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Within 12 years among 21.024 patients hospitalized in the Clinic of Infectious Diseases of the Medical Academy parasitoses were recognized in 485, i.e. 2.3%. The numbers testify to the importance of the problem of parasitoses in that region of Poland. The most frequent parasitoses of the Białystok region are at present giardiasis and taeniasis, most of all in inhabitants of towns, and within the last years also diseases introduced from the tropics - amebiasis, malaria and intestinal trematodosis.
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Selected clinical problems have been discussed in the light of new data on pathogenesis. This has been illustrated by own observations in trichinellosis patients. Value of nail fald capillaroscopy in estimation of spread and intensity of capillary lesions in trichinellosis has been discussed. Changes in eosinophilia have been presented in patients treated with anthelmintics or corticosteroids at the acute stage of symptoms (3rd week). Pathophysiology of gastrointestinal phase of invasion has been discussed and pathomorphology of small intestine biopsies has been presented as observed in trichinellosis patients with diarrhoea. Attention has been drawn to atypical course of trichinellosis, noted with increasing frequency, particularly in persons infected with sylvatic strain of Trichinella spiralis. It is worth stressing that in patients exhibiting an atypical, clinical pattern of trfchinellosis accompanied by low blood eosinophilia, treatment with anthelmintics and corticosteroids is started as a rule with a delay, thus promoting a very intense Trichinella invasion and unfavourable outcome.
We aimed at analysis of the clinical pattern and the course of lymphonodular toxoplasmosis taking into account the intensity and duration of the illness. Ninety seven patients (69 adults and 28 children) with lymphonodular toxoplasmosis were examined. Toxoplasmosis was diagnosed by indirect immunofluorescence; the titres of antibodies of IgG and IgM classes were also estimated. Depending on the duration of the illness, three periods: early, regression of symptoms and protraction of symptoms were defined; depending on the intensity of signs and symptoms of toxoplasmosis three courses of the disease: acute, subacute and chronic were defined. The analysis showed that clinical picture of lymphonodular toxoplasmosis was characterized by swelling of various peripheral lymph nodes as well as by general clinical symptoms (88 ,7% of cases) the intensity and duration of which, to a large extent, determined course of the illness. No correlation between clinical course and duration (early and regression period) of lymphonodular toxoplasmosis and titres IFA-IgG and IFA-IgM (before therapy) was found. Pathomorphology of lymph nodes in patients with toxoplasmic lymphadenopathy is a valuable complementary examination which renders it possible to determine the period of the disease.
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