Travel Medicine and Infectious Disease
2019

Imported human Schistosoma japonicum: A report on two cases in Filipino migrants present in Italy and a systematic review of literature (Review)

Vellere I. , Mangano V.D. , Cagno M.C. , Gobbi F. , Ragusa A. , Bartoloni A. , Biancofiore G. , De Simone P. , Campani D. , Bruschi F. , Zammarchi L.*
  • a Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
  • b Department of Translational Research, University of Pisa, Pisa, Italy
  • c Department of Laboratory Medicine, Pisa University Hospital, Pisa, Italy
  • d Department of Infectious-Tropical Diseases and Microbiology, I.R.C.C.S., Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
  • e Department of Infectious-Tropical Diseases and Microbiology, I.R.C.C.S., Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
  • f Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy, Referral Center for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
  • g Department of Surgical, Medical and Molecular Pathology, Pisa University Hospital, Pisa, Italy
  • h Hepatobiliary Surgery and Liver Transplantation Unit, University of Pisa Medical School Hospital, Pisa, Italy
  • i Department of Surgical, Medical and Molecular Pathology, Pisa University Hospital, Pisa, Italy
  • j Department of Translational Research, University of Pisa, Pisa, Italy, Department of Laboratory Medicine, Pisa University Hospital, Pisa, Italy
  • k Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy, Referral Center for Tropical Diseases of Tuscany, Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy

Abstract

Background: 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. Method: 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the results of a systematic review of the literature on imported S. japonicum infection and describe two previously unpublished cases diagnosed in Filipino migrants in Italy. Results: 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. Conclusions: 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. © 2019 Elsevier Ltd

Author Keywords

Europe Schistosoma japonicum Non endemic migrant Travellers Schistosomiasis

Index Keywords

[No Keywords available]

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85072672080&doi=10.1016%2fj.tmaid.2019.101496&partnerID=40&md5=8349e3e8501ee864d1b0875328297297

DOI: 10.1016/j.tmaid.2019.101496
ISSN: 14778939
Original Language: English