Do not forget the stool examination!-cutaneous and gastrointestinal manifestations of Blastocystis sp infection
Do not forget the stool examination!-cutaneous and gastrointestinal manifestations of Blastocystis sp infection
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DOI：
10.1007/s00436-014-3805-0
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发表时间：
2014-04-01
影响因子：
2
通讯作者：
Molnar, Tamas
中科院分区：
文献类型：
--
作者：
Balint, Anita;Doczi, Ilona;Molnar, Tamas
芽囊原虫是人体肠道最常见的寄生虫之一。这种感染通常伴有腹泻和腹痛，但肠外症状，如皮肤病变，也可能伴随着这种疾病。在这项研究中，我们的目的是评估频率，临床症状和皮肤表现证实阳性芽囊原虫感染。对80例确诊为芽囊原虫感染的患者的资料进行回顾性分析。患者的平均年龄为46.3岁（年龄范围为13 - 85岁）。女性患者数量高于男性患者数量（48 vs. 32; 60 vs. 40%）。收集并分析入组患者的胃肠道和皮肤病症状以及常规生化和血液学检查结果。使用可用数据（包括描述、照片和组织学）分析皮肤表现。我们发现11.25%的入选患者表现出与芽囊原虫属相关的皮肤表现，主要是女性。在2005年至2013年期间需要就医的症状性患者中，芽囊原虫的发生率为6%。80例患者中，73. 75%表示有胃肠道症状：40例患者主诉腹痛，17例患者主诉便血，而其他症状，如腹胀（15例受试者），体重减轻（8名受试者），肛周疼痛或瘙痒（6例受试者）、排便带粘液（5例受试者）、呕吐（2例受试者）和发热（2例受试者）的频率较低。无皮肤病变队列中腹痛的患病率高于有皮肤问题的患者（p = 0.007）。C-反应蛋白的平均值显示水平升高，但嗜酸性粒细胞在正常范围内。此外，我们没有发现有与无皮肤表现的患者之间的嗜酸性粒细胞增多症的显著差异。因此，我们认为嗜酸性粒细胞增多症是不是一个强制性的实验室发现原生动物感染，如芽囊原虫。根据我们的研究结果，我们建议粪便寄生虫检查皮肤病变的起源不明的患者。
Blastocystis sp. is one of the most common parasites in the human intestinal tract. This infection commonly is accompanied by diarrhoea and abdominal pain, but extraintestinal symptoms, such as skin lesions, may also accompany the disease. In this study, our aim was to assess the frequency, clinical symptoms and skin manifestations of confirmed positive Blastocystis sp. infections. Data of 80 patients with confirmed positive Blastocystis sp. infections were assessed retrospectively. The average age of the patients was 46.3 years of age (with a range between 13 and 85 years of age). The number of female patients was higher than the number of males (48 vs. 32; 60 vs. 40 %). Gastrointestinal and dermatological symptoms and the results of routine biochemical and haematological blood tests of enrolled patients were collected and analyzed. The skin manifestations were analyzed using the data available (including descriptions, photos and histologies). We discovered that 11.25 % of our enrolled patients exhibited skin manifestations associated to Blastocystis sp., mainly on the females. The occurrence of Blastocystis sp. was 6 % in symptomatic patients who required medical attendance in the time period between 2005 and 2013. Of the 80 patients, 73.75 % indicated that they had gastrointestinal symptoms: 40 patients complained of abdominal pain and 17 with blood in their stool, while other symptoms, such as meteorism (15 subjects), weigh loss (8 subjects), perianal pain or itching (6 subjects), passing stool with mucus (5 subjects), vomiting (2 subjects) and fever (2 subjects) were less frequent. The prevalence of abdominal pain in the cohort without skin lesions was higher compared to those patients with skin problems (p = 0.007). The mean value of C-reactive protein showed elevated levels, but eosinophils were within a normal range. In addition, we did not find significant difference in eosinophilia between patients with vs. without skin manifestations. Thus, we suggest that eosinophilia is not an obligatory laboratory finding in protozoon infections, such as Blastocystis sp. In the light of our results, we suggest a stool parasite examination for patients with skin lesions of unknown origin.