Kroten Anna, Toczylowski Kacper, Oldak Elzbieta, Sulik Artur
Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274, Bialystok, Poland.
Parasitol Res. 2018 May;117(5):1513-1519. doi: 10.1007/s00436-018-5833-7. Epub 2018 Mar 20.
The objective of this study was to investigate the main clinical signs and symptoms of toxocarosis in children and the treatment results. The study group consisted of 66 seropositive children aged 2 to 16 years, evaluated in an outpatient clinic in north-eastern Poland for 24 months. Male gender and living in urban areas predominated in the study population. Children presented with non-specific symptoms, of which the most common was abdominal pain or tenderness, which was reported by 39 (59%) patients. Absolute eosinophil counts were increased in 32 (48%) children. Total IgE concentrations were increased in 31 of 55 (56%) tested children. All evaluated children received albendazole as a first-line treatment. In 19 cases, additional treatment with albendazole and/or diethylcarbamazine was provided. The analysis of possible causes of prolonged treatment revealed that significant risk factors were geophagia [odds ratio (OR), 6.3; 95% confidence interval (95% CI), 1.8-21.8; p < 0.01] and daily contact with a dog [OR, 5.9; 95% CI, 1.3-27.3, p < 0.05]. We hypothesise that poor hygiene habits and daily contact with a dog pose a risk of reinfection and limits treatment efficiency. Because of non-specific signs and frequent lack of eosinophilia, physicians should maintain high levels of suspicion for toxocarosis, particularly in patients who live in regions heavily contaminated with Toxocara eggs.
本研究的目的是调查儿童弓首蛔虫病的主要临床体征和症状以及治疗效果。研究组由66名2至16岁的血清阳性儿童组成,在波兰东北部的一家门诊诊所进行了24个月的评估。研究人群中男性和居住在城市地区的人占多数。儿童表现出非特异性症状,其中最常见的是腹痛或压痛,39名(59%)患者报告有此症状。32名(48%)儿童的绝对嗜酸性粒细胞计数增加。55名接受检测的儿童中有31名(56%)总IgE浓度升高。所有接受评估的儿童均接受阿苯达唑作为一线治疗。19例患者接受了阿苯达唑和/或乙胺嗪的额外治疗。对治疗时间延长的可能原因分析显示,重要的危险因素是异食癖[比值比(OR),6.3;95%置信区间(95%CI),1.8 - 21.8;p < 0.01]和每天与狗接触[OR,5.9;95%CI,1.3 - 27.3,p < 0.05]。我们推测,不良的卫生习惯和每天与狗接触会带来再次感染的风险,并限制治疗效果。由于体征不特异且经常缺乏嗜酸性粒细胞增多,医生应高度怀疑弓首蛔虫病,尤其是在生活在受弓首蛔虫卵严重污染地区的患者中。