Pulmonary nodules in African migrants caused by chronic schistosomiasis

Gobbi, Federico; Buonfrate, Dora; Angheben, Andrea; Beltrame, Anna; Bassetti, Matteo; Bertolaccini, Luca; Bogina, Giuseppe; Caia, Simone; Duranti, Silvia; Gobbo, Maria; Marchese, Valentina; Marocco, Stefania; Merelli, Maria; Monteiro, Geraldo Badona; Terzi, Alberto; Bisoffi, Zeno

doi:10.1016/s1473-3099(16)30530-8

Cited by 22 publications

(29 citation statements)

References 37 publications

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“…Moreover, this symptom was reported in 69.6% in this subgroup. Pulmonary signs, including calcified nodules, have been reported in patients with this form of bilharziasis [20]. This is easily understood since the development cycle of the disease involves a pulmonary phase.…”

Section: Discussionmentioning

confidence: 95%

Characteristics of the Heart of School-Age Children in a Schistosomiasis Endemic Area in Senegal

Sarr¹,

Camara²,

Hicham³

et al. 2018

WJCD

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Introduction: In Senegal, surveys have revealed areas of high endemicity of Schistosomiasis including the town of Richard Toll. We undertook this study to determine the echocardiocardiographic characteristics of school-age children in endemic bilharziasis. Methodology: We performed a descriptive cross-sectional study in Richard Toll and Dakar in school-age children. Results: A total of 250 children were included. There was male predominance, age between 4 and 16 (10 years old ± 2.77). Hematuria was reported in 69.6% of cases in endemic areas. Positive testing for Schistoma haematobium was found exclusively in Richard-Toll at 33.5%. The diastolic, systolic, basal and median left ventricle dimensions were larger in Richard Toll's population compared to Dakar. It was the same for the right chambers dimensions. The average pulmonary systolic arterial pressure was greater in Richard-Toll: 26.38 ± 3.16 mmHg versus 21.82 ± 1.73 mmHg in Dakar (p < 0.001). There was a correletion between pulmonary systolic artérial pressure and presence of hematuria, anemia and parasitological positivity. Conclusion: The heart of the school-aged child in endemic area is characterized by larger cavitary dimensions.

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Section: Discussionmentioning

confidence: 95%

Characteristics of the Heart of School-Age Children in a Schistosomiasis Endemic Area in Senegal

Sarr¹,

Camara²,

Hicham³

et al. 2018

WJCD

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“…This syndrome may be partly reversible with praziquantel treatment, except when the fibrotic changes are already established at diagnosis. Recently, Italian researchers have identified a new clinical entity related to chronic schistosomiasis, characterized by chronic pulmonary nodules, sometimes symptomatic but usually incidentally diagnosed by chest X-ray, and corresponding to deposition of schistosome eggs [112]. Slow spontaneous cure seems to be the rule, but is accelerated by the administration of praziquantel.…”

Section: Parasitic Diseases With Pulmonary Involvement (Table 3)mentioning

confidence: 99%

Pulmonary Diseases in Refugees and Migrants in Europe

et al. 2018

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More than 2 million people fleeing conflict, persecution, and poverty applied for asylum between 2015 and 2016 in the European Union. Due to this, medical practitioners in recipient countries may be facing a broader spectrum of conditions and unusual presentations not previously encountered, including a wide range of infections with pulmonary involvement. Tuberculosis is known to be more common in migrants and has been covered broadly in other publications. The scope of this review was to provide an overview of exotic infections with pulmonary involvement that could be encountered in refugees and migrants and to briefly describe their epidemiology, diagnosis, and management. As refugees and migrants travel from numerous countries and continents, it is important to be aware of the various organisms that might cause disease according to the country of origin. Some of these diseases are very rare and geographically restricted to certain regions, while others have a more cosmopolitan distribution. Also, the spectrum of severity of these infections can vary from very benign to severe and even life-threatening. We will also describe infectious and noninfectious complications that can be associated with HIV infection as some migrants might originate from high HIV prevalence countries in sub-Saharan Africa. As the diagnosis and treatment of these diseases can be challenging in certain situations, patients with suspected infection might require referral to specialized centers with experience in their management. Additionally, a brief description of noncommunicable pulmonary diseases will be provided.

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“…4,5 We recently revised this scenario, in light of a series of patients with chronic schistosomiasis showing pulmonary nodules, representing a relevant proportion (about 5%) of all schistosomiasis cases diagnosed at our Center for Tropical Diseases (CTD). 6 The main challenge in those cases was to establish a correct diagnosis, avoiding pulmonary biopsies. The characteristics of the six patients diagnosed with lung nodules due to chronic schistosomiasis have been described previously.…”

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confidence: 99%

“…The characteristics of the six patients diagnosed with lung nodules due to chronic schistosomiasis have been described previously. 6 The first four patients underwent both a pulmonary biopsy and bronchoscopy with bronchoalveolar lavage (BAL) to rule out other possible severe diseases such as tuberculosis ( TB) or malignant nodules. The histological examination of the lung biopsies demonstrated the presence of schistosome eggs, thus permitting to establish the diagnosis.…”

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confidence: 99%

“…Testing BAL for possible parasitic causes of pulmonary nodules, namely schistosomes, would be useful for selected cases, such as the ones described previously. 6 Aim of this study was a preliminary retrospective evaluation of the real-time polymerase chain reaction (PCR) method in use at the CTD for the diagnosis of schistosomiasis in the BAL of patients previously diagnosed with schistosome lung nodules. Unfortunately, BAL was available for only two of our four patients who were submitted to bronchoscopy.…”

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confidence: 99%

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Real-Time Polymerase Chain Reaction Assay on Bronchoalveolar Lavage: An Alternative Method for Diagnosing Chronic Pulmonary Schistosomiasis?

Gobbi

Formenti

Perandin

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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Schistosomiasis causes mainly hepatic and genitourinary damage. Although lung nodules have been commonly described in acute phase, they are presumably underdiagnosed in chronic schistosomiasis. We previously reported a series of patients with chronic pulmonary schistosomiasis confirmed by the histological examination of the lung biopsies. In the present work, we retrospectively tested an in-house real-time polymerase chain reaction for (currently validated for diagnosis on stool and on urine) in the bronchoalveolar lavage (BAL) of a couple of those patients, and both resulted positive. The possibility of testing BAL with molecular methods targeting a wide spectrum of pathogens, including parasites, is appealing. Further studies are needed to validate this technique that might reduce unnecessary biopsies.

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Pulmonary nodules in African migrants caused by chronic schistosomiasis

Cited by 22 publications

References 37 publications

Characteristics of the Heart of School-Age Children in a Schistosomiasis Endemic Area in Senegal

Characteristics of the Heart of School-Age Children in a Schistosomiasis Endemic Area in Senegal

Pulmonary Diseases in Refugees and Migrants in Europe

Real-Time Polymerase Chain Reaction Assay on Bronchoalveolar Lavage: An Alternative Method for Diagnosing Chronic Pulmonary Schistosomiasis?

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