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<title xml:lang="en">Probable hepatic capillariosis and hydatidosis in an adolescent from the late Roman period buried in Amiens (France)</title>
<author>
<name sortKey="Mowlavi, Gholamreza" sort="Mowlavi, Gholamreza" uniqKey="Mowlavi G" first="Gholamreza" last="Mowlavi">Gholamreza Mowlavi</name>
<affiliation>
<nlm:aff id="AFF1">
<addr-line> Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences PO Box 6446 Tehran 14155 Iran</addr-line>
</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AFF6">
<addr-line> Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences PO Box 6446 Tehran 14155 Iran</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kacki, Sacha" sort="Kacki, Sacha" uniqKey="Kacki S" first="Sacha" last="Kacki">Sacha Kacki</name>
<affiliation>
<nlm:aff id="AFF2">
<addr-line> PACEA, UMR 5199, Anthropologie des Populations Passées et Présentes, Université de Bordeaux Bâtiment B8, Allée Geoffroy St Hilaire, CS 50023 33615 Pessac Cedex France</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Dupouy Camet, Jean" sort="Dupouy Camet, Jean" uniqKey="Dupouy Camet J" first="Jean" last="Dupouy-Camet">Jean Dupouy-Camet</name>
<affiliation>
<nlm:aff id="AFF3">
<addr-line> Service de Parasitologie-Mycologie, Hôpital Cochin Assistance Publique Hôpitaux de Paris, Université Paris Descartes 27 Faubourg St Jacques 75014 Paris France</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mobedi, Iraj" sort="Mobedi, Iraj" uniqKey="Mobedi I" first="Iraj" last="Mobedi">Iraj Mobedi</name>
<affiliation>
<nlm:aff id="AFF1">
<addr-line> Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences PO Box 6446 Tehran 14155 Iran</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Makki, Mahsasadat" sort="Makki, Mahsasadat" uniqKey="Makki M" first="Mahsasadat" last="Makki">Mahsasadat Makki</name>
<affiliation>
<nlm:aff id="AFF1">
<addr-line> Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences PO Box 6446 Tehran 14155 Iran</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Harandi, Majid Fasihi" sort="Harandi, Majid Fasihi" uniqKey="Harandi M" first="Majid Fasihi" last="Harandi">Majid Fasihi Harandi</name>
<affiliation>
<nlm:aff id="AFF4">
<addr-line> Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences Kerman 76169-14111 Iran</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Naddaf, Saied Reza" sort="Naddaf, Saied Reza" uniqKey="Naddaf S" first="Saied Reza" last="Naddaf">Saied Reza Naddaf</name>
<affiliation>
<nlm:aff id="AFF5">
<addr-line> Department of Parasitology, Pasteur Institute of Iran 69 Pasteur Avenue Tehran 13169-43551 Iran</addr-line>
</nlm:aff>
</affiliation>
</author>
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<title xml:lang="en" level="a" type="main">Probable hepatic capillariosis and hydatidosis in an adolescent from the late Roman period buried in Amiens (France)</title>
<author>
<name sortKey="Mowlavi, Gholamreza" sort="Mowlavi, Gholamreza" uniqKey="Mowlavi G" first="Gholamreza" last="Mowlavi">Gholamreza Mowlavi</name>
<affiliation>
<nlm:aff id="AFF1">
<addr-line> Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences PO Box 6446 Tehran 14155 Iran</addr-line>
</nlm:aff>
</affiliation>
<affiliation>
<nlm:aff id="AFF6">
<addr-line> Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences PO Box 6446 Tehran 14155 Iran</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Kacki, Sacha" sort="Kacki, Sacha" uniqKey="Kacki S" first="Sacha" last="Kacki">Sacha Kacki</name>
<affiliation>
<nlm:aff id="AFF2">
<addr-line> PACEA, UMR 5199, Anthropologie des Populations Passées et Présentes, Université de Bordeaux Bâtiment B8, Allée Geoffroy St Hilaire, CS 50023 33615 Pessac Cedex France</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Dupouy Camet, Jean" sort="Dupouy Camet, Jean" uniqKey="Dupouy Camet J" first="Jean" last="Dupouy-Camet">Jean Dupouy-Camet</name>
<affiliation>
<nlm:aff id="AFF3">
