Abscesso piogênico do fígado e esquistossomose mans?nica: observa??es no Estado do Espírito Santo

摘要

A possible association of the acute toxaemic form of schistosomiasis and pyogenic liver abscess (PLA) has been recently suggested. As in the west of the Espirito Santo state schistosomiasis is endemic and PLA are frequently diagnosed in the Children's Hospital of Vitória we reviewed the records of the Hospital during the period from May 1991 to April 1993 to: a) iddentify all cases of PLA in which Schistosoma mansoni infection was present and b) annotate the procedence of each case to verify if there is an association of the two diseases. 65 cases of PLA were recorded and 39 had the result of a stool examination, being three positive for Schistosoma mansoni (7,6%) and 26 for other helminth (mainly Ascaris and Trichocephalus). The procedence of the patients showed that only 7 (10, 7%) came from endemic areas. These results show that an asociation of Schistosoma mansoni infection and PLA was not significative in the country, where the acute toxaemic form is not frequent. The great majority of PLA in this study came from the urban peripheiy of Vitória, where transmission of schistosomiasis does not occur but intestinal helminth infections are extremely frequent. As 40% of these PLA were criptogenetic it is possible that the immunomodulation induced by intestinal parasites and the liver granulomas produced by the lamae of these helminths would be predisposing factors for pyogenic liver abscess.