in vaccine trials who had negative Montenegro responses after vaccination or had served as controls in the trials. The histological pictures of each group are described and discussed. Histologically, the reactions of vaccinated individuals were indistinguishable from those with naturally acquired infections.