<addr-line> Service de Parasitologie-Mycologie, Hôpital Cochin Assistance Publique Hôpitaux de Paris, Université Paris Descartes 27 Faubourg St Jacques 75014 Paris France</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Mobedi, Iraj" sort="Mobedi, Iraj" uniqKey="Mobedi I" first="Iraj" last="Mobedi">Iraj Mobedi</name>
<affiliation>
<nlm:aff id="AFF1">
<addr-line> Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences PO Box 6446 Tehran 14155 Iran</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Makki, Mahsasadat" sort="Makki, Mahsasadat" uniqKey="Makki M" first="Mahsasadat" last="Makki">Mahsasadat Makki</name>
<affiliation>
<nlm:aff id="AFF1">
<addr-line> Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences PO Box 6446 Tehran 14155 Iran</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Harandi, Majid Fasihi" sort="Harandi, Majid Fasihi" uniqKey="Harandi M" first="Majid Fasihi" last="Harandi">Majid Fasihi Harandi</name>
<affiliation>
<nlm:aff id="AFF4">
<addr-line> Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences Kerman 76169-14111 Iran</addr-line>
</nlm:aff>
</affiliation>
</author>
<author>
<name sortKey="Naddaf, Saied Reza" sort="Naddaf, Saied Reza" uniqKey="Naddaf S" first="Saied Reza" last="Naddaf">Saied Reza Naddaf</name>
<affiliation>
<nlm:aff id="AFF5">
<addr-line> Department of Parasitology, Pasteur Institute of Iran 69 Pasteur Avenue Tehran 13169-43551 Iran</addr-line>
</nlm:aff>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Parasite</title>
<idno type="ISSN">1252-607X</idno>
<idno type="eISSN">1776-1042</idno>
<imprint>
<date when="2014">2014</date>
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<div type="abstract" xml:lang="en">
<p>Two calcified objects recovered from a 3rd to 4th-century grave of an adolescent in Amiens (Northern France) were identified as probable hydatid cysts. By using thin-section petrographic techniques, probable
<italic>Calodium hepaticum</italic>
(syn.
<italic>Capillaria hepatica</italic>
) eggs were identified in the wall of the cysts. Human hepatic capillariosis has not been reported from archaeological material so far, but could be expected given the poor level of environmental hygiene prevalent in this period. Identification of tissue-dwelling parasites such as
<italic>C. hepaticum</italic>
in archaeological remains is particularly dependent on preservation conditions and taphonomic changes and should be interpreted with caution due to morphological similarities with
<italic>Trichuris</italic>
sp. eggs.</p>
</div>
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<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Parasite</journal-id>
<journal-id journal-id-type="iso-abbrev">Parasite</journal-id>
<journal-id journal-id-type="publisher-id">parasite</journal-id>
<journal-title-group>
<journal-title>Parasite</journal-title>
</journal-title-group>
<issn pub-type="ppub">1252-607X</issn>
<issn pub-type="epub">1776-1042</issn>
<publisher>
<publisher-name>EDP Sciences</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">24572211</article-id>
<article-id pub-id-type="pmc">3936287</article-id>
<article-id pub-id-type="doi">10.1051/parasite/2014010</article-id>
<article-id pub-id-type="publisher-id">parasite130094</article-id>
<article-id pub-id-type="other">10.1051/parasite/2014010</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Probable hepatic capillariosis and hydatidosis in an adolescent from the late Roman period buried in Amiens (France)</article-title>
<trans-title-group xml:lang="fr">
<trans-title>Capillariose et hydatidose hépatiques probables chez un adolescent du bas Empire inhumé à Amiens (France)</trans-title>
</trans-title-group>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Mowlavi</surname>
<given-names>Gholamreza</given-names>
</name>
<xref ref-type="aff" rid="AFF1">1</xref>
<xref ref-type="aff" rid="AFF6">6</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Kacki</surname>
<given-names>Sacha</given-names>
