Dinas Sotirios, Diakou Anastasia, Vasiliadis Konstantinos, Chaintoutis Serafeim C, Massa Eleftheria, Konstantinou George N, Totsi Albion, Xakis Athanasios, Papavasiliou Christos
Surgical Department, Papageorgiou General Hospital, 56429 Thessaloniki, Greece.
Laboratory of Parasitology and Parasitic Diseases, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Pathogens. 2024 Feb 6;13(2):149. doi: 10.3390/pathogens13020149.
Consumption of raw and mildly processed seafood, in the context of modern Western world eating trends, is recognized as a major driver for human fish-borne infections. However, these zoonoses and their unfamiliar risks remain neglected and underappreciated among European diagnosticians. In contemporary Europe anisakidosis is one of the most important fish-borne zoonoses. It is caused by ingesting the third-stage infective larvae of the nematode parasites that belong to the family Anisakidae. The case described herein, is an intestinal and ectopic form of anisakiosis ( spp.), causing symptoms of subacute abdomen and masquerading as an intraperitoneal malignancy. It is the first anisakidosis case reported in Greece, affecting a young patient who had been repeatedly exposed to the parasite by consuming homemade raw fish. Right hemicolectomy, omentectomy and excision of a descending colon nodule were uneventfully performed. The pathology report confirmed granulomatous tissue with eosinophilic infiltration and parasites that were morphologically and molecularly identified as spp. Although challenging, acquiring an accurate diagnosis of anisakidosis can prevent unnecessary surgery, as the infection typically is self-resolving, and if treatment is deemed necessary, it can be limited to antiparasitic medication. However, in rare cases, extra-gastrointestinal migration of larvae can cause severe damage with practically unknown risks, posing a diagnostic and therapeutic dilemma. In such a clinical case scenario, surgical exploration can decisively contribute to a definitive diagnosis and early identification of intraabdominal complications necessitating surgical intervention.
在现代西方世界的饮食趋势背景下，食用生的和轻度加工的海鲜被认为是人类食源性鱼类感染的主要驱动因素。然而，这些人畜共患病及其不为人知的风险在欧洲诊断医生中仍然被忽视和低估。在当代欧洲，异尖线虫病是最重要的食源性人畜共患病之一。它是由摄入属于异尖线虫科的线虫寄生虫的第三期感染性幼虫引起的。本文所述病例为肠道和异位型异尖线虫病（ spp.），引起亚急性腹痛症状，伪装成腹腔内恶性肿瘤。这是希腊报告的首例异尖线虫病病例，患者为一名年轻患者，因食用自制生鱼多次接触该寄生虫。顺利进行了右半结肠切除术、网膜切除术和降结肠结节切除术。病理报告证实为肉芽肿组织，伴有嗜酸性粒细胞浸润，寄生虫经形态学和分子学鉴定为 spp.。尽管具有挑战性，但准确诊断异尖线虫病可以避免不必要的手术，因为这种感染通常会自行缓解，如果认为有必要进行治疗，也可以仅限于抗寄生虫药物治疗。然而，在罕见情况下，幼虫的胃肠道外迁移会造成严重损害，且风险几乎未知，这带来了诊断和治疗上的两难困境。在这种临床病例中，手术探查可以决定性地有助于明确诊断和早期识别需要手术干预的腹腔内并发症。
