Persistence of Schistosoma japonicum DNA in a Kidney–Liver Transplant Recipient

Michael Kron Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin;

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Catherine Gordon Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia;

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Timothy Bauers Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin;

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Zouyan Lu Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin;

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Sheran Mahatme Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin;

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Janaki Shah Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin;

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Kia Saeian Division of Gastroenterology and Hepatology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin

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Donald P. McManus Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia;

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Mitochondrial genome analysis of Schistosoma japonicum suggests that diversity of intermediate host snails drove intra-species divergence during its expansion in Asia. We applied the knowledge of this genomic variation to study an unusual patient we recently diagnosed with schistosomiasis. The patient had not visited any schistosomiasis-endemic countries for more than 35 years and had no idea where she became infected. Unusual clinical features of this patient included the absence of egg granulomas in tissue and persistent noncalcified eggs despite multiple praziquantel (PZQ) treatments over 7 years. A digital droplet polymerase chair reaction (PCR) assay that specifically targets the schistosome 1,4 dihydronicotinamide adenine dinucleotide-1 (NADH1) dehydrogenase-1 mitochondrial gene successfully amplified parasite DNA extracted from colon biopsies. DNA sequence analysis of parasite DNA revealed that it was a Philippine strain of S. japonicum. Future molecular studies using stored DNA from patients such as this may provide new insight into why some persons do not respond well to PZQ treatment.

Author Notes

Address correspondence to Michael Kron, Division of Infectious Diseases, Medical College of Wisconsin, 8701 Watertown Plank Rd., 8th Floor, Hub Bldg., Milwaukee, WI 53226. E-mail: mkron@mcw.edu

Authors’ addresses: Michael Kron, Timothy Bauers, Zouyan Lu, Sheran Mahatme, Janaki Shah, and Kia Saeian, Division of Infectious Diseases, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, E-mails: mkron@mcw.edu, tbaures@mcw.edu, zlu@mcw.edu, smahatme@mcw.edu, janaki.shah@arcw.org, and ksaeian@mcw.edu. Catherine Gordon and Donald P. McManus, Molecular Parasitology Laboratory, Berghofer Queensland Institute for Biomedical Research (QIBR), Herston, Australia, E-mails: catherine.gordon@qimrberghofer.edu.au and don.mcmanus@qimrberghofer.edu.au.

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