Suma T K, Shenoy R K, Varghese J, Kuttikkal V V, Kumaraswami V
Department of Medicine, TD Medical College Hospital, Alappuzha, India.
Southeast Asian J Trop Med Public Health. 1997 Dec;28(4):826-30.
Recurrent episodes of acute adenolymphangitis (ADL) are important clinical manifestations of lymphatic filariasis which contribute significantly to the progression of lymphedema. It is increasingly being recognized that secondary bacterial infections play an important role in the etiology of ADL. We examined the role of streptococcal infection as a precipitating factor of ADL in brugian filariasis, by determining the anti-streptolysin O (ASO) titers and by isolating the causative organism wherever possible. The study population consisted of 30 patients with filariasis related ADL (Group A), 30 patients with chronic filarial edema (Group B) and 60 age and sex matched healthy adults (Group C). ASO titer was estimated by the latex agglutination method at the time of entry into the study, at the 15th day and at 3, 6 and 12 months. ASO titers were persistently elevated in 90% of patients in Group A and a portal of entry for bacterial infection was detected in all of these patients. In Group B only six patients had persistently elevated ASO titers. These patients had grade III lymphedema and three of them had monilial infections in the affected limb. In the control group none had persistently elevated ASO titers. The elevated ASO titers and the detection of a site of entry for bacteria in patients with ADL supports a streptococcal etiology for this condition.
急性腺淋巴管炎（ADL）反复发作是淋巴丝虫病的重要临床表现，对淋巴水肿的进展有显著影响。人们越来越认识到继发性细菌感染在ADL的病因中起重要作用。我们通过测定抗链球菌溶血素O（ASO）滴度并尽可能分离致病微生物，研究链球菌感染作为布鲁氏丝虫病中ADL诱发因素的作用。研究人群包括30例丝虫病相关ADL患者（A组）、30例慢性丝虫性水肿患者（B组）和60例年龄及性别匹配的健康成年人（C组）。在研究入组时、第15天以及3、6和12个月时，采用乳胶凝集法估计ASO滴度。A组90%的患者ASO滴度持续升高，且在所有这些患者中均检测到细菌感染的入口。B组只有6例患者ASO滴度持续升高。这些患者有III级淋巴水肿，其中3例患肢有念珠菌感染。在对照组中，没有人ASO滴度持续升高。ADL患者ASO滴度升高以及细菌入口部位的检测支持了这种疾病的链球菌病因。
