背景:阿米巴病是由原生动物溶组织内阿米巴引起的肠道和组织寄生虫感染。尽管具有重要的医学意义和全球分散性,对世界上各种临床形式的阿米巴病的流行病学和独特的地理分布知之甚少。在这项研究中,我们介绍了阿米巴病病例系列,转诊给阿维森医院(Bobigny,法国)从2010年到2022年,随后对已发布的文献进行了概述,以探索变形虫病的各种临床病理学,并更新了全球这种寄生虫病的实际流行病学情况。
方法:转诊患者接受了临床和寄生虫学检查和影像学检查。该研究之后是基于PRISMA(系统评论和荟萃分析的首选报告项目)指南进行的已发布文献的概述。
结果:共有15例阿米巴病患者被诊断为感染发生时的平均年龄为48.5岁。男性(78%)是受影响最大的患者。大多数病例是在前往流行地区之后报告的,比如马里,印度,尼泊尔,阿尔及利亚,喀麦隆或刚果。所有经过处理的患者均表现出肝阿米巴病。所有病例均观察到阿米巴脓肿,平均大小为6.3cm。在这些病人中,7例(46.7%)在脓肿破裂或重复感染的风险后从引流中受益。通过七个主要的医学数据库从390个科学出版物中提取的发现汇编,使我们能够更新导致目前阿米巴病在全球范围内扩展的主要流行病学和临床事件。我们介绍了阿米巴病的临床和流行病学概述,并附有全球说明性地图,显示了亚洲每个地理生态区已知阿米巴病病灶的当前分布。欧洲,非洲,美洲,和澳大利亚。
结论:尽管法国大都会并不是阿米巴病的流行地区,在我们处理的15例患者中,阿米巴肝脓肿是最常见的临床形式。大多数受感染的患者在到达法国之前都有前往或居住在流行地区的历史。
BACKGROUND: Amoebiasis is an intestinal and tissue parasitic infection caused by the protozoan Entamoeba histolytica. Despite significant medical importance and worldwide dispersion, little is known about the epidemiology and distinct geographical distribution of various clinical forms of amoebiasis in the world. In this study, we present an amoebiasis case series referred to Avicenne Hospital (Bobigny, France) from 2010 to 2022 followed by an overview of the released literature to explore diverse clinico-pathology of amoebiasis and to update the actual epidemiological situation of this parasitosis worldwide.
METHODS: The referred patients underwent a combination of clinical and parasitological examinations and imaging. The study was followed by an overview of released literature performed based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline.
RESULTS: A total of 15 patients with amoebiasis were diagnosed with an average age of 48.5 years old at the occurrence time of infection. Men (78%) were the most affected patients. Most of the cases were reported following a trip to endemic regions, such as Mali, India, Nepal, Algeria, Cameroon or Congo. All of the processed patients exhibited a hepatic amoebiasis. Amoebic abscess was observed in all cases with an average size of 6.3 cm. Of these patients, seven cases (46.7%) benefited from drainage following a risk of rupture or superinfection of the abscess. A compilation of findings extracted from 390 scientific publications via seven major medical databases, allowed us to update the main epidemiological and clinical events that has led to the current worldwide expansion of amoebiasis. We presented a clinical and epidemiological overview of the amoebiasis accompanied with a worldwide illustrative map displaying the current distribution of known amoebiasis foci in each geographical ecozone of Asia, Europe, Africa, Americas, and Australia.
CONCLUSIONS: Although Metropolitan France is not known as an endemic region of amoebiasis, amoebic liver abscess was the most frequent clinical form observed among our 15 patients processed. Most of infected patients had a history of travel to or lived-in endemic areas before arriving in France.