Skip to main content

Main menu

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Institutional open access agreements
    • Peer reviewer login
    • WoS Reviewer Recognition Service
  • Alerts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • Early View
  • Archive
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Institutional open access agreements
    • Peer reviewer login
    • WoS Reviewer Recognition Service
  • Alerts
  • Subscriptions

Mammomonogamus laryngeus: an unusual cause of acute and chronic cough in the Caribbean area

Moustapha Agossou, Sandy Jean-Baptiste, Ninon Ehret, Nicole Desbois-Nogard, Moustapha Drame, Nicolas Venissac
ERJ Open Research 2021 7: 00814-2020; DOI: 10.1183/23120541.00814-2020
Moustapha Agossou
1Dept of Respiratory care, CHU Martinique, Fort-de-France, Martinique
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: moustapha.agossou@chu-martinique.fr
Sandy Jean-Baptiste
1Dept of Respiratory care, CHU Martinique, Fort-de-France, Martinique
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ninon Ehret
1Dept of Respiratory care, CHU Martinique, Fort-de-France, Martinique
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nicole Desbois-Nogard
2Parasitology–Mycology Laboratory, CHU Martinique, Fort-de-France, Martinique
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Moustapha Drame
3Dept of Clinical Research and Innovation, CHU Martinique, Fort-de-France, Martinique
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nicolas Venissac
4Dept of Thoracic Surgery, CHRU Lille, Lille, France
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Abstract

Mammomonogamus is an unusual cause of chronic cough found in the Caribbean region. The region is very popular with tourists. There is interest in thinking about a cough that cannot be explained in any patient who has stayed in this region. https://bit.ly/3qnemv9

To the Editor:

Mammomonogamus spp. and Syngamus spp. are nematodes in the Syngamidae family most often found in tropical environments. The parasites infest the respiratory tract of animals such as cattle, goats and sheep but human infestation is rare. Mammomonogamus spp. parasitise the respiratory tract and are responsible for respiratory symptoms dominated by coughing [1]. Approximately 100 cases have been described in the literature, nearly half of which came from the Caribbean [1–3]. In Martinique (a French overseas territory), the description of the parasite was made in the 1950s, and the largest series was published there [2, 3]. Despite the improvement in living conditions since the 1980s, human infestation by Mammomonogamus spp. persists in Martinique.

The objective of this retrospective and descriptive study is to describe the clinical, biological and radiological characteristics of patients with mammomonogamosis.

Cases of mammomonogamosis were identified from records of the Pneumology Department of the Martinique teaching hospitals between January 1, 2008 and August 31, 2020. These were patients who underwent bronchial fibroscopy and in whom endobronchial Mammomonogamus laryngeus worm were found (figure 1).

FIGURE 1
  • Download figure
  • Open in new tab
  • Download powerpoint
FIGURE 1

Mammomonogamus worm in the bronchus.

Patients usually had a consultation with a pneumologist before the examination was performed. Data collection concerned age, sex, reason for consultation, biological abnormalities, radiological abnormalities, treatment and patient's evolution. Subjects provided consent for the image to be used for publication purposes.

During the period from January 1, 2008 to August 31, 2020, 12 patients were diagnosed with mammomonogamosis at the Teaching Hospital Martinique, 10 of whom were women. The average age of the patients was 36±13 years. Cough was the characteristic symptom in all cases, mainly dry cough. In one case, the cough was accompanied by haemoptysis. The duration of symptoms before diagnosis varied from 10 days to >6 months. In addition to coughing, one patient presented with digestive disorders such as vomiting and weight loss (loss of 10% body weight). Another patient presented with a long-term febrile condition.

On thoracic imaging, three patients presented with pulmonary infiltrate-type abnormalities. Imaging was normal in the other cases.

Biologically, two patients presented with blood hypereosinophilia: 1.04×109·L−1 (9.2%) and 0.76×109·L−1 (8.5%). Over 10 patients had eosinophilia under 0.5×109·L−1. The worms were detected during bronchial endoscopy, usually as a pair of worms intertwined. They were removed with the forceps (1–4 pairs).

