RESUMO
OBJECTIVE: Complications of ascariasis are a significant cause of abdominal pain in pediatric emergencies, especially where it is endemic. A literature review was conducted with the aim of improving diagnostic and therapeutic approaches for these patients. DATA SOURCES: A PubMed search was conducted using the key terms "ascariasis complications" and "hepatobiliary ascariasis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, case reports, and reviews published up to December 2023. SUMMARY OF FINDINGS: Obstruction of the small bowel is the most common complication. Others that are, rarer and more difficult to properly identify and treat, such as biliary, hepatic, and pancreatic complications, acute appendicitis, Meckel's diverticulitis, or peritoneal granulomas. Hepatic and pancreatic complications are rarer and more serious in children than in adults. While plain radiography is usually the only option in cases of intestinal obstruction, ultrasonography is the examination of choice in cases of hepatobiliary, pancreatic, and appendicular ascariasis complications in childhood. The treatment is clinical and conservative in most patients. Surgical treatment is indicated if conservative therapy fails, or if there are signs of complications. Laparoscopy has been used as an excellent technical alternative in adults with hepatobiliary complications of ascariasis, but further studies on its use in children are still needed. CONCLUSION: The creation of protocols and greater debate on this subject should be encouraged for a better understanding of the disease and to establish an early diagnosis and adequate treatment for children with complications resulting from massive infestation by Ascaris lumbricoides.
Assuntos
Ascaríase , Obstrução Intestinal , Humanos , Ascaríase/complicações , Ascaríase/terapia , Ascaríase/diagnóstico , Criança , Obstrução Intestinal/parasitologia , Obstrução Intestinal/etiologia , Dor Abdominal/etiologia , Dor Abdominal/parasitologiaRESUMO
Appendicitis is one of the most common conditions that leads to an acute abdomen. Surgical management is the gold standard for therapy. The main cause of appendicitis is an obstruction in the appendicular lumen. Intestinal ascariasis infection is undoubtedly one of the least frequent. We present a female patient with acute appendicitis resulting from Ascaris lumbricoides as an incidental intraoperative diagnosis.
Assuntos
Apendicite , Apêndice , Ascaríase , Obstrução Intestinal , Laparoscopia , Doença Aguda , Animais , Apendicite/complicações , Apendicite/cirurgia , Ascaríase/complicações , Ascaríase/diagnóstico , Ascaríase/tratamento farmacológico , Ascaris lumbricoides , Feminino , Humanos , Obstrução Intestinal/etiologia , Laparoscopia/efeitos adversosRESUMO
Blood transfusion for chronic anemia can lead to acute or decompensated heart failure in patients who have fluid overload as part of their compensatory response and/or have intrinsic heart disease, and then it could be fatal in such clinical scenarios. This is the report of a case of profound chronic anemia in a young male patient, who was not transfused and then developed confusion followed by terminal cardiopulmonary arrest. Autopsy revealed severe trichuriasis to be the cause of the anemia, along with severe ascariasis, but minimal intrinsic brain disease. This supports the conclusion that anemia was the cause of the confusion, and the lesson that confusion may be a sign that the benefit of blood transfusion outweighs the risk in a patient with severe chronic anemia.
