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意大利一例胃过敏性和肠道异尖线虫病:基于双内镜检查和分子鉴定的诊断

A Case of Gastroallergic and Intestinal Anisakiasis in Italy: Diagnosis Based on Double Endoscopy and Molecular Identification.

作者信息

D'Amelio Stefano, Bellini Ilaria, Chiovoloni Claudia, Magliocco Cristina, Pronio Annamaria, Di Rocco Arianna, Pentassuglio Ilaria, Rosati Marco, Russo Gianluca, Cavallero Serena

机构信息

Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy.

Sandro Pertini Hospital, 00157 Rome, Italy.

出版信息

Pathogens. 2023 Sep 18;12(9):1172. doi: 10.3390/pathogens12091172.

Abstract

Nematodes of the genus (Rhabditida, Anisakidae) are zoonotic fish-borne parasites and cause anisakiasis, a disease with mild to severe acute or chronic gastrointestinal and allergic symptoms and signs. Anisakiasis can potentially lead to misdiagnosis or delay in diagnosis, and it has been suggested as a risk factor for gastrointestinal tumors. Here, we describe a case report of a 25-year-old woman who presented with gastrointestinal (abdominal pain, nausea, diarrhea) and allergic (diffuse skin rash) symptoms and reported ingestion of raw fish contaminated by worms. Gastro and colon endoscopy allowed the visualization and removal of nematodes and collection of bioptic tissue from ulcers and polyps. The removed nematodes were molecularly identified as . The patient was treated with chlorphenamine maleate, betamethasone, omeprazole, paracetamol, albendazole. We conclude that an upper endoscopy matched with a colonoscopy and molecular characterization of the pathogen yields the most reliable diagnosis and treatment for human anisakiasis, enabling the complete removal of the larvae and preventing chronic inflammation and damage.

摘要

(杆形目,异尖科)属线虫是一种人畜共患的食源性寄生虫,可引发异尖线虫病,这是一种具有轻度至重度急性或慢性胃肠道及过敏症状和体征的疾病。异尖线虫病可能会导致误诊或诊断延迟,并且有人认为它是胃肠道肿瘤的一个风险因素。在此,我们报告一例25岁女性病例,该患者出现胃肠道症状(腹痛、恶心、腹泻)和过敏症状(弥漫性皮疹),并自述食用过被线虫污染的生鱼。胃肠和结肠镜检查使我们能够观察到并取出线虫,同时从溃疡和息肉处采集活检组织。取出的线虫经分子鉴定为 。患者接受了马来酸氯苯那敏、倍他米松、奥美拉唑、对乙酰氨基酚、阿苯达唑治疗。我们得出结论,上消化道内镜检查结合结肠镜检查以及病原体的分子特征分析可为人类异尖线虫病提供最可靠的诊断和治疗,能够彻底清除幼虫并预防慢性炎症和损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e93/10535146/ba64fa7f9185/pathogens-12-01172-g001.jpg

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