ABSTRACT
Myiasis has been defined as the infestation of organs and/or tissues with dipterous larvae. They are especially widespread in tropical and subtropical areas. Cutaneous myiasis is its most frequent clinical presentation. This report presents a case of furuncular myiasis caused by the larva of Cordylobia anthropophaga in a 22-year-old girl living in Bergamo, Northern Italy, who returned from Kenya (Watamu) with a big, painful furuncle in her right gluteus. The patient accidentally removed the larva from a large pimple and took it to the infectious disease ambulatory clinic at the ASST "Papa Giovanni XXIII" Hospital, Bergamo. In the Microbiology and Virology Department of the same hospital, a larva of C. anthropophaga was identified and the diagnosis of myiasis was confirmed.
Subject(s)
Myiasis/diagnosis , Travel , Animals , Diptera , Female , Humans , Italy , Kenya , Larva , Myiasis/microbiology , Young AdultABSTRACT
INTRODUCTION: In non-endemic countries, one of the most important routes of transmission of Trypanosoma cruzi is vertical transmission. The objective of this work is to report the results of the screening activities for the control of congenital Chagas Disease (CD) implemented in Bergamo province between January 2014 and December 2016. METHODS: The programme addressed Bolivian pregnant women settled in Bergamo province. All the eight hospitals offering antenatal and delivery care in that area were involved. We retrospectively calculated the coverage rate of the screening programme, the prevalence of CD in this population, as well as transmission rate to their offspring. RESULTS: During the study period, 376 Bolivian women accounted for 387 deliveries. The coverage rate of serologic screening was 85.6%. Confirmed seropositive women were 28, accounting for a prevalence of CD of 8.7% (95% IC 5.9-11.5). Among 29 children born to positive mothers, one infected child was detected (transmission rate of 4.3%, 95% IC 0-12.6) and treated accordingly. Other 13 children previously born from the same mothers were retrieved and tested for CD: no additional congenital cases were diagnosed. DISCUSSION: Our screening programme presented a high coverage, although widely variable in the different birthing facilities. National guidelines recommending CD testing in pregnant women would help to increase case detection countrywide.
Subject(s)
Chagas Disease/epidemiology , Chagas Disease/prevention & control , Communicable Disease Control/methods , Bolivia , Chagas Disease/drug therapy , Female , Humans , Infant, Newborn , Italy , Male , Nitroimidazoles/therapeutic use , Pregnancy , Pregnancy Complications, Parasitic/epidemiology , Risk Factors , Trypanocidal Agents/therapeutic use , Trypanosoma cruziABSTRACT
Chagas disease (CD) is an uncommon disease in Europe. Its epidemiology has changed because of mass migration from Latin America to Europe. Herein we describe a congenital case of CD in a Bolivian newborn in Bergamo, the main city of residence for the Bolivian community in Italy. At delivery, serological analyses evidenced IgG antibodies against Trypanosoma cruzi both in the child and mother, as expected. Hemoscopic analyses on peripheral blood were repeatedly negative during the first months of life. Eventually, thanks to T. cruzi Real Time polymerase chain reaction (RT-PCR) positivity on peripheral blood and development of progressive anemia in the following weeks, congenital Chagas disease was diagnosed and benznidazole-based therapy started. A progressive antibodies' index decrease was observed till negativity (306 days apart). RT-PCR was negative at the end of treatment. Our case is instructive and management of congenital CD is discussed from the perspective of a non-endemic country.