Assuntos
Humanos , Masculino , Adulto , Ascaríase/complicações , Tricuríase/complicações , Transfusão de Sangue , Anemia , Autopsia , CardiopatiasRESUMO
Ascaris lumbricoides provoca una de las helmintiasis más frecuentes en los países tropicales, pudiendo producir efectos patológicos en cualquier parte del organismo, siendo los conductos biliales uno de los sitios recurrentes provocando una colecistitis aguda. La CA es una de las principales causas de ingreso al servicio de Emergencia, es una inflamación de la vesícula cuyo diagnóstico oportuno es de vital importancia para la prevención de complicaciones. Por tal razón, determinar la frecuencia de las variables clínicas, de laboratorio y ecográficas, su relación con las comorbilidades asociadas a las características demográficas de los pacientes y el nivel de severidad de la colecistitis aguda causada por la A. lumbricoides de las Guías de Tokio 2018 del Servicio de Emergencia del Hospital Alfredo Noboa Montenegro durante el periodo junio - diciembre 2018, para la elaboración de un esquema diagnóstico. La metodología de investigación fue cuantitativa descriptiva de corte transversal. Dentro de los principales hallazgos, el CA aparece con prevalencia en el género femenino en un 69,41%, promedio de edad de 32 a 45 años, el 10% de 170 pacientes presentaron en su ecografía una forma parasitaria compatible con A. Lumbricoides, los resultados clínicos arrojaron presencia de dolor (67,34%), fiebre (68,65%), náuseas (45,93%); en los laboratorio la Proteína C Reactiva estuvo aumenta en el 94,18% de los casos, en imagenología se refleja presencia de líquido pericolecistico en un 78,82% y un engrosamiento de pared vesicular en un 34,12%. El nivel de severidad registrado según los criterios de las guías de Tokio 2018 fue grado I 35,3%, grado II 47,1% y grado III 17,6%. Se recomienda la estructuración de un esquema diagnóstico oportuno de colecistitis aguda causada por A. Lumbricoides(AU)
Ascaris lumbricoides causes one of the most frequent helminthiases in tropical countries, being able to produce pathological effects in any part of the body, being the bile ducts one of the recurrent sites causing acute cholecystitis. AC is one of the main causes of admission to the Emergency service, it is an inflammation of the gallbladder whose timely diagnosis is of vital importance for the prevention of complications. signs and symptoms, the timely diagnosis is of vital importance for the prevention of complications. For this reason, determine the frequency of clinical, laboratory and ultrasound variables, their relationship with the comorbidities associated with the demographic characteristics of the patients and the level of severity of acute cholecystitis cause of A. lumbricoides of the Tokyo Guidelines 2018 of the Hospital Emergency Service Alfredo Noboa Montenegro during the period June - December 2018, for the elaboration of a diagnostic scheme. The research methodology was quantitative cross-sectional descriptive. Among the main findings that were prevailed in the female gender in 69,41%, average age from 32 to 45 years, 10% of 170 patients presented in their ultrasound a parasitic form compatible with A. lumbricoides, clinical results that prevailed was presence of pain (67.34%), fever (68.65%), nausea (45.93%); in the laboratory findings the C Reactive Protein was increased in 94,18% of cases, in imaging the presence of pericolecist fluid is reflected in 78,82% and a thickening of the vesicular wall in 34,12%. The severity level recorded according to the criteria of the Tokyo 2018 guidelines was grade I 43,53%, grade II 48,24% and grade III 8,24%. The structuring of a timely diagnostic scheme for acute cholecystitis cause of A. lumbricoides is recommended(AU)
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Colecistite Aguda/diagnóstico , Colecistite Aguda/etiologia , Ascaríase/complicações , Dor Abdominal/etiologia , Ascaris lumbricoides , Equador/epidemiologia , NáuseaRESUMO
INTRODUCTION: Biliary ascariasis, although uncommon, can lead to infectious complications and severe outcomes. This study reported three patients with biliary ascariasis and who were admitted to a paediatric hospital in Salvador, Brazil. CASE REPORTS: Case 1: A 1-year-old boy, with HIV, hospitalised with diarrhoea, fever, pain, and abdominal distension. He underwent an exploratory laparotomy, which showed peritonitis secondary to a perforation of the hepatic duct by ascaris. Case 2: A 3-year-old boy admitted with fever, abdominal pain and jaundice. Imaging examination was suggestive of ascaris in the intrahepatic biliary tract and a hepatic abscess. Case 3: A 7-year-old boy who was hospitalised with a history of abdominal colic, jaundice and fever, with a suggestive image of ascaris in the biliary tract and evolution to sepsis. DISCUSSION: Three cases of biliary ascariasis were reported with severe infectious complications involving peritonitis, hepatic abscess and sepsis. CONCLUSION: In endemic regions, biliary ascariasis should be considered in cases with jaundice, abdominal pain and fever, due to its morbidity and risk of complications.
