PDF(Pubmed)
Abstract：
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 (Anisakis 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 Anisakis 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.
摘要：
食用生的和温和加工的海鲜，在现代西方世界饮食趋势的背景下，被认为是人类鱼源感染的主要驱动因素。然而,这些人畜共患病及其不熟悉的风险在欧洲诊断医师中仍然被忽视和低估.在当代欧洲，异位症是最重要的鱼源性人畜共患病之一。它是由摄取属于Anisakidae家族的线虫寄生虫的第三阶段感染幼虫引起的。本文所述的情况，是肠道和异位形式的anisakiosis（Anisakisspp。),引起亚急性腹部症状并伪装成腹膜内恶性肿瘤。这是希腊报道的首例anisakidosis病例，通过食用自制的生鱼影响了一名反复暴露于寄生虫的年轻患者。右半结肠切除术,网膜切除术和降结肠结节切除术均顺利进行。病理报告证实肉芽肿组织具有嗜酸性粒细胞浸润和寄生虫，在形态和分子上被鉴定为Anisakisspp。虽然具有挑战性，获得准确的anisakidosis诊断可以防止不必要的手术，因为感染通常是自我解决的，如果治疗被认为是必要的，它可以仅限于抗寄生虫药物。然而,在极少数情况下，幼虫的胃肠道外迁移可能导致严重的损害，几乎未知的风险，构成了诊断和治疗的两难选择。在这种临床情况下，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内并发症。