The patients then benefited from an antiparasitic treatment, either with albendazole 400 mg·day−1 for 10 days or ivermectin according to the weight in a renewed dose 15 days later. The evolution is often marked by the disappearance of symptoms from the third day of treatment. None of the patients relapsed.

Mammomonogamosis is a parasitosis found in tropical areas. It most often affects animals such as cattle, goats, sheep or feline species. Human involvement is rare but persists in some areas. About a hundred cases have been described in the literature, most from the Caribbean and Latin America, [1, 4, 5], but cases have also been described in Asia [6, 7]. This parasitosis persists in Martinique where the largest series was described by Mornex et al. [3] in the 1980s [2], despite the improvement in living conditions of the population.

In our report, mammomonogamosis mainly affects young women. This sex difference is not reported in the literature. We have no explanation to date for this female predominance other than sampling fluctuation.

The main symptom remains a dry irritant cough with usually normal imaging [1, 8–10], but chest computed tomography can show ground-glass type abnormalities or condensations on the lung.

The endoscopy makes it possible to image worms of Mammomonogamus laryngeus (figure 1).

While nearly half of the cases have been described in people native to Martinique, tourists can also contract mammomonogamosis, and many cases have been diagnosed after their return to their country of origin [1, 11]. This unusual situation can lead to underdiagnosis. The Caribbean is an important tourist destination, and it is imperative that a diagnosis is sought in cases of chronic unexplained cough in patients returning from an endemic area.

Footnotes

  • Conflict of interest: M. Agossou has nothing to disclose.

  • Conflict of interest: S. Jean-Baptiste has nothing to disclose.

  • Conflict of interest: N. Ehret has nothing to disclose.

  • Conflict of interest: N. Desbois-Nogard has nothing to disclose.

  • Conflict of interest: M. Drame has nothing to disclose.

  • Conflict of interest: N. Venissac has nothing to disclose.

  • Received November 25, 2020.
  • Accepted December 16, 2020.
  • Copyright ©ERS 2021
http://creativecommons.org/licenses/by-nc/4.0/

This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

References

  1. ↵
    1. Nosanchuk JS,
    2. Wade SE,
    3. Landolf M
    . Case report of and description of parasite in Mammomonogamus laryngeus (human syngamosis) infection. J Clin Microbiol 1995; 33: 998–1000. doi:10.1128/JCM.33.4.998-1000.1995
    OpenUrlAbstract/FREE Full Text
  2. ↵
    1. Saint-Prix L
    . [Human syngamosis in Martinique]. Ann Parasitol Hum Comp 1950; 25: 235–236. doi:10.1051/parasite/1950253235
    OpenUrlPubMed
  3. ↵
    1. Mornex JF,
    2. Magdeleine J,
    3. De Thore J
    . [Human Syngamus (Mammonogonus nasicola) infestation as a cause of chronic cough in Martinique. 37 cases (author's transl)]. Nouv Presse Med 1980; 9: 3628.
    OpenUrlPubMed
  4. ↵
    1. Castaño JC,
    2. Núñez FA,
    3. González MM, et al.
    [First case report of Mammomonogamus (Syngamus) laryngeus human infection in Colombia]. Biomed Rev Inst Nac Salud 2006; 26: 337–341.
    OpenUrl
  5. ↵
    1. Marques SMT,
    2. Quadros RM,
    3. Pilati C
    . Mammomonogamus laryngeus (Railliet, 1899) infection in buffaloes in Rio Grande do Sul, Brazil. Vet Parasitol 2005; 130: 241–243. doi:10.1016/j.vetpar.2005.03.035
    OpenUrlPubMed
  6. ↵
    1. Van Aken D,
    2. Lagapa JT,
    3. Dargantes AP, et al.
    Mammomonogamus laryngeus (Railliet, 1899) infections in cattle in Mindanao, Philippines. Vet Parasitol 1996; 64: 329–332. doi:10.1016/0304-4017(95)00933-7
    OpenUrlPubMed
  7. ↵
    1. Foitová I,
    2. Koubková B,
    3. Barus V, et al.
    Presence and species identification of the gapeworm Mammomonogamus laryngeus (Railliet, 1899) (Syngamidae: Nematoda) in a semi-wild population of Sumatran orangutan (Pongo abelii) in Indonesia. Res Vet Sci 2008; 84: 232–236. doi:10.1016/j.rvsc.2007.04.021
    OpenUrlPubMed
  8. ↵
    1. Pontes PA,
    2. Gadelha ME,
    3. Gregorio LC
    . Pathologic quiz case 2. Laryngeal syngamosis. Arch Otolaryngol Head Neck Surg 1993; 119: 570–571. doi:10.1001/archotol.1993.01880170096020
    OpenUrlPubMed
    1. Gardiner CH,
    2. Schantz PM
    . Mammomonogamus infection in a human. Report of a case. Am J Trop Med Hyg 1983; 32: 995–997. doi:10.4269/ajtmh.1983.32.995
    OpenUrlAbstract/FREE Full Text
  9. ↵
    1. Timmons RF,
    2. Bowers RE,
    3. Price DL
    . Infection of the respiratory tract with Mammomanogamus (Syngamus) laryngeus: a new case in Largo, Florida, and a summary of previously reported cases. Am Rev Respir Dis 1983; 128: 566–569. doi:10.1164/arrd.1983.128.3.566
    OpenUrlPubMed
  10. ↵
    1. Angheben A,
    2. Gobbo M,
    3. Gobbi F, et al.
    Human syngamosis: an unusual cause of chronic cough in travellers. BMJ Case Rep 2009; 2009: bcr1220081305. doi:10.1136/bcr.12.2008.1305
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top
Vol 7 Issue 1 Table of Contents
ERJ Open Research: 7 (1)
  • Table of Contents
  • Index by author
Email

