img
A familial outbreak of fascioliasis in Eastern Anatolia A report with review of literature     
Yazarlar
Prof. Dr. Mustafa Kasım KARAHOCAGİL Prof. Dr. Mustafa Kasım KARAHOCAGİL
Ahi Evran Üniversitesi, Türkiye
Hayrettin Akdeniz
Abant İzzet Baysal Üniversitesi, Türkiye
Mahmut Sünnetcioğlu
Prof. Dr. Muttalip ÇİÇEK Prof. Dr. Muttalip ÇİÇEK
Dicle Üniversitesi, Türkiye
Rafet Mete
Namık Kemal Üniversitesi, Türkiye
Nevzat Akman
Ebubekir Ceylan
Ankara Üniversitesi, Türkiye
Hasan Karsen
Harran Üniversitesi, Türkiye
Kubilay Yapıcı
Özet
Aim: To present the results of a cross-sectional epidemiological analysis of a familial outbreak of fascioliasis in Eastern Anatolia and to discuss the clinical, diagnostic and therapeutic properties of the patients. Materials and methods: A screening group consisting of 92 individuals from the same family with a history of watercress ingestion and a control group consisting of 30 individuals from neighboring families were included in the study. In both groups, full blood count, erythrocyte sedimentation rate, liver function tests and total IgE levels were assessed. Stool analysis was performed on three consecutive days with native, lugol and sedimentation methods. The diagnosis was based on the detection of parasite ova in the stool or alternatively based on consistent clinical, laboratory, and radiological findings or positive clinical findings in combination with a positive ELISA test. Abdominal ultrasonography and computerized tomography scans were performed on all patients. Results: 24 patients (21 women and 3 men) were diagnosed with fascioliasis. The mean age was 24.5 ± 18.6 years (range, 5-64 years). All cases had a history of watercress ingestion, malaise, fatigue, lack of appetite, and abdominal pain. Clinical features included: weight loss was present in 18 cases (75%), dyspepsia in 12 (50%), headache in 11 (45.8%), sweating in 10 (41.7%), fever and dyspnea each in 8 (33.3%), nausea and vomiting in 6 (25%), and itching in 4 (16.75). The most common laboratory abnormalities were total IgE elevation in 19 cases (79.2%) and eosinophilia in 17 (70.8%). The eosinophilia was >20% in 14 cases (58.3%) and the total IgE was >500. IU/ml in 15 cases (62.5%). Stool examination for ova was positive in 11 cases. 10 patients had positive clinical, laboratory and radiological findings. A further three patients were diagnosed based on their clinical findings and their ELISA results. All cases had positive ELISA results. All patients, except one pregnant woman, were treated with 10. mg/kg triclabendazole. Two patients required a second treatment course of triclabendazole 20. mg/kg in two divided doses due to persistence of ova in the stool. One patient who developed acute urticaria as a side effect of the drug was given three additional courses of 10. mg/kg triclabendazole in combination with prednisolone and antihistamines. The pregnant woman initially received four courses of 25. mg/kg praziquantel treatment for 1 week. As ova were still detected in her stool following delivery, she was subsequently treated with triclabendazole. Conclusions: One case of fascioliasis may indicate a familial outbreak. In the acute stage radiological investigations can assist in confirming the diagnosis. ELISA testing is a reliable and sensitive method for the diagnosis of fascioliasis during any stage of the disease and may also be useful during follow-up. © 2008 Elsevier B.V.
Anahtar Kelimeler
Familial outbreak | Fasciola hepatica | Fascioliasis | Triclabendazole treatment
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayımlanan tam makale
Dergi Adı Acta Tropica
Dergi ISSN 0001-706X
Dergi Tarandığı Indeksler SCI
Makale Dili İngilizce
Basım Tarihi 06-2011
Cilt No 118
Sayı 3
Sayfalar 177 / 183
Doi Numarası 10.1016/j.actatropica.2008.08.013
Makale Linki http://linkinghub.elsevier.com/retrieve/pii/S0001706X08002313
BM Sürdürülebilir Kalkınma Amaçları
Atıf Sayıları
SCOPUS 35
A familial outbreak of fascioliasis in Eastern Anatolia A report with review of literature

Paylaş