Human oesophagostomiasis: a histomorphometric study of 13 new cases in northern Ghana

Oesophagostomiasis is an infrequently described and recognised parasitic in fection in humans, caused by Oesophagostomum bifurcum. Although the disease is most often found in the northern part of Togo and the neighbouring part of Ghana, sporadic cases have been described in other parts of Africa and in Asia and South America: Uganda, Ivory Coast, Sudan, Kenya, Ethiopia, Ind onesia, Malaysia and Brazil. Infection probably occurs by way of the ingest ion of L3 larvae. These larvae penetrate the intestinal wall, especially th at of the colon. Some of these larvae develop into young adult worms and re turn to the bowel lumen. Other larvae, however, develop into immature worms , which fail to settle in the lumen, forming abscesses in the bowel wall an d causing pathology. In the literature 105 human cases have been described, many originating in the northern regions of Ghana and Togo. The present st udy was performed to evaluate 13 new cases originating in the northern part of Ghana (7 female and 6 male patients, aged between 2 and 60 years). Hist opathologically, the patients could be divided into two groups: the first g roup showed multinodular disease, while patients in the second group presen ted with a single, nodular mass. In the first group, abscesses were seen th roughout the colonic wall. The mean size of the cavities was 4.3 +/-0.7 mm. There was no relation between the size and the localisation in the colonic wall. Abscesses were significantly larger in male patients than in female patients. There was no correlation with age. In the second group, histopath ological examination showed a cyst of variable wall thickness with very lim ited inflammation. These cysts represented older lesions, often encapsulate d in the mesentery. In conclusion, in this study we present 13 new cases of human oesophagostomiasis. The abscess formation was found to be organ spec ific, independent of age, and gender-related, producing a more intense tiss ue reaction in male patients.