Although significant strides have been made towards lymphatic filariasis (LF) elimination in Haiti, which has experienced ongoing multidimensional crises, 19 out of 140 communes still require mass drug administration (MDA) despite multiple rounds using the two-drug regimen of diethylcarbamazine (DEC) and albendazole. This includes the commune of Limonade, which has experienced persistently high LF prevalence despite nine rounds of two-drug MDAs since 2010. In September and October 2023 and July 2024, the Haitian Ministry of Public Health and Population, with support from IMA World Health and the US Centers for Disease Control and Prevention, adapted the standard WHO strategy, proving the feasibility, acceptability and scalability of LF MDA with three drugs (ivermectin, DEC and albendazole [IDA]) through the successful implementation of two rounds of IDA MDA in Limonade.

Hydatid disease (HD) is a zoonotic parasitic infection caused by Echinococcus granulosus and remains endemic in many regions. In children, pulmonary involvement is more common than hepatic disease and is often asymptomatic or mildly symptomatic. Massive hemoptysis as an initial presentation in early childhood is extremely rare. We report a case of a previously healthy 4-year-old boy who presented with a 3-day history of productive cough and massive hemoptysis without fever or systemic symptoms. Chest radiography showed right-sided consolidation, and contrast-enhanced computed tomography revealed a large cavitary lesion in the right middle lobe suggestive of a ruptured hydatid cyst. The patient underwent successful video-assisted thoracoscopic surgery-assisted mini-thoracotomy excision with chest tube placement, followed by albendazole therapy. Recovery was uneventful with excellent outcome. This case highlights the need to consider pulmonary HD in the differential diagnosis of hemoptysis in children living in endemic areas and supports minimally invasive surgical management when feasible.

Isolated splenic hydatidosis is a rare manifestation of Echinococcus granulosus infection, accounting for ~0.5%-4% of reported cases. Although often asymptomatic, cyst rupture is an uncommon but severe complication that may result in life-threatening systemic reactions, frequently precipitated by trauma. A 65-year-old Saudi male with type 2 diabetes mellitus and hypertension presented with acute epigastric pain, nausea, vomiting, and low-grade fever one week after minor trauma. He was hypotensive with a tender, non-peritonitic abdomen, and elevated inflammatory markers. Contrast-enhanced computed tomography demonstrated a large ruptured splenic hydatid cyst with intraperitoneal fluid. Emergency laparotomy with total splenectomy was performed, and histopathology confirmed the diagnosis. Recovery was uneventful, and albendazole therapy was initiated. Minor trauma may precipitate rupture of an unrecognized splenic hydatid cyst, and early imaging with prompt surgical management is critical to prevent life-threatening complications, particularly in endemic regions.

In nonendemic countries such as Denmark, hookworm infections in travelers may be rare and difficult to detect because of low-grade shedding of parasite eggs and a lack of clinical suspicion and relevant diagnostic capacity. Two cases of hookworm infection observed in 2025 that were detected only through amplicon-based next-generation sequencing (NGS) of fecal DNA are presented in the current study. Both infections were characterized by hypereosinophilia and acquired during 2-week holidays in Asia. Case 1 was infected with Ancylostoma ceylanicum during a holiday in the Philippines, and Case 2 acquired infection with Ancylostoma duodenale/caninum in Thailand. Eggs were found only in Case 2, and only after careful reexamination. These cases reveal that amplicon-based NGS is a simple and useful diagnostic adjunct when routine parasite screening triggered by eosinophilia and abdominal pain after tropical exposure fails to establish the diagnosis. Both cases were treated with ivermectin and albendazole, respectively, with good effect.

Neurocysticercosis is a frequent parasitic infection of the central nervous system. While parenchymal forms are well recognized, meningitis due to cysticercus remains underdiagnosed. This systematic review assessed clinical features, diagnostics, treatment, and outcomes of neurocysticercosis-associated meningitis. Following PRISMA guidelines and PROSPERO registration, case reports, series, and cohorts describing meningitis attributed to neurocysticercosis were analyzed. Extracted data included demographics, presentation, imaging, cerebrospinal fluid (CSF) findings, diagnostics, therapy, and outcomes. A total of 48 published cases of neurocysticercosis-associated meningitis were analyzed. Headache was the most common presenting symptom (45 cases, 94%), followed by fever and vomiting (20 cases each, 42%), visual impairment or gait disturbance (16 cases, 33%), altered sensorium (15 cases, 31%), and seizures (13 cases, 27%). Chronic meningitis (13 cases, 27%) and meningoencephalitis (10 cases, 21%) were the most frequent subtypes. Neuroimaging most often showed subarachnoid or racemose cysts (14 cases, 29%) and hydrocephalus (13 cases, 27%). Cerebrospinal fluid analysis revealed elevated opening pressure (27 cases, 56%), lymphocytic pleocytosis (25 cases, 52%), eosinophilic pleocytosis (12 cases, 25%), elevated protein (42 cases, 88%), and low glucose (35 cases, 73%). Surgical intervention was required in 26 cases (54%). Albendazole, corticosteroids, and praziquantel were used in 42 (88%), 21 (44%), and 18 (38%) cases, respectively. Complete recovery occurred in 17 cases (35%), and mortality in 3 cases (6%). Neurocysticercosis-associated meningitis is a severe, often subarachnoid disease marked by diagnostic delay and frequent surgical need, but outcomes are favorable when timely, individualized medical/ surgical management is instituted.