Assuntos
Ascaríase/complicações , Ascaríase/diagnóstico , Infecções Bacterianas/parasitologia , Doenças Biliares/diagnóstico , Doenças Biliares/parasitologia , Coinfecção , Animais , Ascaríase/diagnóstico por imagem , Doenças Biliares/complicações , Doenças Biliares/diagnóstico por imagem , Brasil , Criança , Pré-Escolar , Hospitais Pediátricos , Humanos , Lactente , Abscesso Hepático/parasitologia , Masculino , Peritonite/parasitologia , Sepse/parasitologiaRESUMO
INTRODUCTION: Immunological control of Mycobacterium tuberculosis infection is dependent on the cellular immune response, mediated predominantly by Th1 type CD4+ T cells. Polarization of the immune response to Th2 can inhibit the host immune protection against pathogens. Patients with tuberculosis coinfected with helminths demonstrate more severe pulmonary symptoms, a deficiency in the immune response against tuberculosis, and an impaired response to anti-tuberculosis therapy. METHODS: We evaluated the cellular immune response and the impact of the presence of Ascaris lumbricoides on the immune and clinical response in pulmonary tuberculosis patients. Ninety-one individuals were included in the study: 38 tuberculosis patients, 11 tuberculosis patients coinfected with Ascaris lumbricoides and other helminths, 10 Ascaris lumbricoides patients, and 34 non-infected control individuals. Clinical evolution of pulmonary tuberculosis was studied on 0, 30, 60, and 90 days post-diagnosis of Mycobacterium tuberculosis and Ascaris lumbricoides. Furthermore, immune cells and plasma cytokine profiles were examined in mono/coinfection by Mycobacterium tuberculosis and Ascaris lumbricoides using flow cytometry. RESULTS: There were no statistical differences in any of the evaluated parameters and the results indicated that Ascaris lumbricoides infection does not lead to significant clinical repercussions in the presentation and evolution of pulmonary tuberculosis. CONCLUSIONS: The association with Ascaris lumbricoides did not influence the Th1, Th2, and Th17 type responses, or the proportions of T lymphocyte subpopulations. However, higher serum levels of IL-6 in tuberculosis patients may explain the pulmonary parenchymal damage.
Assuntos
Ascaríase/imunologia , Ascaris lumbricoides , Interleucina-6/sangue , Tuberculose Pulmonar/imunologia , Adulto , Animais , Anticorpos Anti-Helmínticos/sangue , Ascaríase/complicações , Estudos de Casos e Controles , Coinfecção , Citocinas/sangue , Citocinas/imunologia , Progressão da Doença , Feminino , Citometria de Fluxo , Humanos , Interleucina-6/imunologia , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Tuberculose Pulmonar/complicações , Adulto JovemRESUMO
Ascariasis is considered the most neglected tropical disease, and is a major problem for the public health system. However, idiopathic pulmonary fibrosis (IPF) is a result of chronic extracellular deposition of matrix in the pulmonary parenchyma, and thickening of the alveolar septa, which reduces alveolar gas exchange. Considering the high rates of ascariasis and pulmonary fibrosis, we believe that these two diseases may co-exist and possibly lead to comorbidities. We therefore investigated the mechanisms involved in comorbidity of Ascaris suum (A. suum) infection, which could interfere with the progression of pulmonary fibrosis. In addition, we evaluated whether a previous lung fibrosis could interfere with the pulmonary cycle of A. suum in mice. The most important findings related to comorbidity in which A. suum infection exacerbated pulmonary and liver injury, inflammation and dysfunction, but did not promote excessive fibrosis in mice during the investigated comorbidity period. Interestingly, we found that pulmonary fibrosis did not alter the parasite cycle that transmigrated preferentially through preserved but not fibrotic areas of the lungs. Collectively, our results demonstrate that A. suum infection leads to comorbidity, and contributes to the aggravation of pulmonary dysfunction during pulmonary fibrosis, which also leads to significant liver injury and inflammation, without changing the A. suum cycle in the lungs.
