| Yazarlar |
Mustafa Kasım KARAHOCAGİL
Ahi Evran Üniversitesi, Türkiye |
Hayrettin Akdeniz
Abant İzzet Baysal Üniversitesi, Türkiye |
|
Mahmut Sünnetcioğlu
|
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 |
| Atıf Sayıları | |
| SCOPUS | 35 |
| Google Scholar | 63 |
