一名年轻意大利患者的内脏幼虫移行:诊断难题。

IF 1.2 3区 农林科学 Q4 PARASITOLOGY
Emanuela Francalanci, Tommaso Manciulli, Giulia Bandini, Pierluigi Blanc, Sara Irene Bonelli, Enrico Brunetti, Eduardo Gotuzzo, Carmen Michaela Cretu, Federico Gobbi, Alessandro Bartoloni, Lorenzo Zammarchi
{"title":"一名年轻意大利患者的内脏幼虫移行:诊断难题。","authors":"Emanuela Francalanci,&nbsp;Tommaso Manciulli,&nbsp;Giulia Bandini,&nbsp;Pierluigi Blanc,&nbsp;Sara Irene Bonelli,&nbsp;Enrico Brunetti,&nbsp;Eduardo Gotuzzo,&nbsp;Carmen Michaela Cretu,&nbsp;Federico Gobbi,&nbsp;Alessandro Bartoloni,&nbsp;Lorenzo Zammarchi","doi":"10.1007/s11686-023-00723-9","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The association of fever, focal hepatic lesions and peripheral hyper-eosinophilia (FHLH) can be observed in both infectious and non-infectious conditions. Fascioliasis, capillariasis, toxocariasis, all causes of visceral larva migrans (VLM), represent most of the former, whilst lymphomas, eosinophilic leukemias and mastocytosis belong in the non-infectious conditions.</p><h3>Methods</h3><p>We prospectively followed a young patient presenting with FHLH in the Tuscany region of Italy.</p><h3>Results</h3><p>The patient was subject to serological and parasitological examination in an attempt to clarify the origin of the lesions. Serologies for both <i>Fasciola hepatica</i> and <i>Toxocara</i> spp. were positive, with the latter presenting a higher index. We opted for treatment with a prolonged course of albendazole due to the serological results and being toxocariasis more frequent in our setting. The patient was then subject to radiological follow-up. The patient responded to treatment with albendazole as shown by a decrease in eosinophils, seronegativization for <i>Toxocara</i> spp., clinical and radiological improvement. Toxocariasis was hence considered the most likely diagnosis.</p><h3>Conclusions</h3><p>Parasitic infections cannot be disregarded in the presence of FHLH. Differential diagnosis between these parasitic infections can be challenging due to the presence of similar clinical presentations and serological cross-reactions, and follow-up of the patient is needed to ensure optimal treatment outcomes.</p></div>","PeriodicalId":6932,"journal":{"name":"Acta Parasitologica","volume":"68 4","pages":"937 - 941"},"PeriodicalIF":1.2000,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s11686-023-00723-9.pdf","citationCount":"0","resultStr":"{\"title\":\"Visceral larva Migrans in a Young Italian Patient: A Diagnostic Dilemma\",\"authors\":\"Emanuela Francalanci,&nbsp;Tommaso Manciulli,&nbsp;Giulia Bandini,&nbsp;Pierluigi Blanc,&nbsp;Sara Irene Bonelli,&nbsp;Enrico Brunetti,&nbsp;Eduardo Gotuzzo,&nbsp;Carmen Michaela Cretu,&nbsp;Federico Gobbi,&nbsp;Alessandro Bartoloni,&nbsp;Lorenzo Zammarchi\",\"doi\":\"10.1007/s11686-023-00723-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>The association of fever, focal hepatic lesions and peripheral hyper-eosinophilia (FHLH) can be observed in both infectious and non-infectious conditions. Fascioliasis, capillariasis, toxocariasis, all causes of visceral larva migrans (VLM), represent most of the former, whilst lymphomas, eosinophilic leukemias and mastocytosis belong in the non-infectious conditions.</p><h3>Methods</h3><p>We prospectively followed a young patient presenting with FHLH in the Tuscany region of Italy.</p><h3>Results</h3><p>The patient was subject to serological and parasitological examination in an attempt to clarify the origin of the lesions. Serologies for both <i>Fasciola hepatica</i> and <i>Toxocara</i> spp. were positive, with the latter presenting a higher index. We opted for treatment with a prolonged course of albendazole due to the serological results and being toxocariasis more frequent in our setting. The patient was then subject to radiological follow-up. The patient responded to treatment with albendazole as shown by a decrease in eosinophils, seronegativization for <i>Toxocara</i> spp., clinical and radiological improvement. Toxocariasis was hence considered the most likely diagnosis.</p><h3>Conclusions</h3><p>Parasitic infections cannot be disregarded in the presence of FHLH. Differential diagnosis between these parasitic infections can be challenging due to the presence of similar clinical presentations and serological cross-reactions, and follow-up of the patient is needed to ensure optimal treatment outcomes.</p></div>\",\"PeriodicalId\":6932,\"journal\":{\"name\":\"Acta Parasitologica\",\"volume\":\"68 4\",\"pages\":\"937 - 941\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2023-10-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://link.springer.com/content/pdf/10.1007/s11686-023-00723-9.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Parasitologica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://link.springer.com/article/10.1007/s11686-023-00723-9\",\"RegionNum\":3,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PARASITOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Parasitologica","FirstCategoryId":"3","ListUrlMain":"https://link.springer.com/article/10.1007/s11686-023-00723-9","RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PARASITOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:在感染和非感染条件下都可以观察到发烧、肝局灶性病变和外周高嗜酸性粒细胞增多症(FHLH)的相关性。吸虫病、毛细管菌病、弓线虫病是内脏幼虫移行症(VLM)的所有病因,代表了前者的大部分,而淋巴瘤、嗜酸性粒细胞白血病和肥大细胞增多症属于非感染性疾病。方法:我们对意大利托斯卡纳地区一名出现FHLH的年轻患者进行了前瞻性随访。结果:患者接受了血清学和寄生虫学检查,试图澄清病变的起源。肝片吸虫和弓形虫的血清学均为阳性,而后者的指数更高。由于血清学结果,我们选择了延长阿苯达唑疗程的治疗,并且在我们的环境中更常见的是弓形虫病。随后对患者进行放射学随访。患者对阿苯达唑治疗有反应,表现为嗜酸性粒细胞减少,弓形虫血清阴性,临床和放射学改善。因此,弓形虫病被认为是最有可能的诊断。结论:在FHLH存在的情况下,不能忽视寄生虫感染。由于存在类似的临床表现和血清学交叉反应,这些寄生虫感染之间的鉴别诊断可能具有挑战性,需要对患者进行随访以确保最佳治疗结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Visceral larva Migrans in a Young Italian Patient: A Diagnostic Dilemma