Assuntos
Ascaríase/complicações , Ascaríase/patologia , Hepatopatias/patologia , Fibrose Pulmonar/complicações , Fibrose Pulmonar/patologia , Animais , Ascaris suum/isolamento & purificação , Modelos Animais de Doenças , Feminino , Inflamação/patologia , Pulmão/parasitologia , Pulmão/patologia , Camundongos Endogâmicos C57BLRESUMO
OBJECTIVES: Little research exists documenting levels of intestinal inflammation among indigenous populations where exposure to macroparasites, like soil-transmitted helminths (STHs), is common. Reduced STH exposure is hypothesized to contribute to increased prevalence of elevated intestinal inflammation in wealthy nations, likely due to coevolutionary histories between STHs and human immune systems that favored anti-inflammatory pathways. Here, we document levels of intestinal inflammation and test associations with STH infection among the Shuar of Ecuador, an indigenous population undergoing socioeconomic/lifestyle changes that influence their hygienic environment. We predict that fecal calprotectin (FC; a measure of intestinal inflammation) will be lower in STH infected individuals and that FC will be negatively associated with infection intensity. METHODS: Stool samples to analyze FC levels and STH infection were collected from 69 Shuar participants (ages 5-75 years). Children (<15 years) and adults (15+ years) were analyzed separately to understand the role of exposure in immune system development and the intestinal inflammatory response. RESULTS: Two species of STH were present: Ascaris lumbricoides and Trichuris trichiura. The relationships between infection and intestinal inflammation were age- and species-specific. While no significant relationships were found among adults, children who were singly infected with T. trichiura had lower FC levels than uninfected children. Infection intensity was not significantly associated with FC in children or adults. CONCLUSIONS: These preliminary results provide limited support for our hypotheses, documenting tentative age- and species-specific associations between FC and infection status. Findings may point to the importance of species-specific STH exposure during immune system development.
Assuntos
Helmintíase/complicações , Helmintíase/epidemiologia , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/epidemiologia , Adolescente , Adulto , Idoso , Ascaríase/complicações , Ascaríase/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Equador , Fezes/química , Fezes/parasitologia , Feminino , Humanos , Complexo Antígeno L1 Leucocitário/análise , Masculino , Pessoa de Meia-Idade , Tricuríase/complicações , Tricuríase/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Soil-transmitted helminth infections have been found to be associated with child development. The objective was to investigate hemoglobin levels and malnutrition as mediators of the association between Ascaris infection and intelligence quotient (IQ) scores in children. METHODS: We conducted a longitudinal cohort study in Iquitos, Peru, between September 2011 and July 2016. A total of 1760 children were recruited at 1 year of age and followed up annually to 5 years. We measured Ascaris infection and malnutrition at each study visit, and hemoglobin levels were measured as of age 3. The exposure was defined as the number of detected Ascaris infections between age 1 and 5. We measured IQ scores at age 5 and used Bayesian models to correct exposure misclassification. RESULTS: We included a sample of 781 children in the analysis. In results adjusted for Ascaris misclassification, mean hemoglobin levels mediated the association between Ascaris infection and IQ scores. The natural direct effects (not mediated by hemoglobin) (95% CrI) and natural indirect effects (mediated by hemoglobin) (95% CrI) were compared with no or one infection: -0.9 (-4.6, 2.8) and -4.3 (-6.9, -1.6) for the effect of two infections; -1.4 (-3.8, 1.0) and -1.2 (-2.0, -0.4) for three infections; and -0.4 (-3.2, 2.4) and -2.7 (-4.3, -1.0) for four or five infections. CONCLUSION: Our results are consistent with the hypothesis that hemoglobin levels mediate the association between Ascaris infection and IQ scores. Additional research investigating the effect of including iron supplements in STH control programs is warranted.
Assuntos
Anemia Ferropriva/psicologia , Ascaríase/psicologia , Hemoglobinas/metabolismo , Inteligência , Desnutrição/psicologia , Anemia Ferropriva/sangue , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/parasitologia , Ascaríase/complicações , Ascaríase/diagnóstico , Teorema de Bayes , Viés , Biomarcadores/sangue , Pré-Escolar , Modificador do Efeito Epidemiológico , Feminino , Humanos , Lactente , Testes de Inteligência , Modelos Lineares , Estudos Longitudinais , Masculino , Desnutrição/diagnóstico , Desnutrição/etiologia , PeruAssuntos
Ascaríase/complicações , Enteropatias Parasitárias/etnologia , Intestinos/parasitologia , Obesidade/etnologia , Obesidade/parasitologia , Adolescente , Animais , Ascaríase/epidemiologia , Ascaris lumbricoides/isolamento & purificação , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Enteropatias Parasitárias/complicações , Modelos Lineares , Masculino , México/epidemiologia , Prevalência , Adulto JovemRESUMO