Thank you for your interest in spreading the word on European Respiratory Society .

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Mammomonogamus laryngeus: an unusual cause of acute and chronic cough in the Caribbean area
(Your Name) has sent you a message from European Respiratory Society
(Your Name) thought you would like to see the European Respiratory Society web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Citation Tools
Mammomonogamus laryngeus: an unusual cause of acute and chronic cough in the Caribbean area
Moustapha Agossou, Sandy Jean-Baptiste, Ninon Ehret, Nicole Desbois-Nogard, Moustapha Drame, Nicolas Venissac
ERJ Open Research Jan 2021, 7 (1) 00814-2020; DOI: 10.1183/23120541.00814-2020

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Mammomonogamus laryngeus: an unusual cause of acute and chronic cough in the Caribbean area
Moustapha Agossou, Sandy Jean-Baptiste, Ninon Ehret, Nicole Desbois-Nogard, Moustapha Drame, Nicolas Venissac
ERJ Open Research Jan 2021, 7 (1) 00814-2020; DOI: 10.1183/23120541.00814-2020
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
Full Text (PDF)

Jump To

  • Article
    • Abstract
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Subjects

  • Respiratory infections and tuberculosis
  • Tweet Widget
  • Facebook Like
  • Google Plus One

More in this TOC Section

  • rs2070600 SNP regulates AGER splicing and sputum sRAGE
  • Procoagulant microparticles and COVID-19
  • Cancer referral and interventional pulmonology during COVID-19
Show more Original research letters

Related Articles

Navigate

  • Home
  • Current issue
  • Archive

About ERJ Open Research

  • Editorial board
  • Journal information
  • Press
  • Permissions and reprints
  • Advertising

The European Respiratory Society

  • Society home
  • myERS
  • Privacy policy
  • Accessibility

ERS publications

  • European Respiratory Journal
  • ERJ Open Research
  • European Respiratory Review
  • Breathe
  • ERS books online
  • ERS Bookshop

Help

  • Feedback

For authors

  • Instructions for authors
  • Publication ethics and malpractice
  • Submit a manuscript

For readers

  • Alerts
  • Subjects
  • RSS

Subscriptions

  • Accessing the ERS publications

Contact us

European Respiratory Society
442 Glossop Road
Sheffield S10 2PX
United Kingdom
Tel: +44 114 2672860
Email: journals@ersnet.org

ISSN

Online ISSN: 2312-0541

Copyright © 2023 by the European Respiratory Society