Skip to main content
Clinical Microbiology Reviews logoLink to Clinical Microbiology Reviews
. 1993 Jan;6(1):34–56. doi: 10.1128/cmr.6.1.34

Unusual infections in humans.

R C Neafie 1, A M Marty 1
PMCID: PMC358265  PMID: 8457979

Abstract

Nine cases of unusual infections in humans are presented. In each case, we present the clinical history, histopathologic changes (if indicated), morphologic features of the causative organism, diagnosis, discussion, differential diagnosis, therapy, and current literature. All of the cases are illustrated with pertinent photographs. The nine cases are as follows: (i) acanthocephaliasis, the first acquired human infection by Moniliformis moniliformis in the United States; (ii) dipylidiasis, an uncommon infection caused by the dog tapeworm, Dipylidium caninum; (iii) granulomatous amebic encephalitis, caused by the recently identified leptomyxid group of amebae; (iv) schistosomiasis, a dual infection of the urinary bladder with the rare presentation of both adult worms and eggs of Schistosoma haematobium and Schistosoma mansoni in tissue sections; (v) syphilitic gastritis, an uncommon presentation of Treponema pallidum infection, in a patient with an additional incidental infection by Helicobacter pylori; (vi) microsporidiosis, the only infection caused by a Pleistophora sp. in humans; (vii) sporotrichosis, a rare disseminated infection caused by Sporothrix schenckii with numerous yeast cells in the scrotum; (viii) angiostrongyliasis, the first and only infection caused by Angiostrongylus costaricensis acquired in either Puerto Rico or the United States; and (ix) botryomycosis of the skin and subcutaneous tissue, caused by gram-positive cocci with an unusually large number of granules.

