Department of General Surgery, Frieri-Criscuoli Hospital, Sant'Angelo dei Lombardi, AV, Italy.
Department of Veterinary Medicine and Animal Production, University of Naples Federico II, CREMOPAR, WHO Collaborating Centre for Diagnosis of Intestinal Helminths and Protozoa (ITA-116), Naples, Italy.
BMC Infect Dis. 2021 Oct 9;21(1):1045. doi: 10.1186/s12879-021-06718-z.
Ascaris lumbricoides and Ascaris suum are the most common soil-transmitted helminths of humans and pigs, respectively. The zoonotic potential of A. suum has been a matter of debate for decades. This study was aimed to present a case of human ascariasis caused by A. suum in southern Italy.
A 75-year-old man presented to the department of surgery in Avellino (southern Italy) complaining of abdominal pain and vomiting. Physical examination revealed bloating and abdominal tenderness. A computed tomography scan showed air-fluid levels and small bowel distension. During exploratory laparotomy a small bowel volvulus with mesenteritis was evident and surprisingly an intraluminal worm was detected. The worm was removed with a small enterotomy and identified as an adult female of A. suum based on morphological and molecular analysis. Faecal examination revealed the presence of unfertilized Ascaris eggs with an intensity of 16 eggs per gram (EPG) of faeces. The patient was treated with mebendanzole 100 mg twice a day for 3 days. The post-operative course was regular with re-alimentation after 3 days and discharge after 12 days.
This report shows as A. suum can function as a relevant agent of human zoonosis. Therefore, in patients with bowel obstruction with no evident aetiology a helminthic infestation should be considered for an accurate diagnosis, especially in patients living in rural areas.
蛔虫和猪蛔虫分别是人类和猪中最常见的土源性蠕虫。猪蛔虫的人畜共患潜力几十年来一直存在争议。本研究旨在报告意大利南部一例由猪蛔虫引起的人类蛔虫病。
一名 75 岁男性因腹痛和呕吐到意大利南部阿韦利诺的外科就诊。体格检查显示腹胀和腹部压痛。计算机断层扫描显示气液平面和小肠扩张。在剖腹探查术中，发现小肠扭转伴肠系膜炎症，令人惊讶的是，发现了一条腔内蠕虫。通过小的肠切开术取出蠕虫，并通过形态学和分子分析鉴定为雌性猪蛔虫成虫。粪便检查显示未受精的蛔虫卵存在，粪便中每克粪便（EPG）有 16 个卵。患者接受了 3 天，每天 2 次的甲苯咪唑 100mg 治疗。术后恢复良好，3 天后开始重新进食，12 天后出院。
本报告表明，猪蛔虫可以作为人类人畜共患病的相关病原体。因此，对于无明显病因的肠梗阻患者，应考虑寄生虫感染以进行准确诊断，尤其是在居住在农村地区的患者中。