</name>
<xref ref-type="aff" rid="AFF2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Dupouy-Camet</surname>
<given-names>Jean</given-names>
</name>
<xref ref-type="aff" rid="AFF3">3</xref>
<xref ref-type="corresp" rid="FN1">*</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Mobedi</surname>
<given-names>Iraj</given-names>
</name>
<xref ref-type="aff" rid="AFF1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Makki</surname>
<given-names>Mahsasadat</given-names>
</name>
<xref ref-type="aff" rid="AFF1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Harandi</surname>
<given-names>Majid Fasihi</given-names>
</name>
<xref ref-type="aff" rid="AFF4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Naddaf</surname>
<given-names>Saied Reza</given-names>
</name>
<xref ref-type="aff" rid="AFF5">5</xref>
</contrib>
</contrib-group>
<aff id="AFF1">
<label>1</label>
<addr-line> Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences PO Box 6446 Tehran 14155 Iran</addr-line>
</aff>
<aff id="AFF2">
<label>2</label>
<addr-line> PACEA, UMR 5199, Anthropologie des Populations Passées et Présentes, Université de Bordeaux Bâtiment B8, Allée Geoffroy St Hilaire, CS 50023 33615 Pessac Cedex France</addr-line>
</aff>
<aff id="AFF3">
<label>3</label>
<addr-line> Service de Parasitologie-Mycologie, Hôpital Cochin Assistance Publique Hôpitaux de Paris, Université Paris Descartes 27 Faubourg St Jacques 75014 Paris France</addr-line>
</aff>
<aff id="AFF4">
<label>4</label>
<addr-line> Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences Kerman 76169-14111 Iran</addr-line>
</aff>
<aff id="AFF5">
<label>5</label>
<addr-line> Department of Parasitology, Pasteur Institute of Iran 69 Pasteur Avenue Tehran 13169-43551 Iran</addr-line>
</aff>
<aff id="AFF6">
<label>6</label>
<addr-line> Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences PO Box 6446 Tehran 14155 Iran</addr-line>
</aff>
<author-notes>
<corresp id="FN1">
<label>*</label>
Corresponding author:
<email>jean.dupouy-camet@cch.aphp.fr</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub">
<year>2014</year>
</pub-date>
<pub-date pub-type="epub">
<day>28</day>
<month>2</month>
<year>2014</year>
</pub-date>
<volume>21</volume>
<issue-id pub-id-type="publisher-id">parasite/2014/01</issue-id>
<elocation-id>9</elocation-id>
<history>
<date date-type="received">
<day>30</day>
<month>10</month>
<year>2013</year>
</date>
<date date-type="accepted">
<day>13</day>
<month>2</month>
<year>2014</year>
</date>
</history>
<permissions>
<copyright-statement>© G. Mowlavi et al., published by EDP Sciences, 2014</copyright-statement>
<copyright-year>2014</copyright-year>
<copyright-holder>G. Mowlavi et al.,</copyright-holder>
<license license-type="open-access">
<license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<p>Two calcified objects recovered from a 3rd to 4th-century grave of an adolescent in Amiens (Northern France) were identified as probable hydatid cysts. By using thin-section petrographic techniques, probable
<italic>Calodium hepaticum</italic>
(syn.
<italic>Capillaria hepatica</italic>
) eggs were identified in the wall of the cysts. Human hepatic capillariosis has not been reported from archaeological material so far, but could be expected given the poor level of environmental hygiene prevalent in this period. Identification of tissue-dwelling parasites such as
<italic>C. hepaticum</italic>
in archaeological remains is particularly dependent on preservation conditions and taphonomic changes and should be interpreted with caution due to morphological similarities with
<italic>Trichuris</italic>
sp. eggs.</p>
</abstract>
<trans-abstract xml:lang="fr">
<p>Deux objets calcifiés découverts dans la tombe d’un adolescent du 3
<sup>ème</sup>
-4
<sup>ème</sup>
siècle à Amiens (France) ont été identifiés comme des kystes hydatiques probables. En utilisant des techniques pétrographiques, des œufs de
<italic>Calodium hepaticum</italic>
(syn.