Hydatid disease (Echinococcus infection) is a parasitic condition primarily affecting the liver and lungs. Cervical involvement is extremely rare and can mimic other benign cystic neck lesions, making diagnosis challenging. We report a 35-year-old woman with a gradually enlarging left cervical mass extending toward the superior mediastinum, causing dysphagia and mild shortness of breath. Imaging revealed a large cystic lesion with daughter cysts abutting cervical vessels and the subclavian artery, with no abdominal or pulmonary involvement. The patient underwent transcervical excision with careful preservation of surrounding structures, followed by postoperative albendazole therapy. She recovered uneventfully and remains recurrence-free. This case highlights that hydatid disease should be considered in the differential diagnosis of cystic neck masses, particularly in rural or endemic regions. Accurate preoperative imaging is essential to delineate lesion extent, especially with mediastinal extension, and meticulous surgical excision without rupture is critical to prevent complications and recurrence.

Helminth infections remain among the most prevalent neglected tropical diseases worldwide, with angiostrongyliasis representing an emerging zoonotic condition associated with eosinophilic meningitis. In this study, spathulenol, a sesquiterpene isolated from Guarea macrophylla (Meliaceae), was evaluated for its anthelmintic potential using first-stage larvae (L1) of Angiostrongylus cantonensis as a phenotypic screening model. Spathulenol exhibited pronounced in vitro activity against L1 larvae, with an EC50 value in the low micromolar range (7.6 μM), outperforming the reference drug albendazole (15.1 μM) and showing slightly higher potency than pyrantel pamoate (10.4 μM) under identical experimental conditions. Phenotypic, morphological, and morphometric analyses further revealed compound-specific effects on parasite larvae, supporting biological differentiation from reference anthelmintics. This activity was accompanied by a favorable selectivity profile, as no cytotoxic effects were observed in human and animal cell lines at concentrations well above those required for antiparasitic activity (CC50 >200 μM). Moreover, spathulenol did not induce lethality in the free-living nematode Caenorhabditis elegans at concentrations up to 1000 μM. Taken together, these findings identify spathulenol as a selective hit compound emerging from phenotypic screening, representing a promising scaffold for early-stage anthelmintic drug discovery.

Cystic echinococcosis (CE), caused by Echinococcus granulosus sensu lato and other Echinococcus species, is a neglected tropical disease that predominantly affects the liver and lungs, with central nervous system involvement being rare but potentially severe. Data on cerebral CE in Afghanistan remain limited, resulting in insufficient characterization of its clinical and management patterns. This study describes seven patients (aged 7-45 years) with isolated cerebral CE and a history of livestock exposure or CE in family members. Lesions were located in the frontal, parietal, or temporal lobes. Headache was present in all patients (100%), followed by seizures (85.7%) and focal neurological deficits (28.6%). All patients underwent complete surgical cystectomy, followed by a three-month course of albendazole. Short-term outcomes were favorable, with resolution of headache in all cases and seizure control achieved in the majority (83.3%). These findings highlight the occurrence of cerebral CE in different regions of Afghanistan, and demonstrate a favorable early clinical response to the combined surgical and medical treatment approach.

Hydatidosis is an endemic, widely distributed anthropozoonosis that involves the liver, lungs, and other organs. We report two cases of large renal hydatid cysts. Diagnosis was suspected based on radiological examinations. The patients were given albendazole tablets 400 mg twice per day (one month before and one month after surgery), with monitoring of blood count and liver enzymes. During follow-up assessment for renal hydatid cysts, the possibility of recurrence must be kept in mind. These cysts can completely destroy the kidney.

Enterobius vermicularis, commonly known as the pinworm, is a prevalent intestinal nematode, particularly affecting children worldwide. Although infection is often asymptomatic, it may occasionally lead to complications, including appendiceal involvement. The role of E. vermicularis in the pathogenesis of acute appendicitis remains controversial and is frequently overlooked. We report a case of a 10-year-old child who presented with intermittent right lower quadrant abdominal pain without fever or systemic symptoms. Initial ultrasound revealed small mesenteric lymph nodes, with no clear evidence of appendiceal pathology. Empirical treatment with antibiotics and anti-inflammatory agents failed to relieve the symptoms. A follow-up ultrasound demonstrated a thickened retrocecal appendix with hypoechoic intraluminal content. Due to persistent pain, a laparoscopic appendectomy was performed, revealing a white, non-segmented roundworm within the appendiceal lumen. Histopathological examination and direct microscopic analysis confirmed follicular appendicitis with intraluminal nematodes morphologically consistent with E. vermicularis. Postoperative parasitological examination further supported the diagnosis, with detection of characteristic eggs using the Scotch tape test, while stool examinations remained negative. These findings suggested E. vermicularis as the most likely etiological agent and supported its pathogenic role in the patient's clinical presentation. The patient was treated with albendazole, followed by a second dose 2 weeks later. Simultaneous treatment was administered to household contacts, and strict hygiene measures were recommended to prevent reinfection. Clinical recovery was complete, with no postoperative complications. This case highlights the importance of considering parasitic infections in the differential diagnosis of acute abdominal pain, even in the absence of systemic inflammatory markers, particularly in endemic or underrecognized settings. Early recognition and targeted therapy are essential to prevent recurrence and intra-familial transmission.

