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日本患者中由弓蛔虫和蛔虫感染引起的幼虫移行症综合征。

Larva migrans syndrome caused by Toxocara and Ascaris roundworm infections in Japanese patients.

作者信息

Yoshida A, Hombu A, Wang Z, Maruyama H

机构信息

Division of Parasitology, Department of Infectious Diseases, Faculty of Medicine, University of Miyazaki, Kihara 5200, Kiyotake-cho, Miyazaki City, Miyazaki, 889-1692, Japan.

出版信息

Eur J Clin Microbiol Infect Dis. 2016 Sep;35(9):1521-9. doi: 10.1007/s10096-016-2693-x. Epub 2016 Jun 6.

Abstract

Larva migrans syndrome (LMS) caused by Toxocara and Ascaris roundworms is generally believed to be more common in children, while a report from Japan suggests that it is more common in adults. We conducted a large-scale retrospective study to confirm these findings and to clarify what caused the difference between Japan and other countries, to reveal overlooked aspects of this disease. The clinical information of 911 cases which we diagnosed as Toxocara or Ascaris LMS during 2001 and 2015 was analysed. Information used included age, sex, address (city or county), chief complaint, present history, dietary history, overseas travelling history, medical imaging findings and laboratory data (white blood cell count, peripheral blood eosinophil number and total IgE). The sex ratio of the disease was 2.37 (male/female = 641/270). The number of patients not younger than 20 years old were 97.8 and 95.1 % among males and females, respectively. Major disease types were visceral, ocular, neural and asymptomatic. The visceral type was more prevalent in older patients, while younger patients were more vulnerable to ocular symptoms. More than two-thirds of the patients whose dietary habits were recorded had a history of ingesting raw or undercooked animal meat. LMS caused by Toxocara or Ascaris is primarily a disease of adult males in Japan, who probably acquired infections by eating raw or undercooked animal meat/liver. Healthcare specialists should draw public attention to the risk of raw or undercooked animal meat in Europe as well.

摘要

由弓蛔虫和蛔虫引起的幼虫移行症综合征(LMS)通常被认为在儿童中更为常见,而日本的一份报告表明其在成年人中更为常见。我们进行了一项大规模回顾性研究,以证实这些发现,并阐明日本与其他国家之间存在差异的原因,揭示该疾病被忽视的方面。我们分析了2001年至2015年期间诊断为弓蛔虫或蛔虫LMS的911例患者的临床信息。所使用的信息包括年龄、性别、地址(市或县)、主诉、现病史、饮食史、海外旅行史、医学影像检查结果和实验室数据(白细胞计数、外周血嗜酸性粒细胞数量和总IgE)。该疾病的男女比例为2.37(男/女 = 641/270)。男性和女性中年龄不小于20岁的患者人数分别为97.8%和95.1%。主要疾病类型为内脏型、眼型、神经型和无症状型。内脏型在老年患者中更为普遍,而年轻患者更容易出现眼部症状。在记录了饮食习惯的患者中,超过三分之二有摄入生的或未煮熟的动物肉的病史。在日本,由弓蛔虫或蛔虫引起的LMS主要是成年男性的疾病,他们可能通过食用生的或未煮熟的动物肉/肝脏而感染。医疗保健专家也应在欧洲引起公众对生的或未煮熟的动物肉风险的关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbb3/4982883/ee2855379c77/10096_2016_2693_Fig1_HTML.jpg

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