Full text

PDF
34

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Auran J. D., Starr M. B., Jakobiec F. A. Acanthamoeba keratitis. A review of the literature. Cornea. 1987;6(1):2–26. [PubMed] [Google Scholar]
  2. Baird J. K., Neafie R. C., Lanoie L., Connor D. H. Abdominal angiostrongylosis in an African man: case study. Am J Trop Med Hyg. 1987 Sep;37(2):353–356. doi: 10.4269/ajtmh.1987.37.353. [DOI] [PubMed] [Google Scholar]
  3. Brunken R. C., Lichon-Chao N., van der Broek H. Immunologic abnormalities in botryomycosis. A case report with review of the literature. J Am Acad Dermatol. 1983 Sep;9(3):428–434. doi: 10.1016/s0190-9622(83)70154-4. [DOI] [PubMed] [Google Scholar]
  4. Buck G. E. Campylobacter pylori and gastroduodenal disease. Clin Microbiol Rev. 1990 Jan;3(1):1–12. doi: 10.1128/cmr.3.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Butz W. C., Watts J. C., Rosales-Wuintana S., Hicklin M. D. Erosive gastritis as a manifestation of secondary syphilis. Am J Clin Pathol. 1975 Jun;63(6):895–900. doi: 10.1093/ajcp/63.6.895. [DOI] [PubMed] [Google Scholar]
  6. COOLEY R. N., CHILDERS J. H. Acquired syphilis of the stomach. Report of two cases. Gastroenterology. 1960 Aug;39:201–207. [PubMed] [Google Scholar]
  7. Chung K. Y., Lee M. G., Chon C. Y., Lee J. B. Syphilitic gastritis: demonstration of Treponema pallidum with the use of fluorescent treponemal antibody absorption complement and immunoperoxidase stains. J Am Acad Dermatol. 1989 Aug;21(2 Pt 1):183–185. doi: 10.1016/s0190-9622(89)70158-4. [DOI] [PubMed] [Google Scholar]
  8. Counselman K., Field C., Lea G., Nickol B., Neafie R. Moniliformis moniliformis from a child in Florida. Am J Trop Med Hyg. 1989 Jul;41(1):88–90. [PubMed] [Google Scholar]
  9. Dingley D., Beaver P. C. Macracanthorhynchus ingens from a child in Texas. Am J Trop Med Hyg. 1985 Sep;34(5):918–920. doi: 10.4269/ajtmh.1985.34.918. [DOI] [PubMed] [Google Scholar]
  10. Dooley C. P., Cohen H., Fitzgibbons P. L., Bauer M., Appleman M. D., Perez-Perez G. I., Blaser M. J. Prevalence of Helicobacter pylori infection and histologic gastritis in asymptomatic persons. N Engl J Med. 1989 Dec 7;321(23):1562–1566. doi: 10.1056/NEJM198912073212302. [DOI] [PubMed] [Google Scholar]
  11. Dye K. R., Marshall B. J., Frierson H. F., Jr, Guerrant R. L., McCallum R. W. Ultrastructure of another spiral organism associated with human gastritis. Dig Dis Sci. 1989 Nov;34(11):1787–1791. doi: 10.1007/BF01540059. [DOI] [PubMed] [Google Scholar]
  12. England D. M., Hochholzer L. Sporothrix infection of the lung without cutaneous disease. Primary pulmonary sporotrichosis. Arch Pathol Lab Med. 1987 Mar;111(3):298–300. [PubMed] [Google Scholar]
  13. Essa M. H., Mangoud A. M., Aly M. A., el-Adl M., Morsy T. A. Schistosomiasis associated bladder carcinoma expression of cytokeratin. J Egypt Soc Parasitol. 1990 Jun;20(1):161–167. [PubMed] [Google Scholar]
  14. Ferrante A. Amphotericin B doses for primary amoebic meningoencephalitis. Lancet. 1986 Jul 5;2(8497):35–36. doi: 10.1016/s0140-6736(86)92575-4. [DOI] [PubMed] [Google Scholar]
  15. Fischer R., Sämisch W., Schwenke E. "Gastrospirillum hominis": another four cases. Lancet. 1990 Jan 6;335(8680):59–59. doi: 10.1016/0140-6736(90)90195-b. [DOI] [PubMed] [Google Scholar]
  16. Georgi J. R. Tapeworms. Vet Clin North Am Small Anim Pract. 1987 Nov;17(6):1285–1305. doi: 10.1016/s0195-5616(87)50003-1. [DOI] [PubMed] [Google Scholar]
  17. Hacker P. Botryomycosis. Int J Dermatol. 1983 Oct;22(8):455–458. doi: 10.1111/j.1365-4362.1983.tb02172.x. [DOI] [PubMed] [Google Scholar]
  18. Ishii A. I., Terada M., Fujiu Y., Sano M. In vivo efficacy of levamisole against larval stages of Angiostrongylus cantonensis and A. costaricensis. Southeast Asian J Trop Med Public Health. 1989 Mar;20(1):109–117. [PubMed] [Google Scholar]
