Armillifer Infections in Humans: A Systematic Review

Area of Science:

• Parasitology
• Zoonotic Diseases
• Human Health

Background:

• Armillifer is a genus of parasites in the Pentastomida subclass, known to cause human disease since 1847.
• Human infections are rare, transmitted via undercooked snake meat or environmental ova.
• Snakes serve as the definitive hosts for Armillifer parasites.

Purpose of the Study:

• To systematically review all available evidence on human infections caused by Armillifer parasites.
• To consolidate epidemiological, clinical, and treatment data for human Armillifer infections.
• To understand the presentation and outcomes of human Armillifer infections.

Main Methods:

• Systematic review of PubMed database up to December 21, 2018.
• Inclusion of 26 studies with data from 40 human patients.
• Analysis of epidemiological, clinical, microbiological, and treatment data.

Main Results:

• The peritoneal cavity, liver, and abdominal tract were the most common infection sites.
• Armillifer armillatus was the most frequent infecting species.
• Most patients were asymptomatic; abdominal pain was the most common symptom when present. Unusual presentations included hepatic encephalopathy and neurological symptoms.
• Diagnosis occurred via surgery or imaging; most patients received no treatment.
• Mortality was low, but ocular infections frequently resulted in permanent vision loss.

Conclusions:

• Human Armillifer infections are uncommon, with varied clinical presentations.
• Prompt diagnosis and management are crucial, especially for ocular involvement.
• Further research is needed to fully elucidate transmission dynamics and optimize treatment strategies.