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输入性皮肤幼虫移行症:在巴塞罗那一家热带病转诊医疗单位进行的流行病学、临床及治疗方面分析

Imported Cutaneous Larva Migrans: Epidemiological, Clinical, and Therapeutic Aspects Analyzed in a Referral Tropical Medicine Unit in Barcelona.

作者信息

López-Neila David, Salvador Fernando, Martínez-Campreciós Joan, Aznar María Luisa, Espinosa-Pereiro Juan, Oliveira-Souto Inés, Bosch-Nicolau Pau, Pou Diana, Sánchez-Montalvá Adrián, Serre-Delcor Núria, Treviño Begoña, Molina Israel

机构信息

International Health Unit Vall d'Hebron-Drassanes,Department of Infectious Diseases, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain.

Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.

出版信息

Am J Trop Med Hyg. 2025 May 6;113(1):81-85. doi: 10.4269/ajtmh.24-0856. Print 2025 Jul 2.

Abstract

Cutaneous larva migrans (CLM) is a clinical syndrome typically found in tropical and subtropical regions. The objective of the study is to describe the epidemiological, clinical, and therapeutic characteristics of patients with CLM acquired during international travel. This retrospective observational study analyzes CLM cases treated at an international health unit in Spain. Sociodemographic, clinical, laboratory, and treatment-related data were collected. Overall, 107 cases were diagnosed, 63 (58.9%) of them in women, with a mean age of 32.6 years. Most frequent geographic regions of CLM acquisition were Southeast Asia (38 cases, 35.5%) and South America (28, 26.2%). Patients had a median of one skin lesion (range 1-11) located mainly in the lower extremities (83, 77.6%). Treatment was administered in 105 cases (98.1%), with albendazole used in 88 (83.8%), ivermectin in nine (8.6%), mebendazole in six (5.7%), and two cases lacking drug information (1.9%). Among treated cases, clinical resolution was achieved in 88 (83.8%) patients. Symptoms persisted in 17 (16.2%) cases, and recurrence was observed in 14 (13.3%) cases. A total of 26 (24.8%) patients required re-treatment with either albendazole or ivermectin (61.5% and 38.5%, respectively). The resolution rates for ivermectin, albendazole, and mebendazole were 88.9%, 88.6%, and 0.0%, respectively. CLM is a common syndrome in certain geographic regions and is more frequently diagnosed in international travelers. A thorough epidemiological assessment, along with a detailed medical history and physical examination, facilitates early diagnosis and treatment. Currently, ivermectin and albendazole appear to achieve the highest cure rates with lower recurrence rates.

摘要

皮肤幼虫移行症(CLM)是一种通常在热带和亚热带地区发现的临床综合征。本研究的目的是描述在国际旅行期间感染CLM的患者的流行病学、临床和治疗特征。这项回顾性观察性研究分析了在西班牙一家国际卫生单位接受治疗的CLM病例。收集了社会人口统计学、临床、实验室和治疗相关数据。总体而言,共诊断出107例病例,其中63例(58.9%)为女性,平均年龄为32.6岁。感染CLM最常见的地理区域是东南亚(38例,35.5%)和南美洲(28例,26.2%)。患者的皮肤病变中位数为1个(范围为1 - 11个),主要位于下肢(83例,77.6%)。105例(98.1%)患者接受了治疗,其中88例(83.8%)使用阿苯达唑,9例(8.6%)使用伊维菌素,6例(5.7%)使用甲苯达唑,2例(1.9%)缺乏药物信息。在接受治疗的病例中,88例(83.8%)患者临床症状得到缓解。17例(16.2%)患者症状持续存在,14例(13.3%)患者出现复发。共有26例(24.8%)患者需要用阿苯达唑或伊维菌素再次治疗(分别占61.5%和38.5%)。伊维菌素、阿苯达唑和甲苯达唑的治愈率分别为88.9%、88.6%和0.0%。CLM在某些地理区域是一种常见综合征,在国际旅行者中更常被诊断出来。全面的流行病学评估以及详细的病史和体格检查有助于早期诊断和治疗。目前,伊维菌素和阿苯达唑似乎治愈率最高且复发率较低。

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本文引用的文献

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Infect Dis Rep. 2021 Mar 5;13(1):215-218. doi: 10.3390/idr13010024.
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Autochthonous Cutaneous Larva Migrans in France and Europe.法国和欧洲的本土性移行性幼虫疹。
Acta Derm Venereol. 2019 Jul 1;99(9):805-808. doi: 10.2340/00015555-3217.
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Treatment of larva migrans syndrome with long-term administration of albendazole.用阿苯达唑长期治疗幼虫移行综合征。
J Microbiol Immunol Infect. 2019 Feb;52(1):100-105. doi: 10.1016/j.jmii.2017.07.002. Epub 2017 Jul 14.

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