PATHOLOGICAL EXAMINATION OF Echinococus granulosus INFECTION IN LUNGS OF SHEEP IN KERBALA PROVINCE

Basrah Journal of Veterinary Research,Vol.17, No.3,2018
Proceeding of 6th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
167
PATHOLOGICAL EXAMINATION OF Echinococus granulosus
INFECTION IN LUNGS OF SHEEP IN KERBALA PROVINCE.
Zahra Saleh Mahdi , Muna Sachit Hashim ,Inam Badr Falih , Eman
Hashim Yousif , Bushra Ibrahim Mustafa.
Department of Pathology,College of Veterinary Medicine ,Unifersity of Baghdad
,Baghdad ,Iraq.
Key word: Sheep, Lung, Hydatid cysts.
Corresponding author: [email protected].
ABSTRACT
Parasitic infection of Ehinococus granulosus infects many animals because of
hosts variation ; intermediate host include ,sheep ,cattle ,goats ,pigs ,horses and
camels as well as human. Transmitted to intermediate host by the ingestion of egg
and transmitted to definitive host via eating infected mature cyst's containing organs.
Final host was dog and canine species were the adult worms may survive for up to 3
years and laying egg after 6-10 month in dog that excretes with feces. The eggs may
be eaten in food such as vegetables , herbs ,fruit or drunk in contaminated water ,they
can also stick to the hands when a person pet an infected dog or cat ,handles a wild
animal or carcass, or touches contaminated soil and vegetation . One hundred 100
lungs specimens were examined in field and in laboratory, results showed that more
than 50% of lungs samples were infected with hydatid cysts or Echinococus
granulosus, histopathological examination showed sever destructive and necrotic with
hemolytic changes in lungs tissues contained Echinococus granulosuscysts
.Conclusions: parasitic infection Echinococus granulosus or hydatid cysts were
predominantly and commonly existence in sheep living in Kerbala.
.
Basrah Journal of Veterinary Research,Vol.17, No.3,2018
Proceeding of 6th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
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INTRODUCTION
hydatid disease is caused by Echinococcus multilocularis, Echinococcus
granulosus, Echinococcus vogeli, and Echinococcus oligarthrus(1;2) Echinococcus
multilocularis causes alveolar or pulmonary echinococcosis (AE), Echinococcus
granulosus causes cystic echinococcosis, Echinococcus vogeli causes polycystic
echinococcosis, and Echinococcus oligarthrus is an extremely rare cause of human
echinococcosis(2) the definitive hosts, foxes, dogs, cats, coyotes, and wolves(2)
Gravid proglottids release eggs that are passed in the feces (2). After ingestion by a
suitable intermediate host (small rodents), the egg hatches in the small bowel and
releases an oncosphere that penetrates the intestinal wall and migrates through the
circulatory system into various organs, particularly the liver and lungs(1;2).The larval
growth in the liver indefinitely remains in the proliferative stage, resulting in invasion
of the surrounding tissues(2) The definite host is infected by ingesting the cystcontaining
organs of the intermediate host(2) After ingestion, the protoscolices
evaginate, attach to the intestinal mucosa, and develop into adult stages within 32–80
days.(2)With Echinococcus vogeli, the definitive hosts are bush dogs and dogs, the
intermediate hosts are rodents, and the larval stage (in the liver, lungs and other
organs) develops both externally and internally, resulting in multiple vesicles (2)
Echinococcus oligarthrus, the life cycle involves wild felids as definitive hosts and
rodents as intermediate hosts(2) infection occur by ingesting embryonated eggs in
feces of the definitive hosts.(2) Pulmonary alveolar echinococcosis is caused by
hematogenous spreading from hepatic lesions (3).The adult Echinococcus granulosus
resides mainly in the small gut of the dogs (1).The intermediate hosts including
humans are infected by ingestion of parasitic eggs excreted in the feces of the dogs(1)
Clinical pulmonary manifestations include cough, dyspnea, chest pain, and fever(1)
