A Case of Gastroallergic and Intestinal Anisakiasis in Italy: Diagnosis Based on Double Endoscopy and Molecular Identification
Stefano D’Amelio,
Ilaria Bellini,
Claudia Chiovoloni,
Cristina Magliocco,
Annamaria Pronio,
Arianna Di Rocco,
Ilaria Pentassuglio,
Marco Rosati,
Gianluca Russo,
Serena Cavallero
Affiliations
Stefano D’Amelio
Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
Ilaria Bellini
Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
Claudia Chiovoloni
Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
Cristina Magliocco
Sandro Pertini Hospital, 00157 Rome, Italy
Annamaria Pronio
Digestive Endoscopy Unit, Department of General Surgery and Surgical Specialties “Paride Stefanini”, Sapienza University of Rome, Azienda Policlinico Umberto I, 00161 Rome, Italy
Arianna Di Rocco
Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
Ilaria Pentassuglio
Sandro Pertini Hospital, 00157 Rome, Italy
Marco Rosati
Sandro Pertini Hospital, 00157 Rome, Italy
Gianluca Russo
Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
Serena Cavallero
Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
Nematodes of the genus Anisakis (Rhabditida, Anisakidae) are zoonotic fish-borne parasites and cause anisakiasis, a disease with mild to severe acute or chronic gastrointestinal and allergic symptoms and signs. Anisakiasis can potentially lead to misdiagnosis or delay in diagnosis, and it has been suggested as a risk factor for gastrointestinal tumors. Here, we describe a case report of a 25-year-old woman who presented with gastrointestinal (abdominal pain, nausea, diarrhea) and allergic (diffuse skin rash) symptoms and reported ingestion of raw fish contaminated by worms. Gastro and colon endoscopy allowed the visualization and removal of nematodes and collection of bioptic tissue from ulcers and polyps. The removed nematodes were molecularly identified as Anisakis pegreffii. The patient was treated with chlorphenamine maleate, betamethasone, omeprazole, paracetamol, albendazole. We conclude that an upper endoscopy matched with a colonoscopy and molecular characterization of the pathogen yields the most reliable diagnosis and treatment for human anisakiasis, enabling the complete removal of the larvae and preventing chronic inflammation and damage.
