Janjetović Zeljka, Arar Zeljka Vuković, Marinić Miljenko, Pandak Nenad
Odjel za ocne bolesti, Opća bolnica "Dr. Josip Bencević", Slavonski Brod, Hrvatska.
Acta Med Croatica. 2006;60(1):63-6.
The course of disease in a 64-year-old man with toxocariasis and ocular manifestations of the disease, treated at Departments of Ophthalmology and of Infectious Diseases, Dr. Josip Bencević General Hospital in Slavonski Brod, Croatia, is presented. The patient was hospitalized for bilateral uveitis of unknown etiology. In several days, the patient developed high fever with respiratory tract involvement and hepatomegaly. Worsening of the patient's general condition and laboratory findings of leukocytosis and eosinophilia indicated clinical examinations for parasitosis, in consultation with a specialist for infectious diseases. Specific serologic testing pointed to toxocariasis. The patient's general condition and ophthalmologic status improved in response to specific therapy with anthelmintics and corticosteorids. Toxocariasis is an acute infectious disease that primarily affects animals and less frequently humans. Clinically, toxocariasis manifests as a systemic disease, and on the eye as parasitic posterior uveitis. The disease is caused by the nematodes Toxocara canis and Toxocara cati, the species parasitic in the intestine of dogs and cats, respectively. When the parasite eggs reach human intestine, larvae are released and migrate via blood and lymphatic system to the liver, lungs, eyes, and other organs. Considering the mechanism of disease transmission, the potential preventive measures should include treatment and appropriate anthelmintic management of infected animals, and due control of public areas such as public gardens, promenades, playgrounds, along with taking pets for exercise to the sites specially intended for this purpose.
本文介绍了一名64岁患有弓蛔虫病及该疾病眼部表现的男性患者的病程,该患者在克罗地亚斯拉沃尼亚布罗德的约西普·本采维奇综合医院眼科和传染病科接受治疗。患者因病因不明的双侧葡萄膜炎住院。几天后,患者出现高热并伴有呼吸道感染和肝肿大。患者一般状况恶化,实验室检查发现白细胞增多和嗜酸性粒细胞增多,这表明在咨询传染病专家后需对寄生虫病进行临床检查。特异性血清学检测指向弓蛔虫病。使用驱虫药和皮质类固醇进行特异性治疗后,患者的一般状况和眼科状况有所改善。弓蛔虫病是一种主要影响动物、较少影响人类的急性传染病。临床上,弓蛔虫病表现为全身性疾病,在眼部表现为寄生虫性后葡萄膜炎。该病由犬弓首线虫和猫弓首线虫引起,这两种线虫分别寄生于狗和猫的肠道。当寄生虫卵进入人体肠道时,幼虫会释放出来,并通过血液和淋巴系统迁移至肝脏、肺、眼睛和其他器官。考虑到疾病传播机制,潜在的预防措施应包括对感染动物进行治疗和适当的驱虫管理,以及对公共区域如公园、散步道、操场等进行适当管控,同时带宠物到专门为此目的设置的场所锻炼。