Rupture of hydatid cysts into a bronchus may result in expectoration of cystic fluid
containing parasite membrane, hemoptysis, asthma-liked symptoms, respiratory
distress, persistent pneumonia, anaphylactic shock, and sepsis (4;5) and elevation of
serum IgG and eosinophilia(6). Rupture of the echinococcal cysts into the pleural
space may result in pleural effusion, empyema, and pneumothorax (1)
Immunodiagnostic tests using purified Echinococcus granulosus antigens have
preferable sensitivity and specificity for the diagnosis of AE(7) A serologic method
Basrah Journal of Veterinary Research,Vol.17, No.3,2018
Proceeding of 6th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
169
using the synthetic p176 peptide for diagnosis of pulmonary hydatinosis demonstrated
overall 78.69% of sensitivity and 96.88 of specificity(8) The most significant factor of
seropositivity is the presence of the hydatid cyst complications or rupture due to
isolation of the hydatid cyst content from the human immune system by developing a
very thick collagen layer, contributing to minimal or nil antigen release and
subsequent minimal or nil antibody responses (8) Chest roentgenographs demonstrate
solitary or multiple round opacification mimicking lung tumors(9) Magnetic
resonance imaging can detect early pulmonary AE (10) Unusual presentation of
endobronchial hydatid cyst with a whitish-yellow gelatinous membrane was
demonstrated by bronchoscopic examination in a child(11).Treatment for many years
with mebendazole, praziquantel, or albendazole is useful, but treatment of hydatid
cyst is primary surgical(12) but should avoid segmentectomy, lobectomy, and
pneumonectomy(13;14).
MATERIALS AND METHODS
Field work: A: samples: one hundred 100 lung were collected from sheep living in
Kerbala Province and were slaughtered in the same province. B- Cleaned containers ;
test tubes and gloves.
Laboratory work: samples: 1- cystic lesions excluded from infected lungs
which attached to small piece's 1cm3 of nearby tissues and fixed with 10% neutral
formalin solution and processing according to(15)(16). 2-Hydatid cyst fluids were
taken in special test tubes by centrifugation at 4000 rmp for30 minutes, ,then taken
one drop from supernatant to see protoscolices under microscope(17).
RESULTS AND DISCUSSION
Examined lungs and cystic lesion indicated for existence of parasitism infection with
Echinococcus granulosus or hydatid cysts. As showed in table (1). Grossly
appearance showed cystic structures scattered out of lungs' surfaces. Figure 1(A,B ,C,
D).Microscopically appearance showed thick wall consists of three structural
component cellular laminated membrane ; germinal membrane and protoscolices.
Figure 2(A, B, C, D).Heavy inflammatory response mainly neutrophils and
Basrah Journal of Veterinary Research,Vol.17, No.3,2018
Proceeding of 6th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
170
eosinophil's and edematous emphysematous changes with interstitials pneumonia
infected lungs. Figures 3 and 4.
Table (1 ): the species of parasite isolated from the lung sheep.
Isolation of Total No.
samples
Negative
Isolation of
samples
Positive
Parasitic samples
100
(100%)
Echinococcus granulosus 52 (52%)* 48(48%)**
No=52
Survey results showed that there are significantly (100%) incidences of echinococcosis in all
samples taken from 100 pieces of lung of infected sheep. *: P= ≤0.05 ; **: P=≥0.05.
Figure (1;A,B,C,D):Gross appearance of Hydatid cysts in examined lungs .A: caudal position;B:
Ventral position C: eternal position D: right dorsal position
A B
C D
Basrah Journal of Veterinary Research,Vol.17, No.3,2018
Proceeding of 6th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
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Figure( 2;A,B,C,D):showed Hydatid cysts structure within lungs tissues of infected sheep.A:
protoscolices B: cellular laminated membrane C:germinal membrane and protoscolices D: All
layers .
