Humana fascioloza u Srbiji lečena triklabendazolom

  • Milorad Pavlovć Clinic for Infectious and Tropical Diseases, University of Belgrade, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Zorica Dakić Parasitological Laboratory, Clinical Center of Serbia, Belgrade, Serbia
  • Branko Milošević Clinic for Infectious and Tropical Diseases, University of Belgrade, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Miloš Korać Clinic for Infectious and Tropical Diseases, University of Belgrade, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Branko Brmbolić Clinic for Infectious and Tropical Diseases, University of Belgrade, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Aleksandar Džamić Laboratory of Parasitology, Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
DOI: https://doi.org/10.2298/1765
Ključne reči: fasciola hepatica||, ||fasciola hepatica, liver diseases, parasitic||, ||jetra, parazitne bolesti, humans||, ||ljudi, diagnosis||, ||dijagnoza, anthelmintics||, ||antihelmintici, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Broj ljudi zaraženih parazitom Fasciola hepatica je u porastu širom sveta. Čovek postaje slučajan domaćin unošenjem infektivnih oblika, metacerkarija, kontaminiranom vodom ili biljkama. Prikaz bolesnika. U radu je prikazana 68-godišnja bolesnica iz Srbije, kod koje je nakon dijagnostičkog lutanja postavljena dijagnoza akutne fascioloze. Na osnovu kliničke slike (bol pod desnim rebarnim lukom, febrilnost, generalizovani bol), visoke eozinofilije i povišene aktivnosti alkalne fosfataze u serumu posumnjalo se  na akutnu fasciolozu. U fecesu i duodenalnom aspiratu nisu nađena jaja Fasciola hepatica. U nedostatku imunološke dijagnostike za fasciolozu u Srbiji, dijagnoza je postavljena na osnovu prisustva specifičnih antitela imunoenzimskim testom i potvrđena imunoblot metodom u Institutu za tropske bolesti u Hamburgu, Nemačka. Lečenje je sprovedeno primenom triklabendazola, posle čega su se simptomi povukli, a biohemijske vrednosti vratile u normalu. Zaključak. Humana fascioloza može biti teška za dijagnostiku naročito u neendemskim područjima, gde kliničari retko pomisle na nju i gde je duga lista bolesti koje treba isključiti u diferencijalnoj dijagnostici. Sindrom eozinofilije, febrilnost i bolovi ispod desnog rebarnog luka sugerišu akutnu fasciolozu. Nejasan izvor infekcije ne isključuje fasciolozu.

Biografije autora

Milorad Pavlovć, Clinic for Infectious and Tropical Diseases, University of Belgrade, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia

Department of Microbiology

Clinical Center of Serbia

Zorica Dakić, Parasitological Laboratory, Clinical Center of Serbia, Belgrade, Serbia
Laboratory of Parasitology
Branko Milošević, Clinic for Infectious and Tropical Diseases, University of Belgrade, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Intensive Care Unit
Miloš Korać, Clinic for Infectious and Tropical Diseases, University of Belgrade, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Department of Gastroenterology
Branko Brmbolić, Clinic for Infectious and Tropical Diseases, University of Belgrade, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Department oh Hepatology
Aleksandar Džamić, Laboratory of Parasitology, Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Laboratory of Parasitology

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Objavljeno
2015/04/21
Broj časopisa
Vol. 71 Br. 2 (2014)
Rubrika
Prikaz bolesnika