Marcos Luis A, Maco Vicente, Castillo Maria, Terashima Angélica, Zerpa Rito, Gotuzzo Eduardo
Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru.
Rev Gastroenterol Peru. 2005 Apr-Jun;25(2):198-205.
Human fascioliosis is one of the most important parasitic diseases in Peru, due to the high prevalence rates reported in the last few years, mainly in the Andean Trapeze. The most affected group is that of children and the clinical manifestations of the disease can be very varied. In this study we reported seven cases of human fascioliosis diagnosed in the Specialized Children's Health Institute (IESN) Lima, Peru, between 1988 and 2003. From 168 medical histories checked with the final diagnosis of parasitosis, 7 children (2 boys and 5 girls), between 2 and 14 years (average +/- DS: 8.52 +/- 1.43) were diagnosed with fascioliosis by a parasitic and/or serological examinations. Six of the seven cases came from cattle raising areas such as: Cajamarca, Ancash, Huancavelica and Junín. The most frequent clinical signs were prolonged fever (up to 42 days), hepatomegaly, moderate abdominal pain (right hypochondriac region and epigastrium), eosinophils count (between 132 and 8321/mm > or =), anemia (hematocrit up to 15%), jaundice and hypergammaglobulinemia. In some cases the diagnosis was difficult to reach with a delay between 1 and 24 weeks. It should be pointed out that one of these patients had hepatic cirrhosis diagnosed by anatomopathological investigations. Finally, we propose that in pediatric patients coming from endemic areas of animal fasciolosis who have prolonged fever, abdominal pain and hepatomegaly, should be considered suspicious and the infection of eliminated, to avoid hepatic damage caused by this parasite. We conclude that human fascioliosis must not be under-estimated as a secondary parasitic disease in patients coming from endemic areas in Peru.
人体片形吸虫病是秘鲁最重要的寄生虫病之一，这是由于过去几年报告的患病率很高，主要集中在安第斯梯形地区。受影响最严重的群体是儿童，该病的临床表现可能多种多样。在本研究中，我们报告了1988年至2003年期间在秘鲁利马市儿童专科医院（IESN）诊断出的7例人体片形吸虫病病例。在168份最终诊断为寄生虫病的病历中，通过寄生虫学和/或血清学检查，确诊7名儿童（2名男孩和5名女孩）患有片形吸虫病，年龄在2至14岁之间（平均±标准差：8.52±1.43）。7例病例中的6例来自畜牧区，如卡哈马卡、安卡什、万卡韦利卡和胡宁。最常见的临床症状为长期发热（长达42天）、肝肿大、中度腹痛（右季肋区和上腹部）、嗜酸性粒细胞计数（在132至8321/mm≥之间）、贫血（血细胞比容高达15%）、黄疸和高球蛋白血症。在某些情况下，诊断困难，延迟时间在1至24周之间。应当指出，其中一名患者经解剖病理学检查诊断为肝硬化。最后，我们建议，对于来自动物片形吸虫病流行地区、有长期发热、腹痛和肝肿大的儿科患者，应怀疑并排除感染，以避免该寄生虫造成肝脏损害。我们得出结论，在来自秘鲁流行地区的患者中，人体片形吸虫病作为一种继发性寄生虫病绝不能被低估。