Visceral larva Migrans in a Young Italian Patient: A Diagnostic Dilemma

Background

The association of fever, focal hepatic lesions and peripheral hyper-eosinophilia (FHLH) can be observed in both infectious and non-infectious conditions. Fascioliasis, capillariasis, toxocariasis, all causes of visceral larva migrans (VLM), represent most of the former, whilst lymphomas, eosinophilic leukemias and mastocytosis belong in the non-infectious conditions.

Methods

We prospectively followed a young patient presenting with FHLH in the Tuscany region of Italy.

Results

The patient was subject to serological and parasitological examination in an attempt to clarify the origin of the lesions. Serologies for both Fasciola hepatica and Toxocara spp. were positive, with the latter presenting a higher index. We opted for treatment with a prolonged course of albendazole due to the serological results and being toxocariasis more frequent in our setting. The patient was then subject to radiological follow-up. The patient responded to treatment with albendazole as shown by a decrease in eosinophils, seronegativization for Toxocara spp., clinical and radiological improvement. Toxocariasis was hence considered the most likely diagnosis.

Conclusions

Parasitic infections cannot be disregarded in the presence of FHLH. Differential diagnosis between these parasitic infections can be challenging due to the presence of similar clinical presentations and serological cross-reactions, and follow-up of the patient is needed to ensure optimal treatment outcomes.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Acta Parasitologica
Acta Parasitologica 医学-寄生虫学
CiteScore
3.10
自引率
6.70%
发文量
149
审稿时长
6-12 weeks
期刊介绍: Acta Parasitologica is an international journal covering the latest advances in the subject. Acta Parasitologica publishes original papers on all aspects of parasitology and host-parasite relationships, including the latest discoveries in biochemical and molecular biology of parasites, their physiology, morphology, taxonomy and ecology, as well as original research papers on immunology, pathology, and epidemiology of parasitic diseases in the context of medical, veterinary and biological sciences. The journal also publishes short research notes, invited review articles, book reviews. The journal was founded in 1953 as "Acta Parasitologica Polonica" by the Polish Parasitological Society and since 1954 has been published by W. Stefanski Institute of Parasitology of the Polish Academy of Sciences in Warsaw. Since 1992 in has appeared as Acta Parasitologica in four issues per year.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信