New insights on severe clinical manifestations and deaths from visceral leishmaniasis in free-living crab-eating foxes (Cerdocyon thous) in Brazil

Visceral leishmaniasis (VL) is a zoonotic and severe neglected tropical disease, with worldwide distribution, that still cause many deaths among dogs and humans. Brazil is the country responsible for about 97% of the cases of leishmaniasis in the Americas and the disease is still considered a serious public health concern. Among wild mammalians, studies demonstrate the involvement of Cerdocyon thous in the biological cycle of Leishmania. Nevertheless, several authors consider the clinical manifestation of the disease to be rare or mild in free-living animals. Herein, we demonstrate the occurrence of severe clinical sings and deaths caused by VL in free-living crab-eating foxes. Three specimens of foxes collected from periurban areas were diagnosed with VL. The animals presented cutaneous, ophthalmological, gastrointestinal, locomotor and hematological alterations, and died after clinical progression. We identified the presence of anti-Leishmania antibodies by immunochromatographic test in all specimens. We also observed intra and extracellular amastigotes in skin cytology and lymph node aspirate. Furthermore, Leishmania infantum DNA was identified in all samples by the polymer chain reaction technique. Additionally, we performed blood count and stool parasitological tests and observed hematological disorders common to VL, such as anemia and lymphopenia. Taken together, our data demonstrate that VL can induce clinical complications and even cause death in C. thous and corroborate that this crab-eating fox is an adequate host for L. infantum.

Profile of adverse events in toxoplasmosis drug therapy: a review

This study aims to analyze the profile of adverse events (AEs) of drugs for the treatment of Toxoplasmosis. This is a review carried out through a bibliographic search in the electronic databases PubMed, SciELO, Cochrane Digital Library and LILACS. The keywords “Toxoplasmosis” AND “Drug Therapy” AND “Drug-Related Side Effects and Adverse Reactions” were used. The selection was performed by two independent reviewers and the articles were included considering the presence of retrospective studies and case reports published in the literature in Portuguese and English and without time restrictions. In total, 40 articles were found, of which 14 met the inclusion criteria. Cases of cerebral, ocular, gestational and congenital Toxoplasmosis were identified. Among these, we observed a total of 85 patients with reports of AEs due to the use of Pyrimethamine, Sulfadiazine, Spiramycin, Clindamycin, Atovaquone, Trimethoprim and Sulfamethoxazole and Sulfadoxine. Clinical reactions were in the form of skin rash (57.1%), hematological alterations (28.5%), Lyell syndromes (7.1%), Stevens-Johnson (21.4%) and DRESS (21 .4%). The prevalence of AEs related to hematological alterations was seen mainly in treatments based on Pyrimethamine + Sulfadiazine, Trimethoprim and Sulfamethoxazole; on the other hand, those associated with severe syndromes are often related to the use of Pyrimethamine + Sulfadiazine. It is important to establish a standard protocol for drug therapy for Toxoplasmosis, which does not yet exist. In addition, the need to monitor patients after drug administration is highlighted, given the possibility of the occurrence of adverse events that can represent a threat to life.

Alterações hematológicas em cães soropositivos ao DPP e ELISA para Leishmania infantum submetidos ao tratamento com Miltefosina 2% / Hematological alterations in dogs seropositive to DPP and ELISA for Leishmania infantum submitted to treatment with Miltefosine 2%

A leishmaniose visceral (LV) é uma doença de caráter crônico, zoonótico de alta letalidade, causada pelo protozoário Leishmania infantum. Os parâmetros hematológicos associados ao estado clínico dos animais são fundamentais no prognóstico da enfermidade e consequentemente na conduta clínica a ser adotada. Com isso, objetivou-se evidenciar as alterações hematológicas em cães soropositivos para LV submetidos ao tratamento com miltefosina 2%. Foram atendidos na Clínica Escola de Medicina Veterinária do Cesmac 9 cães soropositivos ao DPP (Dual Path Platform) e ELISA (Enzyme Linked Immuno Sorbent Assay), os quais foram divididos em grupos de doentes, expostos e infectados, segundo alterações clínicas. Foram coletadas amostras sanguíneas e encaminhadas ao Laboratório de Análises Clínicas da mesma instituição, onde foi realizado o hemograma e bioquímicos, e posteriormente foi feito o perfil hematológico e constatou-se 77,7% (7/9) anemia normocítica normocrômica, 88,8% (8/9) hiperproteinemia, 44,4% (4/9) trombocitopenia, 33,3% (3/9) leucopenia, sendo 11,1% (1/9) associada a neutropenia e 22,2% (2/9) leucocitose associada a 22,2% (2/9) neutrofilia. Na bioquímica a ureia (UR) teve alteração no início do tratamento, permanecendo até o final. Houve alteração no nível de creatinina (CR) no começo e no fim do tratamento. Observou-se albumina (ALB) abaixo dos valores normais no início, permanecendo até o final do tratamento. O nível de proteína total (PT) apresentou alteração no início e ao final houve melhora. Houve alteração na fosfatase alcalina (FA) no início do tratamento, permanecendo alterada até o final do tratamento. Foi vista alteração nos níveis de alanina aminotransferase (ALT) no início, no meio e no final do tratamento. Ao longo do tratamento de 28 dias não foram vistas alterações hematológicas significativas que evidenciaram a melhora dos animais, sendo necessária a utilização de medicamentos associados, a fim de buscar uma melhor qualidade de vida ao animal.

