(FIG.1)
The child was treated with Albendazole 400 mg per day for 10 days. After 15 days the pancolonoscopy was negative for intestinal parasitic lesions.
This case demonstrates that anisakiasis could present with undefined symptoms, as expression of its extraintestinal location. Generally the suspicion is raised with a recent ingestion of raw or undercooked meats, like sushi. (2) In Anisakis infection, the human is an “accidental host” after ingestion of the third-stage encysted larvae in infected fish. The worms progress through the tissues invading the bowel wall, contributing to the formation of intramural or extraintestinal eosinophilic granulomas,when they cross the wall. (3)
An extraintestinal anisakiasis is anecdotal and to our knowledges only two cases have been reported in the literature (2-4) . Herein we present the first case of anaphilaxis and scrotal localization in paediatric age. In literature we found only few cases of scrotal infestation by filariae, mimicking a testicular tumor. (5)
This child lives in Calabria, a Region in the South of Italy, in a normal italian socio-economic and hygienic conditions context. He hasn’t traveled in the past two years and he never has intaken raw fish or he has gone to a sushi restaurant. There were no similar cases in school.
Whether the entrance door of the anisakis remains a mystery, a possible theory on the etiopathogenesis of this case could be related to the persistence of a patent vaginal peritoneum duct, with the migration of worms from the intestinal wall to the scrotum. However, the child had no signs of hydrocele or inguinal swelling.