Zeynep Taş Cengiz

Human infection with Dicrocoelium dendriticum in Turkey.

Human dicrocoeliosis is reported sporadically in various parts of the world. We report a case in a 21-year-old male, who had right upper abdominal pain, weight loss, and chronic relapsing watery diarrhea three to four times daily for four weeks. The patient had abdominal tenderness to palpation in the right upper quadrant. Alkaline phosphatase, alanine aminotransferase, and serum immunoglobulin E levels were slightly elevated; all other biochemical and hematological findings were in their normal ranges. The duodenal biopsy samples were normal and an abdominal ultrasonography showed no biliary or hepatic abnormality. Stool microscopy revealed numerous eggs of Dicrocoelium dendriticum. As pseudoparasitosis can result from eating raw, infected animal liver, the patient was given a liver-free diet for three days, to rule out that possibility. Subsequent stool examinations showed eggs in each of the samples indicating that the infection was genuine. The patient was treated with triclabendazole 10 mg/kg in a single dose. Four weeks later, no parasite eggs were detected in the microscopic examination of the stool samples. The patient got better gradually and the symptoms disappeared. Physicians should keep in mind parasitic diseases such as the rarely encountered dicrocoeliosis.

A nasopharyngeal human infestation caused by Linguatula serrata nymphs in Van province: a case report.

The reason for the presentation of this case is that Linguatula serrata, a parasite rarely encountered in humans, was found in a patient in Van province. The patient, who was 26 years old, lived in Erciş a town in Van province, East Turkey. She was admitted to the Outpatient Clinic of Infectious Diseases of Erciş Government Hospital with a complaint of coughing a few worms about 4 cm long from the oral cavity, and also sore throat, partial voice loss and vomiting. The polyclinic doctor suspected that the worm was a parasite but he could not make a diagnosis, and the patient was referred to Health Research and Training Hospital, Yüzüncü Yıl University. The parasite was examined in the Parasitology Laboratory and it was observed that this parasite was the nymph of L. serrata whose mouth was surrounded with four hooks and had approximately 90 body segments with small hooks. No medical treatment was given to the patient except that gargling with saline solution was recommended. As a result, we think that physicians should consider L. serrata infestation in patients applying to health foundations with complaints such as pharyngitis accompanied by pharyngeal pain, coughing, sneezing and vomiting.

Clinical significance and prevalence of Blastocystis hominis in Van, Turkey

Objectives: To determine the associated clinical symptoms and prevalence of Blastocystis hominis (B. hominis). Methods: Stool samples of 50,185 patients (26,784 males and 23,401 females) who were received at the Parasitology Laboratory of Yuzuncu Yil University Faculty of Medicine, Van, Turkey in the last 5 years were inspected microscopically using saline and iodine-stained wet-mount preparations. Age, gender, and symptoms of patients were recorded and their significance was evaluated. Results: The prevalence of B. hominis in the total sample was 0.54% (275/50185). Out of 275 infected patients, 143 (52%) were males, and 132 (48%) were female (χ2=0.884; p=0.348). The distribution of B. hominis infection was high in 7-13 aged children (34.9%) (χ2=306.8; p=0.001). Blastocystis was higher among symptomatic patients (70.2%) compared with asymptomatic patients (29.8%) (χ2=107.13; p=0.001). The most frequent clinical symptoms associated with the disease were abdominal pain (27.3%) and diarrhea (19.6%) followed by anorexia, fever, saliva, anal itching, and nausea. Conclusion: Blastocystis hominis is considered a causative agent of human disease in patients with recurrent symptoms. Due to the significant risk for zoonotic transmission, molecular techniques must be used to determine the route and source of infection.

Seroprevalence of human fascioliasis in Van province, Turkey.

