Recognition and treatment of endemic and travel-acquire parasitosis.

The diagnosis of parasitic infections depends on a high level of suspicion after a thorough history and physical examination, mindful of relapsing course of long incubation periods (Table 6). Obvious information that alerts one to the diagnosis include recent travel abroad and in endemic areas of the United States. Within this framework, the most important element in the pursuit of parasitosis is persistence on the part of the physician. Advice from infectious disease specialists and laboratory personnel will increase the probability of finding, identifying, and the treating the underlying process. Serologic tests are helpful in this process. Antigen detection of antibody complexes formation by ELISA technique facilitates specific diagnosis (Table 7). The most important primary care issue is prevention. Treatment with unfamiliar drugs is best pursued with infectious disease consultation because these can have significant toxicities (Table 8). Office announcements reminding patients to ask about travel prophylaxis several months in advance of proposed travel and provision of information concerning endemic parasitoses is recommended.