Kütanöz Larva Migrans: Batı Karadeniz Bölgesinden Üç Olgu Sunumu
Küçük Resim Yok
Tarih
2016
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Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Kütanöz larva migrans (KLM), sıklıkla tropikal ve subtropikal bölgelere seyahat eden ve toprakla temas öyküsü olan kişilerde görülen bir parazitoz olarak bilinmektedir. Kancalı kurt larvaları deriyi delerek vücuda girdikten sonra, epidermiste tüneller oluşturarak ilerlemekte ve kaşıntılı, eritematöz, serpijinöz lezyonlar meydana getirmektedir. Sıklıkla Ancylostoma braziliensis ve Ancylostoma caninum türlerine bağlı olarak gelişmektedir. İkincil bakteriyel enfeksiyonların da eklenebildiği lezyonlar özellikle ayak ve kalçada görülmektedir. Bu raporda ülkemizden daha önce bildirimine rastlamadığımız ve atipik yerleşimli üç olgu sunulmaktadır. Elli dört yaşında erkek hasta olan birinci olgu, Ağustos ayında gövde ön yüzünde bir haftadır olan kızarıklık ve kaşıntı şikayetiyle başvurmuştur. Karın sağ yanında bulunan, kaşıntılı, kavisli şekilde, deriden kabarık, eritemli, ip benzeri lezyonlarının küçük bir bölümünde sivilceleşme izlenmiştir. Kültüründe Streptococcus pyogenes üremesi de olan hastada eozinofi li saptanmamıştır. Hastaya mevcut klinikle KLM ile birlikte ikincil bakteriyel enfeksiyon tanısı konularak, amoksisilin-klavulanik asit 1 gr, mupirosin krem ve albendazol 400 mg/gün olmak üzere üç gün tedavi uygulanmıştır. Kontrolünde lezyonların gerilediği görülmüştür. İkinci olgu olan 38 yaşındaki erkek hasta, Ağustos ayında gövdede kaşıntı ve kızarıklık şikayetiyle başvurmuştur. Gövdenin sol tarafına yerleşmiş, kaşıntılı, serpijinöz karakterde, deriden kabarık, ip benzeri lezyonları bulunan hastanın hemogram değerleri normaldir. Bakteriyolojik kültürlerinde üremesi olmayan hastaya klinik olarak KLM tanısı konularak albendazol 400 mg/gün ile üç gün tedavi uygulanmış ve lezyonların gerilediği gözlenmiştir. Üçüncü olgu, 23 yaşında erkek hasta olup Eylül ayında boynunda kaşıntı ve kızarıklık şikayetiyle başvurmuştur. Boyunda yay şeklinde kaşıntılı, eritemli bir lezyon tespit edilen hastanın bakteriyolojik kültürleri ve hemogramı normaldir. Klinik olarak KLM teşhisi konulan hastaya albendazol 400 mg/gün ile üç gün tedavi uygulanmış ve lezyonlar tamamen gerilemiştir. Her üç olguda da fındık bahçesinde motorlu tırpanla ot biçme öyküsü mevcuttur ve yurt dışına seyahat öyküsü bulunmamaktadır. Dolayısıyla KLM'nin, motorlu tırpanın oluşturduğu güçle yüzeyel toprak tabakasının havalanması ve topraktaki larvaların vücudun açık kısımlarından girmesiyle oluştuğu kanısına varılmıştır. Sonuç olarak, KLM etkeni kancalı kurt larvalarıyla ülkemizde de karşılaşılabileceğinin akılda tutulması ve bu parazitozun ülkemizdeki yaygınlığının saptanabilmesi için benzer olguların bildirilmesi gerektiği düşünülmüştür
Cutaneous larva migrans (CLM) is a parasitosis frequently seen in persons who have travelled to tropical or subtropical regions and in those who have worked in contact with soil. The disease frequently develops due to Ancylostoma braziliensis and Ancylostoma caninum species. After penetrating the skin and entering the body, the hookworm larva proceeds to bore tunnels through the epidermis, creating pruritic, erythematous, serpiginous lesions. Secondary bacterial infections of the lesions can often be seen, especially on the legs and buttocks. In this article we presented three atypical local cases which have not been declared previously in our country. The fi rst case, a 54-year-old male who was admitted to hospital in August with complaints of an obverse body rash and itching lasting for a week. Eruptions were observed over a small area on the right side of the abdomen, consisting of itchy, raised, erythematous, curvilinear string-like lesions. Moreover, no eosinophilia was detected in the patient, whose culture showed a growth of Streptococcus pyogenes. The patient was clinically diagnosed with CLM accompanied by secondary bacterial infection and treated for three days with 1 g of amoxicillinclavulanic acid, mupirocin cream and albendazole 400 