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BACKGROUND BK viremia, a prerequisite for BK virus nephropathy (BKVN), affects 5% to 16% of pediatric renal transplant recipients (PRTR). We evaluated the safety and efficacy of a novel approach to treating BK viremia using fluoroquinolones and leflunomide in PRTR. METHODS We studied 230 PRTR at Mattel Children's Hospital, UCLA, who underwent renal transplantation between January 2003 and October 2010. Nineteen patients were found to have BK viremia. Ciprofloxacin was started when the BK viral load was greater than 625 copies/mL, and patients were switched to leflunomide if BK viral load did not decrease after 2 months of ciprofloxacin therapy. All patients underwent transplant kidney biopsy, and their estimated glomerular filtration rate (eGFR) and BK PCR was measured serially. The side effects of ciprofloxacin and leflunomide were recorded in each patient. RESULTS There was a significant decrease in BK viral load in patients treated with ciprofloxacin and leflunomide (P

Allergic reactions to steroids are rare, but are becoming more commonly recognized by clinicians. Although many reactions are thought to be IgE mediated, most are adverse drug reactions caused by nonallergic mechanisms, some related to additives in the steroid preparation being administered. Provocative challenge with the suspected offending agent, serologic tests for allergen-specific IgE, and skin testing are the most reliable methods for assessing hypersensitivity to steroids, although none is infallible. Therapeutic options for patients with documented steroid allergy include the use of alternative steroid preparations, desensitization, and, possibly, the use of monoclonal anti-IgE antibodies.

Six hundred sixty-three Uta stansburiana from the San Gabriel Mountains, Los Angeles County, California collected at monthly intervals from February 1974 to January 1975 were examined for helminths. One species of cestode, Oochoristica macallisteri, two species of nematodes, Physaloptera retusa (larvae) and Spauligodon giganticus and one species of an oligacanthorhynchid acanthocephalan (cystacanths) were found. Spauligodon giganticus had the highest prevalence (23%) and greatest mean abundance (1.0 ± 3.7 sd). It was present in 11 of the 12 mo studied. This is the first report of an oligacanthorhynchid acanthocephalan for U. stansburiana. Infection prevalences and mean intensities appear to be determined by a lizard's position within the habitat and its behavior patterns.

Five hundred seventy-two Sceloporus occidentalis from Los Angeles County, California, were examined for helminths: 200 from the San Gabriel Mountains (montane, ca. 1584 m elevation) and 372 from the Puente Hills (lowland, ca. 150 m elevation). The component helminth community of the montane fence lizard population consisted of four species: two species of cestodes, Mesocestoides sp. and Oochoristica scelopori and two species of nematodes, Physaloptera retusa and Spauligodon giganticus. The component helminth community of the lowland fence lizard population contained three species: Mesocestoides sp., Physaloptera retusa and unidentified nematode acuariid larvae. The two helminth communities are dissimilar in composition.

The gastrointestinal tracts, lungs and urinary bladders from 77 Bufo microscaphus , 61 Bufo woodhousii , and 8 of their hybrids were examined for helminthes. One species of trematode ( Glypthelmins quieta ), 1 species of cestode ( Distoichometra bufonis ), and 5 species of nematodes ( Aplectana incerta, A. itzocanensis, Rhabdias americanus, Physaloptera sp., and Physocephalus sp.) were found. The greatest prevalence (41%) and mean intensity (231.7) were recorded for Aplectana incerta in Bufo woodhousii . It appears hybrids harbor fewer parasites than either parent species.

The gastrointestinal tracts of gekkonid lizards from Guam (Gehyra mutilata [n = 4], Gehyra oceanica [n = 11 ], Hemidactylus frenatus [n = 43], and Lepidodactylus lugubris [n = 38]) and Rota (Gehyra oceanica [n = 2], Hemidactylus frenatus [n = 13], and Lepidodactylus lugubris IN = 20] were examined for helminths. Found were 2 species of cestodes, Cylindrotaenia allisonae, Oochoristica javaensis, 1 species of trematode, Allopharynx macallisteri, and 5 species of nematodes, Pharyngodon lepidodactylus, Spauligodon gehyrae, Spauligodon hemidactylu. Skrjabinelazia machidai, Oswaldocruzia sp. New host records included Gehyra mutilata for Spauligodon hemidactylus. Gehyra oceanica for Oochoristic a javaensis. Hemidactylus frenatus for Skrjabinelazia machidai, and Lepidodactylus lugubris for Cylindrotaenia allisonae and Oswaldocruzia sp. These helminths are known only from Pacific Islands and the Australian biogeographic realm.

From Hispaniola, an island in the West Indies, 6 species of anoles, Anolis cristatellus, Anolis etheridgei, Anolis eugenegrahami, Anolis hendersoni, Anolis monticola, and Anolis olssoni were examined for helminths. Helminths representing 2 species of trematodes, Mesocoelium monas and Urotrema scabridum; 1 species of cestode, Oochoristica maccoyi; 11 species of nematodes, Atractis scelopori, Oswaldocruzia lenteixeirai, Parapharyngodon cubensis, Skrjabinoptera leiocephalorum, Trichospirura teixeirai, Ascarops sp., Physocephalus sp., Porrocaecum sp., Rhabdias sp., Acuariidae gen. sp. and Cosmocercidae gen. sp.; and 1 species of acanthocephalan, Centrorhynchus sp., were found. Skrjabinoptera leiocephalorum, Ascarops sp., and Physocephalus sp. from A. cristatellus and all helminths recovered from the other 5 anole species represent new host records.

Component helminth communities of Aneides lugubris (N = 31), Batrachoseps nigriventris (N = 63), Ensatina eschscholtzii (N = 30), and Taricha torosa (N = 68) from California were determined. The compound helminth community consisted of 1 species of cestode, Bitegmen gerrhonoti and 6 species of nematodes, Batracholandros salamandrae, Cosmocer- coides variabilis, Falcaustra pretiosa, Megalobatrachonema gigantica, Oswaldocruzia pipiens, and Rhabdias joaquinensis. The least diverse infracommunities were associated with Batrachoseps nigriventris while T. torosa had the most diverse fauna. Only B. salamandrae occurred in each of the 4 component communities. Each of the other helminth species was harbored by a single host species. New host records for B. salamandrae in B. nigriventris and T. torosa; 0. pipiens in A. lugubris; C. variabilis in E. eschscholtzii; F. pretiosa and M. gigantica in T. torosa are established.

The gastrointestinal tracts, lungs, urinary bladders, and body cavities of Rana catesbeiana (n = 25), Rana chiricahuensis (n = 25), and Rana yavapaiensis (N = 37) from Arizona were examined for helminths. Helminths representing 9 species of trematodes: Cephalogonimus brevicirrus, Glypthelmins quieta, Gorgoderina attenuata, Haematoloechus complexus, Haematoloechus longiplexus, Megalodiscus temperatus, Alaria sp.. Clinostonium sp., and an unidentified strigeid; and 4 species of nematodes: Falcaustra catesbeianae, Rhabdias ranae, Physalpetera sp., and an unidentified ascarid were found. The helminth fauna of introduced R. catesbeiana differed markedly from that of native ranids. Helminth of R. chiricahuensis and R. yavapaiensis represent new host records. Arizona is a new locality recorded for C. brevicirras, G. attenuatata, H. complexus, H. Longiplexas, M. temperatus, and R. ranae.