<italic>Capillaria hepatica</italic>
) ont été identifiés dans la paroi de ces kystes. La capillariose hépatique n’a jamais été rapportée de restes archéologiques mais n’est pas inattendue compte tenu du bas niveau d’hygiène de cette époque. L’identification de parasites tissulaires comme
<italic>C. hepaticum</italic>
dans des vestiges archéologiques est particulièrement dépendante des conditions de conservation et de changements taphonomiques et doit être interprétée avec circonspection en raison des similitudes morphologiques de ces œufs avec ceux du trichocéphale (
<italic>Trichuris</italic>
sp.).</p>
</trans-abstract>
<kwd-group>
<kwd>Paleoparasitology</kwd>
<kwd>Capillariosis</kwd>
<kwd>Hydatidosis</kwd>
<kwd>
<italic>Calodium</italic>
</kwd>
<kwd>
<italic>Capillaria</italic>
</kwd>
<kwd>
<italic>Echinococcus granulosus</italic>
</kwd>
</kwd-group>
<counts>
<fig-count count="3"></fig-count>
<table-count count="1"></table-count>
<equation-count count="0"></equation-count>
<ref-count count="39"></ref-count>
<page-count count="5"></page-count>
</counts>
</article-meta>
</front>
<body>
<sec id="S1">
<title>Introduction</title>
<p>Paleoparasitology is the identification of parasites found in archaeological material. Sometimes parasitic eggs are relatively well preserved in latrines or mummified bodies, but their identification can be difficult. We report and discuss here the probable occurrence of human hepatic capillariosis associated with hydatidosis in an adolescent from the late Roman period buried in Amiens (Northern France). Although hydatidosis, particularly of the liver, still remains a problem of public health worldwide [
<xref rid="R20" ref-type="bibr">20</xref>
], human capillariosis is quite infrequent, but could have been more prevalent in ancient times due to greater contact with rodents and low hygiene in general.
<italic>Calodium hepaticum</italic>
(syn.
<italic>Capillaria hepatica</italic>
, Bancroft, 1893), the causative agent of hepatic capillariosis, is a parasitic nematode of rodents and other mammalian species, including humans. The adult worms invade the liver parenchyma of the host and lay numerous eggs in the surrounding tissues [
<xref rid="R21" ref-type="bibr">21</xref>
]. Hepatic capillariosis is a rare infection in humans and is associated with septal fibrosis of the liver, which leads to cirrhosis in severe infections [
<xref rid="R16" ref-type="bibr">16</xref>
,
<xref rid="R22" ref-type="bibr">22</xref>
]. Infection transmission mostly occurs after ingestion of embryonated eggs, which are disseminated in the soil following decomposition of parasitized dead animals, or in the environment following defecation by predators or scavengers [
<xref rid="R28" ref-type="bibr">28</xref>
]. Diagnosis requires a liver biopsy or post-mortem examination to demonstrate the presence of eggs [
<xref rid="R27" ref-type="bibr">27</xref>
]. The recovery of capillariid eggs from archaeological remains has been recorded: e.g., in human coprolites from the Neolithic inhabitants of Chalain (Jura, France) [
<xref rid="R7" ref-type="bibr">7</xref>
], in a pellet belonging to a Patagonian bird of prey from 6500 years ago [
<xref rid="R18" ref-type="bibr">18</xref>
], in Argentine rodent coprolites from 8000 years ago [
<xref rid="R33" ref-type="bibr">33</xref>
], in non-human organic remains from the French Medieval site of Charavines [
<xref rid="R5" ref-type="bibr">5</xref>
], and from the archaeological layers of “Place d’Armes” (Namur, Belgium) in which seven historical strata exist from the Roman period up to modern times [
<xref rid="R13" ref-type="bibr">13</xref>
].</p>
</sec>
<sec sec-type="materials|methods" id="S2">
<title>Materials and methods</title>
<p>During an excavation in 2009 in the city of Amiens (Northern France) investigators recovered two ovoid cyst-like objects from the grave of an adolescent of unknown sex (
<xref ref-type="fig" rid="F1">Fig. 1</xref>