  19. Jones W. E. Niclosamide as a treatment for Hymenolepis diminuta and Dipylidium caninum infection in man. Am J Trop Med Hyg. 1979 Mar;28(2):300–302. doi: 10.4269/ajtmh.1979.28.300. [DOI] [PubMed] [Google Scholar]
  20. Ledford D. K., Overman M. D., Gonzalvo A., Cali A., Mester S. W., Lockey R. F. Microsporidiosis myositis in a patient with the acquired immunodeficiency syndrome. Ann Intern Med. 1985 May;102(5):628–630. doi: 10.7326/0003-4819-102-5-628. [DOI] [PubMed] [Google Scholar]
  21. Loría-Cortés R., Lobo-Sanahuja J. F. Clinical abdominal angiostrongylosis. A study of 116 children with intestinal eosinophilic granuloma caused by Angiostrongylus costaricensis. Am J Trop Med Hyg. 1980 Jul;29(4):538–544. [PubMed] [Google Scholar]
  22. Ma P., Willaert E., Juechter K. B., Stevens A. R. A case of keratitis due to Acanthamoeba in New York, New York, and features of 10 cases. J Infect Dis. 1981 May;143(5):662–667. doi: 10.1093/infdis/143.5.662. [DOI] [PubMed] [Google Scholar]
  23. Macher A. M., Neafie R., Angritt P., Tuur S. M. Microsporidial myositis and the acquired immunodeficiency syndrome (AIDS): a four-year follow-up. Ann Intern Med. 1988 Aug 15;109(4):343–343. doi: 10.7326/0003-4819-109-4-343_1. [DOI] [PubMed] [Google Scholar]
  24. Macher A. M., Neafie R., Angritt P., Tuur S. M., Nelson R. P., Cali A. AIDS. Case for diagnosis series, 1988. Mil Med. 1988 Jul;153(7):M41–M48. [PubMed] [Google Scholar]
  25. Mackinnon J. E., Conti-Díaz I. A., Gezuele E., Galiana J., Hormaeche C., Civila E. Experimental botryomycosis produced by Pseudomonas aeruginosa. J Med Microbiol. 1969 Aug;2(3):369–372. doi: 10.1099/00222615-2-3-369. [DOI] [PubMed] [Google Scholar]
  26. Margileth A. M., Strano A. J., Chandra R., Neafie R., Blum M., McCully R. M. Disseminated nosematosis in an immunologically compromised infant. Arch Pathol. 1973 Mar;95(3):145–150. [PubMed] [Google Scholar]
  27. Martinez A. J. Infection of the central nervous system due to Acanthamoeba. Rev Infect Dis. 1991 Mar-Apr;13 (Suppl 5):S399–S402. doi: 10.1093/clind/13.supplement_5.s399. [DOI] [PubMed] [Google Scholar]
  28. McNulty C. A., Dent J. C., Curry A., Uff J. S., Ford G. A., Gear M. W., Wilkinson S. P. New spiral bacterium in gastric mucosa. J Clin Pathol. 1989 Jun;42(6):585–591. doi: 10.1136/jcp.42.6.585. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Morera P. Life history and redescription of Angiostrongylus costaricensis Morera and Céspedes, 1971. Am J Trop Med Hyg. 1973 Sep;22(5):613–621. doi: 10.4269/ajtmh.1973.22.613. [DOI] [PubMed] [Google Scholar]
  30. Orenstein J. M., Zierdt W., Zierdt C., Kotler D. P. Identification of spores of Enterocytozoon bieneusi in stool and duodenal fluid from AIDS patients. Lancet. 1990 Nov 3;336(8723):1127–1128. doi: 10.1016/0140-6736(90)92600-m. [DOI] [PubMed] [Google Scholar]
  31. Patterson J. W., Kitces E. N., Neafie R. C. Cutaneous botryomycosis in a patient with acquired immunodeficiency syndrome. J Am Acad Dermatol. 1987 Jan;16(1 Pt 2):238–242. doi: 10.1016/s0190-9622(87)80072-5. [DOI] [PubMed] [Google Scholar]
  32. Powell K. E., Taylor A., Phillips B. J., Blakey D. L., Campbell G. D., Kaufman L., Kaplan W. Cutaneous sporotrichosis in forestry workers. Epidemic due to contaminated Sphagnum moss. JAMA. 1978 Jul 21;240(3):232–235. [PubMed] [Google Scholar]
  33. Rank E. L., Goldenberg S. A., Hasson J., Cartun R. W., Grey N. Treponema pallidum and Helicobacter pylori recovered in a case of chronic active gastritis. Am J Clin Pathol. 1992 Jan;97(1):116–120. doi: 10.1093/ajcp/97.1.116. [DOI] [PubMed] [Google Scholar]
  34. Raziuddin S., Shetty S., Ibrahim A. T-cell abnormality and defective interleukin-2 production in patients with carcinoma of the urinary bladder with schistosomiasis. J Clin Immunol. 1991 Mar;11(2):103–113. doi: 10.1007/BF00917746. [DOI] [PubMed] [Google Scholar]
