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Capillaria hepatica (Bancroft, 1893)
443 TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE.
Vol. 43.
No. 4. January, 1950.
CAPILLARIA HEPATI6"A (BANCROFT, 1893). A CASE REPORT. BY
GUSTAV ENGLER, M.D., V.I.C.S., AND
GUILLERMO SANCHEZ
(From the Almirante Hospital of the United Fruit Company Panama Division).
Ever since MACARTHUR (1924) described an authentic case of fatal h u m a n infection with Capillaria hepatica (Bancroft, 1893) in a British Soldier in India, the interest in this nematode has been active. T h e subsequent cases which n u m b e r now over 30, were probably spurious infections caused by ingestion of the liver of certain infected animals. T h e parasites seem to be ubiquitous t h r o u g h o u t the tropics. FOSTER and JOHNSON (1939) investigated the probable source of infections in Panama and traced their cases to infection from the liver of the white-lipped peccary (Tayassus pecari spiridens) of the red spider monkey (Ateles geaffroyi) and of the capucine m o n k e y (Cebus capucinus imitator). BROSlUS (1948) added to the possible list of sources of infection, the wild turkey (Meleagris gallopavo silvestris) the " tipesquinte " (Order : Marsupalia) and the " paujui " a species of pheasant. D u r i n g the investigation of the present case all members of the patient's household were examined but no other case of Capillaria hepatica infection could be found. CASE REPORT.
NO. 14143.
Alejandrina S., 19, Panamanian, female, housewife, resident of Almirante, was admitted on 2nd March, 1949. Family history : patient's household includes the persons listed below, all provided for by patient's father, a working man and occasional hunter in the vicinity of Almirante. The animals brought home during the last 12 months were : wild hog, tipesquinty, deer, wild turkey and mountain hen. The names are given as described by the patient. The liver of these animals was fried in sesam oil in an iron pan on charcoal fire, and was allegedly always well done and never raw.
444
CAPILLARIA HEPATICA
Personalhistory.--Kahn 4 plus 1947 ; full course ofantiluetic treatment ; now negative. Normal confinement of first child November, 1948. Present history.--Fever cough for 2 days, sputum streaked with blood. Examination.--llO lb. ; blood pressure 112/70 ; temperature 100°. Fairly nourished young woman, scar after burn of upper and lower lip pharynx injected ; chest, abdomen, pelvic organs without abnormal findings. Laboratory findings : Urine normal ; red and white blood count within normal limits ; Kahn test negative ; blood smear for malaria negative ; Stool : Necator americanus ; Trichuris trichiura and Capillaria hepatica (ova). Chest film normal. Course.--A total of six stool specimens were examined before anthelmintic treatment was instituted. All were positive for Capillaria hepatica. T h r o u g h the courtesy of Dr. H. CLARK, the Gorgas Memorial L a b o r a t o r y examined a specimen and confirmed the diagnosis. T h e u p p e r respiratory infection cleared u n d e r penicillin and sulphonamides. Following Brosius' suggestion c h e n o p o d i u m treatment was administered (chenop o d i u m gtt. xxx, followed by castor oil oz. ii after 2 hours) but this t r e a t m e n t failed to eliminate the ova in our case. One week after the c h e n o p o d i u m treatment the stool specimen still showed numerous ova of Capillaria hepatica. Hexaresorcinol gramme 1-0 (Cystoid Sharp and D o h m e 5 × 0.2) followed by cathartic c o m p o u n d after 12 hours, cleared the infection and the stool specimens have remained negative since then. A stool survey of other members of the household was then undertaken : Emilio M., father, 39 No parasites found. Augustina, mother, 45 Ascaris lumbricoides. Alfonso M., 8 A. lumbricoides ; Trichuris trichiura. Fortunato M., 7 ,, T. trichiura. Inez M., 11 T. trichiura. SUMMARY.
A n o t h e r case of probably spurious infection with Capillaria hepatica (Bancroft) is presented, in the members of a household, where certain wild animals are consumed. T h e other members of the household were f o u n d free from Capillaria hepatica. C h e n o p o d i u m in average doses failed to eliminate the infection. Hexaresorcinol in standard doses eliminated the ova of Capillaria hepatica from the stools. REFERENCES.
D . L . (1942). Text Book of ClinicalParasitology. 267. New York & London : D. Appleton-Century Co., Inc. BRoslus, O. T., THOMAS, E. & BROSlUS, B. (1948). Trans. R. Soe. trop. Med. Hyg., 42, 95. CRAIG, C. F. & FAUST, E. C. (1943). Clinical Parasitology, 3rd Ed., 243. London : Henry Kimpton. FAUST, E. C. & MARTINEZ, W . H . (1935). J. Parasit., 21, 232. FOSTER, A. O. & JOHNSON, C . M . (1939). Trans. R. Soc. trop. Med. Hyg., 82, 639. MACARTHUR, W . P . (1924). Proc. R. Soc. Med., 17, 83. STRONG, R. P. (1945). Stitt's Diagnosis Prevention and Treatment of Tropical Diseases, 7th Ed., 1286. London : H. K. Lewis & Co.
BELDING,
Printed in Great Britain b:¢ H. R. GRtras, LTO., Croydo~
Vol. 43.