Abstract INTRODUCTION: Immunological control of Mycobacterium tuberculosis infection is dependent on the cellular immune response, mediated predominantly by Th1 type CD4+ T cells. Polarization of the immune response to Th2 can inhibit the host immune protection against pathogens. Patients with tuberculosis coinfected with helminths demonstrate more severe pulmonary symptoms, a deficiency in the immune response against tuberculosis, and an impaired response to anti-tuberculosis therapy. METHODS: We evaluated the cellular immune response and the impact of the presence of Ascaris lumbricoides on the immune and clinical response in pulmonary tuberculosis patients. Ninety-one individuals were included in the study: 38 tuberculosis patients, 11 tuberculosis patients coinfected with Ascaris lumbricoides and other helminths, 10 Ascaris lumbricoides patients, and 34 non-infected control individuals. Clinical evolution of pulmonary tuberculosis was studied on 0, 30, 60, and 90 days post-diagnosis of Mycobacterium tuberculosis and Ascaris lumbricoides. Furthermore, immune cells and plasma cytokine profiles were examined in mono/coinfection by Mycobacterium tuberculosis and Ascaris lumbricoides using flow cytometry. RESULTS: There were no statistical differences in any of the evaluated parameters and the results indicated that Ascaris lumbricoides infection does not lead to significant clinical repercussions in the presentation and evolution of pulmonary tuberculosis. CONCLUSIONS: The association with Ascaris lumbricoides did not influence the Th1, Th2, and Th17 type responses, or the proportions of T lymphocyte subpopulations. However, higher serum levels of IL-6 in tuberculosis patients may explain the pulmonary parenchymal damage.
Assuntos
Humanos , Animais , Masculino , Feminino , Adulto , Adulto Jovem , Ascaríase/imunologia , Tuberculose Pulmonar/imunologia , Interleucina-6/sangue , Ascaris lumbricoides , Ascaríase/complicações , Fatores de Tempo , Tuberculose Pulmonar/complicações , Anticorpos Anti-Helmínticos/sangue , Estudos de Casos e Controles , Citocinas/imunologia , Citocinas/sangue , Interleucina-6/imunologia , Progressão da Doença , Coinfecção , Citometria de Fluxo , Pessoa de Meia-IdadeRESUMO
The prevalence and intensity of soil-transmitted helminth (STH) infections in schoolchildren from Corn Islands (Nicaragua) were examined to detect mono- or poly-STH infected children, measuring different intensity levels, and to elucidate measurably increased odds of being anemic. A total of 341 stool samples provided by 2- to 15-year-old children were examined using a concentration technique and a Kato-Katz slide. Intensity of infection was expressed as eggs per gram (epg) of feces to classify light, moderate, or heavy intensity infection. A finger-prick blood sample was obtained from each student in the field. Soil-transmitted helminth prevalence was 54.3%, with Trichuris trichiura as the most prevalent species (48.9%). The combination T. trichiura/Ascaris lumbricoides (12.6%) was the most common. When T. trichiura or A. lumbricoides appeared as a single infection, light or moderate intensity infections were seen, whereas when multiple species were identified, heavy infections were present. Anemia was detected in those with any kind of STH infection (42.7%), with statistically significant differences (P = 0.004) when compared with uninfected individuals (28.2%). Polyparasite infection with one parasite species at moderate intensity and the other parasite species at light intensity or absent was found to be a significant factor for the odds of being anemic (odds ratio = 2.07). The present study reveals a high level of STH transmission requiring a deworming control program in Corn Islands and pointing to the need of improving the education and sanitary conditions of the population to avoid environmental contamination and reinfection.
Assuntos
Anemia/epidemiologia , Ascaríase/epidemiologia , Ascaris lumbricoides/isolamento & purificação , Tricuríase/epidemiologia , Trichuris/isolamento & purificação , Adolescente , Anemia/complicações , Anemia/parasitologia , Animais , Ascaríase/complicações , Ascaríase/parasitologia , Ascaríase/transmissão , Ascaris lumbricoides/classificação , Criança , Pré-Escolar , Coinfecção , Fezes/parasitologia , Feminino , Humanos , Ilhas/epidemiologia , Masculino , Nicarágua/epidemiologia , Contagem de Ovos de Parasitas , Prevalência , Instituições Acadêmicas , Solo/parasitologia , Tricuríase/complicações , Tricuríase/parasitologia , Tricuríase/transmissão , Trichuris/classificaçãoRESUMO
Several studies, in different populations and environments, have shown that severe and light helminthiases diminish and increase allergy symptoms, respectively. However, data on the simultaneous presence of these contrary effects in a single community is lacking. In a rural community from Colombia, effects of helminthiases on allergy were evaluated. In the study population, age and gender-adjusted prevalence of asthma and rhinitis symptoms in the last year was 14.6% and 34.1%, respectively (N = 739). By stool exam, ascariasis and trichuriasis were 62.5% and 35.7%, respectively. Significant odds ratio (OR) for asthma presentation were Ascaris sensitization, by specific-IgE (aOR: 2.69, 95%CI: 1.21-5.98) or skin prick test (OR: 3.59, 95%CI: 1.55-8.29). Moderate/severe ascariasis was protective from asthma (aOR: 0.34, 95%CI: 0.12-0.99) and moderate/severe trichuriasis from rhinitis (aOR: 0.35, 95%CI: 0.15-0.80). In conclusion, in a rural tropical village, ascariasis exerts risk and protective effects on asthma symptoms, an influence associated with the severity of the infection.