BACKGROUND/AIMS Fasciola hepatica is a rare zoonotic parasite that infects the liver of many mammals including humans. The aim of this study was to determine the seroprevalence of fascioliasis in Van province by ELISA (antibody detection) on the assumption that not all cases could be detected by stool examination alone. MATERIALS AND METHODS A total of randomly selected 1,600 patients, directed from affiliated outpatient clinics to Yüzüncü Yıl University Medical Faculty Parasitology Laboratory, were enrolled in the study. Their mean age was 44.44±19.00 years. Blood samples were collected from all the patients, and their stool samples were examined. For the stool examination, native-lugol and sedimentation (in formalin-ethyl acetate) methods were employed. ELISA for F. hepatica was performed on the blood samples from all patients. Seropositive patients were treated with triclabendazole. RESULTS F. hepatica was detected by ELISA in 89 (5.6%) of the 1,600 patients, but eggs were identified on the stool examination in only 29 (1.8%) patients. The prevalence of F. hepatica was higher in females (7.2%) than in males (4.2%) and was higher in the ≥36-year age group (6.7%) than in the ≤35-year age group (4.4%). Abdominal pain (93.3%), fatigue (88.8%), and weight loss (69.7%) were the most common symptoms. Eosinophilia was present in 89.9% of the patients. All seropositive patients had a history of eating raw aquatic plants. CONCLUSION Stool examination alone is not sufficient to diagnose F. hepatica. Serological tests such as ELISA must be used together with stool examination.

Cyclospora cayetanensis, Opportunistic Protozoan Parasite, in Van Province, Turkey: A Report of Seven Cases

The aim of this study is to report seven Cyclospora cayetanensis (C.cayetanensis) cases determined in Yuzuncu Yil University Medical Faculty Parasitology Laboratory, Van province, Turkey. In the study native-Lugol, formalin-ethyl acetate and modified acid-fast staining methods were performed to stool samples of the patients sent from outpatient clinics of the hospital. All of the patients infected with C. cayetanensis were older than 15 years. In our cases there were not a history of international travel. Only one of our seven cases was immunosuppressed. Trimethoprim-sulfamethoxazole (160/800 mg) was administered for the treatment of the patient. In conclusion, it was understood that the physicians should consider cyclosporiosis in the patients with diarrhea and abdominal pain.

[Cystic Echinococcosis Seropositivity in the Blood Samples Sent to Parasitology Laboratory of Yüzüncü Yıl University Medical Faculty between 2005 and 2013: Retrospective Assessment].

OBJECTIVE This study was performed in order to contribute the data on the prevalence of cystic echinococcosis (CE) in Turkey and to reveal this parasitosis problem in Van province. METHODS Blood samples of 2642 patients (1214 men, 1428 women; 506 of them 0-13 age, 2136 of them 14 and over age group), which were sent with suspected CE to Parasitology Laboratory from various policlinics of Yüzüncü Yıl University Medical Faculty, between the dates of 01.09.2005 and 01.09.2013, were evaluated for CE by using Enzyme-Linked Immunosorbent Assay (ELISA) (R-Biopharm, Germany; IgG) method. RESULTS 801 (30.3%) of examined blood samples of these patients were found positive for this parasitosis. Seropositivity was found 31.9% of men, 29% of women; 33.4% of 0-13 age group, 29.6% of 14 and over age group in the study. Cysts, which were obtained from operated seropositive patients, were confirmed that unilocular cysts as pathological. CONCLUSION As a result, it was seen that CE is continued to be a major public health problem in Van province and it was appear that comprehensive protection and control programs should be carry out to struggle this disease.

Prevalence of head lice in some primary schools in Iğdır province

OBJECTIVE This study was carried out to detect the prevalence and evaluate risk factors of Pediculus capitis infestation in four primary schools in Iğdır in April and May, 2010. METHODS The study was performed on 2222 students (6-15 years old), 1116 female and 1106 male. The hair of the students, especially from the neck and back of the head, were examined for egg, nymph and imago of P. capitis. The samples taken from the students were brought to the Medical Laboratory of Health Services Vocational School of Iğdır University for examination. Each student answered a questionnaire containing some questions related to the infestation. RESULTS The imago, nymph or eggs of the parasite were encountered in 22.9% of females and in 3.2% of males. Prevalence of infestation in all students was 13.1%. CONCLUSION It was determined that there was a significant relation between head louse infestation and gender, socioeconomic status of the schools, hair length, number of people living in the home and the number of rooms in the house. In most comparisons, relations between prevalence of pediculosis capitis and education level, income level and job of the childrens father and education level of the childrens mother were found significant at different levels.