Evaluation of Oxidative Stress and Histiocytic Behaviour of Canine TVT using Alpha Antitrypsin

Background: There is scanty literature on evaluation of oxidative stress and alpha antitrypsin marker expression in canine TVT to know its histiocytic behaviour. Since venereal transmissible tumor is one of most important tumor affecting large population of canine, thus, study was conducted to investigate the above based on clinicopathology. Methods: The study was conducted on dogs suffering from transmissible venereal tumor (TVT) for evaluation of clinicopathological alterations, oxidative stress and expression pattern of alpha antitrypsin. Ten bitches and five male dogs with tumour masses seen on the external genitalia were used for the study. Detailed alterations due to TVT with respect to haematobiochemistry, oxidative stress, pathomorphology, proliferation and expression pattern of alpha antitrypsin were assessed. Result: Grossly tumors on the genital area were either pedunculated or sessile and of various shape such as cauliflower, filiform and irregular. Hematological alterations such as normocytic normochromic type of anaemia, thrombocytopenia, neutropenia and lymphocytopenia in TVT cases indicated immunosuppression. Significant alterations in liver enzymes, hypercalcemia and hypoglycaemia were also observed in TVT affected dogs. Increased level of MDA and decreased in concentration of antioxidant enzymes indicated association of oxidative stress in proliferation of tumor and reduction in number of T lymphocytes. Cytological examination revealed characteristic punctuate basophilia and vacuolation in tumour cells. Histopathological examination showed characteristic round cells with a little fibrous septa in a sheet like manner. AgNOR staining indicated moderate proliferative capacity as evidenced by scattered AgNOR dots. TVT cells showed moderate type of immunoreactivity with alpha anti-trypsin confirming its histiocytic origin upon immunohistochemistry.

Púrpura trombocitopénica trombótica versus síndrome HELLP: reto diagnóstico en el embarazo.

Worldwide, thrombocytopenia is one of the first causes of hematological alterations in pregnancy, affecting up to 10% of them. Despite the fact that all clinical entities with thrombocytopenia in pregnancy have a similar clinical spectrum, the distinction between them is vital to establish the appropriate treatment and thus reduce maternal-fetal morbidity and mortality. Purpura thrombotic thrombocytopenic is an infrequent disease, which despite not being linked to pregnancy, is not exempt from occurring in it, compared to HELLP syndrome, which is a multisystemic complication that occurs during pregnancy. The following is the case of a pregnant woman with microangiopathic thrombocytopenic anemia where the clinical similarity of both pathologies is evidenced, representing a diagnostic challenge. Keywords: Thrombocytopenia, Pregnancy, HELLP Syndrome, Purpura thrombotic thrombocytopenic, Anemia.

Alkaloidal fraction of Diospyros mespiliformis protect against Trypanosoma evansi-mediated haematological and hepatic impairment in infected rats

The present study investigated the antitrypanosomal activities of crude and an alkaloidal fraction of Diospyros mespiliformis in Trypanosoma evansi - infected rats. A total of twenty-one (21) rats were divided into seven (7) groups of three (3) rats each. Groups 1-6 were infected with the T. evansi parasite and were treated with 100 and 200 mg/kg BW crude extract, 200 and 400 mg/kg BW of the alkaloid fraction of D. mespiliformis, 3.5mg/kg of berenil (standard control) and 0.2 mL/kg BW of normal saline (negative control) respectively. Group 7 serves as the normal control (non-infected and non-treated) rats. Results revealed that the crude extract at 400 mg/kg BW and alkaloid fraction at all doses tested (100 and 200 mg/kg BW) significantly (P<0.05) increased the RBC, PCV, MCH, MCHC, WBC, and reduced the elevated bilirubin when compared with the untreated control. The extract also significantly increased the reduced total proteins. In conclusion, an alkaloid from Diospyros mespiliformis ameliorative effect on T. evansi-induced biochemical and hematological alterations in rats, thus could be considered a novel agent for the development of a new drug against trypanosomiasis

Hematological Alterations Induced by Visceral Leishmaniasis

The aim of this study was to assess visceral leishmaniasis (VL) among infected Sudanese patients in Al–Gedaref state. Methods and Results: A case-control study was conducted among patients with VL attending Al–Gaderif Teaching Hospital. A total of 80 subjects were included in the study: 40 patients with VL (the main group [MG]) and 40 apparently healthy individuals (the control group [CG]). The complete blood count (CBC) was determined using the Sysmex KX-21 N hematological analyzer. The platelet-poor plasma was used to determine prothrombin time (PT), thrombin time (TT), and activated partial thromboplastin time (aPTT). The age group of 12-21 years was the most frequent (40%) among VL patients. Male patients were significantly more frequent (72.5%) than females (P-value=0.02). In MG, the Hb level was 8.71±1.73g/dL, compared to 14.25±4.11g/dL in CG, which reflected the severity of the disease. WBCs and neutrophils decreased significantly, compared to CG, but lymphocytes increased significantly. Thrombocytopenia was observed among pediatric patients, indicating bleeding tendency as one of the VL complications. The platelet and coagulation profile of patients was also altered. PT and aPTT were prolonged significantly, compared to CG.