Most patients with biliary ascariasis present with acute abdominal pain and biliary colic. Typically, conservative treatment involving deworming agents is employed. However, for those who do not respond to pharmacological therapy, endoscopic or surgical intervention becomes necessary. Generally, the mortality rate is low, and the prognosis is favorable. This case describes a pediatric patient exhibiting symptoms of intestinal disease, including upper abdominal pain and jaundice, resulting from extrahepatic biliary tract obstruction caused by roundworms. This condition subsequently led to complications such as obstructive jaundice and acute liver failure. Abnormal signals within the gallbladder cavity were detected through imaging techniques, including abdominal magnetic resonance cholangiopancreatography (MRCP) and enhanced abdominal computed tomography (CT). These abnormalities typically manifest as strip-shaped, tortuous, and tubular filling defects, thereby confirming the diagnosis of biliary ascariasis. Following the oral administration of albendazole for deworming and DPMAS treatment for acute liver failure, the child's condition improved, and he was discharged from the hospital. Subsequent follow-up indicated no recurrence of the disease. The objective of this study is to facilitate the early identification of biliary ascariasis in children, actively manage associated complications, and prevent the development of severe conditions.

BACKGROUND Toxocariasis has a wide geographic distribution, with high prevalence in tropical and subtropical regions. Ocular larva migrans is one of the most common manifestations in China and classically presents with peripheral granuloma, posterior granuloma, and chronic endophthalmitis. This report describes an atypical case of ocular toxocariasis in an adolescent male patient, initially misdiagnosed as chronic rhegmatogenous retinal detachment. CASE REPORT A 17-year-old male patient presented to our hospital with a 4-month history of progressive vision loss in his right eye, initially misdiagnosed as chronic rhegmatogenous retinal detachment, at a nearby facility. Scanning laser ophthalmoscopy identified a tractional retinal detachment accompanied by a granulomatous tubercle above the temporal peripheral retina in his right eye. The diagnosis of ocular toxocariasis was established by aqueous humor analysis, which revealed markedly elevated intraocular anti-Toxocara IgG levels and a significantly increased Goldmann-Witmer coefficient. The patient subsequently underwent scleral buckling, and 532 nm retinal laser photocoagulation 1 day after scleral buckling, resulting in successful anatomical reattachment. However, he developed retinal granulomatous lesions and vitritis 5 months following the surgery. Oral prednisone and albendazole effectively controlled intraocular inflammation and prevented further granulomatous progression. CONCLUSIONS Ocular toxocariasis may present with nonspecific findings, and serology and the Goldmann-Witmer coefficient are crucial for diagnosis. Scleral buckling is recommended for proliferative retinal changes, with adjunctive systemic therapy and long-term follow-up to prevent recurrence and preserve vision.

Alveolar echinococcosis (AE) caused by Echinococcus multilocularis, is a rare but potentially fatal zoonotic infection. AE most commonly presents with multiple cysts in the liver, may spread to other organs through infiltration or metastasis and can mimic malignancy with fatal consequences if not diagnosed early. Its occurrence in childhood is extremely rare and simultaneous hepatic and pulmonary involvement has been reported only in a few cases. This report aimed to discuss a pediatric AE case with concurrent hepatic and pulmonary involvement, initially misdiagnosed as malignancy, in the light of current literature. The presenting complaints, physical examination findings, diagnostic methods, treatment and follow-up results of a pediatric AE case with hepatic and pulmonary involvement were documented and pediatric AE cases available in the literature were reviewed. A 10-year-old boy presented with a fivemonth history of intermittent fever and weight loss. At admission, multiple cystic lesions were detected in the liver parenchyma, along with widespread cystic foci in both lungs. Laboratory tests revealed marked eosinophilia (44.5%), and E.multilocularis serology (IgG, IHA) together with Western blot (Em70, Em90 positivity) confirmed the diagnosis. According to the "parasitic mass in the liver, neighboring organs involvement and metastasis" classification; the case was staged as P4N0M1. Since surgical resection was not feasible, continuous albendazole therapy (15 mg/kg/day) was initiated. After one year of follow-up, significant radiological regression was observed, without new lesion development or treatment-related toxicity. Pediatric AE with multi-organ involvement may mimic malignancy and cause diagnostic delays. Early diagnosis and appropriate antiparasitic therapy can achieve favorable outcomes even when surgery is not feasible. However, the prolonged duration of therapy and the lack of a well-defined treatment endpoint pose significant challenges in terms of monitoring and potential toxicity. More clinical data are needed to establish optimal treatment duration and follow-up protocols in children.