). The burial was part of a small necropolis dating back to the Late Roman period (3rd–4th century AD). Although the skeleton was poorly preserved, all bones were connected and the cystic objects were obtained from the thoraco-abdominal region. The calcified objects, measuring 46 × 46 × 37 mm and 47 × 33 × 32 mm, respectively, exhibited a rough and irregular outer surface of brown/black color. Several holes in the outer wall revealed a hollow interior, with some powder inside. Contrary to the external surface, the internal surface was smooth. During the initial anthropological study, the aspect of the cysts indicated likely liver hydatidosis. In order to confirm this hypothesis, the cysts and the containing elements were analyzed by X-ray diffraction (XRD) and element analysis by X-ray fluorescence (XRF). X-ray analyses were performed at the Faculty of Sciences, Tarbiat Modares University, Tehran, Iran. To examine the material for parasites, the powder inside the cysts was rehydrated using trisodium phosphate (TSP) aqueous solution, as recommended [
<xref rid="R8" ref-type="bibr">8</xref>
]. In addition, tissue sections were prepared from the wall of the cysts by means of thin-section petrography, a well-established method in geology [
<xref rid="R10" ref-type="bibr">10</xref>
,
<xref rid="R31" ref-type="bibr">31</xref>
,
<xref rid="R37" ref-type="bibr">37</xref>
], but with some modifications. Four pieces of the specimen measuring about 1–2 × 1.5 cm were precisely sawed from the cysts, using a 50-cm-long steel wire. Due to the fragility of the specimen, samples were impregnated with resin (Epofix) in a vacuum chamber for 3 h and embedding was continued for another 8 h in the same chamber. Impregnated blocks were smoothed manually on one side and mounted on glass slides with Epofix resin. Grinding to a thickness of 1–2 mm and 50-60 μm was performed by a diamond blade (Microplan-TR) and diamond grinding wheel (Microplan-TR), respectively. Finally, to achieve the 30-μm thickness required for light transmission, silicon carbide powder (Mesh Nos. 320, 600, 800, and 1000) was used manually. At the end of each grinding step, coarse material was removed with tap water. Section slide mounting was performed using mixed low-viscosity resin and a cover slip under 0.5 kg pressure for 2 h. In addition, some parts of the cysts were thoroughly pulverized and rehydrated in TSP solution for 10 days. The parasite eggs were microscopically detected, photomicrographed, and measured using a calibrated microscope.
<fig id="F1" orientation="portrait" position="float">
<label>Figure 1.</label>
<caption>
<p>Cysts obtained from the grave of a late Roman adolescent in Amiens, France.</p>
</caption>
<graphic xlink:href="parasite-21-9-fig1"></graphic>
</fig>
</p>
</sec>
<sec sec-type="results" id="S3">
<title>Results</title>
<p>For the first cyst, XRD clearly detected the presence of both calcite and apatite (data not shown). These components were also present in the second cyst, together with other crystallographic species (quartz and iron). The XRF analyses showed that the main chemical elements of both cysts were calcium oxide and phosphorus oxide (
<xref ref-type="table" rid="T1">Table 1</xref>
). The high concentration of phosphorus in both samples is highly consistent with an organic origin. In addition, in both cysts, the stoichiometry P/Ca was compatible with that of hydroxyapatite, which can be considered as the main component of the cyst (or even the only one, if the few other elements are due to telluric pollution). Precise detection of larval rostellar hooks, which could have characterized hydatid cysts, was negative, but in one section a faded structure resembling a hydatid cyst laminated layer was observed (
<xref ref-type="fig" rid="F2">Fig. 2</xref>
). In addition, capillariid eggs were detected in all 15 thin-section slides and in the rehydrated pulverized cyst. Eggs in the section slides (
<xref ref-type="fig" rid="F3">Figs. 3b</xref>
<xref ref-type="fig" rid="F3">3d</xref>
) were more transparent than those observed in the rehydrated pulverized cyst (
<xref ref-type="fig" rid="F3">Fig. 3a</xref>
). The mean length and width of the eggs were 46.7 and 25 μm, respectively, and these eggs were tentatively identified as
<italic>C. hepaticum</italic>
. No parasite remains or eggs were seen in the powder from inside the cysts.