  35. Sachar D. B., Klein R. S., Swerdlow F., Bottone E., Khilnani M. T., Waye J. D., Wisniewski M. Erosive syphilitic gastritis: dark-field and immunofluorescent diagnosis from biopsy specimen. Ann Intern Med. 1974 Apr;80(4):512–515. doi: 10.7326/0003-4819-80-4-512. [DOI] [PubMed] [Google Scholar]
  36. Schmidt G. D. Acanthocephalan infections of man, with two new records. J Parasitol. 1971 Jun;57(3):582–584. [PubMed] [Google Scholar]
  37. Schwartz D. A., Finkelstein S. D. Propionibacterium acnes cerebral botryomycosis. The role of plastic embedding in the diagnosis of grain-producing infections. Am J Clin Pathol. 1986 Nov;86(5):682–685. doi: 10.1093/ajcp/86.5.682. [DOI] [PubMed] [Google Scholar]
  38. Shadduck J. A., Greeley E. Microsporidia and human infections. Clin Microbiol Rev. 1989 Apr;2(2):158–165. doi: 10.1128/cmr.2.2.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Shekhar K. C. Schistosomiasis drug therapy and treatment considerations. Drugs. 1991 Sep;42(3):379–405. doi: 10.2165/00003495-199142030-00004. [DOI] [PubMed] [Google Scholar]
  40. Shy S. W., Lai Y. S., Lee W. H., Tseng H. H. Ulceronodular gastritis in secondary syphilis. J Infect. 1991 May;22(3):277–279. doi: 10.1016/s0163-4453(05)80012-x. [DOI] [PubMed] [Google Scholar]
  41. Small I. A., Kobernick S. Botryomycosis of the tongue. Report of a case. Oral Surg Oral Med Oral Pathol. 1967 Oct;24(4):503–509. doi: 10.1016/0030-4220(67)90430-6. [DOI] [PubMed] [Google Scholar]
  42. Tricker A. R., Mostafa M. H., Spiegelhalder B., Preussmann R. Urinary nitrate, nitrite and N-nitroso compounds in bladder cancer patients with schistosomiasis (bilharzia). IARC Sci Publ. 1991;(105):178–181. [PubMed] [Google Scholar]
  43. Ubelaker J. E., Hall N. M. First report of Angiostrongylus costaricensis Morera and Céspedes 1971 in the United States. J Parasitol. 1979 Apr;65(2):307–307. [PubMed] [Google Scholar]
  44. Visvesvara G. S. Classification of Acanthamoeba. Rev Infect Dis. 1991 Mar-Apr;13 (Suppl 5):S369–S372. doi: 10.1093/clind/13.supplement_5.s369. [DOI] [PubMed] [Google Scholar]
  45. Visvesvara G. S., Martinez A. J., Schuster F. L., Leitch G. J., Wallace S. V., Sawyer T. K., Anderson M. Leptomyxid ameba, a new agent of amebic meningoencephalitis in humans and animals. J Clin Microbiol. 1990 Dec;28(12):2750–2756. doi: 10.1128/jcm.28.12.2750-2756.1990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  46. Visvesvara G. S., Stehr-Green J. K. Epidemiology of free-living ameba infections. J Protozool. 1990 Jul-Aug;37(4):25S–33S. doi: 10.1111/j.1550-7408.1990.tb01142.x. [DOI] [PubMed] [Google Scholar]
  47. WINSLOW D. J. Botryomycosis. Am J Pathol. 1959 Jan-Feb;35(1):153–167. [PMC free article] [PubMed] [Google Scholar]
  48. WINSLOW D. J., CHAMBLIN S. A. Disseminated visceral botryomycosis. Report of a fatal case probably caused by Pseudomonas aeruginosa. Am J Clin Pathol. 1960 Jan;33:43–47. doi: 10.1093/ajcp/33.1.43. [DOI] [PubMed] [Google Scholar]
  49. Washburn R. G., Bryan C. S., DiSalvo A. F., Macher A. M., Gallin J. I. Visceral botryomycosis caused by Neisseria mucosa in a patient with chronic granulomatous disease. J Infect Dis. 1985 Mar;151(3):563–564. doi: 10.1093/infdis/151.3.563. [DOI] [PubMed] [Google Scholar]
  50. Wijesundera M. D. The use of praziquantel in human infection with Dipylidium. Trans R Soc Trop Med Hyg. 1989 May-Jun;83(3):383–383. doi: 10.1016/0035-9203(89)90510-5. [DOI] [PubMed] [Google Scholar]
  51. Wolfe M. S. Schistosoma intercalatum infection in an American family. Am J Trop Med Hyg. 1974 Jan;23(1):45–50. doi: 10.4269/ajtmh.1974.23.45. [DOI] [PubMed] [Google Scholar]
  52. Wyatt J. I., Rathbone B. J., Dixon M. F., Heatley R. V. Campylobacter pyloridis and acid induced gastric metaplasia in the pathogenesis of duodenitis. J Clin Pathol. 1987 Aug;40(8):841–848. doi: 10.1136/jcp.40.8.841. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Clinical Microbiology Reviews are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES