Hozyasz Kamil, Milanowski Andrzej
Klinika Pediatrii, Instytut Matki i Dziecka, ul. Kasprzaka 17a, Warszawa, Poland.
Med Wieku Rozwoj. 2002 Apr-Jun;6(2):155-62.
Aspects of Toxocara spp. epidemiology and paratenic infestation of children are described. Human toxocariasis is caused by infestation of zoonotic roundworms of dogs and cats. Soil sampling showes widespread contamination of the environment, particularly parks and playgrounds, with the eggs of Toxocara spp. Toxocara seroprevelance values in children vary between 3.5% in the West Poland and 19% in the South-East Poland. Children more frequently have clinical symptoms o the disease because of the closer contact with contaminated soil in sand-boxes and relatively frequent geophagia. A 3 years old girl with covert toxocariasis is described. As this case illustrates, this disease can be present without its classic visceral, ocular or neurological manifestations. On admission to the hospital the results of blood tests were as follows: white blood cells count, 43x10(3)/ mm3 (norm <13x10(3)) and hyperosinophilia, 81%. The girl was treated with albendazole 15 mg/kg for five days, after one year the treatment was repeated. The patient was followed with blood samples throughout a period of one and half year. During that time results of serological tests for Toxocara canis were strongly positive. The lowest blood count was 20.0x10(3)/mm3 and eosinophilia, 19%. Possible association between high eosinophilia in toxocariasis and development of allergic and cardiovascular diseases is discussed.
描述了弓首蛔虫属的流行病学方面以及儿童的转续宿主感染情况。人体弓首蛔虫病是由犬猫的人畜共患蛔虫感染引起的。土壤采样显示环境中,特别是公园和游乐场,广泛受到弓首蛔虫属虫卵的污染。儿童的弓首蛔虫血清阳性率在波兰西部为3.5%,在波兰东南部为19%。儿童因更多地接触沙箱中受污染的土壤以及相对频繁地食土,所以更易出现该病的临床症状。描述了一名患有隐匿性弓首蛔虫病的3岁女孩。正如该病例所示,这种疾病可能在没有其典型的内脏、眼部或神经表现的情况下存在。入院时血液检查结果如下:白细胞计数为43×10³/mm³(正常范围<13×10³),嗜酸性粒细胞增多,为81%。该女孩接受了为期5天的阿苯达唑15mg/kg治疗,一年后重复治疗。在一年半的时间里对患者进行血液样本跟踪监测。在此期间,犬弓首蛔虫血清学检测结果呈强阳性。最低白细胞计数为20.0×10³/mm³,嗜酸性粒细胞增多为19%。讨论了弓首蛔虫病中高嗜酸性粒细胞增多与过敏性疾病和心血管疾病发展之间可能的关联。