A B
C D
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Proceeding of 6th International Scientific Conference,College of Veterinary Medicine
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Figure 3: Lung of infected sheep showed A: neutrophils infiltration with necrotic debris, B:
eosinophil's beside neutrophils infiltration within interalveolar space .C: edematous fluid filled
interstitium .D: emphysema with edematous and interstial Pneumonia
C D
A B
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Proceeding of 6th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
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Figure 4: affected lungs showed A: interstial Pneumonia with emphysema look like tree
branches': emphysema with formation of fibrotic knobs .C: hemolytic changes due digestion and
destruction's tissue from parasitic effects .D: emphysema and local eosinophil's infiltration with
hemolytic changes.
Microscopic appearance of infected lunges showed that there are severe hemolytic
changed due to tearing effects of scoliosis of parasites associated pus cell from
immune heavy immune response .
Results of field work showed that there are highly incidences of Echinococcus
granulosus infection in Kerbala are disagreement with those reported in Mosul
which 9.3% ,the causes may be attributed to many factors as homing of many dogs
whom play active role in occurrences of hydatid cyst by execrates Echinococcus
granulosus eggs at a great number of segment full of eggs with their feces containing
the soil and grasses food , animal's outside's slaughterhouses usually without
veterinary inspection, as well as unhealthy treatments of infected carcass
(18)Parasitic infection within internal tissues mainly associated with chronic
inflammation due to long time inquiry needs to parasite migration and/or maturation
and also due to host's variation in each stages of infections(19)(20).Planes and
A B
C D
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Proceeding of 6th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
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haemolysis changes accompanied with neutrophils and eosinophil's aggregations
refers to damaging effects from hardening structures of parasites asprotoscolices and a
solid wall, edema and fluid accumulation in interstesium represents inflammatory
response and tearing effects of parasites(19)(20).. Emphysema and thickening
interalveolar septa results from assistance of harmful changes and heavy
inflammatory reactions (21)(22).
Conclusions: Examined samples showed that infected lung reported as significantly
value (100%) occurrence of Echinococus granulosus or hydatid cysts infections
refers to commonly parasitic infection occurs in sheep living in Kerbala/Iraq.
REFERENCES:
1-Patricia Paredes-Lascano, Ivan Toapanta-Yugcha; Andrea Aguayo-Escobar, Mayra
Morales-Salazar; d Alejandro Bravo-Paredes.(2017). Pulmonary Hydatid Disease in
an Adolescent: A Case Report. Paredes et al., Arch Parasitol 2017, 1:3Corresponding
author: Patricia Paredes-Lascano, Department of Pediatrics, General Hospital
Ambato, Av Rodrigo Pachano 10-76 and EdmundoMartínez, AmbatoEcuador, Tel:
593994219101; E-mail: [email protected]
2-United States Centers for Disease Control and Prevention.Echinococcosis—
biology. http://www.cdc.gov/parasites/echinococcosis/biology.html.
3-.Gottstein B, Reichen J. Hydatid lung disease (echinococcosis/hydatidosis) Clinics
in Chest Medicine. 2002;23(2):397–408. [PubMed[
4-Kuzucu A. Parasitic diseases of the respiratory tract.Current Opinion in Pulmonary
Medicine. 2006;12(3):212–221. [PubMed[
5-.Fanne RA, Khamaisi M, Mevorach D, et al. Spontaneous rupture of lung
echinococcal cyst causing anaphylactic shock and respiratory distress
syndrome.Thorax. 2006;61(6):p. 550. [PMC free article] [PubMed[
6-Savani DM, Sharma OP. Eosinophilic lung disease in the tropics.Clinics in Chest
Medicine. 2002;23(2):377–396. [PubMed[
Basrah Journal of Veterinary Research,Vol.17, No.3,2018
Proceeding of 6th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
175
7-.Ito A, Sako Y, Yamasaki H, et al. Development of Em18-immunoblot and Em18-
ELISA for specific diagnosis of alveolar echinococcosis. ActaTropica.
