Venturini Elisabetta, Fusani Lara, Mantella Antonia, Bianchi Leila, Antonelli Alberto, Montagnani Carlotta, Chiappini Elena, Spinicci Michele, Bartoloni Alessandro, Rossolini Gian Maria, Zammarchi Lorenzo, Galli Luisa
Infectious Diseases Unit, Meyer Children's University Hospital, 50139 Florence, Italy.
Department of Health Sciences, University of Florence, 50121 Florence, Italy.
Microorganisms. 2021 Sep 8;9(9):1905. doi: 10.3390/microorganisms9091905.
Strongyloidiasis belongs to the group of neglected tropical diseases, due to diagnostic difficulties and the lack of systematic screening. Studies on strongyloidiasis prevalence are often heterogenous and mainly performed in adults in endemic countries. We retrospectively enrolled 2633 children referred to a tertiary care hospital in Italy between 2009 and 2020 and tested for infection. Sixty-one (2.3%) had a positive serology and for 55 of them, clinical and epidemiological information were available. Thirteen cases (24%) were diagnosed in Italian children without history residency or travel to foreign countries, while the remaining were internationally adopted or migrant children. Seropositive patients were mostly asymptomatic, and often eosinophilia was the only sign of strongyloidiasis. Sero-reactivity to was found in 1/3 of patients. Ivermectin was used in 37 (75.5%) treated patients. A significant reduction of eosinophil levels and IgG titer was seen after treatment. Our study confirms that strongyloidiasis is usually asymptomatic in children. However, due to the ability of the parasite to cause a life-long infection together with the risk of a severe form in case of immunosuppression, it is important to identify and treat infected children. Special consideration should be reserved to high-risk groups, such as immigrants and international adoptees, where screening for is indicated. However, the study highlights that sporadic cases of autochthonous strongyloidiasis in Italy may occur. Therefore, pediatricians should be aware of this condition, which is often under-recognized.
由于诊断困难和缺乏系统筛查，类圆线虫病属于被忽视的热带病范畴。关于类圆线虫病患病率的研究往往存在异质性，且主要在流行国家的成年人中开展。我们回顾性纳入了2009年至2020年间转诊至意大利一家三级护理医院的2633名儿童，并对其进行感染检测。61名（2.3%）儿童血清学检测呈阳性，其中55名儿童可获取临床和流行病学信息。13例（24%）确诊病例为无国外居住或旅行史的意大利儿童，其余为国际收养儿童或移民儿童。血清学阳性患者大多无症状，嗜酸性粒细胞增多往往是类圆线虫病的唯一体征。三分之一的患者对[此处原文缺失相关内容]呈血清反应性。37名（75.5%）接受治疗的患者使用了伊维菌素。治疗后嗜酸性粒细胞水平和IgG滴度显著降低。我们的研究证实，类圆线虫病在儿童中通常无症状。然而，由于该寄生虫能够导致终身感染，且在免疫抑制情况下有发生严重形式疾病的风险，识别并治疗受感染儿童很重要。对于移民和国际收养儿童等高风险群体应给予特别关注，对其进行[此处原文缺失相关内容]筛查是必要的。然而，该研究强调意大利可能会出现散发性本土类圆线虫病病例。因此，儿科医生应了解这种往往未得到充分认识的疾病情况。
