Low dose daily iron supplementation improves iron status and appetite but not anemia, whereas quarterly anthelminthic treatment improves growth, appetite and anemia in Zanzibari preschool children. (65/284)

Iron deficiency and helminth infections are two common conditions of children in developing countries. The consequences of helminth infection in young children are not well described, and the efficacy of low dose iron supplementation is not well documented in malaria-endemic settings. A 12-mo randomized, placebo controlled, double-blind trial of 10 mg daily iron and/or mebendazole (500 mg) every 3 mo was conducted in a community-based sample of 459 Zanzibari children age 6-71 mo with hemoglobin > 70 g/L at baseline. The trial was designed to examine treatment effects on growth, anemia and appetite in two age subgroups. Iron did not affect growth retardation, hemoglobin concentration or mild or moderate anemia (hemoglobin < 110 g/L or < 90 g/L, respectively), but iron significantly improved serum ferritin and erythrocyte protoporphyrin. Mebendazole significantly reduced wasting malnutrition. but only in children <30 mo old. The adjusted odds ratios (AORs) for mebendazole in this age group were 0.38 (95% CI: 0.16, 0.90) for weight-for-height less than -1 Z-score and 0.29 (0.09, 0.91) for small arm circumference. In children <24 mo old, mebendazole also reduced moderate anemia (AOR: 0.41, 0.18, 0.94). Both iron and mebendazole improved children's appetite, according to mothers' report. In this study, iron's effect on anemia was limited, likely constrained by infection, inflammation and perhaps other nutrient deficiencies. Mebendazole treatment caused unexpected and significant reductions in wasting malnutrition and anemia in very young children with light infections. We hypothesize that incident helminth infections may stimulate inflammatory immune responses in young children, with deleterious effects on protein metabolism and erythropoiesis.  (+info)

A pediatric case of disseminated cystic echinococcosis successfully treated with mebendazole. (66/284)

We report a 4-year-old girl with disseminated cystic echinococcosis in the lung and the liver and a solitary cyst in the left kidney. Mebendazole therapy produced complete resolution of the lung and kidney cysts. In the liver, most of the smaller cysts disappeared, whereas the larger cysts showed only partial response and required surgical excision. Our experience reinforce the finding in previous reports that long term medical treatment of cystic echinococcosis with mebendazole can be lifesaving in cases that are unmanageable by surgical treatment.  (+info)

Paeciloxazine, a novel nematicidal antibiotic from Paecilomyces sp. (67/284)

A novel nematicidal antibiotic, paeciloxazine has been isolated from the culture broth of a fungus Paecilomyces BAUA3058 strain. This compound, whose structure was determined by spectroscopic methods, has a pyrrolobenzoxazine skeleton. Paeciloxazine has moderate cidal activity against Rhabditis pseudoelongata and is weakly active against some insects.  (+info)

Strongyloidiasis in patients at a comprehensive cancer center in the United States. (68/284)

BACKGROUND: The frequency of Strongyloides stercoralis infestation and complication in patients with cancer in the United States is unknown. METHODS: The authors performed a retrospective analysis of S. stercoralis infection in patients who were undergoing cancer treatment at The University of Texas M. D. Anderson Cancer Center (Houston, TX). RESULTS: The overall S. stercoralis infection frequency was approximately 1.0 per 10,000 new cancer cases between 1971 and 2003. Twenty-two of 25 patients (88%) were U.S. residents (19 from Texas; 1 each from Mississippi, Tennessee, and Puerto Rico), and the remaining 3 (13%) were from Latin America. Thirteen (52%) had solid-organ malignancies, whereas 12 (48%) had hematologic malignancies (lymphoma or multiple myeloma, n=8; leukemia, n=3; aplastic anemia, n=1). Twelve patients (48%) received systemic corticosteroids, 9 (36%) received antineoplastic therapy, and 2 underwent hematopoietic stem cell transplantation (HSCT). Diarrhea was reported in 13 patients (57%), and eosinophilia was observed in 11 patients (48%); 4 patients (16%) had probable hyperinfection syndrome (in 3 cases of polymicrobial gram-negative bacteremia, 1 patient had Klebsiella pneumoniae pneumonia, whereas 1 patient presented with K. pneumoniae lung infection alone). Evidence of definite pulmonary hyperinfection syndrome was observed in 2 HSCT recipients (8%). Fourteen (74%) of 19 patients responded to thiabendazole therapy. Two patients with definite pulmonary hyperinfection syndrome developed fatal S. stercoralis hemorrhagic alveolitis despite receiving high-dose thiabendazole plus ivermectin therapy. CONCLUSIONS: In the current study, strongyloidiasis was uncommon in patients with cancer and remained localized in individuals with solid-organ malignancies. Definite pulmonary accelerated autoinfections were observed only in HSCT recipients. Therefore, pre-HSCT S. stercoralis screening in individuals from endemic regions of the United States warrants further study.  (+info)