<fig id="F2" orientation="portrait" position="float">
<label>Figure 2.</label>
<caption>
<p>Laminated layers observed on a thin section of the cyst wall suggesting hydatidosis.</p>
</caption>
<graphic xlink:href="parasite-21-9-fig2"></graphic>
</fig>
<fig id="F3" orientation="portrait" position="float">
<label>Figure 3.</label>
<caption>
<p>Probable
<italic>Calodium hepaticum</italic>
eggs detected in the rehydrated pulverized cyst (a) and in thin-section slides (b–d). Scale bars = 50 μm, a–d: from top to base.</p>
</caption>
<graphic xlink:href="parasite-21-9-fig3"></graphic>
</fig>
<table-wrap id="T1" orientation="portrait" position="float">
<label>Table 1.</label>
<caption>
<p>Chemical analysis by X-ray fluorescence of samples from the two cysts.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr valign="top">
<th align="left" rowspan="1" colspan="1">%</th>
<th align="left" rowspan="1" colspan="1">Na
<sub>2</sub>
O</th>
<th align="left" rowspan="1" colspan="1">MgO</th>
<th align="left" rowspan="1" colspan="1">AlO
<sub>3</sub>
</th>
<th align="left" rowspan="1" colspan="1">SiO
<sub>2</sub>
</th>
<th align="left" rowspan="1" colspan="1">P
<sub>2</sub>
O
<sub>5</sub>
</th>
<th align="left" rowspan="1" colspan="1">SO
<sub>3</sub>
</th>
<th align="left" rowspan="1" colspan="1">CaO</th>
<th align="left" rowspan="1" colspan="1">Fe
<sub>2</sub>
O
<sub>3</sub>
</th>
<th align="left" rowspan="1" colspan="1">Sr</th>
</tr>
</thead>
<tbody>
<tr valign="top">
<td align="left" rowspan="1" colspan="1">Cyst 1</td>
<td align="char" char="." rowspan="1" colspan="1">0.19</td>
<td align="char" char="." rowspan="1" colspan="1">0.42</td>
<td align="char" char="." rowspan="1" colspan="1">0.15</td>
<td align="char" char="." rowspan="1" colspan="1">0.85</td>
<td align="char" char="." rowspan="1" colspan="1">37.9</td>
<td align="char" char="." rowspan="1" colspan="1">0.3</td>
<td align="char" char="." rowspan="1" colspan="1">59.6</td>
<td align="char" char="." rowspan="1" colspan="1">0.39</td>
<td align="char" char="." rowspan="1" colspan="1">0.07</td>
</tr>
<tr valign="top">
<td align="left" rowspan="1" colspan="1">Cyst 2</td>
<td align="char" char="." rowspan="1" colspan="1">0.24</td>
<td align="char" char="." rowspan="1" colspan="1">0.58</td>
<td align="char" char="." rowspan="1" colspan="1">2.1</td>
<td align="char" char="." rowspan="1" colspan="1">20.4</td>
<td align="char" char="." rowspan="1" colspan="1">18.9</td>
<td align="char" char="." rowspan="1" colspan="1">0.36</td>
<td align="char" char="." rowspan="1" colspan="1">54.2</td>
<td align="char" char="." rowspan="1" colspan="1">1.7</td>
<td align="char" char="." rowspan="1" colspan="1">0.08</td>
</tr>
</tbody>
</table>
</table-wrap>
</p>
</sec>
<sec sec-type="discussion" id="S4">
<title>Discussion</title>
<p>These findings support the biological origin of the two cysts, as apatite is the main component of bones and teeth [
<xref rid="R38" ref-type="bibr">38</xref>
] and is also commonly found in tissue calcifications linked to various pathological conditions [
<xref rid="R25" ref-type="bibr">25</xref>
]. The mineral composition of the cysts, their location, their morphology, and the observation of a laminated layer are compatible with the diagnosis of liver hydatidosis [
<xref rid="R3" ref-type="bibr">3</xref>
,
<xref rid="R25" ref-type="bibr">25</xref>
]. However, in the absence of larval rostellar hooks, only DNA-based techniques would allow a definitive diagnosis. Hydatid cysts frequently undergo calcification, and numerous ancient cases have been reported from Europe [
<xref rid="R3" ref-type="bibr">3</xref>
,
<xref rid="R24" ref-type="bibr">24</xref>
,
<xref rid="R30" ref-type="bibr">30</xref>
,
<xref rid="R39" ref-type="bibr">39</xref>
