Kucik Corry Jeb, Martin Gary L, Sortor Brett V
Naval Hospital Jacksonville, Jacksonville, Florida, USA.
Am Fam Physician. 2004 Mar 1;69(5):1161-8.
Intestinal parasites cause significant morbidity and mortality. Diseases caused by Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica occur in the United States. E. vermicularis, or pinworm, causes irritation and sleep disturbances. Diagnosis can be made using the "cellophane tape test." Treatment includes mebendazole and household sanitation. Giardia causes nausea, vomiting, malabsorption, diarrhea, and weight loss. Stool ova and parasite studies are diagnostic. Treatment includes metronidazole. Sewage treatment, proper handwashing, and consumption of bottled water can be preventive. A. duodenale and N. americanus are hookworms that cause blood loss, anemia, pica, and wasting. Finding eggs in the feces is diagnostic. Treatments include albendazole, mebendazole, pyrantel pamoate, iron supplementation, and blood transfusion. Preventive measures include wearing shoes and treating sewage. E. histolytica can cause intestinal ulcerations, bloody diarrhea, weight loss, fever, gastrointestinal obstruction, and peritonitis. Amebas can cause abscesses in the liver that may rupture into the pleural space, peritoneum, or pericardium. Stool and serologic assays, biopsy, barium studies, and liver imaging have diagnostic merit. Therapy includes luminal and tissue amebicides to attack both life-cycle stages. Metronidazole, chloroquine, and aspiration are treatments for liver abscess. Careful sanitation and use of peeled foods and bottled water are preventive.
肠道寄生虫会导致严重的发病和死亡。在美国，由蛲虫、蓝氏贾第鞭毛虫、十二指肠钩口线虫、美洲板口线虫和溶组织内阿米巴引起的疾病均有发生。蛲虫会引起刺激和睡眠障碍。可通过“透明胶带试验”进行诊断。治疗方法包括使用甲苯达唑以及家庭卫生清洁。贾第虫会导致恶心、呕吐、吸收不良、腹泻和体重减轻。粪便虫卵和寄生虫检查可用于诊断。治疗方法包括使用甲硝唑。污水处理、正确洗手和饮用瓶装水可起到预防作用。十二指肠钩口线虫和美洲板口线虫是钩虫，会导致失血、贫血、异食癖和消瘦。在粪便中发现虫卵即可确诊。治疗方法包括使用阿苯达唑、甲苯达唑、噻嘧啶，补充铁剂以及输血。预防措施包括穿鞋和处理污水。溶组织内阿米巴可导致肠道溃疡、血性腹泻、体重减轻、发热、胃肠道梗阻和腹膜炎。阿米巴可在肝脏形成脓肿，脓肿可能会破裂进入胸腔、腹腔或心包。粪便和血清学检测、活检、钡剂检查以及肝脏成像均具有诊断价值。治疗包括使用肠腔和组织内抗阿米巴药物来攻击两个生命周期阶段。甲硝唑、氯喹和穿刺引流是治疗肝脓肿的方法。注意卫生以及食用去皮食品和瓶装水可起到预防作用。