Assuntos
Ascaríase/complicações , Ascaríase/epidemiologia , Asma/epidemiologia , Asma/etiologia , Rinite/epidemiologia , Rinite/etiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Colômbia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Adulto JovemRESUMO
Host-parasite interactions in diabetic patients might influence diabetes complications and intestinal parasitosis. The aim was to investigate the occurrence of enteroparasites in individuals with diabetes types 1 and 2. A descriptive study was designed to estimate frequencies of parasites and to compare them in individuals with diabetes types 1 and 2 from two Health Centers and one hospital in the Federal District of Brazil. Patients were allocated to the study by convenience. Three fecal samples of 156 diabetic individuals (120 type 1 and 36 type 2) were analyzed using two parasitological methods. Enteroparasites or commensals frequency in diabetics was 64%. Diabetics infected with up to six species of intestinal parasites or commensals were found. Frequencies of Ascaris lumbricoides and Giardia lamblia were higher in individuals with type 2 diabetes. The lower frequency of A. lumbricoides found in type 1 diabetes may be related to a strong Th2 response to parasites. Autoimmune response developed in type 1 diabetic individuals characterized by the production of Th1 cytokines could explain low frequency of G. lamblia. High frequency of parasites found in type 2 diabetes emphasizes the importance of periodic parasitological examinations in these individuals.
Assuntos
Ascaríase/epidemiologia , Ascaris lumbricoides/isolamento & purificação , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Giardia lamblia/isolamento & purificação , Giardíase/epidemiologia , Interações Hospedeiro-Parasita/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Ascaríase/complicações , Ascaris lumbricoides/imunologia , Brasil/epidemiologia , Criança , Pré-Escolar , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/imunologia , Diabetes Mellitus Tipo 1/parasitologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/imunologia , Diabetes Mellitus Tipo 2/parasitologia , Feminino , Giardia lamblia/imunologia , Giardíase/complicações , Interações Hospedeiro-Parasita/imunologia , Humanos , Lactente , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/imunologia , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto JovemRESUMO
Introducción: El Eritema nudoso es una paniculitis, de relativa frecuencia, que se expresa como manifestación de trastornos internos de gran envergadura, como las enfermedades del tejido conectivo, las enfermedades infecciosas y el cáncer. Es por ello, que los pacientes que lo presenten, deben ser estudiados cuidadosamente en busca de la causa. Objetivo: Presentar un caso clínico de Eritema nudoso resaltando el diagnóstico de la causa parasitaria y su tratamiento. Presentación de Caso: Se muestra el caso de una paciente femenina de 29 años, de raza blanca, residente en un municipio rural (Jatibonico), profesora de escuela primaria, sin antecedentes patológicos, quien acude a consulta por eritema elevado muy doloroso en la superficie anterior de ambos miembros inferiores, malestar general y artralgias. Se le diagnosticó clínicamente un eritema nudoso, y durante varios meses se realizaron complementarios para establecer la posible causa; se encontró solo un parasitismo intestinal por Ascaris lumbricoides. Recibió tratamiento médico con antiparasitarios, y desapareció el eritema. Conclusiones: El diagnóstico clínico certero, más la búsqueda constante de la causa del eritema nudoso y el tratamiento del parasitismo encontrado, llevaron a la solución del problema de la paciente. El eritema nudoso siempre debe ser estudiado por la posibilidad de ser un síndrome reactivo a procesos grave(AU)