]. The morphological characteristics of these published examples – ovoid, hollow concretions with a smooth internal surface and an irregular external surface – are quite similar to those of the two calcified objects reported here. These morphological features rule out most of the other diagnostic options, such as calcified objects that are solid (e.g., urinary or renal calculi, uterine leiomyoma, dermoid cysts), that are not expected to be so large (e.g., calcified lymph nodes), or which exhibit imprints of vascularization (e.g., calcified ovarian cysts) [
<xref rid="R2" ref-type="bibr">2</xref>
,
<xref rid="R23" ref-type="bibr">23</xref>
]. Calcification of internal organs, induced by a normal taphonomic process after a long burial, seems quite unlikely according to the experience of one of the authors of the present work. Finally, although we cannot definitely exclude that the cysts underwent migration within the body during its decomposition, their location in the thoraco-abdominal region of the skeleton is again compatible with liver hydatidosis. The attachment of the cysts to the liver parenchyma would explain why
<italic>C. hepaticum</italic>
eggs were found in the wall of these cysts. A review of the literature shows that the only archaeological materials in which capillariid eggs have been detected so far are human coprolites, sediment of sewage structures, and garbage dumps [
<xref rid="R4" ref-type="bibr">4</xref>
,
<xref rid="R9" ref-type="bibr">9</xref>
,
<xref rid="R13" ref-type="bibr">13</xref>
]. Within these types of archaeological remains a definite diagnosis of human hepatic capillariosis could not be concluded. The finding of capillariid eggs in human coprolites can be explained by the transitional passing of parasite eggs, following the ingestion of an infected animal liver [
<xref rid="R17" ref-type="bibr">17</xref>
], as reported among Indians of the Amazonian region [
<xref rid="R12" ref-type="bibr">12</xref>
]. The proof of hepatic capillariosis in archaeological remains would only be possible through the examination of remaining tissues in mummified bodies, or by analyzing exceptional samples like the ones isolated in Amiens. In all 15 slides, several
<italic>C. hepaticum</italic>
eggs were detected possessing the main characters of
<italic>Calodium hepaticum</italic>
eggs, such as a double barrel-shape, pitted shell, polar plugs not extending beyond the outline shell and radiation between the external layers [
<xref rid="R19" ref-type="bibr">19</xref>
,
<xref rid="R21" ref-type="bibr">21</xref>
,
<xref rid="R34" ref-type="bibr">34</xref>
]. However, due to ultra-structural changes that may occur to helminth eggs over a long period of time [
<xref rid="R6" ref-type="bibr">6</xref>
], all morphological and morphometric features were not simultaneously observed in individual eggs. The mean length and width of the recovered eggs (46.7 and 25 μm) are in agreement with the findings reported by others [
<xref rid="R21" ref-type="bibr">21</xref>
,
<xref rid="R26" ref-type="bibr">26</xref>
]. The thoraco-abdominal location of the examined cysts, besides the findings presented here, are altogether in favor of a true hepatic capillariosis. Actually,
<italic>Capillaria</italic>
-like eggs have already been found in human graves, but in that report the authors suggested secondary contamination by feces of rodents [
<xref rid="R15" ref-type="bibr">15</xref>
]. In our case, this type of contamination can be excluded, as the eggs were found in the wall of the cysts. Another possibility could be the contamination of the cysts by
<italic>Trichuris trichiura</italic>
(Linnaeus, 1771) eggs from the intestine of the young adolescent. However,
<italic>Trichuris</italic>
sp. eggs have thicker shells and are usually very well preserved (in particular the polar plugs) as, for example, in the famous Ötzi mummy dating from the Neolithic times [
