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眼玻璃体内的罗阿丝虫病:一例报告及最新进展

Loa loa in the Vitreous Cavity of the Eye: A Case Report and State of Art.

作者信息

Pallara Elisabetta, Cotugno Sergio, Guido Giacomo, De Vita Elda, Ricciardi Aurelia, Totaro Valentina, Camporeale Michele, Frallonardo Luisa, Novara Roberta, Panico Gianfranco G, Puzo Pasquale, Alessio Giovanni, Sablone Sara, Mariani Michele, De Iaco Giuseppina, Milano Eugenio, Bavaro Davide F, Lattanzio Rossana, Patti Giulia, Papagni Roberta, Pellegrino Carmen, Saracino Annalisa, Di Gennaro Francesco

机构信息

Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro," Bari, Italy.

Section of Ophthalmology, Department of Medical Science, Neuroscience and Senso Organs, Bari Policlinico Hospital University of Bari, Bari, Italy.

出版信息

Am J Trop Med Hyg. 2022 Aug 1;107(3):504-16. doi: 10.4269/ajtmh.22-0274.

Abstract

Loa loa is a filarial nematode responsible for loiasis, endemic to West-Central Africa south of the Sahara and transmitted by flies. This study reports a case of L. loa in the vitreous cavity of the eye of a young patient, along with an in-depth literature review. A 22-year-old woman from Cameroon who migrated from Cameroon to Italy was referred to the Emergency Ophthalmology Department at Policlinico di Bari in July 2021 with the presence of a moving parasite in the subconjunctiva of the left eye. A recent onset of a papular lesion on the dorsal surface of the right wrist and a nodular lesion in the scapular region were detected. L. loa filariasis was diagnosed based on anamnestic data, clinical and paraclinical signs, and a parasitological test confirming the presence of microfilariae in two blood samples collected in the morning of two different days. Because of the unavailability of diethylcarbamazine (DEC), albendazole (ALB) 200 mg twice daily was administered for 21 days. A mild exacerbation of pruritus occurred during treatment, but resolved with the use of an antihistamine. A single dose of 12 mg ivermectin was prescribed at the end of the treatment with albendazole. Unlike other endemic parasite infections, L. loa is not included in the Global Program to Eliminate Lymphatic Filariasis, because it is not mentioned in the WHO and CDC list of neglected tropical diseases. This can result in an overall risk of lack of attention and studies on loiasis, with lack of data on global burden of the disease.

摘要

罗阿丝虫是一种引起罗阿丝虫病的丝虫线虫,流行于撒哈拉以南的非洲中西部地区,通过苍蝇传播。本研究报告了一例年轻患者眼玻璃体内出现罗阿丝虫的病例,并进行了深入的文献综述。一名22岁从喀麦隆移民到意大利的女性于2021年7月因左眼结膜下有活动寄生虫被转诊至巴里综合医院的眼科急诊部。检测到右腕背侧近期出现丘疹性病变以及肩胛区有结节性病变。根据既往病史、临床和辅助检查体征以及寄生虫学检测确诊为罗阿丝虫病,该检测在两个不同日期的早晨采集的两份血样中均证实存在微丝蚴。由于无法获得乙胺嗪(DEC),给予阿苯达唑(ALB)200mg每日两次,共服用21天。治疗期间出现轻度瘙痒加重,但使用抗组胺药后缓解。在阿苯达唑治疗结束时开具了单剂量12mg伊维菌素。与其他地方性寄生虫感染不同,罗阿丝虫未被纳入全球消除淋巴丝虫病规划,因为它未在世卫组织和美国疾病控制与预防中心的被忽视热带病名单中提及。这可能导致对罗阿丝虫病缺乏关注和研究的总体风险,以及缺乏关于该疾病全球负担的数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3536/9490677/e4d4e863f5cd/ajtmh.22-0274f1.jpg

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