|CURRENT Diagnosis & Treatment: Pediatrics|
Chapter 41. Infections: Parasitic & MycoticSamuel R. Dominguez, MD, PhD, Myron J. Levin, MD
Sections: Protozoal Infections, Systemic Infections, Gastrointestinal Infections, Trichomoniasis, Metazoal Infections, Nematode Infections, Cestode Infections (Flukes), Trematode Infections, Mycotic Infections, Blastomycosis, Candidiasis, Coccidioidomycosis, Cryptococcosis, Histoplasmosis, Sporotrichosis, Opportunistic Fungal Infections, Pneumocystis jiroveci Infection, References.
Excerpt:"Parasitic diseases are common and may present clinically in a variety of ways (Table 411). Although travel to endemic areas suggests particular infections, many are transmitted through fomites or acquired from contact with human carriers and can occur anywhere. Some of the less common parasitic infections and those seen primarily in the developing world are presented in abbreviated form in Table 412.The incidence of parasitic infections varies greatly with geographic area. Children who have traveled or lived in areas where parasitic infections are endemic are at risk for infection with a variety of intestinal and tissue parasites. Children who have resided only in developed countries are usually free of tissue parasites (except Toxoplasma). Searching for intestinal parasites is expensive for the patient and time-consuming for the laboratory. More than 90% of ova and parasite examinations performed in most hospital laboratories in the United States are negative; many have been ordered inappropriately. An approach to determining which children with diarrhea need such examinations is presented in Figure 411. It can be more cost-effective to treat symptomatic U.S. immigrants with albendazole or nitazoxanide, a broad-spectrum antiparasitic drug, and to investigate only those whose symptoms persist...."
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