Nadir bir olgu olarak küçük bir çocukta hymenolepis diminuta enfeksiyonu
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Dosyalar
Tarih
2015
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Cilt Başlığı
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnsandan insana direkt olarak bulaşan Hymenolepis nananın aksine, Hymenolepis diminutanın insanlara bulaşı, ara konak olan ve sistiserkoid larvaları taşıyan artropodların yanlışlıkla ağız yoluyla alınması ile olur. Bu sestod, hijyenik koşulların kötü olduğu bölgelerde, özellikle çocukluk döneminde nadir görülen enfeksiyonlara neden olmaktadır. Yapılan çalışmalarda, farklı popülasyonlardaki H.diminuta prevalans oranlarının %0.001 ile %5.5 arasında değiştiği; olguların çoğunun çocuk olmasına rağmen, hastalığın tüm yaş gruplarında görülebildiği bildirilmektedir. Bu raporda H.diminuta enfeksiyonu saptanan bir çocuk olgu sunulmaktadır. Yirmi bir aylık erkek hasta, bir haftadır süren, günde 3-4 defa kusma ve çamur şeklinde ishal şikayetleriyle pediatri polikliniğine başvurmuştur. Alınan anamneze göre, hastanın ahırın üstünde bulunan bir evde yaşadığı ve böcek yeme öyküsü olduğu öğrenilmiş, laboratuvar incelemesinde demir eksikliği anemisi olduğu saptanmıştır. Dışkı örneğinin makroskobik görünümü camcı macunu kıvamında açık renkli olup, lugol eriyiği ile yapılan direkt mikroskobik incelemede 70-75 ?m çapında, kalın kabuklu, altı adet polar çıkıntısı olan H.diminuta yumurtaları tanımlanmıştır. Hastaya ilk gün 500 mg ve takip eden beş gün 250 mg olmak üzere toplam altı gün oral niklozamid tedavisi ve ayrıca demir eksikliği anemisi tedavisi başlanmıştır. On beş gün sonra oral niklozamid tedavisinin tekrarı önerilmiştir. İkinci tedavinin tamamlanmasından bir ay sonra yapılan parazitolojik incelemede H.diminuta yumurtasına rastlanmamıştır. Sunulan bu olgu ile, nadir bir parazitoz olan H.diminuta enfeksiyonunun tanısında, hastanın öyküsü ve mikroskobik değerlendirmenin önemine dikkat çekilmesi amaçlanmıştır.
Unlike Hymenolepis nana that transmits directly from person to person, the transmission of Hymenolepis diminuta to human is via accidentally ingesting of arthropods carrying cysticercoid larvae as intermediate host. In places with poor hygienic conditions, this cestod may cause seldom infections especially in children. Studies carried out on various populations have reported the prevalence rate of H.diminuta between 0.001% and 5.5%. Although the reported cases are mostly children, the disease can be seen in every age group. In this report, a pediatric case of H.diminuta infection is presented. A twenty one-month-old male patient with the symptoms of vomiting 3-4 times a day along with mud- like diarrhea continuing for a week was admitted to the pediatric outpatient clinic. According to the history, it was learned that the house where he lived was above a barn and there was a history of insect swallowing. Laboratory findings revealed iron-deficiency anemia. The macroscopic appearance of the stool was in a pale clay-like form, and by direct microscopic examination with lugol solution, 70-75 μm in diameter, thick-shelled and six central hookleted eggs that are characteristic for H.diminuta were identified. A six-day course of oral niclosamide was administered to the patient beginning with 500 mg on the first day and 250 mg on the following five days, together with the treatment for the iron defi- ciency anemia. After fifteen days, the oral niclosamide treatment was repeated. No H.diminuta eggs were detected in the parasitological examination performed one month after completion of the second round of treatment. This case has been presented to call attention to the importance of patient anamnesis and microscopic examination in the diagnosis of H.diminuta infection which is a rarely seen parasitosis.
Unlike Hymenolepis nana that transmits directly from person to person, the transmission of Hymenolepis diminuta to human is via accidentally ingesting of arthropods carrying cysticercoid larvae as intermediate host. In places with poor hygienic conditions, this cestod may cause seldom infections especially in children. Studies carried out on various populations have reported the prevalence rate of H.diminuta between 0.001% and 5.5%. Although the reported cases are mostly children, the disease can be seen in every age group. In this report, a pediatric case of H.diminuta infection is presented. A twenty one-month-old male patient with the symptoms of vomiting 3-4 times a day along with mud- like diarrhea continuing for a week was admitted to the pediatric outpatient clinic. According to the history, it was learned that the house where he lived was above a barn and there was a history of insect swallowing. Laboratory findings revealed iron-deficiency anemia. The macroscopic appearance of the stool was in a pale clay-like form, and by direct microscopic examination with lugol solution, 70-75 μm in diameter, thick-shelled and six central hookleted eggs that are characteristic for H.diminuta were identified. A six-day course of oral niclosamide was administered to the patient beginning with 500 mg on the first day and 250 mg on the following five days, together with the treatment for the iron defi- ciency anemia. After fifteen days, the oral niclosamide treatment was repeated. No H.diminuta eggs were detected in the parasitological examination performed one month after completion of the second round of treatment. This case has been presented to call attention to the importance of patient anamnesis and microscopic examination in the diagnosis of H.diminuta infection which is a rarely seen parasitosis.
Açıklama
Anahtar Kelimeler
Mikrobiyoloji
Kaynak
Mikrobiyoloji Bülteni
WoS Q Değeri
Scopus Q Değeri
Cilt
49
Sayı
1