2003;85(2):173–182. [PubMed[
8-Santivañez SJ, Arias P, Portocarrero M, et al. Serological diagnosis of lung cystic
hydatid disease using the synthetic p176 peptide. Clinical and Vaccine Immunology.
2012;19(6):944–947. [PMC free article] [PubMed[
9-Gencer M, Ceylan E. Pulmonary echinococcosis with multiple nodules mimicking
metastatic lung tumor in chest radiography.Respiration. 2008;75(3):p. 345. [PubMed[
10-Asanuma T, Kawahara T, Inanami O, et al. Magnetic resonance imaging of
alveolar echinococcosis experimentally induced in the rat lung. Journal of Veterinary
Medical Science. 2006;68(1):15–20. [PubMed[
11-Cakir E, Ozaydin SE, Tasci E, Baran R. Unusual presentation of hydatid cyst:
diagnosis with bronchoscopy. Journal of Infection in Developing Countries.
2010;4(5):352–354. [PubMed[
12-Gottstein B, Reichen J. Hydatid lung disease. In: Sharma OP, editor. Lung Biology
in Health and Disease: tropical Lung Disease. 2nd edition. New York, NY, USA:
Taylor and Francis Group; 2006. pp. 327–350.
13-Kavukcu S, Kilic D, Tokat AO, et al. Parenchyma-preserving surgery in the
management of pulmonary hydatid cysts. Journal of Investigative Surgery.
2006;19(1):61–68. [PubMed].
14-Dincer SI, DemirA, Sayar A, Gunluoglu MZ, Kara HV, Gurses A. Surgical
treatment of pulmonary hydatid disease: a comparison of children and adults. Journal
of Pediatric Surgery. 2006;41(7):1230–1236. [PubMed].
15- (Lunna,1996).
16. HISTOLOGY LABORATORY MANUAL 2016-2017. College of Physicians and
Surgeons Columbia University Patrice F Spitalnik MD Histology Director
[email protected]
Basrah Journal of Veterinary Research,Vol.17, No.3,2018
Proceeding of 6th International Scientific Conference,College of Veterinary Medicine
University of Basrah,Iraq
176
17-Pinto P (2017) Diagnóstico, tratamiento y seguimiento de la hidatidosis. Rev Chil
Cir 69: 94-98.
18-Ünver E, Kaymak M, Caylan Ö, Kaptanoğlu M (2017) Ruptured Pulmonary Cyst
Echinococcosis Mimicking Tuberculosis in Childhood: A Case Report.
TurkiyeParazitolDerg 41: 126-129.
19-Dfiz B, Al-qurani A, Al-Malki A, Kheel E, Esheba G (2016) Pulmonary Hydatid
Cyst in a 13 Years Old Child: A Case Report . J Clin Case Rep 6: 1-3. 9.
20-Akgul Ozmen C, Onat S (2017) Computed Tomography (CT) Findings of
Pulmonary Hydatid Cysts in Children and the Factors Related to Cyst Rupture. Med
SciMonit 29: 3679-3686.
21-Ufuk Cobanoglu1 ;Selvi Asker(2015).( Complications of Hydatid Cysts in the
Lung). *Corresponding author: UfukCobanoglu, Journal of Surgery and Surgical
Research Citation: Cobanoglu U, Asker S (2015) Complications of Hydatid Cysts in
the Lung. J Surg Surgical Res 1(2): 023-028. DOI: 10.17352/2455-2968.000006
023E-mail: www.peertechz.com ISSN: 2455-2968 Keywords: Hydatid cyst; Lung;
Complication.
22-Ronald E. Blanton , Timothy M. Wachira, Eberhard E., Zeyhle, Ernest M.
Njoroge, Japheth K. Magambo, and Peter M. Schantz.(1998).(Oxfendazole
Treatment for Cystic Hydatid Disease in Naturally Infected Animals). Antimicrobial
agents and chemotherapy, Mar. 1998, p. 601–605 Vol. 42, No. 3 Copyright © 1998,
American Society for Microbiology.