No. 4. January, 1950.
CAPILLARIA HEPATI6"A (BANCROFT, 1893). A CASE REPORT. BY
GUSTAV ENGLER, M.D., V.I.C.S., AND
GUILLERMO SANCHEZ
(From the Almirante Hospital of the United Fruit Company Panama Division).
Ever since MACARTHUR (1924) described an authentic case of fatal h u m a n infection with Capillaria hepatica (Bancroft, 1893) in a British Soldier in India, the interest in this nematode has been active. T h e subsequent cases which n u m b e r now over 30, were probably spurious infections caused by ingestion of the liver of certain infected animals. T h e parasites seem to be ubiquitous t h r o u g h o u t the tropics. FOSTER and JOHNSON (1939) investigated the probable source of infections in Panama and traced their cases to infection from the liver of the white-lipped peccary (Tayassus pecari spiridens) of the red spider monkey (Ateles geaffroyi) and of the capucine m o n k e y (Cebus capucinus imitator). BROSlUS (1948) added to the possible list of sources of infection, the wild turkey (Meleagris gallopavo silvestris) the " tipesquinte " (Order : Marsupalia) and the " paujui " a species of pheasant. D u r i n g the investigation of the present case all members of the patient's household were examined but no other case of Capillaria hepatica infection could be found. CASE REPORT.
NO. 14143.
Alejandrina S., 19, Panamanian, female, housewife, resident of Almirante, was admitted on 2nd March, 1949. Family history : patient's household includes the persons listed below, all provided for by patient's father, a working man and occasional hunter in the vicinity of Almirante. The animals brought home during the last 12 months were : wild hog, tipesquinty, deer, wild turkey and mountain hen. The names are given as described by the patient. The liver of these animals was fried in sesam oil in an iron pan on charcoal fire, and was allegedly always well done and never raw.
444
CAPILLARIA HEPATICA
Personalhistory.--Kahn 4 plus 1947 ; full course ofantiluetic treatment ; now negative. Normal confinement of first child November, 1948. Present history.--Fever cough for 2 days, sputum streaked with blood. Examination.--llO lb. ; blood pressure 112/70 ; temperature 100°. Fairly nourished young woman, scar after burn of upper and lower lip pharynx injected ; chest, abdomen, pelvic organs without abnormal findings. Laboratory findings : Urine normal ; red and white blood count within normal limits ; Kahn test negative ; blood smear for malaria negative ; Stool : Necator americanus ; Trichuris trichiura and Capillaria hepatica (ova). Chest film normal. Course.--A total of six stool specimens were examined before anthelmintic treatment was instituted. All were positive for Capillaria hepatica. T h r o u g h the courtesy of Dr. H. CLARK, the Gorgas Memorial L a b o r a t o r y examined a specimen and confirmed the diagnosis. T h e u p p e r respiratory infection cleared u n d e r penicillin and sulphonamides. Following Brosius' suggestion c h e n o p o d i u m treatment was administered (chenop o d i u m gtt. xxx, followed by castor oil oz. ii after 2 hours) but this t r e a t m e n t failed to eliminate the ova in our case. One week after the c h e n o p o d i u m treatment the stool specimen still showed numerous ova of Capillaria hepatica. Hexaresorcinol gramme 1-0 (Cystoid Sharp and D o h m e 5 × 0.2) followed by cathartic c o m p o u n d after 12 hours, cleared the infection and the stool specimens have remained negative since then. A stool survey of other members of the household was then undertaken : Emilio M., father, 39 No parasites found. Augustina, mother, 45 Ascaris lumbricoides. Alfonso M., 8 A. lumbricoides ; Trichuris trichiura. Fortunato M., 7 ,, T. trichiura. Inez M., 11 T. trichiura. SUMMARY.
A n o t h e r case of probably spurious infection with Capillaria hepatica (Bancroft) is presented, in the members of a household, where certain wild animals are consumed. T h e other members of the household were f o u n d free from Capillaria hepatica. C h e n o p o d i u m in average doses failed to eliminate the infection. Hexaresorcinol in standard doses eliminated the ova of Capillaria hepatica from the stools. REFERENCES.
D . L . (1942). Text Book of ClinicalParasitology. 267. New York & London : D. Appleton-Century Co., Inc. BRoslus, O. T., THOMAS, E. & BROSlUS, B. (1948). Trans. R. Soe. trop. Med. Hyg., 42, 95. CRAIG, C. F. & FAUST, E. C. (1943). Clinical Parasitology, 3rd Ed., 243. London : Henry Kimpton. FAUST, E. C. & MARTINEZ, W . H . (1935). J. Parasit., 21, 232. FOSTER, A. O. & JOHNSON, C . M . (1939). Trans. R. Soc. trop. Med. Hyg., 82, 639. MACARTHUR, W . P . (1924). Proc. R. Soc. Med., 17, 83. STRONG, R. P. (1945). Stitt's Diagnosis Prevention and Treatment of Tropical Diseases, 7th Ed., 1286. London : H. K. Lewis & Co.
BELDING,
Printed in Great Britain b:¢ H. R. GRtras, LTO., Croydo~