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Imaging features of pediatric pentastomiasis infection: a case report
Can Lai1, Xi Qun Wang, Long Lin
1Department of Radiology, Children's Hospital, Zhejiang University School of Medicine, Zhejiang Key Laboratory for the Diagnosis and Therapy of Neonatal Diseases, Zhejiang 310003, China. laican1@126.com
Insights
Pentastomiasis infection in a child presented with fever and abdominal pain. Diagnosis involved imaging and biopsy confirming parasitic granuloma from pentastomid larvae.
Area of Science:
- Parasitology
- Pediatric Infectious Diseases
- Medical Imaging
Background:
- Pentastomiasis is a rare parasitic infection caused by pentastomid larvae.
- Diagnosis can be challenging due to non-specific symptoms and varied presentations.
Observation:
- A 3-year-old girl presented with high fever, abdominal pain, abdominal tension, and anemia.
- Abdominal ultrasound revealed liver nodules and ascites; MRI showed hepatomegaly, peritoneal and retroperitoneal nodules.
- Chest CT identified small lung nodules; laparoscopy revealed diffuse white nodules on the liver and peritoneum.
Findings:
- Histological examination of biopsies showed parenchymal tubercles with pentastomid larvae and significant inflammatory infiltration.
- The pathological diagnosis was parasitic granuloma secondary to pentastomiasis infection.
Implications:
- This case highlights the importance of considering rare parasitic infections in pediatric patients with unexplained symptoms and imaging findings.
- Early and accurate diagnosis through a combination of clinical, imaging, and pathological evaluation is crucial for effective management of pentastomiasis.
- Further research into the epidemiology and diagnostic modalities for pentastomiasis in children is warranted.
Abstract:
We report here a case of pentastomiasis infection in a 3-year-old girl who had high fever, abdominal pain, abdominal tension and anemia. Ultrasound scanning of the abdomen revealed disseminated hyperechoic nodules in the liver and a small amount of ascites. Abdominal MRI showed marked hepatomegaly with disseminated miliary nodules of high signal intensity throughout the hepatic parenchyma on T2-weighted images; retroperitoneal lymphadenopathy and disseminated miliary nodules on the peritoneum were also noted. Chest CT showed scattered small hyperdense nodules on both sides of the lungs. The laparoscopy demonstrated diffuse white nodules on the liver surface and the peritoneum. After the small intestinal wall and peritoneal biopsy, histological examination revealed parenchymal tubercles containing several larvae of pentastomids and a large amount of inflammatory cell infiltration around them. The pathological diagnosis was parasitic granuloma from pentastomiasis infection.
