Department of Clinical Sciences L Sacco, Section of Infectious Diseases and Immunopathology, Università degli Studi di Milano, Via GB Grassi, 74, 20157 Milan, Italy.
Int J Infect Dis. 2012 Sep;16(9):e649-62. doi: 10.1016/j.ijid.2012.05.1023. Epub 2012 Jul 10.
The aim of this study was to highlight the increasing chance of Western physicians encountering patients (both immigrants and expatriates/travelers) seeking help for loiasis.
We describe three cases of imported loiasis observed at two hospitals in Italy and France, and present a review of all previously published cases in the medical literature in the last 25 years (1986-2011). The search was performed using PubMed and Scopus databases using the terms "Loa loa" AND "loiasis".
We reviewed 101 cases of imported loiasis of which 61 (60.4%) were reported from Europe and 31 (30.7%) from the USA. Seventy-five percent of infestations were acquired in three countries: Cameroon, Nigeria, and Gabon. Overall, peripheral blood microfilariae were detected in 61.4% of patients, eosinophilia in 82.1%, eye worm migration in 53.5%, and Calabar swellings in 41.6%. However, Calabar swellings and eosinophilia were more common among expatriates/travelers, whereas African immigrants were more likely to have microfilaremia. Eye worm migration was observed in a similar proportion in the two groups. Only 35 patients (including the three described here) underwent clinical follow-up for a median period of 10.5 months (range 1-84 months); clinical relapse occurred in three of these patients and persistence or reappearance of blood microfilaria in another two.
Due to increasing travel and the migration of people from the endemic countries of West Africa to Europe and the USA, we speculate on the possible emergence of loiasis. Western physicians should be aware of the typical (eye worm migration and Calabar swellings) as well as unusual clinical presentations.
本研究旨在强调西方医生遇到寻求罗阿丝虫病治疗的患者（包括移民和侨民/旅行者）的机会日益增加。
我们描述了在意大利和法国的两家医院观察到的三例输入性罗阿丝虫病病例，并对过去25年（1986 - 2011年）医学文献中所有先前发表的病例进行了综述。使用PubMed和Scopus数据库，以“罗阿丝虫”和“罗阿丝虫病”为关键词进行检索。
我们回顾了101例输入性罗阿丝虫病病例，其中61例（60.4%）来自欧洲，31例（30.7%）来自美国。75%的感染发生在三个国家：喀麦隆、尼日利亚和加蓬。总体而言，61.4%的患者检测到外周血微丝蚴，82.1%的患者出现嗜酸性粒细胞增多，53.5%的患者有眼虫移行，41.6%的患者出现卡拉巴肿。然而，卡拉巴肿和嗜酸性粒细胞增多在侨民/旅行者中更为常见，而非洲移民更易出现微丝蚴血症。两组中眼虫移行的比例相似。只有35例患者（包括此处描述的3例）接受了中位时间为10.5个月（范围1 - 84个月）的临床随访；其中3例患者出现临床复发，另外2例患者血液微丝蚴持续存在或再次出现。
由于旅行增加以及人们从西非流行国家向欧洲和美国迁移，我们推测罗阿丝虫病可能会出现。西方医生应了解其典型临床表现（眼虫移行和卡拉巴肿）以及不寻常的临床表现。