mg/d. Under this regime, the lesions were seen to decline. The second case, a 38-year-old male was also admitted in August, complaining of itching and redness on his body. The patient, whose blood count values were normal, exhibited itchy, raised, serpiginous string-like lesions located on the left side of his body. The patient, whose bacterial culture was negative, was clinically diagnosed as CLM and treated for three days with albendazole 400 mg/d and the lesions were seen to improve. The third case, a 23-year old male was admitted in September complaining of itching and redness on his neck. An itchy, crescent-shaped erythematous lesion was detected on his neck; bacteriological cultures and blood count were normal. The common feature for all three cases was the story of working in a hazelnut orchard and mowing weeds using a motorized string trimmer (weed whacker). None of them had a history of travel outside the country. Therefore CLM assumed to be occurred due to the aeration of surface earth layer with the force of motorized string trimmer and entrance of the larvae were from the open parts of the body. In conclusion, it should be keep in mind that hookworm larva-related CLM can be encountered in our country, and reporting of the patients with similar fi ndings are necessary to determine the prevalence of this parasitosis in our country
Cutaneous larva migrans (CLM) is a parasitosis frequently seen in persons who have travelled to tropical or subtropical regions and in those who have worked in contact with soil. The disease frequently develops due to Ancylostoma braziliensis and Ancylostoma caninum species. After penetrating the skin and entering the body, the hookworm larva proceeds to bore tunnels through the epidermis, creating pruritic, erythematous, serpiginous lesions. Secondary bacterial infections of the lesions can often be seen, especially on the legs and buttocks. In this article we presented three atypical local cases which have not been declared previously in our country. The fi rst case, a 54-year-old male who was admitted to hospital in August with complaints of an obverse body rash and itching lasting for a week. Eruptions were observed over a small area on the right side of the abdomen, consisting of itchy, raised, erythematous, curvilinear string-like lesions. Moreover, no eosinophilia was detected in the patient, whose culture showed a growth of Streptococcus pyogenes. The patient was clinically diagnosed with CLM accompanied by secondary bacterial infection and treated for three days with 1 g of amoxicillinclavulanic acid, mupirocin cream and albendazole 400 mg/d. Under this regime, the lesions were seen to decline. The second case, a 38-year-old male was also admitted in August, complaining of itching and redness on his body. The patient, whose blood count values were normal, exhibited itchy, raised, serpiginous string-like lesions located on the left side of his body. The patient, whose bacterial culture was negative, was clinically diagnosed as CLM and treated for three days with albendazole 400 mg/d and the lesions were seen to improve. The third case, a 23-year old male was admitted in September complaining of itching and redness on his neck. An itchy, crescent-shaped erythematous lesion was detected on his neck; bacteriological cultures and blood count were normal. The common feature for all three cases was the story of working in a hazelnut orchard and mowing weeds using a motorized string trimmer (weed whacker). None of them had a history of travel outside the country. Therefore CLM assumed to be occurred due to the aeration of surface earth layer with the force of motorized string trimmer and entrance of the larvae were from the open parts of the body. In conclusion, it should be keep in mind that hookworm larva-related CLM can be encountered in our country, and reporting of the patients with similar fi ndings are necessary to determine the prevalence of this parasitosis in our country
Açıklama
Anahtar Kelimeler
Mikrobiyoloji
Kaynak
Mikrobiyoloji Bülteni
WoS Q Değeri
Scopus Q Değeri
Cilt
50
Sayı
1