Appendiceal enterobius vermicularis infestation associated with right-sided chronic pelvic pain. (69/284)

Parasitic infestation is an uncommon cause of chronic pelvic pain among women of reproductive age. A case of chronic right-sided pelvic pain associated with appendiceal Enterobius vermicularis infestation was managed with appendectomy and antiparasitic therapy resulting in a complete resolution of symptoms.  (+info)

Treatment with mebendazole is not associated with distal migration of adult Angiostrongylus costaricensis in the murine experimental infection. (70/284)

Abdominal angiostrongyliasis is a zoonotic infection produced by a metastrongylid intra-arterial nematode, Angiostrongylus costaricensis. Human accidental infection may result in abdominal lesions and treatment with anti-helminthics is contra-indicated because of potential higher morbidity with excitement or death of worms inside vessels. To evaluate the effect of mebendazole on localization of the worms, male Swiss mice, 5 week-old, were infected with 10 third stage larvae per animal. Twelve infected mice were treated with oral mebendazol, at 5 mg/kg/day, for 5 consecutive days, begining 22 days after inoculation. As control groups, 12 infected but non-treated mice and other 12 non-infected and non-treated mice were studied. The findings at necropsy were, respectively for the treated (T) and control (C) groups: 92% and 80% of the worms were inside the cecal mesenteric arterial branch; 8% and 10% were located inside the aorta. Only in the group C some worms (10%) were found inside the portal vein or splenic artery. These data indicate that treatment with mebendazole does not lead to distal or ectopic migration of A. costaricensis worms.  (+info)

A modified critical test for the efficacy of pyrantel pamoate for Anoplocephala perfoliata in equids. (71/284)

Aims of this study with 13 equids naturally infected with Anoplocephala perfoliata were to document (i) a critical test with a period of 48 h from treatment to necropsy to assess the efficacy of an anthelmintic against the tapeworm, (ii) the efficacy of pyrantel pamoate oral paste at 13.2 mg pyrantel base/kg body weight, and (iii) the time after treatment when fecal egg counts would best estimate the tapeworm's prevalence in a herd. Feces passed in successive 12-h periods after treatment were examined for tapeworms. At necropsy, tapeworms in equids were identified as attached to the mucosa or unattached and, with a stereoscope, as normal or abnormal. At the time of treatment and at 6-h intervals thereafter, fecal samples were taken for egg counts. The efficacy of pyrantel pamoate was 96.6%; in 1 equid the efficacy was 75.3%, and in 8 it was 100%. "Major fragments" (worms without a scolex) accounted for 10% of the tapeworms recovered; they were not included in the efficacy analysis but should be. In 3 untreated equids necropsied, tapeworms were in the cecum, and 21.3% were detached. This protocol, when compared with a 24-h one without examination of feces, was more efficient in the treatment of trial animals and reduced underestimation and overestimation of an anthelmintic's efficacy. However, a protocol similar to this 48-h critical test but with a 24- or 36-h post-treatment period should be investigated. The mean egg count peaked 18 to 24 h after treatment and the samples taken at that time would provide the best estimate of prevelance of tapeworms in a herd. The Cornell-Wisconsin centrifugal flotation technique had a sensitivity and specificity of 100% at 18 h and 92% and 100%, respectively, at 24 h.  (+info)

Molecular basis of the differential sensitivity of nematode and mammalian muscle to the anthelmintic agent levamisole. (72/284)

Levamisole is an anthelmintic agent that exerts its therapeutic effect by acting as a full agonist of the nicotinic receptor (AChR) of nematode muscle. Its action at the mammalian muscle AChR has not been elucidated to date despite its wide use as an anthelmintic in humans and cattle. By single channel and macroscopic current recordings, we investigated the interaction of levamisole with the mammalian muscle AChR. Levamisole activates mammalian AChRs. However, single channel openings are briefer than those activated by acetylcholine (ACh) and do not appear in clusters at high concentrations. The peak current induced by levamisole is about 3% that activated by ACh. Thus, the anthelmintic acts as a weak agonist of the mammalian AChR. Levamisole also produces open channel blockade of the AChR. The apparent affinity for block (190 microm at -70 mV) is similar to that of the nematode AChR, suggesting that differences in channel activation kinetics govern the different sensitivity of nematode and mammalian muscle to anthelmintics. To identify the structural basis of this different sensitivity, we performed mutagenesis targeting residues in the alpha subunit that differ between vertebrates and nematodes. The replacement of the conserved alphaGly-153 with the homologous glutamic acid of nematode AChR significantly increases the efficacy of levamisole to activate channels. Channel activity takes place in clusters having two different kinetic modes. The kinetics of the high open probability mode are almost identical when the agonist is ACh or levamisole. It is concluded that alphaGly-153 is involved in the low efficacy of levamisole to activate mammalian muscle AChRs.  (+info)