Intestinal criptococosis in a dog - case report

Cutaneous cryptococcosis with atypical location in a cat - case report

A clinical case of cutaneous cryptococcosis in a domestic cat, presenting a single lesion on the abdominal wall, without ulceration, an uncommon presentation in veterinary literature is reported on.

Disseminated histoplasmosis in a late post-liver transplant recipient: a case report and literature review.

Histoplasmosis is an endemic mycosis in certain regions of Brazil and represents a rare opportunistic infection in solid organ transplant recipients. This report describes the case of a 68-year-old female liver transplant recipient (due to Caroli disease) who presented with abdominal pain, nausea, vomiting, and a distended, tender abdomen. Abdominal computed tomography revealed parietal thickening of the bowel wall, and colonoscopy identified polymorphic ulcers and ileocecal stenosis. Given the suspicion of tuberculosis, chest computed tomography was performed, which demonstrated pulmonary opacities. Although testing for acid-fast bacilli was negative, fungal staining was positive for Histoplasma capsulatum. Antifungal therapy with amphotericin B was initiated; however, due to clinical refractoriness, surgical intervention was required, including ileocecal resection with ileo-ascending anastomosis. A reoperation was performed due to postoperative complications, resulting in the creation of a terminal ileostomy. Following this intervention, the patient showed clinical improvement and tolerated an oral diet. This case highlights an atypical presentation of disseminated histoplasmosis with pulmonary and intestinal involvement, culminating in intestinal subocclusion in a late-stage liver transplant recipient. It underscores the importance of considering histoplasmosis in the differential diagnosis of immunosuppressed patients and the need for early investigation and treatment.

Ascariasis with Paralytic Ileus and Acute Gastroenteritis in a 2-Year-Old Child: A Case Report

Ascariasis, caused by Ascaris lumbricoides, is a common soil-transmitted helminth infection among children in developing countries. Severe infestation may cause gastrointestinal complications, including intestinal obstruction and ileus. This case report describes the clinical presentation, diagnostic findings, and management of a pediatric patient with ascariasis complicated by ileus, acute gastroenteritis, dehydration, and electrolyte imbalance.A 2-year-old girl presented with watery diarrhea for three days, vomiting, fever, decreased appetite, and a history of passing worms in her stool. Physical examination revealed a moderately ill appearance, a tympanic abdomen, and decreased bowel peristalsis. Laboratory findings showed eosinophilia, basophilia, hypokalemia at 3.2 mmol/L, and hypochloremia at 93.1 mmol/L. Stool examination revealed watery stool with mucus, 6–11 leukocytes per high-power field, and Ascaris lumbricoides eggs. Abdominal radiography demonstrated dilated small and large bowel loops with a herringbone pattern suggestive of ileus.The patient was diagnosed with ascariasis complicated by ileus, acute gastroenteritis, mild-to-moderate dehydration, and electrolyte imbalance. Management included intravenous rehydration, nasogastric decompression, ondansetron, albendazole 400 mg as a single dose, zinc supplementation, oral rehydration therapy, and empirical ceftriaxone. During hospitalization, gastrointestinal symptoms gradually improved, accompanied by continued passage of worms in the stool.This case emphasizes the importance of prompt diagnosis and comprehensive management of complicated pediatric ascariasis. Hygiene education, environmental sanitation, and regular deworming remain essential to prevent infection and reinfection in endemic areas.

Duodenal Strongyloidiasis Mimicking Inflammatory Bowel Disease: A Case Report of a 52-Year-Old Immunocompetent Woman

Background Strongyloides stercoralis is an intestinal nematode with a unique autoinfective life cycle that enables decades-long persistence in the human host. Its gastrointestinal manifestations may resemble inflammatory bowel disease (IBD), creating a clinically important diagnostic pitfall. Misdiagnosis is particularly hazardous because corticosteroids or other immunosuppressive therapies may precipitate Strongyloides hyperinfection syndrome or disseminated disease. Case Presentation We report a 52-year-old immunocompetent woman from northern Iran who presented with a 20-day history of persistent watery inflammatory diarrhea, severe hypokalemia (2.4 mEq/L), leukocytosis, and thrombocytosis. Serial stool examinations for ova and parasites were repeatedly negative for larvae; however, fecal leukocytes and erythrocytes, together with erosive duodenopathy, initially raised concern for IBD. Duodenal biopsy established the diagnosis by demonstrating marked eosinophilic infiltration of the lamina propria, reaching 45–50 eosinophils per high-power field, and rhabditiform larvae within the mucosal crypts. The larvae showed morphologic features supporting Strongyloides stercoralis, including a short buccal cavity/canal and a characteristic rhabditiform esophagus. Molecular testing, serology, and independent expert parasitologist confirmation were not performed, which represents a diagnostic limitation. The patient was treated with oral ivermectin plus adjunctive albendazole. The addition of albendazole was an individualized, non-standard clinical decision rather than a routine evidence-based recommendation. Her symptoms improved rapidly, and she remained asymptomatic at one-month follow-up. Conclusion This case emphasizes the clinical and histopathological overlap between duodenal strongyloidiasis and IBD, particularly when stool parasitology is unrevealing. The novelty of this report lies primarily in its didactic value for clinicians in endemic regions: Strongyloides should remain in the differential diagnosis of IBD-like presentations with unexplained eosinophilic mucosal inflammation before immunosuppressive therapy is considered.

Fulminant Intestinal Amebiasis in a Young Female Patient: A Case Report

Chronic Fasciola hepatica infection in a patient with cutaneous visceral loxoscelism: paediatric case report

We present the case of a 9-year-old girl from the Peruvian Andean Region (Ancash), diagnosed with fascioliasis, who was also suffering from severe malnutrition. Initially, she was referred for treatment of skin necrosis caused by cutaneous visceral loxoscelism, but during hospitalisation she developed persistent vomiting and pancreatitis. Magnetic resonance cholangiography showed dilation of the intrahepatic and common bile ducts. Endoscopic retrograde cholangiopancreatography identified an adult Fasciola spp. specimen. She also expelled adult worms of Ascaris lumbricoides during vomiting. Delivery of triclabendazole was initiated via a nasogastric tube initially and subsequently via the rectal route, although absorption was limited due to persistent oral intolerance. The patient later developed upper gastrointestinal bleeding and sepsis of abdominal origin and died. During this period, the patient remained on broad-spectrum antibiotic therapy, although sepsis was attributed to persistent biliary obstruction. Fascioliasis and ascariasis should remain in the differential diagnosis for pancreatitis and cholestasis in paediatric patients from endemic areas. Oral triclabendazole is the treatment of choice for fascioliasis, but surgical management should be considered in cases of persistent biliary obstruction or treatment failure, usually seen in complicated chronic infections.