<xref rid="R1" ref-type="bibr">1</xref>
], or in the French Medieval site of Charavines [
<xref rid="R5" ref-type="bibr">5</xref>
]. The possibility of infection with
<italic>Eucoleus aerophilus</italic>
(Creplin, 1839), another capillariid parasite with morphologically similar eggs, could be ruled out as eggs of this parasite are larger (60–83 × 25–40 μm) and have asymmetric polar plugs [
<xref rid="R36" ref-type="bibr">36</xref>
]. Human hepatic capillariosis can be acquired under various circumstances, including high exposure to rodent populations and poor hygiene [
<xref rid="R35" ref-type="bibr">35</xref>
]. Soil, vegetables, and water contaminated by rat feces containing embryonated eggs are known sources of infection [
<xref rid="R16" ref-type="bibr">16</xref>
,
<xref rid="R29" ref-type="bibr">29</xref>
]. In ancient times due to the lack of public health awareness the incidence of hepatic capillariosis could have been more significant than today, as only 37 case reports of human
<italic>C. hepaticum</italic>
infection have been reported up to 2010 [
<xref rid="R17" ref-type="bibr">17</xref>
,
<xref rid="R26" ref-type="bibr">26</xref>
]. Moreover, new findings of
<italic>C. hepaticum</italic>
infection in mice in human-inhabited houses in Portugal [
<xref rid="R32" ref-type="bibr">32</xref>
] and the respective prevalence of 36% and 44%
<italic>Capillaria</italic>
infection of rats in Italy [
<xref rid="R11" ref-type="bibr">11</xref>
] and Marseille [
<xref rid="R14" ref-type="bibr">14</xref>
], respectively, support the idea of the possible frequent occurrence of human hepatic capillariosis in the 3rd–4th century AD. This work revealed that the petrographic thin-section technique is an efficient tool for identification of hepatic capillariosis and other tissue-dwelling parasites in very old organic remains, as well as in fossilized specimens. This current observation illustrates quite well the difficulties of differential diagnosis in paleoparasitology, related to the resemblance of the eggs of different species of capillariids. It underlines the usefulness of a precise registration of the position of samples within the skeleton and the possible influence of taphonomic processes in the modification of egg morphology. Finally, this case of probable liver hydatidosis is certainly the most ancient reported so far in France.</p>
</sec>
</body>
<back>
<ack>
<p>We thank Mr. Vincent Lascour (Institut National de Recherches Archéologiques Préventives, Amiens), who directed the archaeological excavation and entrusted us with the study of the two calcified objects. We are also very grateful to Dr. Abdolhosein Aminyat of the Faculty of Science, Tehran University, and Mr. Hamid Sojiudi, Teyfazarin Company, Tehran, Iran, for their technical assistance in using the petrographic thin-section method. Dr. Armel Bouvier (CIRAM, Talence, France) and Mr. Mehdi Saffari (Faculty of Sciences, Tarbiat Modares University, Tehran, Iran) are acknowledged for XRD and XRF interpretation and analysis. Special thanks also to Dr. Zohreh Eslami Rasekh at Texas A&M University and Dr. Gordon Langsley (Cochin Institute) for revising the manuscript. This article was published with the help of ADERMEPT (Association pour le Développement et la Recherche en Médecine Tropicale) and ACMSFI (Association de Coopération Médico Scientifique Franco Iranienne).</p>
</ack>
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<bold>Cite this article as</bold>
: Mowlavi G, Kacki S, Dupouy-Camet J, Mobedi I, Makki M, Harandi MF & Naddaf SR: Probable hepatic capillariosis and hydatidosis in an adolescent from the late Roman period buried in Amiens (France). Parasite, 2014,
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