İnsan toksokariyazı

İnsan toksokariyazı, köpek nematodu Toxocara canis ve kedi nematodu T.cati larvalarının sindirim yoluylaalınmasıyla oluşan parazitik bir enfeksiyondur. Enfekteköpek ve kedilerin dışkılarıyla dış ortama atılan Toxocarayumurtaları içinde embriyon gelişerek enfektif halegelirler. İnsanlar, özellikle çocuklar, embriyonlu Toxocarayumurtalarını sindirim yoluyla alarak enfekte olabilirler.İnce bağırsakta yumurtadan çıkan larvalar, ince bağırsakduvarına penetre olup kan dolaşımına geçerek vücudundiğer bölgelerine göç eder. Göç eden larvalar, dokuve organlara zarar verebilmesine ve özellikle beyintutulumunda ciddi morbidite oluşturabilmesine rağmenhastalık genellikle iyi huylu, asemptomatik ve kendinisınırlayan bir seyir izlemektedir. Visseral larva migrans(VLM) (önemli organlara larval migrasyonun neden olduğusistemik bir hastalık) ve oküler larva migrans (OLM) (gözve optik sinirlerde sınırlı bir hastalık), toksokariyazıniki temel klinik sudur. Ayrıca son zamanlarda biriçoğunlukla çocuklarda (gizli toksokariyaz), diğeri dahaçok yetişkinlerde (yaygın toksokariyaz) görülen dahahafif klinik seyirli iki sendrom daha tanımlanmıştır. Tanı,genellikle klinik belirti / bulgular, hastanın epidemiyolojiktemeli ve immünolojik yöntemlerin (ELISA veya Western-konması, larvaların biyopsi veya otopside gösterilmesinigerektirdiğinden oldukça güçtür. Çoğu toksokariyaz olgusu,herhangi bir tedavi gerektirmeden iyileşir. VLM, birincilolarak albendazol veya mebendazol gibi antihelmintikilaçlarla tedavi edilmektedir. OLM tedavisi ise daha zordurve genellikle steroidler gibi gözde ilerleyici hasar oluşumunuönleyen işlemleri kapsamaktadır. Ayrıca şiddetli olgularıntedavisinde lazer fotokoagülasyon ve kriyoretinopeksikullanılabilmektedir. T.canis enfeksiyonunun eradikasyonu,parazitin yaşam döngüsünün karmaşıklığı sebebiyle zorolduğu için her zaman toksokariyazdan korunma tercihedilir. Toxocara yumurtaları, dış ortamda uygun koşullaraltında aylarca, hatta yıllarca hayatta kalmasını sağlayangüçlü bir koruyucu tabakaya sahiptir. Bu derlemede,halen önemini koruyan ve romatolojik, dermatolojik verespiratuvar hastalıklara neden olduğundan şüphelenileninsan toksokariyazı hakkında güncel bilgiler sunulmuştur.

Human Toxocariasis

Human toxocariasis is an parasitic infection caused by the ingestion of larvae of dog nematode Toxocara canis and less frequently of cat nematode T.cati. Toxocara eggs, shed to environment by infected dogs’ and cats’ droppings, become infective by embryonation. Humans, particularly children, can be infected by accidentally ingesting embryonated Toxocara eggs. Larvae hatch in the small intestine, penetrate the intestinal wall and migrate to other parts of body via the bloodstream. It is generally a benign, asymptomatic, and self-limiting disease, although migrating larvae can cause damage to tissues and organs, especially brain involvement can cause severe morbidity. The two main clinical presentations of toxocariasis are visceral larva migrans (VLM) (a systemic disease caused by larval migration through major organs) and ocular larva migrans (OLM) (a disease limited to the eyes and optic nerves). There are also two less-severe syndromes which have recently been described, one mainly in children (covert toxocariasis) and the other mainly in adults (common toxocariasis). Diagnosis is usually made by clinical signs/symptoms, epidemiological background of the patient and the use of immunological methods (ELISA or western-blot). On the other hand definitive diagnosis is much more challenging, since it requires the demonstration of larvae via biopsy or autopsy. Most cases of toxocariasis clear up without any treatment. VLM is primarily treated with antihelmintic drugs, such as; albendazole or mebendazole. Treatment of OLM is more difficult and usually consists of measures to prevent progressive damage to the eye like steroids. Laser photocoagulation and cryoretinopexy may also be used to treat severe cases. Since eradicating T.canis infection is difficult due to the complexity of its life cycle, prevention of toxocariasis is always preferred. Toxocara eggs have a strong protective layer which makes the eggs able to survive in the environment for months or even years under the right conditions. In this review, current information about human toxocariasis, a continuing and important problem suspected to cause rheumatologic, dermatologic and respiratory system diseases, is presented. blot) kullanımı ile konmaktadır. Öte yandan kesin tanının

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