一个家庭病例的贾第虫病表现为过敏性荨麻疹在家庭医生和儿科医生的联合实践

Maria O. Mokhika Estepa, I. Vasilenko, I. Moiseeva
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摘要

迄今为止,在家庭医生、内科医生和儿科医生的实践中,贾第虫病仍然是一种紧迫的疾病。贾第虫病的家庭病例很常见。如果在家庭中发现一个贾第虫病病例,有必要对所有家庭成员进行检查。目前,贾第虫病仍然具有相关性,特别是在儿科。贾第虫病在儿童中检测的困难主要是由于其表现往往被伪装成各种胃肠病的临床变异(胃肠道功能障碍、小肠微生物群过度生长综合征、吸收不良综合征),并且经常与临床变应性疾病一起发生:复发性荨麻疹、特应性皮炎、胃肠道形式的食物过敏和其他形式。本文介绍了一例家族性贾第虫病的临床病例,其中一名儿童的疾病的初步诊断造成了最大的困难,因为其过敏表现是在家中可能存在过敏原的情况下出现的严重荨麻疹类型,这导致了长时间的诊断和两次儿童医院的紧急住院,尽管进行了检查和治疗,但没有及时怀疑正确的诊断。在患者管理的第一阶段对变应性荨麻疹、传染性单核细胞增多症和链球菌感染进行鉴别诊断,未考虑贾第虫病的可能性。诊断困难导致全身性糖皮质激素治疗和不合理的抗菌治疗。间接地,诊断时间过长,治疗开始不及时,导致患者家长对医生的不信任而降低了检查和治疗的积极性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A family case of giardiasis manifested as allergic urticaria in the joint practice of a family doctor and a pediatrician
To date, giardiasis remains an urgent disease in the practice of family doctors, internists and pediatricians. Family cases of giardiasis are quite common. If one case of giardiasis is detected in the family, it is necessary to examine all family members. Currently, giardiasis remains relevant, especially in pediatrics. The difficulty of detecting giardiasis in children is primarily due to the fact that its manifestations are often disguised as various clinical variants of gastroenterological pathology (functional disorders of the gastrointestinal tract, syndrome of excessive growth of microflora in the small intestine, malabsorption syndrome) and often occur with the clinic of allergic diseases recurrent urticaria, atopic dermatitis, gastrointestinal forms of food allergies and others forms. The article presents a clinical case of familial giardiasis, in which the primary diagnosis of the disease in a child caused the greatest difficulty due to its allergic manifestations by the type of severe urticaria in the presence of possible allergens at home, which led to a long diagnosis and two emergency hospitalizations in childrens hospitals, where despite the examination and treatment, the correct diagnosis was not suspected timely. Differential diagnosis at the first stages of patient management was carried out between allergic urticaria, infectious mononucleosis and streptococcal infection, the possibility of giardiasis was not considered. Difficulties in diagnosis led to the appointment of systemic glucocorticosteroids and unjustified antibacterial therapy. Indirectly, prolonged diagnosis and untimely start of treatment led to a decrease in motivation for examination and treatment of the patients parents due to distrust of doctors.
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