[Report of cases of human fascioliosis in the Specialized Children's Health Institute, Lima, Peru (1988'-2003)].
Human fascioliosis is one of the most important parasitic diseases in Peru, due to the high prevalence rates reported in the last few years, mainly in the Andean Trapeze. The most affected group is that of children and the clinical manifestations of the disease can be very varied. In this study we reported seven cases of human fascioliosis diagnosed in the Specialized Children's Health Institute (IESN) Lima, Peru, between 1988 and 2003. From 168 medical histories checked with the final diagnosis of parasitosis, 7 children (2 boys and 5 girls), between 2 and 14 years (average +/- DS: 8.52 +/- 1.43) were diagnosed with fascioliosis by a parasitic and/or serological examinations. Six of the seven cases came from cattle raising areas such as: Cajamarca, Ancash, Huancavelica and Junín. The most frequent clinical signs were prolonged fever (up to 42 days), hepatomegaly, moderate abdominal pain (right hypochondriac region and epigastrium), eosinophils count (between 132 and 8321/mm > or =), anemia (hematocrit up to 15%), jaundice and hypergammaglobulinemia. In some cases the diagnosis was difficult to reach with a delay between 1 and 24 weeks. It should be pointed out that one of these patients had hepatic cirrhosis diagnosed by anatomopathological investigations. Finally, we propose that in pediatric patients coming from endemic areas of animal fasciolosis who have prolonged fever, abdominal pain and hepatomegaly, should be considered suspicious and the infection of eliminated, to avoid hepatic damage caused by this parasite. We conclude that human fascioliosis must not be under-estimated as a secondary parasitic disease in patients coming from endemic areas in Peru.
Marcos
Luis A
LA
Instituto de Medicina Tropical Alexander von Humboldt, Lima, Peru.
Maco
Vicente
V
Castillo
Maria
M
Terashima
Angélica
A
Zerpa
Rito
R
Gotuzzo
Eduardo
E
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D002417:Cattle; D002418:Cattle Diseases / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D004197:Disease Reservoirs; D019353:Endemic Diseases; D004802:Eosinophilia / Q000209:etiology; D005211:Fascioliasis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission / Q000662:veterinary; D005260:Female; D005334:Fever / Q000209:etiology; D006529:Hepatomegaly / Q000209:etiology; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology; D008297:Male; D010568:Peru / Q000453:epidemiology; D012189:Retrospective Studies; D012424:Rural Population
D000871:Anthelmintics