日本血吸虫在菲律宾流行,中国,印度尼西亚,是第三常见的血吸虫。感染可以多年无症状,但是,如果不及时治疗,会导致不可逆的并发症。
我们报告了对进口日本血吸虫感染的文献进行系统回顾的结果,并描述了在意大利的菲律宾移民中诊断出的两个以前未发表的病例。
检索到25例日本血吸虫病输入病例。除一名患者外,所有患者都是移民。大多数受试者在菲律宾获得感染(n=18,72%)。诊断时的中位年龄为46岁。诊断前在非流行国家的中位居住期为14.5年。普遍肝脾受累的病例为10例(40%),有普遍肠道受累的人是10人(40%),而5例(20%)表现重叠.十名患者患有肝硬化;两名接受了肝移植。3例因肠道并发症而出现急腹症,导致剖腹探查术.在所有情况下,但是一个,诊断是基于活检标本的组织学检查,揭示日本血吸虫。17名患者接受了吡喹酮治疗,在其中三个中,可能发生治疗失败。
S.日本的感染在非流行地区是罕见的,但可能被低估,原因是临床医师的阈值意识较低,且无法使用特定的诊断工具.有活力的日本血吸虫成虫可能会持续数十年,表明以前在高风险地区暴露的移民或旅行者可能藏有可行的蠕虫,应得到治疗。
Schistosoma japonicum is endemic in the Philippines, China, and Indonesia, and is the third-most common schistosoma species. The infection can be asymptomatic for years but, if left untreated, can lead to irreversible complications.
We report the results of a systematic
review of the literature on imported S. japonicum infection and describe two previously unpublished cases diagnosed in Filipino migrants in Italy.
Twenty-five imported cases of S. japonicum schistosomiasis were retrieved. All patients but one were migrants. Most subjects acquired the infection in Philippines (n = 18, 72%). Median age at diagnosis was 46 years. Median period of residence in non-endemic countries before diagnosis was 14.5 years. Cases of prevalent hepatosplenic involvement were 10 (40%), those with prevalent intestinal involvement were 10 (40%), whereas five (20%) had overlapping manifestations. Ten patients suffered from cirrhosis; two underwent liver transplantation. Three patients presented with acute abdomen due to intestinal complications, leading to explorative laparotomy. In all cases, but one, the diagnosis was based on a histological examination of biopsy specimen, revealing S. japonicum ova. Seventeen patients were treated with praziquantel, and in three of them, possible treatment failures occurred.
S. japonicum infection is uncommonly reported in non-endemic areas, but is probably underestimated because of a low threshold awareness of clinicians and unavailability of specific diagnostic tools. Viable S. japonicum adults may persist for decades, indicating that migrants or travellers previously exposed in areas with high-risk areas can harbour viable worms and deserve treatment.