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法国一家门诊诊所69名患者的类圆线虫病的流行病学、临床和实验室特征

Epidemiological, Clinical and Laboratory Features of Strongyloidiasis in 69 Attendees at a French Outpatient Clinic.

作者信息

Magnaval Jean-François, Fillaux Judith, Fabre Richard, Cassaing Sophie, Valentin Alexis, Iriart Xavier, Berry Antoine

机构信息

Service de Parasitologie Médicale, Faculté de Médecine, Université de Toulouse, 31000 Toulouse, France.

Service de Parasitologie-Mycologie, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse, TSA 4003, 31059 Toulouse, France.

出版信息

Pathogens. 2023 Jul 27;12(8):983. doi: 10.3390/pathogens12080983.

Abstract

The present retrospective study analyzed the characteristics of strongyloidiasis in patients who were diagnosed at the Outpatient Clinic of the Department of Parasitology-Mycology, Toulouse, France. Sixty-nine file records were included in the study on the basis of a positive stool examination that used Baermann's method. The prominent epidemiological findings were the presence of former immigrants from Italy or Portugal, veterans from the 1st Indochina war, and autochthonous cases. Almost 1/4 of the patients were asymptomatic. Manifestations of skin allergy were the main clinical feature. Blood eosinophilia was present in 76.8% of the patients, and serum total IgE was ≥150 kIU/L in 79.7%. Immunodiagnosis was achieved from 1990 to 2001 by indirect immunofluorescence (IFAT) that was then replaced with ELISA, both methods using filariform larvae. ELISA was found to be similar to IFAT in terms of specificity but exhibited a greater sensitivity. Patients were primarily treated with albendazole or ivermectin beginning in 1993. Forty-eight patients attended the follow-up consultation. Kinetics of the clinical picture and blood eosinophilia were found to be the most convenient parameters to assess the efficacy of anthelmintic therapy. In conclusion, strongyloidiasis remains a neglected disease in Southwestern France. The resolution of clinical features along with the kinetics of eosinophilia appeared to be the most appropriate parameters to check during the posttreatment follow-up.

摘要

本回顾性研究分析了在法国图卢兹寄生虫学 - 真菌学系门诊确诊的类圆线虫病患者的特征。基于使用贝曼氏法进行的粪便检查呈阳性,69份病历记录被纳入研究。突出的流行病学发现包括来自意大利或葡萄牙的前移民、第一次印度支那战争的退伍军人以及本地病例。近四分之一的患者无症状。皮肤过敏表现是主要临床特征。76.8%的患者有血液嗜酸性粒细胞增多,79.7%的患者血清总IgE≥150 kIU/L。1990年至2001年通过间接免疫荧光法(IFAT)进行免疫诊断,之后被ELISA取代,两种方法均使用丝状蚴。发现ELISA在特异性方面与IFAT相似,但敏感性更高。自1993年起,患者主要接受阿苯达唑或伊维菌素治疗。48名患者参加了随访咨询。发现临床症状和血液嗜酸性粒细胞增多的动态变化是评估驱虫治疗效果最便捷的参数。总之,在法国西南部,类圆线虫病仍然是一种被忽视的疾病。临床特征的消退以及嗜酸性粒细胞增多的动态变化似乎是治疗后随访期间最适宜检查的参数。

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