一名5岁男孩的精索中重现Dirofilaria:意大利罕见的儿科病例。

IF 2.6 4区 医学 Q2 INFECTIOUS DISEASES
Alessandro Franzò, Andrea Marino, Benedetto Maurizio Celesia, Roberto Bruno, Pieralba Catalano, Sebastiano Cacciaguerra, Stefano Reale, Bruno Santi Cacopardo, Giuseppe Nunnari
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引用次数: 0

摘要

我们报告的情况下,一个5岁的男孩从一个斯里兰卡移民家庭在卡塔尼亚,意大利,诊断为Dirofilaria再感染精索。患儿表现为左侧腹股沟疼痛和肿胀。初步评价提示是睾丸附睾炎,用阿莫西林/克拉维酸盐和非甾体抗炎药治疗不成功。当症状加重时,考虑Morgagni棘球体扭转。探查性手术发现左侧精索有一个坚固的肿块。切除病变的组织病理学检查显示肉芽肿性炎症反应中有蠕虫碎片。随后的PCR分析检测到D. repens DNA。手术切除肿块后,病人完全康复。鉴于人类双丝虫病发病率的增加,在鉴别诊断不明原因的皮下或腹股沟结节时应考虑repens,特别是在有相关旅行史的患者中。该病例强调了准确诊断的重要性,以避免不必要的侵入性手术或延长抗菌药物治疗。这是意大利报告的最年轻的生殖器感染儿科病例之一,意大利占欧洲病例的一半。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Dirofilaria repens in the Spermatic Cord of a 5-Year-Old Boy: A Rare Pediatric Case in Italy.

We report the case of a 5-year-old boy from a Sri Lankan migrant family in Catania, Italy, diagnosed with a Dirofilaria repens infection in the spermatic cord. The child presented with pain and swelling in the left inguinal area. Initial evaluation suggested orchiepididymitis, which was treated unsuccessfully with amoxicillin/clavulanate and NSAIDs. As symptoms worsened, torsion of the Morgagni hydatid was considered. An exploratory surgery revealed a firm mass in the left spermatic cord. Histopathological examination of the excised lesion showed fragments of a helminth within a granulomatous inflammatory reaction. Subsequent PCR analysis detected D. repens DNA. The patient fully recovered after surgical excision of the mass. Given the increasing incidence of human dirofilariasis, D. repens should be considered in the differential diagnosis of unexplained subcutaneous or inguinal nodules, especially in patients with a relevant travel history. This case highlights the importance of accurate diagnosis to avoid unnecessary invasive procedures or prolonged antimicrobial therapies. It represents one of the youngest pediatric cases with genital involvement reported in Italy, a country that accounts for half of the cases in Europe.

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来源期刊
Tropical Medicine and Infectious Disease
Tropical Medicine and Infectious Disease Medicine-Public Health, Environmental and Occupational Health
CiteScore
3.90
自引率
10.30%
发文量
353
审稿时长
11 weeks
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