Early Postnatal and Preschool-Age Infection by Fasciola spp.: Report of Five Cases from Vietnam and Worldwide Review
Fascioliasis is reported in five Vietnamese children aged 4 years or younger. A 10-month-old girl child and a 12-month-old boy child are the youngest patients ever diagnosed. Eggs in stools suggested an infection occurred at 5-6 months and 7-8 months of age, respectively. DNA sequencing and egg size...
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Published in | The American journal of tropical medicine and hygiene Vol. 103; no. 4; pp. 1578 - 1589 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
United States
Institute of Tropical Medicine
01.10.2020
The American Society of Tropical Medicine and Hygiene |
Subjects | |
Online Access | Get full text |
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Summary: | Fascioliasis is reported in five Vietnamese children aged 4 years or younger. A 10-month-old girl child and a 12-month-old boy child are the youngest patients ever diagnosed. Eggs in stools suggested an infection occurred at 5-6 months and 7-8 months of age, respectively. DNA sequencing and egg size indicated this to be the first report of a verified
infection in so small children. No specific diagnosis could be obtained in two 3-year-old children detected in the acute phase. A big and gravid ectopic
-like worm was surgically found in a 4-year-old boy presenting with peritonitis. A worldwide review showed only 38 past cases in preschool children. They included 3, 7, 12, and 16 cases of 1, 2, 3, and 4 years, respectively, with a faster infection increase in males from 2 years onward. Reports were from all continents, except Oceania, including severe complications and death. The causal agent, when specifically diagnosed, was always
. Analyses include detection in hospital, surveys, and family outbreaks; infection sources; disease phases; parasite burden; ectopic cases; symptom onset; eosinophilia; biochemical markers; and clinical complications. C-reactive protein, creatinine, and γ-glutamyl transferase are the most useful biomarkers. A serological test and a coprological analysis are recommended for so small children, in which typical symptoms may be overlooked. Treatment problems were described with many drugs, except triclabendazole. Triclabendazole should be considered the drug of choice for such small children. The possibility of a very early infection by
spp. should be henceforth considered. |
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Bibliography: | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Review-3 content type line 23 ObjectType-Feature-5 ObjectType-Article-4 ObjectType-Report-1 Disclosure: Studies of this article have been performed within the framework of the Worldwide Initiative of WHO against Human Fascioliasis (WHO Headquarters, Geneva, Switzerland). The support by the Department of Control of Neglected Tropical Diseases, World Health Organization, WHO/OMS, Geneva, Switzerland, is greatly acknowledged for their help in facilitating the international collaboration necessary for the research activities developed. Authors’ addresses: Nguyen Van De, Department of Parasitology, Hanoi Medical University, Hanoi, Vietnam, E-mail: ngvdeyhn@gmail.com. Thanh Hoa Le, Department of Immunology, Institute of Biotechnology, Vietnam Academy of Science and Technology, Hanoi, Vietnam, E-mail: imibtvn@gmail.com. Veronica H. Agramunt and Santiago Mas-Coma, Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain, E-mails: veronica.hernandez@uv.es and s.mas.coma@uv.es. Financial support: This research was funded by Vietnam National Foundation for Science and Technology Development (NAFOSTED) under grant number 108.05–2017.301. Spanish collaboration funded by project number SAF2010-20805 of the Ministry of Economy and Competitiveness (MINECO), Madrid, Spain; by Health Research project number PI16/00520, Subprograma Estatal de Generación de Conocimiento de la Acción Estratégica en Salud (AES), Plan Estatal de Investigación Científica y Técnica y de Innovación y Fondos FEDER, ISCIII-MINECO/FEDER, Madrid, Spain; by project number 2017/ACDE/001583 de Innovación para el Desarrollo of the Agencia Española de Cooperación Internacional para el Desarrollo (AECID), Ministry of Foreign Affairs and Cooperation, Madrid, Spain; and by the Red de Investigación de Centros de Enfermedades Tropicales—RICET (Project number RD16/0027/0023 of the PN de I+D+I, ISCIII-Subdirección General de Redes y Centros de Investigación Cooperativa RETICS), Ministry of Health and Consumption, Madrid. |
ISSN: | 0002-9637 1476-1645 |
DOI: | 10.4269/ajtmh.20-0139 |