| Popis: |
Toxocariasis is usually transmitted by ingesting invasive eggs from the soil, howeverrecent reports indicate that the pathogen can also be transmitted by ingesting raw meatfrom infected chicken, rabbit or lamb. Also, the infection of infants through mother's milkand transplacental is very relevant now.Objective. The aim of the study was to determine the state of clinical and laboratoryparameters in the case of Toxocara canis invasion in infants, to optimize the principlesof diagnosis and prevention of toxocariasis in infants based on the study of the epidemiological, clinical and immunological characteristics of the course of the invasion,assessment of the severity of the general condition and natural resistance of the organism.Material and methods. 38 children (24 boys and 14 girls) aged from 6 to 12 monthswere examined. During clinical and laboratory examination of children, clinical andepidemiological, biochemical, serological, immunological research methods were used.ELISA samples with an antibody titer of 1:800 and higher were considered diagnosticallypositive. In addition to the history of life and illness, much attention was paid to theepidemiological, allergic and obstetric history.Results. To analyze the frequency and nature of clinical and laboratory manifestations,their correlation with the results of serological studies, all sick children were divided into3 groups. The first group consisted of 16 children with a seropositive reaction and a scoreof 28.94±1.2 (from 24.5 to 34). The second group included 17 children with a seronegativereaction and a score of 6.91±3.1 (from 2 to 11.5). The third group consisted of 5 childrenwith a seronegative reaction and a score of 19.5±1.4 (from 15.5 to 23). An analysis ofthe results obtained and a comparative assessment of the frequency of manifestation ofthe revealed disorders in each group made it possible to establish that such clinical andlaboratory indicators as hypergammaglobulinemia, hypoalbuminemia and leukocytosiswere significantly more often (5, 8 and more times) observed in children of group 1.Anemia and enlargement of the liver were equally common in all three groups. There wereno significant differences in the frequency of manifestations in children of groups 1 and 3of such clinical and laboratory parameters as recurrent fever, increased ESR, pulmonarysyndrome, radiological signs of lung damage, abdominal syndrome, neurologicaldisorders, lymphadenopathy, eosinophilia, which were significantly less common or werenot detected in group 2 children in general. As for eosinophils in the blood, at the samefrequency, more stable and high eosinophilia was observed in children with toxocariasis(from 20 to 42%) than with food allergies (11-20%). Similar results were obtained whenevaluating clinical and laboratory parameters in points (by Glikman). In all children withtoxocariasis and food allergy, the sum of clinical and laboratory parameters exceeded 12scores and significantly differed from the results of group 2. At the same time, the sum ofpoints in children of group 1 was 28.94±3.1 (from 24.5 to 34), and in children of group3 it was 19.5±2.3 (from 19.5 to 23). As for skin manifestations, they were more commonwith food allergies than with toxocariasis.Conclusions. In infants, invasion by toxocara larvae is possible. In addition to theusual routes of infection, there is the possibility of transplacental invasion from amother infected with toxocariasis. For the timely detection of toxocariasis, infants withhypergammaglobulinemia, hypoalbuminemia, leukocytosis with persistent eosinophiliaabove 20% and a score above 20 (according to Glikman) should be examined fortoxocariasis. To clarify the diagnosis and exclude toxocariasis in both the child andmother, it is necessary to conduct serological tests for toxocariasis. |
