Soil-transmitted helminth infections.

摘要

Having read Jeffrey Bethony and colleagues' excellent Seminar on ground helminths (May 6, p 1521),I feel several points should be addressed.Although it is true that the greatest burden of these pathogens is felt in developing countries, the average practitioner in developed countries is most likely to diagnose ground helminth infections in a specific population: returning travellers. Here, the acute manifestations resulting from helminthic migration discussed briefly by Bethony and colleagues are the main concern. Fever, cough, myalgia, and fatigue are common, with eosinophilia being the sole finding suggestive of helminthic infection. Ground itch-the typical rash of human hookworm infection-is often intensely pruritic, and can continue for weeks.Since many other disorders more familiar to Western practitioners (eg, atopy and lymphatic and solid cancers) can be associated with similar symptoms and eosinophilia, many patients undergo the added morbidity of multiple radiological and invasive diagnostic procedures.