Introduction: Nudose erythema is a panniculitis, of relative frequency, that it is expressed like a manifestation of internal disorders of great significance, like the illnesses of the connective tissue, the infectious diseases and the cancer. So the patients that show it, must be studied carefully in search of the cause. Objective: To Present a nudose erythema clinic case highlighting the diagnose of parasitical cause. Cases presentation: Is show the case of a white female patient, 29 years old, resident at rural municipality (Jatibonico), elementary school teacher, without pathological past health history, that assist at the consult for nodular due to a high very painful erythema on the anticus surface of both inferior members, general discomfort and arthralgia. Was clinically diagnosed a nudose erythema, and during several months were performed complementary to establish the possible cause, finding only an intestinal parasitism for Ascaris lumbricoides. He received medical treatment with antiparasitcs, disappearing the erythema. Conclusions: The accurate diagnostic, furthermore, a constantly cause searching of the cause of the nudose erythema plus the treatment of parasitism found, solve the patients problem. Nudose erythema always must be studied due to the possibility to be a reactive syndrome of seriously ill process(AU)
Assuntos
Humanos , Feminino , Adulto , Ascaríase/complicações , Ascaríase/tratamento farmacológico , Ascaris lumbricoides , Eritema Nodoso/diagnóstico , Eritema Nodoso/parasitologiaRESUMO
Ascaris lumbricoides is considered the largest intestinal nematode with a higher incidence in the childhood, representing a truly medical and public health problem, principally in undeveloped countries. We present the case of an 83 year old man, born and coming from the amazon region, without any relevant previous history of disease, admitted in the emergency department of our hospital for presenting intestinal obstruction and also presumptive biliary obstruction due to multiple balls of parasites, requiring immediate surgical intervention. We emphasize the need of consider this etiologic possibility in the differential diagnosis, that in this particular case, wasn't suspected in the first place.
Ascaris lumbricoides es considerado el nemátodo intestinal de mayor tamaño. Se presenta con mayor frecuencia en la infancia, representando un verdadero problema médico y de salud pública, especialmente en países en vías de desarrollo. Presentamos el caso de un varón de 83 años, natural y procedente de la región amazónica del Perú, sin antecedentes médicos de relevancia, que ingresa a Servicio de urgencias de nuestro hospital por un cuadro de obstrucción intestinal y presunta obstrucción biliar, requiriendo una intervención quirúrgica inmediata. El diagnóstico final de obstrucción intestinal por la presencia de múltiples ovillos de Ascaris lumbricoides, no fue considerado dentro de los diagnósticos diferenciales previo al acto quirúrgico.
Assuntos
Humanos , Animais , Masculino , Idoso de 80 Anos ou mais , Ascaríase/complicações , Ascaris lumbricoides/isolamento & purificação , Enteropatias Parasitárias/parasitologia , Obstrução Intestinal/parasitologia , Enteropatias Parasitárias/complicações , Obstrução Intestinal/cirurgiaRESUMO
La ascariasis es una infección parasitaria causada por un helminto de distribución global, con más de 1.4 billones de personas infectadas en el mundo. La mayoría de estas infecciones ocurren en países en vías de desarrollo de América latina y Asia. El helminto usualmente se aloja en el intestino delgado en forma silente pero puede causar obstrucción intestinal o peritonitis perforativa, siendo más común en la niñez. A su vez, puede migrar a través de la ampolla de Vater y producir pancreatitis, colecistitis, colangitis y, en forma menos frecuente, absceso hepático. El objetivo de nuestra comunicación es notificar un caso de pancreatitis aguda secundaria a Ascaris lumbricoides, siendo ésta una complicación infrecuente pero grave de una enfermedad endémica como la ascariasis.
Ascariasis is a helminthic infection of global distribution with more than 1.4 billion persons infected throughout the world. The majority of infections occur in the developing countries of Latin America and Asia. This helminth usually lives harmlessly in small intestine but can also cause intestinal obstruction or perforation peritonitis that is common in childhood. Ascaris can also migrate through ampulla of Vater to produce pancreatitis, cholecystitis, cholangitis and, rarely, hepatic abscess. The main goal of this article is to present a case of an acute pancreatitis due to Ascaris lumbricoides, an uncommon but severe complication of an endemic disease such as ascariasis.